Browsing by Author "Berntsen, Dorthe"

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Open Access
A memory-based model of posttraumatic stress disorder: evaluating basic assumptions underlying the PTSD diagnosis.
(Psychol Rev, 2008-10) Rubin, David C; Berntsen, Dorthe; Bohni, Malene Klindt
In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The model accounts for important and reliable findings that are often inconsistent with the current diagnostic view and that have been neglected by theoretical accounts of the disorder, including the following observations. The diagnosis needs objective information about the trauma and peritraumatic emotions but uses retrospective memory reports that can have substantial biases. Negative events and emotions that do not satisfy the current diagnostic criteria for a trauma can be followed by symptoms that would otherwise qualify for PTSD. Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only to traumatic memories are not needed, increasing parsimony and the knowledge that can be applied to understanding PTSD.
Open Access
Contrasting Models of Posttraumatic Stress Disorder: Reply to.
(Psychol Rev, 2008-10) Berntsen, Dorthe; Rubin, David C; Johansen, Malene Klindt
We address the four main points in Monroe and Mineka (2008)'s Comment. First, we first show that the DSM PTSD diagnosis includes an etiology and that it is based on a theoretical model with a distinguished history in psychology and psychiatry. Two tenets of this theoretical model are that voluntary (strategic) recollections of the trauma are fragmented and incomplete while involuntary (spontaneous) recollections are vivid and persistent and yield privileged access to traumatic material. Second, we describe differences between our model and other cognitive models of PTSD. We argue that these other models share the same two tenets as the diagnosis and we show that these two tenets are largely unsupported by empirical evidence. Third, we counter arguments about the strength of the evidence favoring the mnemonic model, and fourth, we show that concerns about the causal role of memory in PTSD are based on views of causality that are generally inappropriate for the explanation of PTSD in the social and biological sciences.
Open Access
Cultural life scripts structure recall from autobiographical memory.
(Mem Cognit, 2004-04) Berntsen, Dorthe; Rubin, David C
Three classes of evidence demonstrate the existence of life scripts, or culturally shared representations of the timing of major transitional life events. First, a reanalysis of earlier studies on age norms shows an increase in the number of transitional events between the ages of 15 and 30 years, and these events are associated with narrower age ranges and more positive emotion than events outside this period. Second, 1,485 Danes estimated how old hypothetical centenarians were when they had been happiest, saddest, most afraid, most in love, and had their most important and most traumatic experiences. Only the number of positive events showed an increase between the ages of 15 and 30 years. Third, undergraduates generated seven important events that were likely to occur in the life of a newborn. Pleasantness and whether events were expected to occur between the ages of 15 and 30 years predicted how frequently events were recorded. Life scripts provide an alternative explanation of the reminiscence bump. Emphasis is on culture, not individuals.
Open Access
Emotionally charged autobiographical memories across the life span: the recall of happy, sad, traumatic, and involuntary memories.
(Psychology and aging, 2002-12) Berntsen, Dorthe; Rubin, David C
A sample of 1,241 respondents between 20 and 93 years old were asked their age in their happiest, saddest, most traumatic, most important memory, and most recent involuntary memory. For older respondents, there was a clear bump in the 20s for the most important and happiest memories. In contrast, saddest and most traumatic memories showed a monotonically decreasing retention function. Happy involuntary memories were over twice as common as unhappy ones, and only happy involuntary memories showed a bump in the 20s. Life scripts favoring positive events in young adulthood can account for the findings. Standard accounts of the bump need to be modified, for example, by repression or reduced rehearsal of negative events due to life change or social censure.
Open Access
Flashbulb memories and posttraumatic stress reactions across the life span: age-related effects of the German occupation of Denmark during World War II.
(Psychol Aging, 2006-03) Berntsen, Dorthe; Rubin, David C
A representative sample of older Danes were interviewed about experiences from the German occupation of Denmark in World War II. The number of participants with flashbulb memories for the German invasion (1940) and capitulation (1945) increased with participants' age at the time of the events up to age 8. Among participants under 8 years at the time of their most traumatic event, age at the time correlated positively with the current level of posttraumatic stress reactions and the vividness of stressful memories and their centrality to life story and identity. These findings were replicated in Study 2 for self-nominated stressful events sampled from the entire life span using a representative sample of Danes born after 1945. The results are discussed in relation to posttraumatic stress disorder and childhood amnesia.
