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Varma MM, Zeng S, Singh L, Holmes EA, Huang J, Chiu MH, Hu X. A systematic review and meta-analysis of experimental methods for modulating intrusive memories following lab-analogue trauma exposure in non-clinical populations. Nat Hum Behav 2024:10.1038/s41562-024-01956-y. [PMID: 39169230 DOI: 10.1038/s41562-024-01956-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 07/15/2024] [Indexed: 08/23/2024]
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.
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Affiliation(s)
- Mohith M Varma
- 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
| | - Shengzi Zeng
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
- The State Key Lab of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Swedish Collegium for Advanced Study, Uppsala, Sweden
| | - Emily A Holmes
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jingyun Huang
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Man Hey Chiu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoqing Hu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China.
- The State Key Lab of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
- HKU-Shenzhen Institute of Research and Innovation, Shenzhen, China.
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