Between happiness and sorrow: Phenomenal characteristics of autobiographical memories concerning war episodes and positive events in the Gaza Strip

Abstract

In the present study, we investigated the characteristics of memories concerning both traumatic events (war-related memories) and positive life events (happy memories) in a group of Palestinian students who were victims of war and military violence. An ad hoc questionnaire was developed to explore differences in how the traumatic and happy events were recalled, both in relation to the actual events experienced and in relation to their phenomenological features in autobiographical memory. Traumatic memories were observed to be richer in sensory characteristics, more vivid, and generally more detailed; the emotions associated with traumatic episodes were more intense and played a key role in recall, as did recurrent thoughts and discussion of events and post-event autobiographical memories. In sum, traumatic memories are more complex than non-traumatic ones given their more sensory and analogical nature, which can also undermine accuracy of recall. The clinical implications of these findings and possible directions for future research are discussed.

Keywords

autobiographical memory eyewitness testimony trauma victims war

Introduction

People living in war-affected zones are at risk of developing trauma-related symptoms, such as post-traumatic stress disorder (PTSD) and other stress-related illnesses. It follows that exposure to episodes of severe conflict affects the cognitive functioning of adults and children (Attanayake et al., 2009; Ayazi et al., 2014; Bentley et al., 2011; Bronstein and Montgomery, 2011; de Fouchier et al., 2012; Dimitry, 2012; Manzanero et al., 2017; Mollica et al., 2014; Stanciu and Rogers, 2011; Thabet and Sultan, 2016; Vinson and Chang, 2012). PTSD is characterized by intrusion (flashbacks, dreams or recurrent feelings), avoidance (efforts to avoid thoughts, feelings, memories, places or people associated with the event), negative thoughts or feelings that began with or worsened after the trauma (inability to recall key features of the trauma, overly negative thoughts or assumptions about oneself or the world …), arousal and reactivity (insomnia, irritability, or outbursts of anger) (American Psychiatric Association (APA), 2013).

One of the factors that can have the greatest impact on memory is event-related stress (Kim and Diamond, 2002; McEwen, 2000). Indeed, memories appear to be influenced by the subject’s emotion intensity and degree of involvement (Vallet et al., 2017). Individuals who have been exposed to high-intensity stress display impaired explicit and implicit memory in relation to the traumatic sequence of events they have undergone (Rubin et al., 2008). A range of studies have identified both everyday memory problems and specific memory impairments in individuals diagnosed with PTSD (Moradi et al., 1999, 2008; Yehuda et al., 1995). While some authors have reported that psychogenic amnesia may be associated with traumatic experience (Carelli, 2015; Van der Kolk et al., 2001), most scholars have not found evidence of dissociative memory in cases of violent trauma (Freyd et al., 2010; Lindblom and Gray, 2010; Pope et al., 1998). Rather, it has been proposed that PTSD is a memory-based disorder (Rubin et al., 2008). Thus, symptoms are determined by memories of the traumatic event, to which access may be partly involuntary (Berntsen and Hall, 2004) depending on how they were encoded in the first place (Tulving and Thomson, 1973).

In this regard, researchers have found that the traumatic memories of clinical-referred patients differ from those of non-clinical individuals in that their perceptual features are more prominent, they are often highly emotional, and they provoke intense reliving of the traumatic events (Berntsen et al., 2003; Ehlers et al., 2002; Van der Kolk et al., 2001).

Brewin (2007) summarized the controversy surrounding traumatic memories into the following main points: (a) are these memories different from other types of autobiographical memory in terms of “dissociation” from conscious awareness and voluntary control? (b) are traumatic memories more or less accurate than memories of non-traumatic events? and (c) may these memories be completely forgotten and retrieved long after?

A number of studies have shown that traumatic memories display different features to other autobiographical memories. A recent review of research on the recall and narration of traumatic events found that trauma narratives are dominated by sensory/perceptual and emotional details (Crespo and Fernández-Lansac, 2016). Within this framework, two different theories have been proposed: (a) memories of traumatic events are more accurate and detailed than neutral memories and (b) memories of traumatic events are associated with memory deficits (Manzanero and Recio, 2012).

In relation to the first theory, several studies have highlighted the apparent accuracy of reports of traumatic events. For example, Peace and Porter (2004) have shown that traumatic events are remembered better than non-traumatic events 3 months after they occur Peace et al. (2008) found, by comparing memories of sexual assault and non-traumatic events, that the former were more vivid, detailed and sensory than the latter. Fernández-Lansac and Crespo (2017) found that memories of traumatic experiences in abused battered women were more detailed and spatially oriented than positive memories.

In addition, it has been found that traumatic episodes are recalled more consistently over time than non-traumatic events. Core details can be remembered more clearly and accurately (Manzanero et al., 2015; Schmidt, 2004; Schönfeld and Ehlers, 2017; Segovia et al., 2017), and irrelevant details less accurately than for other autobiographical memories.

However, Chung et al. (2014) found that women victims of domestic violence with PTSD displayed less accurate recall for core details and similar levels of recall for minor details, compared to a control group. Schaefer and Philippot (2005) found that memories of emotional events were more vivid than memories of neutral events, but no more specific. In addition, negative emotional memories featured less sensory, spatial, and temporal detail than positive memories. Similarly, memories of positive facts contained more temporal and sensory information than memories of negative events.

In keeping with these last findings, some authors claim that memories of trauma are less accurate and detailed than autobiographical memories of other kinds of event, because they are often recovered in a fragmented fashion (Byrne et al., 2001; Kihlstrom, 1996; Neisser and Harsch, 1992; Southwick et al., 1997; Yuille and Cutshall, 1986). In addition, traumatic memories are difficult to express in narrative form, but may be associated with intense sensory feelings (smell, hearing, touch, etc.), and are very visual (Herman, 1992; Van der Kolk, 1996). It has even been proposed that these memories may be associated with episodes of amnesia, especially when extreme emotions, such as those that elicit crimes of passion, are involved (Yuille and Cutshall, 1986). Amnesia is often physical in origin, as, for example, when alcohol has been taken (Baddeley, 2009).