Open Access
Involuntary Memories and Dissociative Amnesia: Assessing Key Assumptions in PTSD Research.
(Clin Psychol Sci, 2014-03-01) Berntsen, Dorthe; Rubin, David C
Autobiographical memories of trauma victims are often described as disturbed in two ways. First, the trauma is frequently re-experienced in the form of involuntary, intrusive recollections. Second, the trauma is difficult to recall voluntarily (strategically); important parts may be totally or partially inaccessible-a feature known as dissociative amnesia. These characteristics are often mentioned by PTSD researchers and are included as PTSD symptoms in the DSM-IV-TR (American Psychiatric Association, 2000). In contrast, we show that both involuntary and voluntary recall are enhanced by emotional stress during encoding. We also show that the PTSD symptom in the diagnosis addressing dissociative amnesia, trouble remembering important aspects of the trauma is less well correlated with the remaining PTSD symptoms than the conceptual reversal of having trouble forgetting important aspects of the trauma. Our findings contradict key assumptions that have shaped PTSD research over the last 40 years.
Open Access
Life scripts help to maintain autobiographical memories of highly positive, but not highly negative, events.
(Mem Cognit, 2003-01) Rubin, David C; Berntsen, Dorthe
A representative sample of 1,307 respondents between the ages of 20 and 94 was asked how old they were when they felt most afraid, most proud, most jealous, most in love, and most angry. They were also asked when they had experienced their most important event and whether this event was positive or negative. In general, there was a reminiscence "bump" for positive but not negative events. To provide data on life scripts, 87 psychology students answered the same questions for a hypothetical 70-year-old. The undergraduates were more confident in dating positive than in dating negative events, and when they were confident, the distribution of responses predicted the survey data. The results support the idea of culturally shared life scripts for positive but not negative events, which structure retrieval processes and spaced practice.
Open Access
Memory in posttraumatic stress disorder: properties of voluntary and involuntary, traumatic and nontraumatic autobiographical memories in people with and without posttraumatic stress disorder symptoms.
(J Exp Psychol Gen, 2008-11) Rubin, David C; Boals, Adriel; Berntsen, Dorthe
One hundred fifteen undergraduates rated 15 word-cued memories and their 3 most negatively stressful, 3 most positive, and 7 most important events and completed tests of personality and depression. Eighty-nine also recorded involuntary memories online for 1 week. In the first 3-way comparisons needed to test existing theories, comparisons were made of memories of stressful events versus control events and involuntary versus voluntary memories in people high versus low in posttraumatic stress disorder (PTSD) symptom severity. For all participants, stressful memories had more emotional intensity, more frequent voluntary and involuntary retrieval, but not more fragmentation. For all memories, participants with greater PTSD symptom severity showed the same differences. Involuntary memories had more emotional intensity and less centrality to the life story than voluntary memories. Meeting the diagnostic criteria for traumatic events had no effect, but the emotional responses to events did. In 533 undergraduates, correlations among measures were replicated and the Negative Intensity factor of the Affect Intensity Measure correlated with PTSD symptom severity. No special trauma mechanisms were needed to account for the results, which are summarized by the autobiographical memory theory of PTSD.
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Most People who Think that They are Likely to Enter Psychotherapy also Think it is Plausible that They could have Forgotten their own Memories of Childhood Sexual Abuse.
(Applied cognitive psychology, 2009-01) Rubin, David C; Berntsen, Dorthe
Pezdek and Blandon-Gitlin (in press) found that 25% of their participants reported as plausible or very plausible that they themselves could have been a victim of childhood sexual abuse without being able to remember it. In addition, they found that the 25% figure increased to 61% for participants who reported that they were likely at some point in their life to seek psychotherapy. Given past work showing that it is easier to implant a false memory for plausible events, and counter to Pezdek and Blandon-Gitlin's conclusions, these data point to a substantial danger of implanting false memories of childhood sexual abuse during therapy in many people and in most people who are likely to go into therapy. Theoretical issues regarding plausibility are discussed.
