Thinking of attachment security can reduce arousal, and arousal has been shown to modulate memory reconsolidation. We investigated the effect of priming attachment security during reactivation of a distressing memory. We hypothesized that attachment priming would result in less frequent, distressing, and vivid subsequent intrusive, distressing memories. Seventy-one participants viewed a traumatic film and recorded the frequency, distress, and vividness of subsequent intrusive memories for the following week. The day after initial consolidation, the memory was reactivated before presentation of either an attachment or a positive nonattachment control prime. The attachment prime reduced the vividness and distress of intrusions during the ensuing week. These effects were stronger for participants with less avoidant attachment tendencies, suggesting that the reconsolidating effect of attachment priming is stronger for those with secure attachment systems. Thinking of attachment figures during reactivation of distressing memories may decrease the distressing nature of subsequent intrusive memories.

Laboratory procedures have been used for decades as analogues for clinical processes with the goal of improving our understanding of psychological treatments for emotional disorders and identifying strategies to make treatments more effective. This research has often focused on translation from the laboratory to the clinic. Although this approach has notable successes, it has not been seamless. There are many examples of strategies that work in the laboratory that fail to lead to improved outcomes when applied clinically. One possible reason for this gap between experimental and clinical research is a failure to focus on translation from the clinic to the laboratory. Here, we discuss potential benefits of translation from the clinic to the laboratory and provide examples of how this might be implemented. We first consider two well-established laboratory analogues (extinction and cognitive reappraisal), identify critical aspects of the related clinical procedures (exposure and cognitive restructuring) that are missing from these analogues, and propose variations to better capture the clinical process. Second, we discuss two clinical procedures that have more recently been brought into the laboratory (eye-movement desensitization and reprocessing and imagery rescripting). We conclude by highlighting potential implications of this proposed shift in focus for translational research.

Simultaneous execution of memory retrieval and cognitively demanding interventions alter the subjective experience of aversive memories. This principle can be used in treatment to target traumatic memories. An often-used interpretation is that cognitive demand interferes with memory reconsolidation. Laboratory models applying this technique often do not meet some important procedural steps thought necessary to trigger reconsolidation. It remains therefore unclear whether cognitively demanding interventions can alter the reconsolidation process of aversive memories. Here, 78 (41 included) healthy participants completed an established 3-day threat conditioning paradigm. Two conditioned stimuli were paired with a shock (CS+???s) and one was not (CS-). The next day, one CS+???(CS+???R), but not the other (CS+), was presented as a reminder. After 10??min, participants performed a 2-back working memory task. On day three, we assessed retention. We found successful acquisition of conditioned threat and retention (CS+???s???>???CS-). However, SCRs to the CS+???R and the CS+???during retention did not significantly differ. Although threat conditioning was successful, the well-established cognitively demanding intervention did not alter the reconsolidation process of conditioned threat memories. These findings challenge current views on how cognitively demand may enhance psychotherapy-outcome.

Additional file 1: Other pre-specified outcomes and additional assessments. Secondary and other pre-specified outcome description: results. Table S1. Additional baseline characteristics. Table S2. Secondary and other pre-specified outcomes across all time points. Table S3. Number of Adverse Events. Table S4. Types of Adverse Events. Table S5. Subjective Units of Distress. Table S6. Diagnostics for the multiple imputation. Table S7a. Number of intrusive memories for complete and Table 7 b for incomplete diary data. Figure S1. Time course of the number of intrusive memories day-by-day. Table S8. Breakdown of the category’other’ in the type of trauma. Table S9. Number of prior psychological traumas per category. Table S10. Coping categories based on free text responses assessed at baseline. Table S11-S15. Sensitivity analyses. Table S16. Primary endpoint by gender. Table S17. Primary endpoint by age. Table S18. Acceptance and feasibility measure. Table S19. Assessments related to procedure. Table S20. Time since traumatic events leading to intrusive memories. Procedure-related changes during the study.

Additional file 1: Other pre-specified outcomes and additional assessments. Secondary and other pre-specified outcome description: results. Table S1. Additional baseline characteristics. Table S2. Secondary and other pre-specified outcomes across all time points. Table S3. Number of Adverse Events. Table S4. Types of Adverse Events. Table S5. Subjective Units of Distress. Table S6. Diagnostics for the multiple imputation. Table S7a. Number of intrusive memories for complete and Table 7 b for incomplete diary data. Figure S1. Time course of the number of intrusive memories day-by-day. Table S8. Breakdown of the category’other’ in the type of trauma. Table S9. Number of prior psychological traumas per category. Table S10. Coping categories based on free text responses assessed at baseline. Table S11-S15. Sensitivity analyses. Table S16. Primary endpoint by gender. Table S17. Primary endpoint by age. Table S18. Acceptance and feasibility measure. Table S19. Assessments related to procedure. Table S20. Time since traumatic events leading to intrusive memories. Procedure-related changes during the study.