Intrusive memories as conditioned responses to trauma cues: An empirically supported concept?

Laila K. Franke*, Julina A. Rattel, Stephan F. Miedl, Sarah K. Danböck, Paul Christian Bürkner, Frank H. Wilhelm

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

18 Citations (Scopus)
154 Downloads (Pure)


Intrusions in posttraumatic stress disorder (PTSD) are clinically understood as conditioned responses (CRs) to trauma-cues; however, experimental evidence for this is limited. We subjected 84 healthy participants to a differential conditioned-intrusion paradigm, where neutral faces served as conditioned stimuli (CSs) and aversive film clips as unconditioned stimuli (USs). While one group only completed acquisition, another group additionally received extinction. Subsequently, participants provided detailed e-diary intrusion reports. Several key findings emerged: First, participants in both groups re-experienced not only USs but also CSs as content of their intrusions. Second, intrusions were elicited by cues resembling CSs, USs, and experimental context. Third, extinction reduced probability and severity of US intrusions, and accelerated their decay, and this was particularly the case in participants showing greater cognitive (US-expectancy) and physiological (SCR) differential responding to CS+ vs. CS- at end of acquisition (i.e., conditionability). Similarly, extinction reduced CS-intrusion probability and severity, but only in participants with greater cognitive conditionability. These results support conditioning's role in re-experiencing in two critical ways: (1) Conditioning during trauma provides cues that not only function as reminder cues, but also as content of intrusions; (2) After strong conditioning, weakening the original CS-US relationship via extinction reduces intrusion formation after analogue-trauma.

Original languageEnglish
Article number103848
Number of pages27
JournalBehaviour Research and Therapy
Publication statusPublished - Aug 2021
MoE publication typeA1 Journal article-refereed


  • Exposure therapy
  • Extinction
  • Imagery
  • Intrusive memories
  • Pavlovian conditioning
  • Posttraumatic stress disorder
  • Trauma film


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