Cross-Cultural Validation of Manual and Automated Methods for Extracting Trauma Memory Features and Predicting PTSD...

Cognitive models of post-traumatic stress disorder (PTSD) propose that traumatic events are encoded in fragmented, sensory-rich, and poorly contextualised memories that maintain PTSD symptoms. Although this hypothesis has received support in adults, evidence in children and adolescents remains limited, methodologically heterogeneous, and largely restricted to high-income, English-speaking settings. We pooled data from 407 children and adolescents exposed to trauma (6-17 years) recruited from emergency departments in South Africa and the United Kingdom. A month after their traumatic experience, participants were asked to recall their traumatic event and completed self-report measures of trauma memory quality and PTSD symptoms. Trauma narratives were transcribed, and indices of coherence and sensory valence were derived using three narrative-based approaches. We examined the validity of narrative-derived indices with self-reported memory quality, their associations with concurrent PTSD symptoms, and whether these patterns varied across cultural context and age. Across both cultural contexts, self-reported trauma memory qualities were significantly associated with PTSD symptoms. By contrast, narrative-derived indices showed no convergence with the corresponding self-report measures and did not meaningfully predict PTSD symptoms. Limited age-related differences were observed: in the South African sample, self-reported trauma memory characteristics were associated with PTSD only among older youth, whereas in the UK sample, they were predictive across age groups. In children and adolescents exposed to trauma, commonly used narrative-based indices of memory disorganisation and sensory content have no construct validity nor clinical utility for predicting PTSD. In contrast, self-report measures of trauma memory features emerge as a reliable and cross-culturally valid indicator of PTSD symptomatology.