Words and images: the effects of verbalization and imagery on intrusions following trauma

Intrusive memories represent a core symptom of posttraumatic stress disorder (PTSD). Accordingly, experimental and clinical research has strongly focused on advancing our understanding of intrusions and, in turn, on developing approaches to reduce them, with visual and verbal processes emerging as key targets in this context. This narrative review presents an overview of both visual and verbal approaches aiming at manipulating intrusion frequency. Specifically, tasks are described that either facilitate or interfere with verbal or visual processes, and core results of these manipulations are summarized. Overall, results showed that facilitating verbal processes can reduce the intrusion frequency, while facilitating visual processes can lead to both increases and decreases in intrusions. Visual interference tasks can also reduce intrusions, however the specific task used appears to be important. Studies on verbal interference tasks, however, present a rather heterogenous picture. Based on these results, possible mechanisms underlying reductions or increases in intrusions in response to these tasks are discussed, including (re)consolidation, rumination, and (re)appraisal. In addition, suggestions for future (mechanism-driven) clinical and experimental research are presented.