This study examined the differences in posttraumatic symptomology among the groups categorized by organizational characteristics of voluntary trauma memory and intrusion level of intrusive(involuntary) trauma memory in order to explain how autobiograp...
This study examined the differences in posttraumatic symptomology among the groups categorized by organizational characteristics of voluntary trauma memory and intrusion level of intrusive(involuntary) trauma memory in order to explain how autobiographical trauma memory relates to post-traumatic psychological symptoms.
Fire fighters who volunteered to participate in the study were given questionnaires to fill out and were interviewed. All of the participants had been exposed to multiple traumatic incidents during their job. Excluding those who were undergoing drug treatment or had high risk of suicide, the data from 56 male fire officers who had traumatic experiences within two years were eventually used in the analyses. Psychological symptoms, intrusive memories using the Korean version of Impact of Event Scale-Revised, and demographic information were first gathered with a questionnaire, and then each participant was individually interviewed to collect their voluntary trauma memories and intrusive trauma memories. The format of the interview was semi-structured interview. Specifically, the participants were asked to recall their most traumatic incident in the past two years which were all tape-recorded with permission. The recorded narratives were then transcribed to be analyzed.
For the narrative analysis of voluntary trauma memory, researcher referred to the narrative coding category by Foa, Monar, and Cashman(1995)'s narrative coding system. The coding system included the organization of trauma memory, micro-organization based on connectivity among detail contents, and macro-organization based on connectivity of trauma memory to other autobiographical memories or personal identity. For this study, this investigator checked for the validity of the narrative coding system by cross-examining the Korean language characteristics. For the reliability check, two raters were asked to divide the narrative materials according to the coding system, and additionally two other raters were asked to code the narrative materials. The agreement rate between the two raters who divided the narratives(utterance unit) was .74, and the agreement rate between the two raters on the narrative contents was .74, which showed that narrative coding had high reliability. After the narrative analysis of voluntary trauma memory, z scores were calculated for the voluntary trauma memories and the intrusive trauma memories respectively, which led to categorization of four groups according to their trauma memory characteristics. The four groups are as follows: organized voluntary trauma memory and high level of intrusion of intrusive trauma memory (Group 1, 11 people); disorganized voluntary trauma memory and high level of intrusion of intrusive trauma memory (Group 2, 11 people); organized voluntary trauma memory and low level of intrusion of intrusive trauma memory (Group 3, 17 people); and disorganized voluntary trauma memory and low level of intrusion level of intrusive trauma memory (Group 1, 11 people).
The results of one way multi-variate analysis (MANOVA) verified the difference in re-experience, avoidance/emotional numbness, hyperarousal, depression, and anxiety among the four groups, with Group 2 being significantly high in re-experience of PTSD, depression, and anxiety compared to Group 3. Especially regarding re-experience of PTSD, Group 2 was significantly high compared to both Group 3 and Group 4 of which the intrusion trauma memory was low. However, avoidance/numbing and hyperarousal symptoms of PTSD appeared not to be related with any memory characteristics. Such results suggest that post-trauma psychological symptoms are most related to memories that are characterized by disconnection among detailed information of the incident, difficulty remembering parts of the incident, and that are accompanied by intrusive memories and when such intrusive memories are experienced as if they were occurring at the present moment and disconnected with the whole context of the incident.
Micro-organization and macro-organization had little correlation with psychological symptoms. However, macro-organization had positive correlation with negative emotional reactions, suggesting that when disorganized voluntary trauma memories are enmeshed with other autographic memories of the individual or personal identity in general, more negative emotions are experienced. Interestingly, voluntary trauma memories and intrusive trauma memories had no significant correlation with each other. This implies that voluntary trauma memories and intrusive trauma memories may each have independent psychological and physiological underlying mechanism.
Based on the result of this study, the application of different theories of trauma memory processing were discussed as well as how trauma memories should be dealt with during psychotherapy. Limitations of this study and future research suggestions were also included in the discussion.
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