Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisals.
Abstract
Two studies of assault victims examined the roles of (a) disorganized trauma memories in the development of posttraumatic stress disorder (PTSD), (b) peritraumatic cognitive processing in the development of problematic memories and PTSD, and (c) ongoing dissociation and negative appraisals of memories in maintaining symptomatology. In the cross-sectional study (n = 81), comparisons of current, past, and no-PTSD groups suggested that peritraumatic cognitive processing is related to the development of disorganized memories and PTSD. Ongoing dissociation and negative appraisals served to maintain PTSD symptoms. The prospective study (n = 73) replicated these findings longitudinally. Cognitive and memory assessments completed within 12-weeks postassault predicted 6-month symptoms. Assault severity measures explained 22% of symptom variance; measures of cognitive processing, memory disorganization, and appraisals increased prediction accuracy to 71%.
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In Halligan et al.'s cross-sectional analysis, higher peritraumatic dissociation on the SDQ was associated with higher meta-memory disorganization on the TMQ.
“In the cross-sectional analyses, individuals reporting higher peritraumatic dissociation on the State Dissociation Questionnaire (SDQ) also reported higher meta-memory disorganization on the five-item Trauma Memory Questionnaire (TMQ; Halligan, Clark, & Ehlers, 2002).”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Across studies, higher peritraumatic dissociation is associated with higher meta-memory fragmentation, with a positive moderate association in most studies.
“Across studies, individuals reporting higher peritraumatic dissociation reported higher meta-memory fragmentation.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Halligan et al. found a moderate link between peritraumatic dissociation and meta-memory disorganization, but their results weaken the case that disorganization drives PTSD.
“Taken together, higher peritraumatic dissociation was moderately associated with meta-memory disorganization; however, these results cast doubt on disorganization as a mechanism of PTSD development.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Across Criterion A trauma samples, higher peritraumatic dissociation consistently accompanied higher self-rated fragmentation.
“Taken together results of Halligan et al. (2003), Murray et al. (2002), and Hardy et al. (2009) generally suggest that, in Criterion A trauma-exposed samples, individuals with higher peritraumatic dissociation consistently show higher meta-memory ratings of fragmentation.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Seven studies examined peritraumatic dissociation and meta-memory fragmentation.
“Seven studies have investigated peritraumatic dissociation and meta-memory fragmentation (Buck, Kindt, & van den Hout, 2005b; Engelhard, van den Hout, Kindt, Arntz, & Schouten, 2003; Halligan et al., 2003; Hardy, Young, & Holmes, 2009; Kindt & van den Hout, 2003; Kindt, van den Hout, & Buck, 2005; Murray et al., 2002).”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
In Halligan et al.'s prospective analysis, higher peritraumatic dissociation predicted greater disorganization six months after assault.
“Prospectively, higher peritraumatic dissociation predicted higher disorganization assessed six months after assault.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Halligan et al. (2003) found in cross-sectional and prospective samples that higher peritraumatic dissociation was associated with higher subjective rater-coded disorganization, using blind raters on single-item and multi-item coding.
“Consistent with meta-memory findings above, Halligan and colleagues (2003) found in their cross-sectional and prospective samples that individuals reporting higher peritraumatic dissociation had higher subjective rater-coded disorganization, using blind raters on both a single-item rating and multi-item coding.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Taken together, only the Halligan et al. (2003) study suggests that peritraumatic dissociation is related to rater-coded fragmentation.
“Taken together, only the Halligan et al. (2003) study suggests that peritraumatic dissociation is related to rater-coded fragmentation.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
In Halligan et al. (2003), prospective change in coded disorganization did not predict change in PTSD.
“Prospectively, change in coded disorganization did not predict change in PTSD.”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Halligan et al., 2003
Results using self-reported questionnaire ratings were more variable, with two studies showing similar significant effects and two studies showing no significant group differences.
“In contrast, the results using self-reported questionnaire ratings were more variable with two studies (Halligan et al., 2003, studies 1 and 2) showing similar significant effects and two studies (Berntsen, et al., 2003; Jelinek, et al., 2009) showing no significant group differences.”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Halligan et al., 2003
Impairments in voluntary trauma memory predict the course of PTSD over and above initial symptom levels in some cases.
“in some cases over and above the effects of initial symptom levels (Halligan, et al., 2003; Jones, et al., 2007).”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Halligan et al., 2003
Higher levels of fragmentation in trauma narratives are related to self-reported dissociation either during or after the traumatic event.
“Subsequent research has consistently found that higher levels of fragmentation in trauma narratives are related to self-reported dissociation either during or after the traumatic event (Engelhard, et al., 2003; Giesbrecht, Merckelbach, van Oorsouw, & Simeon, 2010; Halligan, et al., 2003; Harvey & Bryant, 1999; Murray, Ehlers, & Mayou, 2002; Rubin, et al., 2004).”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Halligan et al., 2003
In assault survivors, there was a significant group x memory type interaction for self-rated disorganization, with greater disorganization for the assault than a non-traumatic event, and this effect was strongest in the PTSD group.
“Significant group x memory type interaction ( p < .01): Disorganization greater for assault than non-traumatic event, this effect strongest in PTSD group”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Halligan et al. (2003) study 2
In assault survivors, current PTSD and recovered PTSD groups had more disorganized trauma narratives than the no PTSD group.
“Current PTSD ( p < .01) and recovered PTSD ( p < .05) more disorganized than no PTSD”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Halligan et al. (2003) study 1
Disrupted or disorganized processing of trauma memories has been shown to increase symptomatology in SA survivors.
“Disrupted or disorganized processing of trauma memories has been shown to increase symptomatology in SA survivors (Ehlers & Clark, 2000; Halligan, Michael, Clark, & Ehlers, 2003).”
From Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment (2022) · cites this paper as Halligan et al., 2003
Data-driven processing was assessed with the 8-item data-driven processing subscale from the Cognitive Processing Scale, with Cronbach's α = 0.87 in the present sample.
“Internal consistency in the present sample was good, Cronbach's α = 0.87.”
From Early Linguistic Markers of Trauma-Specific Processing Predict Post-trauma Adjustment (2018) · cites this paper as [40]
The psychological and behavioral responses of these individuals may relate to differences in the appraisal and interpretation of major concerns such as losing control of the situation, contracting SARS in public, and effects on the wellbeing of family members.
“The psychological and behavioral responses of these individuals may relate to differences in the appraisal and interpretation of major concerns such as a sense of losing control of the situation, contracting SARS in public, as well as its effects on the wellbeing of family members (Table 4) [38], [39].”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [38]
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- Authors
- Halligan, S. L., Michael, T., Clark, D. M., & Ehlers, A.
- Affiliations
- University of Oxford (GB)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2003
- Volume
- 71
- Issue
- 3
- Pages
- 419-431
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2002693215
- Cited by
- 585
- References
- 17
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 21 · 2023: 18 · 2022: 24 · 2021: 22 · 2020: 34 · 2019: 23 · 2018: 42 · 2017: 27 · 2016: 30 · 2015: 35 · 2014: 25 · 2013: 27 · 2012: 33
- FWCI
- 22.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Wellcome Trust (069777)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, assault victims, dissociation, negative appraisals
- MeSH terms
- Adult, Cognition, Female, Follow-Up Studies, Humans, Male, Memory, Prospective Studies, Surveys and Questionnaires, Retrospective Studies, Stress Disorders, Post-Traumatic, Violence
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