PTSD and Memory

Post-traumatic stress disorder in victims of rape.
Burge, Sandra K.
Journal of Traumatic Stress, Vol 1(2), Apr, 1988. Special Issue: Progress in traumatic stress research. pp. 193-210.
Abstract:
Used posttraumatic stress disorder (PTSD) diagnostic criteria to determine relevant symptomatology and 2 self-report instruments to measure the severity of symptoms for 29 female rape victims (aged 18–46 yrs). Diagnostic criteria of PTSD included reexperiencing the traumatic event, numbing of responsiveness, hyperalertness and exaggerated startle response, sleep disturbances, survival guilt, memory impairmentand trouble concentrating, phobic avoidance, and intensification of the symptoms. This assessment framework determined that 25 out of 29 Ss were at least moderately affected by PTSD symptoms. Implications for mental health and legal professionals as well as researchers are explored.

Dissociation and the fragmentary nature of traumatic memories: Overview.
Bloom, Sandra L.
British Journal of Psychotherapy, Vol 12(3), Spr 1996. pp. 352-361.
Abstract:
Reviews studies of people’s memories of highly stressful and of traumatic experiences, focusing on the differences between recollections of these 2 types of events. Research shows that accuracy of memory is affected by the emotional valence of an experience such that highly personal events are remembered more accurately. However, trauma can lead to extremes of remembering and forgetting that can be categorized into 4 sets of functional disturbances: traumatic amnesia, global memory impairment, dissociative processes, and the sensorimotor organization of traumatic memories. The evidence for dissociation as the central pathogenic mechanism that gives rise to posttraumatic stress disorder (PTSD) is reviewed. Brief clinical material from various groups, including combat soldiers, is provided

Neuroendocrine activity and memory-related impairments in posttraumatic stress disorder.
Golier, Julia
Development and Psychopathology, Vol 10(4), Fal 1998. Special Issue: Risk, trauma, and memory. pp. 857-869.
Abstract:
This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.

Complaints of impaired memory in veterans with PTSD.
Roca, Vincent and Freeman, Thomas W.
The American Journal of Psychiatry, Vol 158(10), Oct, 2001. pp. 1738-1739.
Abstract:
Reports on an examination of archival data evaluating the relationship between the existence of subjective and objective memory deficits in people with chronic combat-related posttraumatic stress disorder (PTSD). Data from 129 male veterans (mean age 52 yrs) with PTSD indicated that the Ss’s Everyday Memory Scale scores were not significantly correlated with the verbal memory index, nor were they significantly correlated with any of the IQs. This scale was, however, significantly correlated with each of the measures for psychopathology—Beck Depression Inventory, the global severity index from the Brief Symptom Inventory, the Dissociative Experiences Scale, and the Mississippi Scale for Combat Related PTSD. The findings suggest that self-reports of poor memorymay not reliably reflect the degree of memory impairment that veterans experience. Rather, such self-reports may be effective indicators of emotional distress.

Memory impairments following chronic stress? A critical review.
Jelicic, Marko and Bonke, Benno
The European Journal of Psychiatry, Vol 15(4), Oct-Dec, 2001. pp. 225-232.
Abstract:
Does chronic stress lead to memory impairments? Several authors hypothesized that elevated levels of glucocorticosteroids, released in the blood during sustained stress, cause damage to the hippocampus–a brain area involved in episodic memory. The authors reviewed evidence for impaired memory performance due to chronic stress and found that glucocorticoid excess as a result of Cushing’s syndrome, atypical aging, or use of synthetic corticosteroids such as prednisone is associated with hippocampal atrophy and memory dysfunction. However, studies showing reduced memory performance after acute stress suffer from methodological shortcomings. In addition, attributing memory impairments and reduced hippocampal volume in trauma survivors suffering from posttraumatic stress disorder to the effects of sustained stress appears to be problematic. The authors promote longitudinal research into glucocorticoids and memory functioning in individuals with stressful professions. This could yield more information about the possibly deleterious effects of stress on memory.

