Department of Management, Marketing, and Information Systems, Hong Kong Baptist University, Hong Kong SAR, China.
Department of Psychology, The University of Hong Kong, Hong Kong SAR, China.
Nat Hum Behav. 2024 Oct;8(10):1968-1987. doi: 10.1038/s41562-024-01956-y. Epub 2024 Aug 21.
Experiencing trauma leads to intrusive memories (IMs), a hallmark symptom of post-traumatic stress disorder (PTSD), which also occurs transdiagnostically. Understanding why IMs increase or decrease is pivotal in developing interventions to support mental health. In this preregistered meta-analysis (PROSPERO: CRD42021224835), we included 134 articles (131 techniques, 606 effect sizes and 12,074 non-clinical participants) to investigate how experimental techniques alter IM frequency, intrusion-related distress and symptoms arising from lab-analogue trauma exposure. Eligible articles were identified by searching eight databases until 12 December 2023. To test potential publication biases, we employed methods including Egger's test and three-parameter selection models. We employed three-level multilevel modelling and meta-regressions to examine whether and how experimental techniques would modulate IM frequency and associated outcomes. Results showed that techniques (behavioural, pharmacological, neuromodulation) significantly reduced intrusion frequency (g = 0.16, 95% confidence interval [0.09, 0.23]). Notably, techniques aimed to reduce IMs also ameliorated intrusion-related distress and symptoms, while techniques that increased IMs exacerbated these related outcomes, thus highlighting IM's centrality in PTSD-like symptoms. Techniques tapping into mental imagery processing (for example, trauma reminder followed by playing Tetris) reduced intrusions when administered immediately after, or at a delayed time after trauma. Although our meta-analysis is limited to symptoms induced by lab-analogue trauma exposure, some lab-based results have now generalized to real-world trauma and IMs, highlighting the promising utility of lab-analogue trauma paradigms for intervention development.
经历创伤会导致侵入性记忆（IMs），这是创伤后应激障碍（PTSD）的一个标志性症状，也会发生在跨诊断中。了解 IM 增加或减少的原因对于开发支持心理健康的干预措施至关重要。在这项预先注册的荟萃分析（PROSPERO：CRD42021224835）中，我们纳入了 134 篇文章（131 种技术、606 个效应量和 12074 名非临床参与者），以研究实验技术如何改变 IM 频率、与侵入相关的痛苦和源自实验室模拟创伤暴露的症状。通过搜索八个数据库，直到 2023 年 12 月 12 日，确定了符合条件的文章。为了测试潜在的出版偏差，我们采用了包括 Egger 检验和三参数选择模型在内的方法。我们采用了三级多层建模和荟萃回归来检验实验技术是否以及如何调节 IM 频率和相关结果。结果表明，技术（行为、药理学、神经调节）显著降低了侵入频率（g=0.16，95%置信区间[0.09，0.23]）。值得注意的是，旨在减少 IM 的技术也改善了与侵入相关的痛苦和症状，而增加 IM 的技术则加剧了这些相关的结果，从而突出了 IM 在 PTSD 样症状中的中心地位。技术利用心理意象处理（例如，创伤提醒后玩 Tetris），当立即或在创伤后延迟时间后施用时，会减少侵入。虽然我们的荟萃分析仅限于实验室模拟创伤暴露引起的症状，但一些实验室结果现在已经推广到真实世界的创伤和 IM，突出了实验室模拟创伤范式在干预开发中的应用前景。
