Research Article: Cultural Differences in the Relationship between Intrusions and Trauma Narratives Using the Trauma Film Paradigm

Date Published: September 9, 2014

Publisher: Public Library of Science

Author(s): Laura Jobson, Tim Dalgleish, Peter Howell.

http://doi.org/10.1371/journal.pone.0106759

Abstract

Two studies explored the influence of culture on the relationship between British and East Asian adults’ autobiographical remembering of trauma film material and associated intrusions. Participants were shown aversive film clips to elicit intrusive images. Then participants provided a post-film narrative of the film content (only Study 1). In both studies, participants reported intrusive images for the film in an intrusion diary during the week after viewing. On returning the diary, participants provided a narrative of the film (delayed). The trauma film narratives were scored for memory-content variables. It was found that for British participants, higher levels of autonomous orientation (i.e. expressions of autonomy and self-determination) and self-focus in the delayed narratives were correlated significantly with fewer intrusions. For the East Asian group, lower levels of autonomous orientation and greater focus on others were correlated significantly with fewer intrusions. Additionally, Study 2 found that by removing the post-film narrative task there was a significant increase in the number of intrusions relative to Study 1, suggesting that the opportunity to develop a narrative resulted in fewer intrusions. These findings suggest that the greater the integration and contextualization of the trauma memory, and the more the trauma memory reflects culturally appropriate remembering, the fewer the intrusions.

Partial Text

Involuntary autobiographical memories are memories of personal events that consciously and spontaneously come to mind without any deliberate retrieval intention [1]. While they are common and frequently recalled in the daily life of healthy adults, in their more extreme form they have been found to be associated with a range of psychological disorders [2]–[5]. For instance, posttraumatic stress disorder (PTSD) is characterized by involuntary memory retrieval; the hallmark symptom of PTSD is the involuntary, intrusive recollection of memories of the traumatic experience [6]–[8]. Therefore, the psychological processes autobiographical remembering and information-processing have become central to the understanding of PTSD [4]. An account for these intrusive trauma memories has been offered by cognitive autobiographical memory models, such as the Self Memory System (SMS) [9], [10], and PTSD specific models, such as the cognitive model of PTSD [8] and the Dual Representation Theory (DRT) [7] (see [11] for a review).

Study 1 investigated whether there was an association between the culturally expected memory-content qualities of the trauma film narratives and the reporting of trauma film-related intrusions. British and East Asian participants watched the trauma film and then provided an immediate narrative account of the film. Participants completed the intrusion diary in the week following watching the film [4]. Then when participants returned their diary the following week, they again provided a written account (delayed account) about their memory of the film. The memory-content variables (mention of others in relation to oneself, autonomous orientation and social interactions) of the two trauma film accounts were coded, as in previous cross-cultural research, to assess integration and contextualization of the memory (e.g., [31], [36]). Culturally appropriate integration and contextualization of the memory was indexed by the expected memory-content variables being evident in the narratives. It was hypothesized that integration and contextualization of the memory in the culturally appropriate way would be associated with the reporting of fewer intrusions. Specifically, it was predicted that for British participants, the trauma film narratives that contained greater emphasis on autonomy and self-focus would be associated with the reporting of fewer trauma film-related intrusions. In contrast, it was predicted that for the East Asian group, reduced autonomous orientation and greater mention of others and social interactions would be associated with the reporting of fewer trauma film-related intrusions. Second, cultural differences in self-construal act as a constructive filter influencing the manner in which information is initially encoded and represented in memory. Cultural differences in self-construal also serve as a reconstructive filter that shapes memory over the course of retention and at the time of retrieval [34]. Therefore, it was hypothesized that both the immediate and delayed trauma film narratives would culturally differ in terms of levels of autonomous orientation, self-focus and mention of social interactions. British participants would have significantly greater levels of autonomous orientation and self-focus and significantly less mention of social interactions than East Asian participants.

This study investigated whether integration and contextualization of memories of a trauma film were associated with trauma film-related intrusions. Integration and contextualization was indexed by culturally expected levels of autonomous orientation, social interactions and egocentricity being present in the narratives. It was first hypothesized that culturally appropriate integration and contextualization of the memory would be associated with fewer intrusions. In support of this, British participants who had lower levels of autonomous orientation and self-focus in their delayed narratives reported a higher frequency of film-related intrusions. In Western autobiographical remembering autonomous orientation and self-focus are valued [31]. In contrast, among East Asian participants, those with higher levels of autonomous orientation and less mention of others reported a higher frequency of film-related intrusions. In East Asian cultures autonomous orientation is downplayed and other-focus is emphasized [31]. Interestingly, there was no significant relationship between the memory-content variables associated with the immediate trauma film narrative and film-related intrusions. Thus contextualization and integration of the memory may take time and such differences may not emerge immediately following encoding. Rather rehearsal may be required to contextualize and integrate the memory and to allow for differences in self-construal to serve as a reconstructive filter that shapes memory over this period of retention [34].