Retrieval and emotional processing of traumatic memories in posttraumatic stress disorder: Peripheral and central correlates.
Wessa, Michèle, et.al.
Neuropsychologia, Vol 44(10), 2006. pp. 1683-1696.
Abstract:
Posttraumatic stress disorder (PTSD) is thought to be characterized by dysfunctional memory processes, i.e., the automatic re-experiencing of the traumatic event and the inability to consciously recall facts about the traumatic event, as well as altered emotional processing of trauma-relevant cues. The present study examined the cerebral mechanisms underlying the cued recall of trauma-specific memories and the emotional processing of the presented cues in 16 PTSD patients, 15 trauma-exposed subjects without PTSDand 16 healthy controls. Subjects received questions about their specific trauma as well as other disastrous and neutral events while the electroencephalogram and heart rate were measured. The PTSD patients showed no impairment in trauma-specific declarative memorycompared to non-PTSD subjects but had some deficits in general declarative memory as assessed by the Wechsler Memory Scale-Revised. Compared to healthy control subjects, PTSD patients displayed increased P300 and late positive complex amplitudes to trauma-specific questions, indicating enhanced emotional processing of these cues. In line with their behavioral performance, both trauma-exposed groups showed decreased terminal contingent negative variation amplitudes to trauma-specific questions over frontal electrodes reflecting altered memoryretrieval. Within-group comparisons revealed that only the PTSD group but not the other groups showed a differentiation between trauma-specific and neutral questions with respect to the LPC, tCNV and P300. Concordantly with previous studies, PTSD patients showed elevated resting heart rate compared to the healthy controls. These findings are discussed in the context of current models of the role of declarative memory in the development and maintenance of PTSD.

General intelligence and short-term memory impairments in Post Traumatic Stress Disorder patients.
Emdad, Reza and Söndergaard, Hans Peter
Journal of Mental Health, Vol 15(2), Apr, 2006. pp. 205-216.
Abstract:
Background: Studies of the relationship between short-term memory and intelligence in Post Traumatic Stress Disorder (PTSD) patients are scarce. Aim: (1) To explore whether people with PTSD have equivalent levels of short-term, non-verbal memory on the Benton Visual Retention Test (BVRT), and whether they have equivalent levels of intelligence on the Raven Standard Progressive Matrices (RSPM), (2) If memory deficit is evident in the PTSD group, is it related to intelligence on the RSPM compared to the control group? Method: BVRT and RSPM were used with 30 PTSD patients, and 20 controls. Results: There was no significant difference between the groups with respect to the RSPM. There was a significant difference between the groups with regard to the BVRT. In the PTSD group, there was a significant, negative, partial correlation between the BVRT sum of error scores from all forms, and the RSPM sum of correct scores from all sets. A regression model, controlled for co-linearity, was performed to assess the variables, which independently of each other would explain changes in the BVRT test performance in the PTSD group: Number of years of education, age, anxiety, and depression (from the General Health Questionnaire) were not significant, but RSPM test performance was correlated with BVRT test performance in the PTSD group. Conclusion: People with PTSD had worse short-term, non-verbal memory on the BVRT, despite having comparable levels of intelligence on the RSPM. This could suggest focal deficits related to impact of trauma/PTSD on hippocampal function or a more general dysfunction. Memory deficits on the BVRT were related to intelligence on the RSPM for the PTSD group but not the control group. This could mean gross impairments in memoryinfluence intelligence assessments in these patients.

Memory of the Traumatic Event as a Risk Factor for the Development of PTSD: Lessons from the Study of Traumatic Brain Injury.
Gil, Sharon, et.al.
CNS Spectrums, Vol 11(8), Aug, 2006. pp. 603-607.
Abstract:
Traumatic memories, and the mechanisms by which they operate, continue to occupy a central role in the scientific investigation of risk factors for the development of posttraumatic stress disorder (PTSD). However, empirically based studies are constrained by practical and ethical considerations and are limited to naturalistic models. Consequently, the paradigms most appropriate for the exploration of the relationship between traumatic memoriesand PTSD have been identified in conditions involving traumatic events where memories may be compromised. Indeed, traumatic brain injury, a condition that is commonly associated with memory impairment, has often been utilized as a naturally occurring model for the study of traumatic memory and its contribution to the development of PTSD. This article presents a critical review of these research efforts and discusses their theoretical and clinical implications.

Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder.
Elsesser, Karin and Sartory, Gudrun.
Clinical Psychology & Psychotherapy, Vol 14(6), Nov-Dec, 2007. pp. 464-474.
Abstract:
In order to investigate whether cognitive dysregulation contributed to memory impairment in trauma patients, recent trauma victims, post-traumatic stress disorder (PTSD) patients and healthy controls were compared with regard to verbal memory and dysfunctional cognitions. There were no significant group differences with regard to verbal memory. Concerning dysfunctional cognitions, recent trauma victims hardly differed from controls, unlike PTSD patients, who showed more negative appraisal, more dysfunctional thought control strategies and externality than controls. None of them were related to memory performance in the recent trauma group, and there was a negative correlation with distraction strategy in PTSD patients. In recent trauma victims, negative appraisal increased with time since the trauma

Subjective premorbid memory in posttraumatic stress disorder.
Larbig, Florentine, et.al.
German Journal of Psychiatry, Vol 11(4), 2008. pp. 149-152.
Abstract:
Background: It is unclear whether memory deficits found in patients with PTSD (posttraumatic stress disorder) precede the traumatic event and may thus represent a vulnerability factor or a consequence of the trauma. Objective: The aim of this study was to shed light on this question. Method: A newly developed neurocognitive interview to estimate premorbid memory performance was administered along with an objective memory test on 21 PTSD patients and 21 healthy controls. Possible confounds, such as comorbid depressive symptoms and social desirability, were considered. Results: PTSD patients and controls did not exhibit significant differences on estimated premorbid memory. The majority of the PTSD patients (73%) reported a decline of memory performance following the traumatic event that was associated with objective memory impairment. Conclusion: The findings suggest that memory deficits in PTSD emerge after and not before the trauma. Further research with larger sample sizes and prospective studies are warranted to substantiate our results.

Memory impairments in posttraumatic stress disorder are related to depression.
Johnsen, Grethe E. and Kanagaratnam, Pushpa.
Journal of Anxiety Disorders, Vol 22(3), Apr, 2008. pp. 464-474.
Abstract:
The present study focuses on verbal learning and memory alterations in refugees with posttraumatic stress disorder, and whether the alterations are related to attention, acquisition, storage, or retrieval. Twenty-one refugees exposed to war and political violence with chronic PTSD, were compared to an exposed control sample of 21 refugees without PTSD. No differences were found in attention span, but tests of verbal memory showed less efficient learning in the PTSD sample. Group differences in delayed recall could be explained by learning efficiency. No differences were seen in recognition memory. These results indicate that memory alterations in PTSD are related to impaired acquisition and less effective encoding of the memorymaterial and not to impaired attention span and/or impaired retrieval. Controlling for specific PTSD symptom clusters and self-reported depression showed that the intrusion subscale and depressive reactions are the most important symptoms in understanding the memory alterations in PTSD.

Consistent impaired verbal memory in PTSD: A meta-analysis.
Johnsen, Grethe E., et.al.
Journal of Affective Disorders, Vol 111(1), Nov, 2008. pp. 74-82.
Abstract:
Background: Qualitative review papers have indicated that verbal memory impairment is found to be the most consistent cognitive impairment related to PTSD. These review papers have used qualitative methods to describe the effects, and consequently they have not been able to estimate the strength of the memory-PTSD association. Methods: This meta-analysis of 28 studies examined the empirical evidence for this relationship, and factors affecting the results. Results: Overall, the results showed medium effect sizes in patients with PTSD compared to controls on verbal memory across studies. Marked impairment was found in the patient groups compared to healthy controls, while modest impairment was found compared to exposed non-PTSD controls. Meta-analyses found strongest effects in war veterans compared to sexual and physical assault related PTSD. Rather unexpectedly no effect was found for the sexually abused PTSDgroups compared to exposed controls. The analyses further showed that the effect was dependent on the test procedures used. The studies using WMS and AVLT had stronger effects than studies using CVLT. Limitations: Insufficient data were available to analyze a more complete attention-memory profile. Conclusions: This meta-analysis confirms that verbal memoryimpairment is present in adults with PTSD, and they are consistent across studies. This impairment should be the focus of work in clinical settings.