The hypothesis that memories of traumatic events are fragmented and disorganized is also borne out by experimental and clinical studies of PTSD, whose symptoms reflect this type of fragmented memory (Cottencin et al., 2006; Nemeroff et al., 2006). Symptoms of fragmentation and disorganization include selectively forgetting the details of the event on the one hand, while vividly and persistently remembering other aspects of it in the form of flashbacks.

We may consider different possible reasons for these discrepancies among research findings. First, the object of study varies from one investigation to another: If researchers see trauma as defined by its psychological effects on victims, they will tend to focus their analysis on the proposed differences between traumatic and non-traumatic memories (Wittekind et al., 2017). If, on the other hand, their definition of trauma rests on the intrinsic characteristics of the agents that caused it, then they will tend to seek similarities between traumatic memories and other kinds of memory. However, trauma is less defined by the facts that give rise to it than by the physical or psychological effects it has on the victims. It exceeds the individual’s ability to tolerate and process events, generating strong emotions and disrupting habitual coping strategies (Briere and Scott, 2015). An attack, a car accident or a tsunami may or may not be traumatic, depending on the psychological effects they unleash (Wilson, 1989). In this way, higher prevalence levels of PTSD are found in people who are exposed to specific conditions characterized by assaults on their personal integrity. The trauma types with highest potential for PTSD development, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, are rape (13.1%), other sexual assaults (15.1%), being stalked (9.8%), and the unexpected death of a loved one (11.6%) (Kessler et al., 2017). Nonetheless, some accept the view that such events are traumatic merely by virtue of the fact that they pose a threat to personal integrity. Regardless of a study’s focus, when analysing it, the first thing we need to take into account is the conception of trauma underpinning it, with a view to explaining apparently conflicting findings about traumatic memories (Bedard-Gilligan et al., 2017; Schönfeld and Ehlers, 2017). Mounting neurobiological evidence may also contribute to explaining the broad variability of these findings: more specifically, individual levels of neuroendocrine responsiveness, perceived control and genetic predisposition can modulate intensity of symptoms and prognosis (Miller and Wiener, 2014; Van Rooij et al., 2016; Wilker et al., 2014).

In other way, traumatic memories vary across cultures, and result to be culture-related constructs. For example, researches carried out in South America, showed as within communities that are promoting collectivist interactions such as villages in rural Perú, traumatic memories after violent episodes of guerrilla were not repressed as a result of an individual breakdown, but as Summerfield (1999) found studying an Ethiopian context, an ‘active collective forgetting’ for controlling and reducing individual suffering. On the opposite, individualistic South American communities in Colombia were valuing more subjective recall of traumatic memories (Elsass, 2001). Consequently, the perception and quality of the recall can be subjected to cultural influences, varying in accordance with socio-cultural contexts and historical periods (e.g. peace and war, circumscribed difficult times versus continuous social suffering, etc.) (Fivush and Saunders, 2015). Recalling must be considered a cultural and social activity. In a study about memories on 9/11, Fagin et al. (2013) describe how recalls about this tragic event changed quite dramatically over the first 2 years after the disaster and then stabilize around a canonical socially informed narrative showing how cultural and social interactions may provide frameworks for how to understand important events in the community that reshape individual memory. The case of Palestine can be considered quite peculiar. The Palestinian ongoing social suffering is lasting since at least 70 years. Since 1948, communities are enduring constant and cyclical traumatic experiences that are pervasive of the individual and collective narratives as well. Some traumatic events are transmitted generationally under the umbrella of the Palestinian catastrophe (the Al-Nakbha), while passing through popular uprisings (I and II Intifadas), until the today siege on Gaza and periodical attacks by the Israeli defence force, individual lives are undermined by traumatic and violent episodes (Nur, 2008). Individual memories are the source of collective memories, and both are biased by different factors such as gender, political ideas, religion (Sayigh, 1998) or media technology (Allan, 2005). Macro and micro narratives on the chronic trauma are coexisting and most probably influencing interactively individual memories on traumatic events. Individually, the victims’ memory of war seems to focus on sensory experiencing, most often unorganized, fragmented and painful (Peltonen et al., 2017), while more contextual information is permeating the collective memory of trauma characterizing the Palestinian lives (Afana et al., 2018). This oscillation between individual and collective features of the earliest memories after trauma are confirmed by Peltonen and colleagues in the study carried out in Gaza with children affected by war and trauma.

In any case, such different perspectives on the characteristics of traumatic memories imply the need for caution in generalizing about how traumatic events are remembered. It seems reasonable to conclude, in light of the research evidence, that the same traumatic event may either be consistently and vividly remembered, or in contrast, generate fragmented recall, or not be remembered at all (Crespo and Fernández-Lansac, 2016). A better understanding of the factors underpinning these outcomes is required to explain differences between traumatic memories and neutral autobiographical memories.

In this article, we present an exploratory case study, using data collected from a group of non-clinical participants who had been exposed to war and episodes of conflict. The research was informed by a previous study conducted in the Gaza Strip in autumn 2009 soon after the Israeli offensive known as ‘Operation Cast Lead’, in which both negative and positive low-intensity memories were evaluated in university students (Manzanero et al., 2015). The results showed that memories of negative events were more confusing, more complex, and more impaired than positive memories.

