Complexity of trauma narratives as an index of fragmented memory in PTSD: a critical analysis

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Abstract
PTSD researchers and clinicians report observing fragmented and disorganized trauma memories (FDTM) in interviews with PTSD patients and more coherent, organized, and detailed trauma narratives as treatment progresses. Some hypothesize a causal role for FDTM in developing and/or maintaining PTSD symptoms. Operationally defining FDTM is difficult, but a recent study used Flesch reading formulas to gauge narrative complexity and articulation in FDTM. We evaluated the validity of this method by comparing written trauma narratives of 58 undergraduates with and without PTSD on word counts and articulation complexity. Additional narratives on unpleasant and pleasant experiences tested the specificity of group differences. Large initial effect sizes disappeared when writing skill and cognitive ability were controlled suggesting Flesch analyses may not be useful. Furthermore, trauma narrative lengths exceeded those of other memories for both groups, which is inconsistent with FDTM predictions. Most studies supporting FDTM have used oral accounts which we hypothesize may provoke more anxiety than written accounts and thereby produce more fragmented and disorganized narratives. Copyright © 2001 John Wiley & Sons, Ltd.

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