Cognitive abnormalities in posttraumatic stress disorder.
Moore, Sally A.
Current Opinion in Psychiatry, Vol 22(1), Jan, 2009. pp. 19-24.
Abstract:
Purpose of review: The current review aims to describe and evaluate research on cognitive difficulties associated with posttraumatic stress disorder (PTSD) published between January 2007 and June 2008. Recent findings: The reviewed studies provide additional evidence that negative appraisals and decrements on verbal and autobiographical memory tasks are exhibited by individuals with PTSD relative to controls and may represent preexisting risk factors for PTSD rather than a result or concomitant of PTSD symptoms. In addition, the reviewed findings provide further evidence for source monitoring difficulties and attentional biases toward trauma-relevant information in PTSD. Recent research also provides evidence that, although memories of traumatic events differ in PTSD relative to other types of memories and memories of depressed individuals, they are likely on the same continuum as nontraumatic memories rather than qualitatively different. Summary: Individuals with PTSDexperience cognitive alterations ranging from impairments in overall memory functioning to difficulties specific to trauma-related cues. These cognitive difficulties appear to be importantly related to the development and/or maintenance of the disorder. At this point, it is unclear whether common mechanisms may account for these diverse cognitive difficulties and whether cognitive impairments are attributable to comorbid depression.

Pilot neuroimaging study in civilian trauma survivors: Episodic recognition memory, hippocampal volume, and posttraumatic stress disorder symptom severity.
Dörfel, Denise, et.al.
Zeitschrift für Psychologie/Journal of Psychology, Vol 218(2), 2010. pp. 128-134.
Abstract:
Despite its hypothesized role in the etiology of posttraumatic stress disorder (PTSD), little research has investigated neural correlates of episodic memory impairment in trauma survivors. This pilot study utilized a correlational design to investigate the association between PTSD symptom severity, hippocampal volume, episodic memory, and brain activation during the Remember-Know task. Eleven non-medicated, right-handed survivors of civilian trauma participated in the study. Significant positive correlations were found between PTSDsymptom severity and the activation of brain areas implicated in the episodic recognition network such as hippocampus, precuneus, and occipital gyrus. Higher PTSD symptoms were also significantly negatively correlated with brain activations in areas associated with episodic memory but also visuospatial attention such as the superior parietal lobule and the supramarginal gyrus. The pattern of results indicates specific alterations in the recruitment of the episodic memory network, possibly with a focus on internal mental imagery at the cost of integration between internal processes and external visuospatial online monitoring.

The nature and significance of memory disturbance in posttraumatic stress disorder.
Brewin, Chris R.
Annual Review of Clinical Psychology, Vol 7, 2011. pp. 203-227.
Abstract:
Disturbances in aspects of memory described in current learning and cognitive theories are much more strongly associated with the presence of psychiatric disorder than with mere exposure to traumatic events. In posttraumatic stress disorder (PTSD), there are numerous associated changes that involve memory capacity, the content of memories for trauma, and a variety of memory processes. Whereas some changes appear to reflect the effects of the disorder, other evidence supports a predictive or causal role for memory disturbance. The following aspects of memory are likely to play a causal role in the development or maintenance of PTSD: verbal memory deficits, negative conceptual knowledge concerning the self, overgeneral memory, avoidance or suppression of memories, and negative interpretation of memory symptoms. Other aspects of memory likely to play a causal role that are in addition specific to PTSD are the integration of the trauma with identity, impairment in retrieval of voluntary trauma memories, and increased incidence of sensation-based memories or flashbacks.

Traumatic stress is linked to a deficit in associative episodic memory.
Guez, Jonathan, et.al.
Journal of Traumatic Stress, Vol 24(3), Jun, 2011. pp. 260-267.
Abstract:
Individuals with posttraumatic stress disorder (PTSD) are haunted by persistent memories of the trauma, but ironically are impaired in memories of daily life. The current set of 4 experiments compared new learning and memory of emotionally neutral content in 2 groups of patients and aged- and education-matched controls: 20 patients diagnosed with chronic posttraumatic stress disorder (C-PTSD) and 20 patients diagnosed with acute stress disorder (ASD). In all experiments, participants studied a list of stimuli pairs (words or pictures) and were then tested for their memory of the items, or for the association between items in each pair. Results indicated that both types of patients showed associative memory impairment compared to a control group, although their item memory performance was relatively intact. Potential mechanisms underlying such associative memory deficits in posttraumatic patients are discussed.

Posttraumatisk stressforstyrrelse er forbundet med kognitive dysfunksjoner.
Translated Title: PTSD are related to cognitive impairment.
Johnsen, Grethe E., et.al.
Tidsskrift for Norsk Psykologforening, Vol 50(3), Mar, 2013. pp. 201-207.
Translation: Journal of the Norwegian Psychological Association
Abstract:
This article summarizes research on cognitive impairment in posttraumatic stress disorder (PTSD). PTSDdevelops in some individuals as a response to traumatic stress and is characterised by three main clusters of symptoms: intrusive recollections, avoidance behaviors, and hyperarousal. There is evidence that PTSD is associated with distinct brain dysfunction patterns and cognitive impairments. Qualitative reviews and meta-analyses of neuropsychological studies have found that verbal memory impairment is the most consistent cognitive impairment related to PTSD. In addition, studies using trauma-neutral stimuli have found that basic attentional capacities seem to be preserved, but complex attentional and executive skills, such as inhibiting inaccurate responses and filtering irrelevant information, are impaired in patients with PTSD. These cognitive impairmentsmay have psychosocial and occupational consequences and implications for treatment, and may hinder the processing and restructuring of trauma material essential for recovery. Thus, increased awareness of memoryimpairments by clinicians may be beneficial for treatment planning.

Memory deficits, postconcussive complaints, and posttraumatic stress disorder in a volunteer sample of veterans.
Larson, Eric, et.al.
Rehabilitation Psychology, Vol 58(3), Aug, 2013. pp. 245-252.
Abstract:
Purpose: To better understand how memory impairment is related to postconcussive complaints and to posttraumatic stress disorder (PTSD) and whether these relationships remain after controlling for premorbid cognitive ability. Method: We examined memory impairment, premorbid cognitive ability, postconcussive complaints, and symptoms of PTSD in 205 veterans, 135 of who gave a self-reported history of concussion and exposure to a traumatic life event. We limited our sample to those who gave good effort on cognitive testing according to a symptom validity measure. Results: Although memory impairment was not associated with a history of concussion, it was associated with severity of postconcussive complaints. That association was no longer significant after controlling for premorbid IQ. A similar analysis yielded slightly different findings for PTSD. Memory impairment was associated with PTSD diagnosis, although it was not associated with severity of PTSD symptoms after controlling for premorbid ability. Conclusions: These data are consistent with multifactorial models of the etiology of postconcussion disorder and PTSD such as the ‘burden of adversity hypothesis’ described by Brenner, Vanderploeg, and Terrio (2009). In such models, symptom severity and course of recovery are determined not only by trauma severity but (also) premorbid risk factors and postonset complications.

False memory susceptibility in OEF/OIF veterans with and without PTSD.
Dasse, Michelle N., et.al.
Military Psychology, Vol 27(6), Nov, 2015. pp. 354-365.
Abstract:
False memory susceptibility was measured in 80 Iraq/Afghanistan veterans with (n = 32) and without posttraumatic stress disorder (PTSD; n = 48) using a modified Deese-Roediger-McDermott (DRM) word list task that included trauma-related critical (nonpresented) lures. PTSD was classified using medical record diagnoses. Participants completed a variety of self-report assessments, including the Beck Depression Inventory, the Anxiety and Stress subscales of the Depression Anxiety Stress Scales, the Dissociative Experiences Scale, and the Tellegen Absorption Scale. Veterans with PTSD displayed global memory impairments on all types of items, except for trauma-related critical lures; on these critical lures, they exhibited false memory levels equal to those seen in veterans without PTSD. The magnitude of most effects were reduced, but not entirely eliminated, when controlling for depression, suggesting that neither PTSD nor co-occurring depression entirely explain these findings. The potential effects of other mental health conditions, such as alcohol dependence, could not be ruled out. Our results support explanations of PTSD that emphasize differential processing of trauma-related information.