The Palestinian traumatic reality must be inscribed in a continuous and prolonged intractable conflict lasting since the foundation of the State of Israel in 1948 (Giacaman, 2017). Even if it is essential to acknowledge the uniqueness of the Israeli/Palestinian conflict, than of the Palestinian ongoing trauma and dispossession, we need, on the other hand, to have a glimpse on the extreme traumatic experiences in the Region in the last 10–15 years. Iraq before, Egypt, Libya and Yemen and the ‘Syrian holocaust’ later have been theatre of systematic and continuous violence, discrimination and wars that have undermined individuals and communities over the time (Amawi et al., 2014). The state of the art of clinical research in Middle East suggests that little attention has been paid to the construction and implementation of adapted instruments and the collective nature of trauma in these region. Survivors of the wars in Middle East continue to live in desperate conditions shaping their suffering as collective and social rather than mostly individual and parcelled (Giacaman, 2018). Terror, displacement, death and human insecurity are challenging the current notions of PTSD and complex trauma. Thus, the continuous trauma and daily exposure to life threat are featuring and contributing in construing traumatic realities and memories that cumulatively can produce pathologies and dangers to the survivors psychological well-being (Ottersen et al., 2014).

Given the background just outlined, the aim of our present study was to explore the features of traumatic (war-related) and non-traumatic (happy) memories in a group of non-clinical youth who had been exposed to war and related traumatic experiences. We hypothesized that, compared to recall of happy events (a) war-related traumatic memories would be more vivid, display greater complexity (Rubin et al., 2016), and in general feature more detail than positive memories (H1). On the other hand, we expected that detailed recall of traumatic events would not necessarily amount to a coherent and true-to-life account if underpinned by emotional distress and more informed by sensory than by semantic features (Brewin, 2016) (H2).

Method

Participants

A purposive sample of 207 university students attending the University of Al Azhar-Gaza in the Gaza Strip (Palestine) participated in this study. Their mean age was 22.72 years (SD = 5.47). Ninety-nine took part in the war-related memories group, 62 women and 37 men, with a mean age of 20.93 years (SD = 3.18). Over 50 days of continuous armed conflict, all participants had been exposed to one or more episodes of war (e.g. bombardment by drones and aircraft, shelling by tanks and navy, gunfire from snipers) (Joronen, 2016). One hundred and eight students participated in the comparison group of memories for happy events, 78 women and 30 men, with a mean age of 24.36 years (SD = 6.52).

Instruments

The Phenomenological Questionnaire for Autobiographical Memory (CCFRA) (Manzanero and López, 2007) was administered to explore the phenomenological features of participants’ war-related and happy memories. This questionnaire is a revised and adapted version of the Trauma Memory Quality Questionnaire (Meiser-Stedman et al., 2007) and the Memory Characteristics Questionnaire (Johnson et al., 1988). Participants were asked to rate the characteristics of autobiographical memories that they had described earlier. The original questionnaire is divided into two main sections. The first section contains eight questions about the features of the event itself (e.g. duration, when and where the event took place, implications for the respondent, level of significance for the respondent, strength of feelings elicited, whether feelings were positive or negative, and whether the respondent’s role in the event was that of spectator or active participant). The second section comprised 28 questions about the phenomenological characteristics of the memory (sensory and temporal information, vividness, feelings and remembered thoughts, level of detail characterizing the memory).

The instrument was translated from Spanish into Arabic. Then, a pilot study showed that the original 7-point rating scale gave rise to comprehension difficulties. For this reason, the final version used a 5-point Likert-type scale ranging from 1 (totally disagree) to 5 (totally agree). For the four items concerning doubts, remembered thoughts, whether respondents had told others about the traumatic event, and their own perspective on the event, the two-choice answers in the original questionnaire were replaced with 5-point rating scales in the Arabic translation. Finally, additional items were introduced to explore differences between negative and positive memories in relation to temporal and spatial context, delay and fragmentation of recall, difficulty in recalling core details, and episodes of amnesia. In this way, the final questionnaire turned out to contain 36 items in the second section (see Table 2). Psychometric properties of the 36-item questionnaire in the present sample show that Cronbach’s alpha was .823, and inter-item correlation was .129.

Procedure

The experimental design was carried out between-subjects, due to the impossibility of recruiting the same participants for the two conditions, since the data collection was done in two different moments: before and after the war episode of the summer of 2014. Data about positive memories were collected in a period of relative calm in the Israeli–Palestinian conflict from the ceasefire of November 2012 to the summer of 2014. Data about war-related memories were collected over a period of 1 month in October 2015, 1 year after a 50-day war on Gaza that involved intensive bombardment from sky and sea by the Israeli army and a violent ground operation that gave rise to extensive causalities among civilians and considerable damage to infrastructures. During the conflict, nowhere in the Gaza Strip was considered safe (Dawson and Azzam, 2016; United Nation Relief and Work Agency in Middle East, 2014).

All participants were informed about the specific aims of the research and the fact that they were free to withdraw from the study (or not answer particular questions) at any time. All students who were invited to join the study completed the questionnaire. The research was conducted in keeping with APA ethical principles and approved by the Ethics Boards of both the University of Al Azhar-Gaza and the Universidad Complutense de Madrid. Due to cultural resistance to providing written informed consent and widespread insecurity about signing documents that could expose them to Israeli surveillance, participants preferred to provide their formal oral consent to being administered the questionnaire. The questionnaires were administered at the University Al Azhar-Gaza. Participants took between 10 and 15 minutes to complete the questionnaire.

Data analysis

Memories were evaluated via an unifactorial analysis of the variance between groups to identify any statistically significant differences between recall of a traumatic episode (a war-related event that had occurred during summer 2014 in the Gaza Strip) and recall of non-traumatic events.

Results

Table 1 reports the main characteristics of the analysed memories. No significant differences were found between war-related memories and happy memories with regard to the temporal aspects of recall (duration of the event), spatial aspects (familiarity with place where the event took place) and involvement in the recalled event (implications).

Table 1.

Characteristics of recalled events analysed via the CCFRA.

	War-related		Happy		F	p	η ²
	M	DT	M	DT	F	p	η ²
Duration of the events	4.01	1.16	4.06	1.28	0.088	.768	.001
Familiarity with place	4.44	1.08	4.64	0.70	0.900	.344	.006
Implications	4.56	0.76	4.47	0.69	0.640	.425	.004

CCFRA: The Phenomenological Questionnaire for Autobiographical Memory.

