This document summarizes a research study on post-traumatic stress disorder (PTSD) and repressed memories. The study aims to determine if women with repressed or recovered memories of childhood sexual abuse exhibit the same brain abnormalities as those with PTSD. Participants include women with repressed, recovered, or continuous memories of abuse, as well as a control group. Participants complete questionnaires and interviews and undergo MRI brain scans. The study predicts that women with repressed or recovered memories who meet PTSD criteria will show similar brain abnormalities to those with PTSD, such as reduced hippocampal volume.

1. Running head: POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 1
Post-Traumatic Stress Disorder, Repressed Memories and Abnormalities in the Brain
Elizabeth Wolf
Lynn University

2. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 2
Abstract
Post-Traumatic Stress Disorder, Repressed Memories and Abnormalities in the Brain
Sufferers of post-traumatic stress disorder due to the trauma of deceptive memories, or
false memories, can cause the patient great distress even though a real traumatic event did not
happen it doesn’t mean that those feelings of distress aren’t real to that person, in fact those
feelings are very real. The participants of the perspective experiment are adult women who have
repressed, recovered, and continuous memories of being sexually abused as a child were divided
into clinical, subclinical, and control groups. The participants must meet our definition of sexual
abuse, “Sexual abuse involved physical sexual contact ranging from fondling to penetration (e.g.,
anal, oral, vaginal) occurring prior to the participant's sixteenth birthday. The perpetrator had to
be at least 5 years older than the participant” (McNally, 2006, 238). These participants went
through a vigorous process of questionnaires, interviews, the MMPI hysterics scale, and MRI’s
to determine whether the same abnormalities in the brain would be present as a PTSD sufferer.
More research is needed to determine if recovered memories and repressed memories are
eventually going to be accepted by the APA.

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Sexual abuse of children depicts a considerable problem in our society because, “women
who had been abused as children, as compared to those who had not been abused as children,
were more likely to present in the emergency room with problems involving drug abuse, sex,
suicidal ideation, suicide attempts, and severe personality disorder, especially Borderline
Personality Disorder” ( Reisner, 1996, 1). Neuropsychology and neuropsychiatry use brain scans
as a tool to diagnosis and understand mental illnesses. But when they diagnosis an individual
they do not solely use the brain scan they do a clinical history and tests to make sure that
everything matches up, that’s why they call it a tool. The use of brain scans can help see if a
PTSD patient is having abnormalities in the brain and maybe what they can do to counteract that.
“Post-traumatic stress disorder, or PTSD, is an anxiety disorder that affects 7 percent to 8
percent of the population in the United States. It develops after a person experiences a traumatic
event or witnesses something traumatic happening to someone else” (“PTSD”, n.d.). These
events are stressful and outside the normal range of human occurrence. Post-Traumatic Stress
Disorder is a multifaceted condition that involves flashbacks, hyper arousal symptoms, limited
affect, avoidance of people/ places/ things that is a reminder of the event, cognitive impairments
which include trouble recalling certain aspects of the traumatic event, poor autobiographical
memory for recall of positive events in their life, and poor working memory, signifying the
disturbance of some of their neural mechanisms distressing precise brain circuits. In 1980 the
APA officially added PTSD to the DSM, in order to get a diagnosis of PTSD specific criteria laid
out in the DSM IV-TR must be met. According to the DSM IV- TR PTSD is present in
individuals, who present these symptoms and behaviors,
“ Post-traumatic stress disorder: 309.81
A.) person has been exposed to traumatic event in which both are present:

4. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 4
1.) person witnessed, experienced, or confronted an event or events that
involved actual or threatened death or serious injury or threat to physical
integrity to self or others
2.) persons response involved intense fear, helplessness, or horror.
B.) traumatic event is persistently reexperienced in one or more of the following
ways:
1.) recurrent and distressing recollections of event ( images, thoughts, or
perceptions)
2.) recurrent distressing dreams of event
3.) acting or feeling as if the traumatic event were recurring ( reliving the
experience, illusions, hallucinations, dissociative flashbacks
4.) internal psychological distress at exposure to internal and external cues
that symbolize or resemble an aspect of the traumatic event
5.) physiological reactivity to exposure to internal or external cues to
traumatic event
C.) persistent avoidance of stimuli associated with trauma and general numbing
responsiveness, indicated by 3 or more of the following:
1.) effort to avoid thoughts, feelings, or conversations associated with
trauma
2.) avoid activities, places, or people that arouse recollections of trauma
3.) inability to recall an important aspect of trauma
4.) feeling of detachment from others
5.) diminished interest or participation in significant activities

5. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 5
6.) restricted range of affect
7.) sense of foreshortened future
D.) persistent symptoms of increased arousal, indicated by 2 or more:
1.) difficulty falling or staying asleep
2.) irritability or outbursts of anger
3.) difficulty concentrating
4.) hypervigilance
5.) exaggerated startle response
F.) duration of disturbance must last more than 1 month” (First, M. B., MD, 2000,
467-468).
Some of the causes associated with PTSD are rape, sexual abuse, physical abuse, emotional
abuse, soldiers, people who have been assaulted, disasters and people in serious accidents; this is
not a exhausted list of all the possible causes of PTSD. No one exactly knows why some people
develop PTSD and others do not, there are risk factors that makes an individual more prone to
developing this disorder, “Children and adolescents have a higher risk of PTSD than adults, the
longer a traumatic event's duration, the higher the risk that a person will develop post-traumatic
stress disorder, and women are twice as likely to develop post-traumatic stress disorder as men”
(“PTSD”, n.d.). Symptoms of PTSD are physiological and psychological impairments that are
the direct consequence from trauma. Post-traumatic stress disorder is characterized by continual
thinking and reliving of the traumatic experience. PTSD can produce nightmares and flashbacks
where the trauma is repetitively relived, and anxiety when encountered with events or objects
that trigger memories of the event. Treatments for PTSD include Trauma-Focused Cognitive-
Behavioral Therapy and Trauma Systems Therapy which integrates psychopharmacology with

6. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 6
numerous psychotherapeutic techniques. Some medications include clonidine for emotion
regulation and mirtazapine for sleep, but this is not an exhausted list.
“Both of these treatments involve the acquisition of emotional and cognitive coping
skills as well as trauma-processing techniques. The acquisition of coping skills is a
necessary prerequisite for trauma processing, as these skills help to combat much of the
physiological symptomatology in response to traumatic reminders and, over time, allow
for less hesitancy with regard to approaching the trauma. Trauma-processing techniques,
such as the writing of a trauma narrative, enable the adult to process thoughts and
feelings associated with the trauma and begin to ascribe meaning to the traumatic event”
( Kaplow, 2006, 365).
Repressed memories are a controversial issue in the field of psychology, due to the fact
that many people have false memories of a traumatic event happening and then go on to sue the
alleged perpetrator, when in fact these traumatic events never happened. The APA it is not able
to differentiate between true repressed memories from a false memory, without support from
other evidence, since there is not empirical evidence that repressed memories are in fact true
memories. “A repressed memory is a theoretical concept used to describe a significant memory,
usually of a traumatic nature, that has become unavailable for recall, in which a subject blocks
out painful or traumatic times in one's life” (“Repressed memories”, n.d.). According to the
repressed memory theory, repressed memories can be recovered years or decades after the
supposed event, but this is not always the case, repressed memories are unexpectedly, triggered
by a certain smell, taste, or other trigger correlated to the lost memory, this can happen through
suggestion at some point in psychotherapy as well. Along these same lines is recovered memory
therapy, which is used to portray as a wide scope of psychotherapy modalities based on

7. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 7
remembering memories of abuse that had been forgotten by the individual. Many psychologists
believe that these individuals are having false memories brought on by suggestion through
psychotherapy. “Even when patients who decide that their recovered memories are false and
retract their claims they can still suffer post-traumatic stress disorder due to the trauma of the
illusory memories” (“Repressed memories”, n.d.). I hypothesize that, if a person with repressed
memories exhibits the same behaviors and symptoms as someone who has PTSD, according to
the DSM IV-TR, and remembers the event happening; then when the clinician does a brain scan,
the clinician is going to see the same abnormalities in both brain scans of adults.
The pathophsiology of PTSD are linked to genetics and the environment in which the
individual is immersed in. Reactions to acute stress involve a genetic tendency. Changes in
specific brain systems are directly correlated with early life stress in adult psychopathology.
When childhood stresses are present there is a great chance that there will be long term
alterations in stress reactivity and brain maturity. “Studies have also shown that long-term
neurobiological changes associated with early stress may be influenced by familial/genetic
factors, quality of the subsequent caregiving environment, and pharmacological interventions.
Early traumatic events can lead to a wide range of psychopathological manifestations as well as
into factors associated with vulnerability or resilience” (Jackowski, 2009,6).
The corpus callosum, “contains interhemispheric projections from brain structures
involved in circuits that mediate the processing of emotional stimuli and various memory aspects
core disturbances associated with PTSD. There is a decrease in total white matter brain volume
and has also been reported in adults with chronic, severe PTSD” (Jackowski, 2009, 4). The
hippocampus is, “ gray matter structure of the limbic system that is involved in explicit
(declarative) memory, working memory, and memory for episodic events. The hippocampus is

8. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 8
rich in glucocorticoids receptors and is vulnerable to petrochemical changes. Chronic stress may
affect the hippocampus through excess release of glucocorticoids, corticotropin-releasing
hormone, and glutamate, inhibition of neurogenesis, impaired long-term potentiating induction,
inhibition of brain-derived neurotrophic factor (BDNF), and alteration in serotonergic receptor
function” ( Jackowski,2009, 3). Adults who have encountered sexual abuse as a child have a
reduced volume in their hippocampus. In cases of severe trauma stress hormones that damage the
hippocampus and other correlated areas of the brain and over time patchy reminiscences of the
traumatic event appear. The Hippocampus size is positively linked with the age the trauma took
place and psychopathology severity especially when it came to the externalizing of Posttraumatic
Stress Disorder behaviors or symptoms. These decreases can be seen in MRI scans of
individuals who a sexual abuse history.
When sexual abuse happens recurring times in childhood there is harm done to the brain
composition that helps coordinate memory.
“According to Freyd's (1996) betrayal trauma theory, children abused by a
caretaker are more likely than those abused by a noncaretaker to
experience amnesia for their CSA. Freyd has maintained that children
abused by caretakers are confronted with a seemingly senseless situation:
The perpetrators are the same individuals on whom they must rely for
shelter, food, and clothing. To resolve this conflict, the children maintain
the necessary bond to the perpetrators by blocking out memories of the
abuse. If we assume that participants were more dependent for caregiving
on parental perpetrators than on other perpetrators (e.g., priests, neighbors,
uncles), then Freyd's theory predicts that parents and stepparents should be

9. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 9
identified as perpetrators more often in the recovered memory group than
in the continuous memory group” (McNally,2006, 238).
When undergoing stress or trauma the declarative, explicit, and implicit memory systems
become unfasten, these memory systems are usually greatly coordinated. When this uncoupling
happens sensory and affective rudiments become dissociated from any rational semantic memory
system. “The conscious result of this uncoupling is to feel a certain way without knowing why.
Because these memories continue to exist, even in an unintegrated form, they continue to
influence emotion and behavior. Situationally accessible memories cannot be accessed
deliberately, but resurface automatically when the individual is confronted with a
situation/context that has physical features or meaning similar to those of the trauma” (Kaplow,
2006, 369). These individuals that have undergone trauma use a defense mechanism of denial to
block out memory of the traumatizing event.
“The defense mechanism of denial (keeping threatening external information
from entering the conscious cognitive system) versus the defense mechanism of
repression (banishing from consciousness information which has entered
consciousness or which threatens to enter consciousness from the unconscious).
This threatening information must first enter the cognitive system (probably at an
unconscious level) in order to later be "denied." Whether perceptual defense
operates primarily via denial or primarily through repression, in either case
information which has entered the system has been kept from consciousness”
(Reisner,1996,3).

10. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 10
To keep these memories at bay trauma victims may dissociate where there is a change in
consciousness that is induced by panic, “absorption in one's thoughts to the exclusion of the
external world, feelings of detachment from one's body or self, and memory lapses” (Bower,
1995, 1). Empirical evidence has shown that long term memory is matter that is prone to
distortions or alterations on the basis of experience.
Method
Participants:
All participants were recruited from a women’s health clinic. Where the first requirement
to participate in this experiment is that you must be a woman who has encountered abuse as a
child or have memories of being abused, whether they are recovered memories does not matter.
There will be a repressed memory group, recovered memory group, continuous memory group,
and finally a control group. The repressed memory group encompassed women who have alleged
non accessible memories of abuse, but still displayed symptoms and behaviors of PTSD. The
recovered memory groups are individuals who state recalling memories of abuse after a period of
time, and show symptoms and behaviors of PTSD. The continuous memory group are women
who never forgot their abuse and display PTSD symptoms and behaviors, and the control group
encompass women who have never been abused.
Materials:
The materials that are needed for this experiment are as follows; - Dissociative
Experiences Scale, which tapped dissociative symptoms, Absorption Scale, which tapped
proneness to become engaged in imaginative experiences—a correlate of fantasy proneness,
Vividness of Visual Imagery Questionnaire, which served as a measure of imagery ability, Beck

11. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 11
Depression Inventory, which measured depressive symptoms, Short form of the Manifest
Anxiety Scale, which measured trait anxiety, Shipley measures of verbal and nonverbal cognitive
ability, and a magnetic resonance imaging (MRI) machine, to observe abnormalities in the brain.
Procedure:
Behavioral scientists will use questionnaires to assess psychological distress and
personality. The second procedure will be a series of interviews to, “elucidate the character of
their abuse memories (e.g., kind of abuse, relationship to perpetrator) and to determine whether
they qualified for PTSD or depression” (McNally, 2006, 238). The interviews will be designed
to see if they qualify for PTSD according to the DSM, the PTSD symptom scale Interview will
be used, a clinical Interview for DSM IV, and participants will be assessed for Axis I mental
disorders. After going through the questionnaires and the interviews the participants who meet
all criteria will be given an MRI to determine if they have abnormalities in their brain.
Predicted results
Structural MRI has been successfully used to study the neural basis of PTSD”
(Jackowski, 2009, 5). MRI’s have referred to the fact that contact with severe emotional trauma
can cause changes in brain structure. This suggests that women who have the smallest
hippocampal volume tend to score higher on the standard dissociation scale. When comparing
women who have repressed memories, recovered memories, and continuous memories the
women who have never forgotten their abuse were identical to women who had never been
abused on depression, posttraumatic stress, dissociation, personality, and who are negative
emotionally. Although the repressed memory group will tend to state more distress and score

12. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 12
higher than the recovered memory group and the continuous memory group. The repressed
memory group will also state more anxiety and dissociative symptoms and depression than the
other groups. Although the continuous, recovered, and repressed groups scored higher on
amnesia, absorption, derealization, and depersonalization than the control group did on all these
factors.
The “False memory perspective implies that participants reporting either
repressed or recovered memories of CSA should score higher than those reporting
continuous memories on measures empirically or theoretically linked to false
memory formation, but , inconsistent with the prediction that the repressed and
recovered memory groups would score higher than the continuous memory group
on absorption (related to fantasy proneness), all three of these groups were
statistically indistinguishable; however, they did score higher than the control
group” (McNally, 2006, 240).
Behavioral neuroscientists have revealed that a release of stress hormones throughout
extremely negative emotional events can reinforce memory for the experience, and this
course may cause the memorability of the trauma.
Discussion
The participants in this study might skew the results due to the fact that, “individuals who
meet researcher-defined criteria for having been sexually abused may reject the label of sexual
abuse survivor because they regard it as stigmatizing. However, members of our repressed
memory group embraced the label of abuse survivor despite not having any memories of abuse.

13. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 13
Finally, rejection of the victim identity may signify psychological resilience rather than stigma
avoidance” (McNally, 2006, 241).
And even though the controversy of false memories and repressed memories is about the fact
that, “those experienced as overwhelmingly terrifying and perceived as life threatening—are
seldom forgotten by victims” (McNally, 2006, 237). It doesn’t matter unless the individual who
is having the false memories is bringing the perpetrator to court for alleged abuse. Once these
individuals, who have repressed memories, have memories of abuse the stress hormone will still
be released and decrease the size of the hippocampus leaving them vulnerable to PTSD
symptoms, just like individuals who meet the DSM IV-TR criteria for PTSD. Individuals who
have repressed memories still experience PTSD symptoms, therefore those memories are very
real to them and the symptoms they experience are as well. Even though the memories of these
individuals might be false, physicians shouldn’t deny them of a PTSD diagnosis, because to the
individual it is very real and distressing in every aspect of their life.

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References
Bower, B. (1995). Child sex abuse leaves mark on brain. Science News, 147(22), 340. Retrieved
from Academic Search Premier database.
First, M. B., MD., et al. (2000). Posttraumatic Stress Disorder. In Anxiety Disorders (Vol. DSM
IV-TR, pp. 463-468). Arlington, VA: American Psychiatric Publishing.
Jackowski, A., de Araújo, C., de Lacerda, A., de Jesus Mari, J., & Kaufman, J. (2009).
Neurostructural imaging findings in children with post-traumatic stress disorder:
Brief review. Psychiatry & Clinical Neurosciences, 63(1),1-8. doi:10.1111/
j.1440-1819.2008.01906.x.
Kaplow, J., Saxe, G., Putnam, F., Pynoos, R., & Lieberman, A. (2006). The Long-Term
Consequences of Early Childhood Trauma: A Case Study and Discussion.
Psychiatry: Interpersonal & Biological Processes 69(4), 362-375.
Retrieved from Academic Search Premier database.
McNally, R., Perlman, C., Ristuccia, C., & Clancy, S. (2006). Clinical characteristics
of adults reporting repressed, recovered, or continuous memories of childhood
sexual abuse. Journal of Consulting and Clinical Psychology, 74(2), 237-242.
doi:10.1037/0022-006X.74.2.237.
Post-traumatic stress disorder (PTSD) (n.d.). Retrieved on May. 11, 2010 from
www.psychiatric-disorders.com
Repressed memories (n.d.). Retrieved on May. 18, 2010 from

15. POST-TRAUMATIC STRESS DISORDER, REPRESSED MEMORIES 15
http://en.wikipedia.org/wiki/Repressed_memory
Reisner, A. (1996). Repressed memories: True and false. Psychological Record, 46(4), 563.
Retrieved from Academic Search Premier database.