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Neural responses to emotional involuntary memories in posttraumatic stress disorder: Differences in timing and activity.
(NeuroImage. Clinical, 2018-01) Hall, Shana A; Brodar, Kaitlyn E; LaBar, Kevin S; Berntsen, Dorthe; Rubin, David C
Background:Involuntary memories are a hallmark symptom of posttraumatic stress disorder (PTSD), but studies of the neural basis of involuntary memory retrieval in posttraumatic stress disorder (PTSD) are sparse. The study of the neural correlates of involuntary memories of stressful events in PTSD focuses on the voluntary retrieval of memories that are sometimes recalled as intrusive involuntary memories, not on involuntary retrieval while being scanned. Involuntary memory retrieval in controls has been shown to elicit activity in the parahippocampal gyrus, precuneus, inferior parietal cortex, and posterior midline regions. However, it is unknown whether involuntary memories are supported by the same mechanisms in PTSD. Because previous work has shown that both behavioral and neural responsivity is slowed in PTSD, we examined the spatiotemporal dynamics of the neural activity underlying negative and neutral involuntary memory retrieval. Methods:Twenty-one individuals with PTSD and 21 non-PTSD, trauma-exposed controls performed an involuntary memory task, while undergoing a functional magnetic resonance imaging scan. Environmental sounds served as cues for well-associated pictures of negative and neutral scenes. We used a finite impulse response model to analyze temporal differences between groups in neural responses. Results:Compared with controls, participants with PTSD reported more involuntary memories, which were more emotional and more vivid, but which activated a similar network of regions. However, compared to controls, individuals with PTSD showed delayed neural responsivity in this network and increased vmPFC/ACC activity for negative > neutral stimuli. Conclusions:The similarity between PTSD and controls in neural substrates underlying involuntary memories suggests that, unlike voluntary memories, involuntary memories elicit similar activity in regions critical for memory retrieval. Further, the delayed neural responsivity for involuntary memories in PTSD suggests that factors affecting cognition in PTSD, like increased fatigue, or avoidance behaviors could do so by delaying activity in regions necessary for cognitive processing. Finally, compared to neutral memories, negative involuntary memories elicit hyperactivity in the vmPFC, whereas the vmPFC is typically shown to be hypoactive in PTSD during voluntary memory retrieval. These patterns suggest that considering both the temporal dynamics of cognitive processes as well as involuntary cognitive processes would improve existing neurobiological models of PTSD.
Open Access
Peace and war: trajectories of posttraumatic stress disorder symptoms before, during, and after military deployment in Afghanistan.
(Psychol Sci, 2012-12) Berntsen, Dorthe; Johannessen, Kim B; Thomsen, Yvonne D; Bertelsen, Mette; Hoyle, Rick H; Rubin, David C
In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not. These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.
Open Access
People believe it is plausible to have forgotten memories of childhood sexual abuse.
(Psychon Bull Rev, 2007-08) Rubin, David C; Berntsen, Dorthe
Pezdek, Blandon-Gitlin, and Gabbay (2006) found that perceptions of the plausibility of events increase the likelihood that imagination may induce false memories of those events. Using a survey conducted by Gallup, we asked a large sample of the general population how plausible it would be for a person with longstanding emotional problems and a need for psychotherapy to be a victim of childhood sexual abuse, even though the person could not remember the abuse. Only 18% indicated that it was implausible or very implausible, whereas 67% indicated that such an occurrence was either plausible or very plausible. Combined with Pezdek et al.s' findings, and counter to their conclusions, our findings imply that there is a substantial danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy.
Open Access
People over forty feel 20% younger than their age: subjective age across the lifespan.