Regarding the quality of war-related and happy memories, the associated emotions, and accessibility, a number of differences were identified. Table 2 reports the main differences between the two types of recall item.

Table 2.

Characteristics of traumatic memories analysed via the CCFRA.

		War		Happy		F	p	η ²
		M	DT	M	DT	F	p	η ²
Quality	Definition	4.52	0.77	4.53	0.64	0.017	.895	.000
	Vividness	4.44	0.83	4.34	0.79	0.265	.607	.002
	Detail*	4.23	0.98	3.98	1.08	5.663	.019	.035
	Fragmentation	2.83	1.39	2.61	1.33	0.225	.636	.001
	Comprehension**	4.36	0.98	2.83	1.50	45.335	.000	.224
	Complexity**	3.65	1.25	2.32	1.26	35.359	.000	.184
	Doubts	2.06	1.14	2.02	1.20	0.425	.515	.003
	Recall perspective**	3.66	1.40	3.26	1.36	11.044	.001	.066
	Colour*	3.83	1.26	3.43	1.32	4.835	.029	.030
	Visual Info*	4.17	1.15	3.82	1.27	5.738	.018	.035
	Sound**	4.28	1.21	3.59	1.29	16.861	.000	.097
	Smell**	3.54	1.43	2.40	1.31	23.864	.000	.132
	Haptic info	3.37	1.50	3.30	1.48	0.388	.534	.002
	Taste	2.39	1.46	2.35	1.32	0.002	.966	.000
	Where	4.52	0.97	4.45	0.80	0.388	.534	.002
	Year	4.45	0.87	4.46	0.78	0.017	.897	.000
	Day	4.21	1.08	4.07	1.15	0.511	.476	.003
	Hour	4.22	1.05	4.13	1.16	0.073	.787	.000
Associated emotions	Implications	4.56	0.76	4.47	0.69	0.640	.425	.004
	Valence**	2.24	1.53	4.56	0.78	170.947	.000	.521
	Intensity of feelings	4.31	0.84	4.20	1.03	1.443	.231	.009
	Relevance**	3.95	1.22	4.72	0.68	29.473	.000	.158
	Feeling during event	4.42	0.93	4.50	0.69	2.857	.093	.018
	Feelings now	3.90	1.12	3.69	1.20	1.318	.253	.008
	Thoughts during event	4.11	1.06	3.73	1.28	3.823	.052	.024
Accessibility	Memory impairment	2.78	1.51	2.26	1.26	1.935	.166	.012
	Effort to recall	4.39	0.81	4.22	0.95	1.903	.780	.012
	Intrusions	4.09	0.98	3.99	1.00	0.931	.336	.006
	Amnesia	1.98	1.14	1.92	1.13	0.233	.630	.001
	Problems to talk about	3.26	1.46	3.02	1.40	1.683	.196	.011
	Problems to recall details	2.27	1.23	2.17	1.24	0.078	.780	.000
	Previous events	3.77	1.12	3.51	1.30	1.108	.294	.007
	Post-events**	3.96	1.05	3.63	1.28	9.694	.002	.058
	Recurrent thoughts**	3.88	1.08	3.37	1.35	7.721	.006	.047
	Flashbacks**	2.63	1.41	3.28	1.39	9.564	.002	.057
	Talking about*	4.07	1.12	3.74	1.24	6.546	.011	.040

CCFRA: The Phenomenological Questionnaire for Autobiographical Memory.

Significant at p < .05, ** p < .01.

War-related and happy memories differed in terms of quality of recall. More specifically, traumatic memories featured a greater number of details than happy ones. In addition, participants provided more complex and comprehensible accounts of traumatic memories than they did of happy events; the first type of memories were recovered more from an observer perspective (as if it were a movie) than the second ones, what can be an indicator of dissociation; and participants reported that they recalled colours, sounds, visual information and olfactory stimuli more frequently while remembering war-related episodes.

With regard to implications, there were few differences between the two types of memory. As expected, happy memories were found to be of higher positive emotional valence and greater relevance to the respondents, indicating perhaps that the traumatic memories had been partially emotionally suppressed. No differences emerged in relation to the recall of feelings.

Finally, differences emerged in the ways traumatic versus positive episodes were accessed. Access to traumatic memories appeared to fit with trauma-related signs and symptoms. Specifically, respondents reported accessing traumatic memories via recurrent thoughts, which are part of the intrusion cluster of trauma-related symptoms. Flashbacks recurred more frequently in relation to happy memories than in the recall of war-related events. Thinking about post-trauma life events appeared to elicit recall of the war event, while talking about the event itself tended to elicit other conscious war-related memories.

Discussion

In this study, we compared recall of war-related and happy memories in a group of young Palestinian university students who had experienced high-intensity conflict in summer 2014. The findings seem to partially confirm our hypothesis about the richness and complexity of traumatic memories (H1), while greater fragmentation and incoherence of recall were not fully confirmed, and it was possible to infer lesser accuracy (H2).

Specifically, in our sample, we observed that memories of traumatic events were more detailed and complex than happy memories, albeit confused (El Haj et al., 2016). More specifically, traumatic memories were rich in detail (in the terms of Nahari and Vrij, 2015), thanks in great part to the large number of sensory characteristics that were consciously recalled (MacIntosh et al., 2016). Sensory information appears to be a more important feature of traumatic memory than contextual information (i.e. when and where the fact happened): in our sample, context was no more frequently recalled for traumatic than for happy memories. Surprisingly, flashbacks featured more frequently in the recall of positive events than in that of war-related events, suggesting a form of positive rumination that several studies (Li et al., 2017; Rieck et al., 2005; Sutherland and Bryant, 2007) have suggested play a role in influencing daily mood and depressive symptoms and in coping with traumatic experiences.

