Consistency of Written Trauma Narratives Over a Course of Trauma-Focused Therapy

Several of the procedures commonly used in trauma-focused therapies are similar to techniques that have been shown to influence the consistency and accuracy of memory in experimental settings. These techniques include verbalizing a non-verbal memory, repeatedly recalling an event, and recalling an event in the presence of another person. In an effort to examine the impact of such techniques on memory for a traumatic event, and in turn the impact of traumatic memory change on treatment outcome, the present study examined changes in written trauma narratives created over the course of trauma-focused therapy. Participants were PTSD-positive female survivors of interpersonal assault (N = 41). Specific hypotheses predicted that participants who produced five written narratives would demonstrate greater increases in trauma-specific detail, more inconsistencies with respect to trauma details, and greater improvement in psychogenic amnesia than those participants who produced two written narratives. Results did not support these primary hypotheses and instead indicated that narrative length, amount of trauma-specific detail, and self-assessed ability to remember important aspects of the trauma did not change significantly from first to final narrative for either narrative condition. Although few factual inconsistencies were detected, qualitative analysis of the narratives revealed that many participants included important trauma related details in the first account but not the final account, or vice versa. Within the 5-narrative condition, narrative change was found to be predictive of PTSD symptom severity such that those participants who added more trauma details in the final narrative had more severe PTSD at post-treatment. Clinical and legal implications are discussed