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Verbal therapy could block consolidation of fear memories in trauma victims

King's College London

A verbal 'updating' technique aimed at blocking the consolidation of traumatic memories could protect against the long-term psychological and physiological effects of trauma, according to new research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London and the University of Oxford.

Published today in PLOS ONE, this study is the first to examine whether updating - a verbal therapy currently only used for patients with chronic post-traumatic stress disorder (PTSD) - could be applied more widely to victims of trauma before PTSD develops, during a period known as the 'consolidation window'. This period, thought to last around six hours after a traumatic event, is when fear memories are established and strengthened.

The findings could have implications for the many millions of people who experience a traumatic event in their lifetime, as well as the thousands of people regularly exposed to trauma in their line of work, including those in the emergency services, the military and journalists in conflict zones.

The researchers looked at two cognitive behavioural techniques used to treat PTSD: 'updating', where traumatic memories are re-written with factual information, bringing the meaning of trauma in line with what actually happened and the consequences for those involved; and 'exposure', a key therapy for anxiety, which involves presenting the original object of fear for long enough to decrease the intensity of an emotional reaction.

In the study, 115 participants watched a series of six film clips containing real-life footage of humans and animals in distress, a procedure regularly used to investigate causal factors in the development of PTSD. ??Researchers found that verbally updating the trauma memory with information about the fate of the films' protagonists reduced the frequency of intrusive memories by half (5.6 intrusive memories on average) compared to those in the exposure group (11.2, where the films were viewed again); and control group (10.6, where participants viewed non-traumatic films).

In addition, a self-reported measure of distress caused by these intrusions was found to be much lower in the updating group (19.7 rating) compared to the exposure (27.2) and control groups (25.5).

Updating also led to the greatest decrease in distress and the greatest changes in physical arousal (as measured by skin conductance) when participants were faced with reminders of the trauma.

The study also discovered that a strong initial response to the films significantly predicted the development of PTSD symptoms. This suggests marked individual differences in how people initially respond to traumatic experiences, which could open up the possibility of tailored support for those identified as being at higher risk of developing PTSD symptoms.

Dr Victoria Pile, lead author from the IoPPN at King's College London, said: 'Although most people will experience a traumatic event in their lifetime, almost all will recover over time from the post-traumatic stress symptoms that initially develop. However, nine per cent will go on to develop PTSD. Our findings have important implications for identifying those at risk as well as for designing novel early interventions to prevent the development of PTSD.

'This research implies that finding out what actually happened as soon as possible after the trauma might change the way the memory is stored and so limit the devastating effects of PTSD. It could be particularly relevant for groups regularly exposed to trauma, such as emergency service workers, military personnel and journalists in conflict zones, who have higher rates of PTSD and for whom there are currently no established interventions to prevent the development of PTSD.'

Dr Jennifer Wild, a co-author from the University of Oxford, said: 'The updating approach is painless and carries no harmful side effects. With this approach the brain appears to re-encode the traumatic memory with new information, making the memory less frightening and less likely to be triggered in the future.'

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For a copy of the paper or interview, please contact Jack Stonebridge, Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King's College London jack.stonebridge@kcl.ac.uk/ (+44) 020 7848 5377

About King's College London: http://www.kcl.ac.uk

King's College London is one of the top 20 universities in the world (2014/15 QS World University Rankings) and among the oldest in England. King's has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide, and nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £600 million.

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.

King's fundraising campaign - World questions|King's answers - created to address some of the most pressing challenges facing humanity has reached its £500 million target 18 months ahead of schedule. The university is now aiming to build on this success and raise a further £100 million by the end of 2015, to fund vital research, deliver innovative new treatments and to support scholarships. The campaign's five priority areas are neuroscience and mental health, leadership and society, cancer, global power and children's health. More information about the campaign is available at http://www.kcl.ac.uk/kingsanswers.

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