Memory and narrative of traumatic events: A literature review.
Crespo, María and Fernández-Lansac, Violeta
Psychological Trauma: Theory, Research, Practice, and Policy, Vol 8(2), Mar, 2016. pp. 149-156.
Abstract:
This study presents a literature review of 22 studies published since 2004 that use linguistic procedures to evaluate narratives by persons who had suffered any traumatic event. The aim is to analyze the features of traumaticmemories and, thus, how individuals construct and integrate their recall of what happened with other autobiographical memories. It uses cognitive theoretical models of posttraumatic stress disorder (PTSD) and their hypotheses about trauma memories as a framework. Findings reveal that trauma narratives are dominated by sensorial/perceptual and emotional details. The study of other narrative aspects (i.e., fragmentation, length, temporal context, and references to self) provides heterogeneous results. Results are discussed in light of the current state of PTSD research, exploring the principal hypotheses that have been proposed in cognitive theories to explain clinical findings

The role of memory in posttraumatic stress disorder: Implications for clinical practice.
Rigoli, Marcelo Montagner, et.al.
Trends in Psychiatry and Psychotherapy, Vol 38(3), Jul-Sep, 2016. pp. 119-127.
Abstract:
Introduction: Posttraumatic stress disorder (PTSD) is a highly prevalent disorder with important social consequences. Several models have been developed with the aim of understanding the mechanisms underlying its symptoms. Intrusions are idiosyncratic symptoms that commonly take the form of involuntary recollection of images or flashbacks about the traumatic event. Objective: To review how memory is conceptualized in each of these models and the implications for clinical practice. Methods: A narrative review of the literature was conducted through analysis of the perspectives of memory in theoretical models of PTSD. Results: Two main perspectives were identified: 1) models in which specific mechanisms of memory for processing traumatic events are proposed, especially those based on clinical studies, and 2) models in which common mnemonic mechanisms are utilized to explain the phenomenon, primarily based on basic experimental research studies investigating memory. The different theories based on these approaches have led to distinct psychotherapy interventions. Conclusion: In order to clarify these discrepancies, future research should aim for the methodological rigor of experimental studies, while maintaining the ecological applicability of findings. Cognitive experimental psychopathology is therefore an area on which research funding should be focused. Such studies could elucidate the role of mnemonic aspects in PTSD and how they impact psychological treatments

Coherence, disorganization, and fragmentation in traumatic memory reconsidered: A response to Rubin et al. (2016).
Brewin, Chris R.
Journal of Abnormal Psychology, Vol 125(7), Oct, 2016. pp. 1011-1017.
Abstract:
Although clinical theories of posttraumatic stress disorder (PTSD) claim that in this condition trauma memoriestend to be disorganized and fragmented, this has been disputed by some autobiographical memory researchers, such as Rubin, Berntsen, and their colleagues (e.g., Rubin et al., 2016). In this article I review the evidence for and against the fragmentation hypothesis and identify important sources of methodological variability between the studies. This analysis suggests that fragmentation and disorganization are associated with differences in the type of narrative (specifically, with detailed rather than general narratives) and in the focus of the analysis (specifically, with a local focus on sections of text concerned with the worst moments of the trauma rather than with a global focus on the text as a whole). The implication is that apparently discrepant data and discrepant views can be accommodated within a more comprehensive formulation of memory impairment in PTSD.

Quality of memories in women abused by their intimate partner: Analysis of traumatic and nontraumatic narratives.
Fernández‐Lansac, Violeta and Crespo, María.
Journal of Traumatic Stress, Jan 18, 2017.
Abstract:
Traditional models of posttraumatic stress disorder (PTSD) claim that the high emotional intensity of traumaticevents leads to deficits in the voluntary access of traumatic memories. This may result in disorganized narratives, with a high sense of emotional and sensory reliving. Alternatively, the basic mechanisms view suggests that high arousal leads to more available involuntary and voluntary memories. Traumaticnarratives would not be impaired; indeed, they would be immersive and rich in detail. To test this perspective, this study compared the trauma narratives of 50 battered women (trauma‐exposed group) with narratives about positive experiences and narratives of 50 nonexposed women (controls), and analyzed the relationship between trauma narrative aspects and the severity of PTSD. Results showed that trauma narratives were detailed, oriented, and coherent. Affective process words and emotional tone were related to trauma centrality and anxiety during disclosure, and predicted the severity of PTSD (R2 = .26). These variables, together with the use of present tense verbs, accounted for a significant variance in intrusions (R2 = .34). As hypothesized, narrative aspects related to a sense of reliving and narrative immersion were better predictors of PTSD than aspects reflecting impaired access to voluntary traumaticmemories.