In contrast with current opinions about memory and violent trauma, our participants did not display greater difficulty in recalling war events. Contrary to our predictions, neither did they display greater fragmentation and inconsistency in recalling traumatic episodes. Finally, we did not detect levels of intrusion or amnesia that could impair the ability to recall events in a detailed fashion (Brewin, 2016; Rubin et al., 2016).

Indeed, traumatic suffering in our sample appears to be mainly characterized by emotional distress. The picture of traumatic memory that emerges from this study is partially in keeping with Symptoms 1 and 4, Criterion B for diagnosing PTSD in the DSM-5 (APA, 2013). Specifically, Symptom 1 is reflected because war events seem to be associated with recurring memories that contain images, thoughts or perceptions and cause distress. Our participants reported experiencing recurring thoughts about the traumatic event. Psychological distress caused by exposure to internal or external stimuli that symbolized or recalled an aspect of the traumatic event could be inferred from the strong salience and emotional valence of the recalled memories (Symptom 4). Our sample did not report experiencing recurring dreams about the event, nor the consequent distress (Symptom 2), and neurophysiological activation (Symptom 5). Nor were they subject to flashbacks in relation to war-related memory (Symptom 3). In addition, effortful avoidance of thoughts, feelings or discussion about traumatic events had implications for accessing memories of them. In sum, our findings contribute to building up a complex picture of traumatic memory that only partially fits with the DSM-5 diagnostic criteria. War events are likely to be exceptionally well-remembered, mainly thanks to more primitive, less semantic and more sensory characteristics, which are presumably connected with emotional and affectively laden limbic memories (McNally, 2003).

Second, our findings only superficially appear to support evidence that traumatic memories are not impaired but conserve both complexity and coherence, or as Rubin and colleagues have put it, that notion that ‘instead of leading to disintegration, highly emotional and (thus) distinctive events may help to keep the autobiography integrated by forming reference points for the organization of other less distinctive events’ (Rubin et al., 2016: 678). On closer analysis, our results suggest that active traumatic memories, though complex and detailed, are less realistic and more discrepant than positive memories (Brewin and Holmes, 2003). In fact, memories of war are driven by emotional activation and distress that can lead to dramatic changes (and distortions) in one’s life goals, generating uncertainty and incoherence both at individual and relational levels (Ehlers and Clark, 2000).

Considering the three points of controversy pointed out by Brewin (2007), we can affirm that the present study finds partial evidence about differences in terms of dissociation, and a greater quality in traumatic memories compared to non-traumatic memories. However, with the data found we cannot support that traumatic memories present recovery problems, as these memories are more accessible than positive ones.

Some limitations of the present study should be noted. First, the cross-sectional research design does not inform us about the trajectories followed by traumatic memories or how they change over time, or whether they display a linear or curvilinear relationship with severity of traumatic impact or cumulative traumatic experiences. In addition, the small sample size does not allow us to generalize from the research findings. Finally, the absence of formal diagnoses for our sample prevents us from separating clinical from non-clinical individuals. However, an interesting picture has been sketched that requires more in-depth follow-up research using a mixed-method design, and suggests interesting directions to be further explored in relation to the role of memory in war-affected populations.

Concerning the practical implications of the study, our results are of interest in settings other than contexts of war and extreme violence. For example, from the perspective of forensic psychology, the lesson learned from our pilot study is that while traumatic memories can be rich in detail, mainly regarding sensory experience and emotional distress, they also can be inaccurate in terms of reliability and objectivity (Nahari and Vrij, 2015; Otgaar et al., 2017). The complexity and richness of traumatic memories seem to feature more strongly at a primitive (sensory and emotional) level than at the semantic level. Again, our findings may provide useful information about the memory processes of migrants escaping from war and persecution. Those seeking asylum in Western countries need to testify to their history of persecution in front of a mixed national and United Nations High Commissioner for Refugees (UNHCR) commission in order to obtain international protection or refugee status (McKenzie and Thomas, 2017). Accuracy of recall during hearings will determine whether applicants are successful in obtaining asylum (United Nations High Commissioner for Refugees, 2014; Veldhuizen et al., 2017). However, the present findings suggest that instead of evaluating refugees’ testimony exclusively in terms of veracity and coherence of recall, the commission should take into account that the autobiographical memories, and therefore the narratives of asylum seekers have been severely disrupted, causing them significant emotional and cognitive distress, due to the traumatic events that they are escaping from such as violence, war and atrocities (Guarch-Rubio and Manzanero, 2017; Gómez-Varas et al., 2016).

In conclusion, the increased levels of emotionally driven complexity in traumatic memories identified in this study, as well as their sensory, neurovegetative correlates need to be further investigated to shed greater light on their link with PTSD and other trauma-related syndromes. This is even more urgent in relation to populations in environments characterized by the ongoing risk of exposure to trauma and significant cultural implications such as attributions of meaning that can influence memory impairment and, consequently, psychological distress, in war-affected people.

Footnotes

Acknowledgements

We would like to thank the invaluable collaboration of the surveyors that worked in the Gaza Strip and took part in the study.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

This work is part of the research project Assessment of psychological trauma in vulnerable refugees and asylum seekers (children and women), financed by Santander-Universidad Complutense de Madrid (PR75/18-21661).

ORCID iD

Antonio L Manzanero

Author biographies

Antonio L Manzanero, PhD, is Professor of Psychology at Universidad Complutense de Madrid (Spain). Director of UCM Research Group in Eyewitness Testimony. His research focuses on the analysis of memories and other psychological disorders associated to trauma.

Juan Fernández, PhD, is Full Professor of Developmental and Educational Psychology at Universidad Complutense de Madrid (Spain). He has published articles and books on teaching assessment and gender roles and stereotypes.

María del Mar Gómez, PhD, is Professor in Clinical Psychology at the Complutense University of Madrid and a researcher of the UCM Research Group in Victimology. She provides psychological treatment for victims of different traumatic events and has received the European Certificate in Psychology (2013).