Direct efforts to enhance conceptual post-memory integration have been found to reduce the frequency of trauma film-related intrusions [51]. Krans et al. [51] conducted a study that aimed to enhance memory integration by administering a verbal recognition memory test for one part of the film directly after viewing in order to allow trauma film material to be rehearsed in a structured way. They hypothesized that such a task should enhance the formation of a memory that is verbally accessible, contextualized, organized, and able to be deliberately retrieved and thus, associated with fewer trauma film-related intrusions. Their findings supported this hypothesis. Additionally, participants’ performance on a cued-recall memory test administered during the one-week follow-up session was improved. They concluded that completing this memory recognition task immediately post-viewing resulted in the film material being better contextualized and integrated in autobiographical memory. Therefore, the immediate narrative provided by participants in Study 1 may have similarly enhanced conceptual post-memory integration of the trauma film material. That is, developing a narrative about the film content immediately after viewing may have served a similar function to Krans et al.’s verbal recognition memory test. Therefore, the first aim of Study 2 was to investigate the effect of removing the immediate narrative on the frequency of intrusions during the week. It was predicted that by removing the initial narrative there would be an increase in the number of trauma film-related intrusions and reduced performance on the recognition and free recall memory tasks (relative to Study 1). The second aim of Study 2 was to investigate whether the relationships between memory-content qualities and frequency of intrusions found in Study 1 could be replicated. Third, cultural differences in self-construal are proposed to act as a reconstructive filter that influences memory over the period of retention and at the time of retrieval [34]. However, Study 1 provided no evidence to suggest cultural differences in the memory-content qualities of the trauma film narratives. Therefore, the final aim of this study was to again investigate whether the delayed trauma film narrative would culturally differ in terms of levels of autonomous orientation, self-focus and mention of social interactions.

Study 2 replicated Study 1 and found that for the British group, a higher frequency of film-related intrusions was correlated significantly with lower levels of autonomous orientation and self-focus in the trauma film narrative. In contrast, for the East Asian group, a higher frequency of film-related intrusions correlated significantly with higher levels of autonomous orientation. These correlation coefficients differed significantly. Thus, Study 2 further supports the notion that integration and contextualization of memories (as indexed by evidence of culturally emphasized memory-content variables being present) of a trauma film is associated with fewer trauma film-related intrusions. Trauma memories that reflected culturally appropriate remembering were correlated significantly with fewer intrusions being experienced by an individual.

These two studies investigated the influence of culture on the relationship between the memory-content variables of the autobiographical remembering of trauma film material and film-related intrusions. Empirical work has demonstrated that the Western perspective of self-construal emphasizes autonomy, self-determination and self-expression in autobiographical remembering. In contrast, East Asian cultures discourage excessive self-focused, autonomously oriented remembering and rather focus on social interactions and others [33]. Verbal conceptual processing, integration and contextualization of the memory provides the required opportunities for cultural differences in self-construal to influence the way in which information is encoded and represented in memory. These processes also provide the required opportunities for cultural differences in self-construal to shape the memory over the course of retention and at the time of retrieval [34], [36]. Hence, evidence of culturally valued memory-content was taken as an index of integration and contextualization of the memory. In support of this, it was found that for British participants lower levels of expressions of self-determination and autonomy and self-focus (Studies 1 and 2) in the autobiographical remembering of the trauma film material was correlated significantly with a higher frequency of film-related intrusions. In contrast, for East Asian participants higher levels of self-determination and autonomy (Studies 1 and 2) and less focus on others (Study 1) were correlated significantly with a higher frequency of film-related intrusions. These findings suggest that those who contextualized and integrated the trauma film material in autobiographical memory may experience fewer intrusions than those who failed to contextualize and integrate the trauma film material in autobiographical memory. Thus, encouraging one to engage with the material in a way that aligns with one’s cultural self-construal and facilitating the process of narrative construction in a way that gives meaning and substance to one’s self-construal [34] may be effective in reducing trauma-related intrusive images.

 

Source:

http://doi.org/10.1371/journal.pone.0106759