(Psychon Bull Rev, 2006-10) Rubin, David C; Berntsen, Dorthe
Subjective age--the age people think of themselves asbeing--is measured in a representative Danish sample of 1,470 adults between 20 and 97 years of age through personal, in-home interviews. On the average, adults younger than 25 have older subjective ages, and those older than 25 have younger subjective ages, favoring a lifespan-developmental view over an age-denial view of subjective age. When the discrepancy between subjective and chronological age is calculated as a proportion of chronological age, no increase is seen after age 40; older respondents feel 20% younger than their actual age. Demographic variables (gender, income, and education) account for very little variance in subjective age.
Open Access
Pretraumatic Stress Reactions in Soldiers Deployed to Afghanistan.
(Clin Psychol Sci, 2015-09) Berntsen, Dorthe; Rubin, David C
Posttraumatic Stress Disorder is a diagnosis related to the past. Pre-traumatic stress reactions, as measured by intrusive involuntary images of possible future stressful events and their associated avoidance and increased arousal, have been overlooked in the PTSD literature. Here we introduce a scale that measures pre-traumatic stress reactions providing a clear future-oriented parallel to the posttraumatic stress reactions described in the diagnostic criteria for PTSD. We apply this pre-traumatic stress reactions checklist (PreCL) to Danish soldiers before, during, and after deployment to Afghanistan. The PreCL has good internal consistency and is highly correlated with a standard measure of PTSD symptoms. The PreCL as answered before the soldiers' deployment significantly predicted level of PTSD symptoms during and after their deployment, while controlling for baseline PTSD symptoms and combat exposure measured during and after deployment. The findings have implications for the conceptualization of PTSD, screening, and treatment.
Open Access
Psychological and clinical correlates of the Centrality of Event Scale: A systematic review.
(Clinical psychology review, 2018-11) Gehrt, Tine B; Berntsen, Dorthe; Hoyle, Rick H; Rubin, David C
The Centrality of Event Scale (CES) was introduced to examine the extent to which a traumatic or stressful event is perceived as central to an individual's identity and life story, and how this relates to Posttraumatic Stress Disorder (PTSD) symptoms. In addition, the CES has been examined in relation to a range of other conditions and dispositions. We present a systematic review of the correlates of the CES. Results from 92 publications resulted in 25 measurement categories in the six theoretical domains of trauma, negative affect and distress, autobiographical memory, personality, positive affect, and gender. The mean weighted correlations of the 25 measurement categories ranged from -.17 to .55, with standard errors from .01 to .02, allowing us to distinguish empirically among effects. Consistent with the theoretical motivation for the CES and predictions predating the review, the CES correlated positively with a range of measures, correlating most highly with measures related to trauma, PTSD, grief, and autobiographical memory. The findings show that the CES probes aspects of autobiographical memory of broad relevance to clinical disorders, and with specific implications for theories of PTSD.
Open Access
Scientific evidence versus outdated beliefs: A response to Brewin (2016).
(Journal of abnormal psychology, 2016-10) Rubin, David C; Berntsen, Dorthe; Ogle, Christin M; Deffler, Samantha A; Beckham, Jean C
We find Brewin's (2016) critiques of the narratives, power, and coherence measures in Rubin et al. (2016) without merit; his suggestions for a "revised formulation" (p. 1015) of coherence are contradicted by data readily available in the target article but ignored. We place Brewin's commentary in a historical context and show that it reiterates views of trauma memory fragmentation that are unsupported by data. We evaluate an earlier review of fragmentation of trauma memories (Brewin, 2014), which Brewin uses to support his position in the commentary. We show that it is contradicted by more comprehensive reviews and fails to include several studies that met Brewin's inclusion criteria but provided no support for his position, including 3 studies by the present authors (Rubin, 2011; Rubin, Boals, & Berntsen, 2008; Rubin, Dennis, & Beckham, 2011). In short, the commentary's position does not stand against scientific evidence; attempts to rescue it through arguments unsupported by data advance neither science nor clinical practice. (PsycINFO Database Record
Open Access
Self-narrative focus in autobiographical events: The effect of time, emotion, and individual differences.
