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Biomedical subjects

Emily A Holmes

Publications and source records attributed to Emily A Holmes.

10 recordsLinked to original sources

The influence of a visuospatial grounding task on intrusive images of a traumatic film.

Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system.

Accidents, Traffic↗

Are there two qualitatively distinct forms of dissociation? A review and some clinical implications.

This review aims to clarify the use of the term 'dissociation' in theory, research and clinical practice. Current psychiatric definitions of dissociation are contrasted with recent conceptualizations that have converged on a dichotomy between two qualitatively different phenomena: 'detachment' and 'compartmentalization'. We review some evidence for this distinction within the domains of phenomenology, factor analysis of self-report scales and experimental research. Available evidence supports the distinction but more controlled evaluations are needed. We conclude with recommendations for future research and clinical practice, proposing that using this dichotomy can lead to clearer case formulation and an improved choice of treatment strategy. Examples are provided within Depersonalization Disorder, Conversion Disorder and Posttraumatic Stress Disorder (PTSD).

Consciousness↗

Intrusive images and "hotspots" of trauma memories in Posttraumatic Stress Disorder: an exploratory investigation of emotions and cognitive themes.

This study aimed to investigate the emotions and cognitions contained in "hotspots" of memory for trauma, as well as their associated images. Thirty-two participants at a specialist outpatient trauma clinic had experienced a range of traumatic events and met diagnostic criteria for Posttraumatic Stress Disorder (PTSD). Data were collected within an agreed protocol, involving reliving therapy. Patients described the different intrusive images of the trauma that they were re-experiencing. Their reports of cognitions and emotions during "hotspots" in their memory of the traumatic experience were recorded as part of reliving therapy. Hotspots refer to moments of peak emotional distress during the event. There was a high degree of match reported between intrusive images and hotspots. The cognitive and emotional contents of hotspots were qualitatively analysed into themes. The relative of frequency of these peritraumatic themes is presented. The exploratory findings are discussed with respect to our understanding and treatment of intrusive imagery in PTSD.

Adult↗

Mental imagery and emotion: a special relationship?

A special association between imagery and emotion is often assumed, despite little supporting evidence. In Experiment 1, participants imagined unpleasant events or listened to the same descriptions while thinking about their verbal meaning. Those in the imagery condition reported more anxiety and rated new descriptions as more emotional than did those in the verbal condition. In Experiment 2, 4 groups listened to either benign or unpleasant descriptions, again with imagery or verbal processing instructions. Anxiety again increased more after unpleasant (but not benign) imagery; however, emotionality ratings did not differ after a 10-min filler task. Results support the hypothesis of a special link between imagery and anxiety but leave open the question of whether this also applies to other emotions.

Affect↗

Trauma films, information processing, and intrusive memory development.

Three experiments indexed the effect of various concurrent tasks, while watching a traumatic film, on intrusive memory development. Hypotheses were based on the dual-representation theory of posttraumatic stress disorder (C. R. Brewin, T. Dalgleish, & S. Joseph, 1996). Nonclinical participants viewed a trauma film under various encoding conditions and recorded any spontaneous intrusive memories of the film over the following week in a diary. Changes in state dissociation, heart rate, and mood were also measured. As predicted, performing a visuospatial pattern tapping task at encoding significantly reduced the frequency of later intrusions, whereas a verbal distraction task increased them. Intrusive memories were largely unrelated to recall and recognition measures. Increases in dissociation and decreases in heart rate during the film were also associated with later intrusions.

Adolescent↗

Occurrence of imagery and its link with early memories in agoraphobia.

Recent cognitive models suggest that mental imagery can help us understand the maintenance of anxiety disorders (e.g., de Silva, 1986; Hackmann, Surawy, & Clark, 1998). However, imagery is relatively unexplored within agoraphobia. Such images are also thought to be useful in uncovering memories that occurred around the onset of a disorder (Hackmann, Clark, & McManus, 2000). A total of 20 patients with agoraphobia and 20 matched controls took part in this investigation. Participants described any recurrent images they experienced in agoraphobic situations, and also any associated memories. All patients with agoraphobia (but no control participants) reported having distinct recurrent images in "agoraphobic situations". Most images involved several sensory modalities and in the majority of cases appeared to be linked with unpleasant memories of events experienced many years previously. While these exploratory findings require replication, potential treatment implications are discussed.

Adult↗

Reflecting on imagery: a clinical perspective and overview of the special issue of memory on mental imagery and memory in psychopathology.

The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post-traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.

Anxiety Disorders↗

Schizotypy: a vulnerability factor for traumatic intrusions.

Intrusive mental experiences occur within posttraumatic stress disorder (PTSD) and some psychotic disorders. Similarities in the phenomenology and content in the intrusions of both disorders have been noted. Currently there is little understanding of any common etiology in terms of information-processing styles. This study investigated predictors of analogue posttraumatic intrusive cognitions within a nonclinical sample, including schizotypy, dissociation, and trauma history. Forty-two participants watched a trauma video and recorded trauma-related intrusions occurring for 1 week. More reported intrusive experiences were associated with high positive symptom schizotypy. Our findings are discussed in relation to the possible role of trauma-related intrusions within psychotic disorders.

Adolescent↗

Psychological theories of posttraumatic stress disorder.

We summarize recent research on the psychological processes implicated in posttraumatic stress disorder (PTSD) as an aid to evaluating theoretical models of the disorder. After describing a number of early approaches, including social-cognitive, conditioning, information-processing, and anxious apprehension models of PTSD, the article provides a comparative analysis and evaluation of three recent theories: Foa and Rothbaum's [Foa, E. B. & Rothbaum, B. O. (1998). Treating the trauma of rape: cognitive behavioral therapy for PTSD. New York: Guilford Press] emotional processing theory; Brewin, Dalgleish, and Joseph's [Psychological Review 103 (1996) 670] dual representation theory; Ehlers and Clark's [Behaviour Research and Therapy 38 (2000) 319] cognitive theory. We review empirical evidence relevant to each model and identify promising areas for further research.

Adaptation, Psychological↗