Miguel A Álvarez, PhD, is Professor of Neurosciences at the Universidad de La Habana and Researcher at the Institute of Neurology and Neurosurgery (Cuba). Member of the Research Group in Eyewitness Testimony. His research focuses in neurobiology of cognitive processes.

Sofián El-Astal, PhD, is Professor of Psychology at University of Al Azhar-Gaza (Palestine). His research investigates the psychological situation of the population in the Gaza Strip.

Fairouz Hemaid, MS, is School counsellor-MH (Gaza Strip, Palestine). And also is a member of United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).

Guido Veronese, PhD, is a Senior lecturer in Clinical and Community Psychology. He is a family therapist and expert on trauma intervention with extensive experience in war and violence affected zones (Palestine, Iraq, and West Africa). Coordinator of the lab for Psychology and Human Rights at the Department of Human Science and Education ‘R. Massa’, University of Milano-Bicocca in Italy.

References

Afana

Tremblay

Ghannam

, et al. (2018) Coping with trauma and adversity among Palestinians in the Gaza Strip: a qualitative, culture-informed analysis. Journal of Health Psychology. Epub ahead of print 5 July 2018. DOI: 10.1177/1359105318785697.

Allan

(2005) Mythologising Al-Nakba: narratives, collective identity and cultural practice among Palestinian refugees in Lebanon. Oral History 33(1): 47–56.

Amawi

Mollica

Lavelle

, et al. (2014) Overview of research on the mental health impact of violence in the Middle East in light of the Arab Spring. The Journal of Nervous and Mental Disease 202: 625–629.

American Psychiatric Association (APA) (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington, DC: American Psychiatric Publishing.

Attanayake

McKay

Joffres

, et al. (2009) Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, Conflict and Survival 25(1): 4–19.

Ayazi

Lien

Eide

, et al. (2014) Association between exposure to traumatic events and anxiety disorders in a post-conflict setting: a cross-sectional community study in South Sudan. BMC Psychiatry 14(1): 6.

Baddeley

(2009) Autobiographical memory. In: Baddeley

Eysenck

Anderson

(eds) Memory. New York: Psychology Press, pp. 137–162.

Bedard-Gilligan

Zoellner

Feeny

(2017) Is trauma memory special? trauma narrative fragmentation in PTSD: effects of treatment and response. Clinical Psychological Science 5(2): 212–225.

Bentley

Thoburn

Stewart

, et al. (2011) The indirect effect of somatic complaints on report of posttraumatic psychological symptomatology among Somali refugees. Journal of Traumatic Stress 24(4): 479–482.

10.

Berntsen

Hall

(2004) The episodic nature of involuntary autobiographical memories. Memory & Cognition 32(5): 789–803.

11.

Berntsen

Willert

Rubin

(2003) Splintered memories or vivid landmarks? qualities and organization of traumatic memories with and without PTSD. Applied Cognitive Psychology 17(6): 675–693.

12.

Brewin

(2007) Autobiographical memory for trauma: update on four controversies. Memory 15(3): 227–248.

13.

Brewin

(2016) Coherence, disorganization, and fragmentation in traumatic memory reconsidered: a response to Rubin et al. (2016). Journal of Abnormal Psychology 125(7): 1011–1017.

14.

Brewin

Holmes

(2003) Psychological theories of posttraumatic stress disorder. Clinical Psychology Review 23(3): 339–376.

15.

Briere

Scott

(2015) Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment (DSM-5 Update). Los Angeles, CA: SAGE.

16.

Bronstein

Montgomery

(2011) Psychological distress in refugee children: a systematic review. Clinical Child and Family Psychology Review 14(1): 44–56.

17.

Byrne

Hyman

Scott

(2001) Comparisons of memories for traumatic events and other experiences. Applied Cognitive Psychology 15: 119–133.

18.

Carelli

(2015) Dissociative amnesia or psychogenic amnesia as results of war’s shocking events. London Journal of Primary Care 7(4): 78–79.

19.

Chung

Tang

Shie

, et al. (2014) Emotional memory and posttraumatic stress disorder: a preliminary neuropsychological study in female victims of domestic violence. Journal of Psychiatry 17(6): 148.

20.

Cottencin

Vaiva

Huron

, et al. (2006) Directed forgetting in PTSD: a comparative study versus normal controls. Journal of Psychiatric Research 40(1): 70–80.

21.

Crespo

Fernández-Lansac

(2016) Memory and narrative of traumatic events: a literature review. Psychological Trauma: Theory, Research, Practice, and Policy 8(2): 149–156.

22.

Dawson

Azzam

(2016) Interview with Dr. Yasser Abu Jamei: the Gaza community mental health programme. Journal of Palestine Studies 45: 120–126.

23.

de Fouchier

Blanchet

Hopkins

, et al. (2012) Validation of a French adaption of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries. European Journal of Psychotraumatology 3(1): 19225.

24.

Dimitry

(2012) A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East. Child: Care, Health and Development 38(2): 153–161.

25.

Ehlers

Clark

(2000) A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38(4): 319–345.

26.

Ehlers

Hackmann

Steil

, et al. (2002) The nature of intrusive memories after trauma: the warning signal hypothesis. Behaviour Research and Therapy 40(9): 995–1002.

27.

El Haj

Gandolphe

Wawrziczny

, et al. (2016) Flashbulb memories of Paris attacks: recall of these events and subjective reliving of these memories in a case with Alzheimer disease. Medicine 95(46): e5448.

28.

Elsass

(2001) Individual and collective traumatic memories: a qualitative study of post-traumatic stress disorder symptoms in two Latin American localities. Transcultural Psychiatry 38(3): 306–316.

29.

Fagin

Yamashiro

Hirst

(2013) The adaptive function of distributed remembering: contributions to the formation of collective memory. Review of Philosophy and Psychology 4: 91–106.

30.

Fernández-Lansac

Crespo

(2017) Quality of memories in women abused by their intimate partner: analysis of traumatic and nontraumatic narratives. Journal of Traumatic Stress 30(1): 80–87.

31.

Fivush

Saunders

(2015) The social and cultural context of remembering: implications for recalling childhood sexual abuse. Applied Cognitive Psychology 29(6): 843–845.

32.

Freyd

Klest

DePrince

(2010) Avoiding awareness of betrayal: comment on Lindblom and Gray (2009). Applied Cognitive Psychology 24(1): 20–26.

33.

Giacaman

(2017) Social suffering, the painful wounds inside. American Journal of Public Health 107(3): 357.

34.

Giacaman

(2018) Reframing public health in wartime: from the biomedical model to the ‘wounds inside’. Journal of Palestine Studies 47(2): 9–27.

35.

Gómez-Varas

Valdés

Manzanero

(2016) Evaluación demorada de trauma psicológico en víctimas de tortura durante la dictadura militar en Chile [Delayed asessment of psychological trauma in tortured victims during the military dictatorship in Chile]. Revista de Victimología / Journal of Victimology 4: 105–123.

36.

Guarch-Rubio

Manzanero

(2017) Psychological disorders in women in long-term forced displacement in the Sahrawi refugee camps. Revista de Victimología / Journal of Victimology 5: 151–170.

37.

Herman

(1992) Trauma and Recovery: The Aftermath of Violence. New York: Basic Books.

38.

Johnson

Foley

Suengas

, et al. (1988) Phenomenal characteristics of memories for perceived and imagined autobiographical events. Journal of Experimental Psychology: General 117(4): 371–376.

39.

Joronen

(2016) ‘Death comes knocking on the roof’: thanatopolitics of ethical killing during operation protective edge in Gaza. Antipode 48(2): 336–354.

40.

Kessler

Aguilar-Gaxiola

Alonso

, et al. (2017) Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology 8(Suppl. 5): 1353383.

41.

Kihlstrom

(1996) The trauma-memory argument and recovered memory therapy. In: Pezdek

Banks

(eds) The Recovered Memory/False Memory Debate. San Diego, CA: Academic Press, pp. 297–231.

42.

Kim

Diamond

(2002) The stressed hippocampus, synaptic plasticity and lost memories. Nature Reviews Neuroscience 3(6): 453–462.

43.

Starr

Hershenberg

(2017) Responses to positive affect in daily life: positive rumination and dampening moderate the association between daily events and depressive symptoms. Journal of Psychopathology and Behavioral Assessment 39: 1–14.

44.

Lindblom

Gray

(2010) Relationship closeness and trauma narrative detail: a critical analysis of betrayal trauma theory. Applied Cognitive Psychology 24(1): 1–19.

45.

McEwen

(2000) Effects of adverse experiences for brain structure and function. Biological Psychiatry 48(8): 721–731.

46.

MacIntosh

Fletcher

Collin-Vézina

(2016) ‘As time went on, I just forgot about it’: thematic analysis of spontaneous disclosures of recovered memories of childhood sexual abuse. Journal of Child Sexual Abuse 25(1): 56–72.

47.

McKenzie

Thomas

(2017) Assisting asylum seekers in a time of global forced displacement: five clinical cases. Journal of Forensic and Legal Medicine 49: 37–41.

48.

McNally

(2003) Remembering Trauma. Cambridge, MA: Harvard University Press.

49.

Manzanero

López

(2007) Características de los recuerdos autobiográficos sobre sucesos traumáticos. Boletín de Psicología 90: 7–17.

50.

Manzanero

Recio

(2012) El recuerdo de hechos traumáticos: exactitud, tipos y características [Memories for traumatic events: accuracy, types and characteristics]. Cuadernos de Medicina Forense 18(1): 19–25.

51.

Manzanero

Crespo

Barón

, et al. (2017) Traumatic events exposure and psychological trauma in children victims of war in the Gaza Strip. Journal of Interpersonal Violence. Epub ahead of print 23 November 2017. DOI: 10.1177/0886260517742911.

52.

Manzanero

López

Aróztegui

, et al. (2015) Autobiographical memories for negative and positive events in war contexts. Anuario de Psicología Jurídica 25: 57–64.

53.

Meiser-Stedman

Smith

Yule

, et al. (2007) The Trauma Memory Quality Questionnaire: preliminary development and validation of a measure of trauma memory characteristics for children and adolescents. Memory 15(3): 271–279.

54.

Miller

Wiener

(2014) PTSD recovery, spatial processing, and the val66met polymorphism. Frontiers in Human Neuroscience 8: 100.

55.

Mollica

Chernoff

Berthold

, et al. (2014) The mental health sequelae of traumatic head injury in South Vietnamese ex-political detainees who survived torture. Comprehensive Psychiatry 55: 1626–1638.

56.

Moradi

Doost

HTN

Taghavi

, et al. (1999) Everyday memory deficits in children and adolescents with PTSD: performance on the Rivermead Behavioural Memory Test. The Journal of Child Psychology and Psychiatry and Allied Disciplines 40(3): 357–361.

57.

Moradi

Herlihy

Yasseri

, et al. (2008) Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder (PTSD). Acta Psychologica 127(3): 645–653.

58.

Nahari

Vrij

(2015) Systematic errors (biases) in applying verbal lie detection tools: richness in detail as a test case. Crime Psychology Review 1(1): 98–107.

59.

Neisser

Harsch

(1992) Phantom flashbulbs: false recollections of hearing the news about Challenger. In: Winograd

Neisser

(eds) Affect and Accuracy in Recall: Studies of ‘Flashbulb’ Memories. New York: Cambridge University Press, pp. 9–31.

60.

Nemeroff

Bremner

Foa

, et al. (2006) Posttraumatic stress disorder: a state-of-the-science review. Journal of Psychiatric Research 40: 1–21.

61.

Nur

(2008) Remembering the Palestinian Nakba: commemoration, oral history and narratives of memory. Holy Land Studies 7(2): 123–156.

62.

Otgaar

Merckelbach

Jelicic

, et al. (2017) The potential for false memories is bigger than what Brewin and Andrews suggest. Applied Cognitive Psychology 31(1): 24–25.

63.

Ottersen

Dasgupta

Blouin

, et al. (2014) The political origins of health inequity: prospects for change. The Lancet 383(9917): 630–667.

64.

Peace

Porter

(2004) A longitudinal investigation of the reliability of memories for trauma and other emotional experiences. Applied Cognitive Psychology 18(9): 1143–1159.

65.

Peace

Porter

Brinke

(2008) Are memories for sexually traumatic events ‘special’? a within-subjects investigation of trauma and memory in a clinical sample. Memory 16(1): 10–21.

66.

Peltonen

Kangaslampi

Qouta

, et al. (2017) Trauma and autobiographical memory: contents and determinants of earliest memories among war-affected Palestinian children. Memory 25(10): 1347–1357.

67.

Pope

Hudson

Bodkin

, et al. (1998) Questionable validity of ‘dissociative amnesia’ in trauma victims: Evidence from prospective studies. British Journal of Psychiatry 172(3): 210–215.

68.

Rieck

Shakespeare-Finch

Morris

, et al. (2005) A mixed-method analysis of posttrauma outcomes: trauma severity and social support from a psychotherapeutic perspective. Canadian Journal of Counselling 39(2): 86–100.

69.

Rubin

Berntsen

Bohni

(2008) A memory-based model of posttraumatic stress disorder: evaluating basic assumptions underlying the PTSD diagnosis. Psychological Review 115(4): 985–1011.

70.

Rubin

Deffler

Ogle

, et al. (2016) Participant, rater, and computer measures of coherence in posttraumatic stress disorder. Journal of Abnormal Psychology 125(1): 11–25.

71.

Sayigh

(1998) Palestinian camp women as tellers of history. Journal of Palestine Studies 27(2): 42–58.

72.

Schaefer

Philippot

(2005) Selective effects of emotion on the phenomenal characteristics of autobiographical memories. Memory 13(2): 148–160.

73.

Schmidt

(2004) Autobiographical memories for the September 11th attacks: reconstructive errors and emotional impairment of memory. Memory & Cognition 32(3): 443–454.

74.

Schönfeld

Ehlers

(2017) Posttraumatic stress disorder and autobiographical memories in everyday life. Clinical Psychological Science 5(2): 325–340.

75.

Segovia

Strange

Takarangi

(2017) Trauma memories on trial: is cross-examination a safeguard against distorted analogue traumatic memories? Memory 25(1): 95–106.

76.

Southwick

Morgan

Nicolaou

, et al. (1997) Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm. The American Journal of Psychiatry 154(2): 173–177.

77.

Stanciu

Rogers

(2011) Survivors of political violence: conceptualizations, empirical findings, and ecological interventions. International Journal for the Advancement of Counselling 33: 172–183.

78.

Summerfield

(1999) A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Social Science & Medicine 48(10): 1449–1462.

79.

Sutherland

Bryant

(2007) Rumination and overgeneral autobiographical memory. Behaviour Research and Therapy 45(10): 2407–2416.

80.

Thabet

AAM

Sultan

SMA

(2016) War trauma, anxiety, and resilience among university students in the Gaza Strip. Clinical Psychiatry 2(4): 19.

81.

Tulving

Thomson

(1973) Encoding specificity and retrieval processes in episodic memory. Psychological Review 80(5): 352–373.

82.

United Nations High Commissioner for Refugees (2014) The Heart of the Matter: Assessing Credibility When Children Apply for Asylum in the European Union. Brussels: European Commission.

83.

United Nation Relief and Work Agency in Middle East (2014) Gaza situation report 20. Available at: https://www.unrwa.org/newsroom/emergency-reports/gaza-situation-report-20

84.

Vallet

Manzanero

Aróztegui

García-Zurdo

(2017) Age-related differences in phenomenal characteristics of long-term memories for the attack of March 11, 2004. Anuario de Psicología Jurídica 27: 85-93.

85.

Van der Kolk

(1996) Trauma and memory. In: van der Kolk

McFarlane

Wesaeth

(eds) Traumatic Stress. New York: Guilford Press, pp. 279–302.

86.

Van der Kolk

Hopper

Osterman

(2001) Exploring the nature of traumatic memory: combining clinical knowledge with laboratory methods. Journal of Aggression, Maltreatment & Trauma 4(2): 9–31.

87.

Van Rooij

Kennis

Vink

, et al. (2016) Predicting treatment outcome in PTSD: a longitudinal functional MRI study on trauma-unrelated emotional processing. Neuropsychopharmacology 41(4): 1156–1165.

88.

Veldhuizen

Horselenberg

Landström

, et al. (2017) Interviewing asylum seekers: a vignette study on the questions asked to assess credibility of claims about origin and persecution. Journal of Investigative Psychology and Offender Profiling 14(1): 3–22.

89.

Vinson

Chang

(2012) PTSD symptom structure among West African War trauma survivors living in African refugee camps: a factor-analytic investigation. Journal of Traumatic Stress 25(2): 226–231.

90.

Wilker

Pfeiffer

Kolassa

, et al. (2014) The role of FKBP5 genotype in moderating long-term effectiveness of exposure-based psychotherapy for posttraumatic stress disorder. Translational Psychiatry 4(6): e403.

91.

Wilson

(1989) Trauma, Transformation, and Healing: An Integrative Approach to Theory, Research, and Post-Traumatic Therapy. Philadelphia, PA: Brunner/Mazel.

92.

Wittekind

Jelinek

Kleim

, et al. (2017) Age effect on autobiographical memory specificity: a study on autobiographical memory specificity in elderly survivors of childhood trauma. Journal of Behavior Therapy and Experimental Psychiatry 54: 247–253.

93.

Yehuda

Keefe

Harvey

, et al. (1995) