The role of stress during memory reactivation on intrusive memories

Intrusive memories are unwanted recollections that maintain distress in psychological disorders. Increasing evidence suggests that memories that are reactivated through retrieval become temporarily vulnerable to environmental or pharmacological manipulation, including changes in levels of circulating stress hormones. This study investigated the influence of stress during memory reactivation of an emotionally arousing trauma film on subsequent intrusive memories. Three groups of participants (N=63) viewed a trauma film depicting a serious car accident at baseline. Two days later (Time 2), one group received a reactivation induction following a socially evaluated cold pressor test (SECPT; Stress/Reactivation condition), whilst the second group reactivated the memory after a control procedure (Reactivation condition). A third group underwent the SECPT but was not asked to reactivate memory of the trauma film (Stress condition). Two days later (Time 3), all participants received a surprise cued memory recall test and intrusions questionnaire which they completed online. Results showed that those in the Stress/Reactivation group had higher intrusions scores than the other two groups, suggesting that acute stress promotes intrusive memories only when the memory trace is reactivated shortly afterwards. Increased cortisol predicted enhanced intrusive experiences in the Stress/Reactivation condition but not in the other conditions. This pattern of results suggests that acute stress during the reactivation of emotional material impacts on involuntary emotional memories. These findings suggest a possible explanation for the mechanism underlying the maintenance of intrusive memories in clinical disorders.