(Memory & cognition, 2019-01) Rubin, David C; Berntsen, Dorthe; Deffler, Samantha A; Brodar, Kaitlyn
Individuals may take a self-narrative focus on the meaning of personal events in their life story, rather than viewing the events in isolation. Using the Centrality of Event Scale (CES; Berntsen & Rubin in Behaviour Research and Therapy, 44, 219-231, 2006) as our measure, we investigated self-narrative focus as an individual differences variable in addition to its established role as a measure of individual events. Three studies, with 169, 182, and 190 participants had 11, 10, and 11 different events varied across the dimensions of remembered past versus imagined future, distance from the present, and valence. Imagined future events, events more distant from the present, and positive events all had increased self-narrative focus, in agreement with published theories and findings. Nonetheless, CES ratings for individual events correlated positively with each other within individuals (r ~ .30) and supported a single factor solution. These results are consistent with a stable individual differences tendency toward self-narrative focus that transcends single events. Thus, self-narrative focus is both a response whereby people relate individual events to their life story and identity and an individual differences variable that is stable over a range of events. The findings are discussed in relation to narrative measures of autobiographical reasoning.
Open Access
Taking tests in the magnet: Brain mapping standardized tests.
(Human brain mapping, 2017-11) Rubin, David C; Li, Dawei; Hall, Shana A; Kragel, Philip A; Berntsen, Dorthe
Standardized psychometric tests are sophisticated, well-developed, and consequential instruments; test outcomes are taken as facts about people that impact their lives in important ways. As part of an initial demonstration that human brain mapping techniques can add converging neural-level evidence to understanding standardized tests, our participants completed items from standardized tests during an fMRI scan. We compared tests for diagnosing posttraumatic stress disorder (PTSD) and the correlated measures of Neuroticism, Attachment, and Centrality of Event to a general-knowledge baseline test. Twenty-three trauma-exposed participants answered 20 items for each of our five tests in each of the three runs for a total of 60 items per test. The tests engaged different neural processes; which test a participant was taking was accurately predicted from other participants' brain activity. The novelty of the application precluded specific anatomical predictions; however, the interpretation of activated regions using meta-analyses produced encouraging results. For instance, items on the Attachment test engaged regions shown to be more active for tasks involving judgments of others than judgments of the self. The results are an initial demonstration of a theoretically and practically important test-taking neuroimaging paradigm and suggest specific neural processes in answering PTSD-related tests. Hum Brain Mapp 38:5706-5725, 2017. © 2017 Wiley Periodicals, Inc.
Open Access
The centrality of event scale: a measure of integrating a trauma into one's identity and its relation to post-traumatic stress disorder symptoms.
(Behav Res Ther, 2006-02) Berntsen, Dorthe; Rubin, David C
We introduce a new scale that measures how central an event is to a person's identity and life story. For the most stressful or traumatic event in a person's life, the full 20-item Centrality of Event Scale (CES) and the short 7-item scale are reliable (alpha's of .94 and .88, respectively) in a sample of 707 undergraduates. The scale correlates .38 with PTSD symptom severity and .23 with depression. The present findings are discussed in relation to previous work on individual differences related to PTSD symptoms. Possible connections between the CES and measures of maladaptive attributions and rumination are considered along with suggestions for future research.
Open Access
The Frequency and Impact of Exposure to Potentially Traumatic Events Over the Life Course.
(Clin Psychol Sci, 2013-10-01) Ogle, Christin M; Rubin, David C; Berntsen, Dorthe; Siegler, Ilene C
We examined the frequency and impact of exposure to potentially traumatic events among a nonclinical sample of older adults (n = 3,575), a population typically underrepresented in epidemiological research concerning the prevalence of traumatic events. Current PTSD symptom severity and the centrality of events to identity were assessed for events nominated as currently most distressing. Approximately 90% of participants experienced one or more potentially traumatic events. Events that occurred with greater frequency early in the life course were associated with more severe PTSD symptoms compared to events that occurred with greater frequency during later decades. Early life traumas, however, were not more central to identity. Results underscore the differential impact of traumatic events experienced throughout the life course. We conclude with suggestions for further research concerning mechanisms that promote the persistence of post-traumatic stress related to early life traumas and empirical evaluation of psychotherapeutic treatments for older adults with PTSD.

Browsing by Author "Berntsen, Dorthe"

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