A systematic review and meta-analysis of experimental methods for modulating intrusive memories following lab-analogue trauma exposure in non-clinical populations

Mohith M. Varma, Shengzi Zeng, Laura Singh, Emily A. Holmes, Jingyun Huang, Man Hey Chiu and Xiaoqing Hu ()
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Mohith M. Varma: Hong Kong Baptist University
Shengzi Zeng: The University of Hong Kong
Laura Singh: Uppsala University
Emily A. Holmes: Uppsala University
Jingyun Huang: Sun Yat-sen University
Man Hey Chiu: The University of Hong Kong
Xiaoqing Hu: The University of Hong Kong

Nature Human Behaviour, 2024, vol. 8, issue 10, 1968-1987

Abstract: Abstract 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.

Date: 2024
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DOI: 10.1038/s41562-024-01956-y

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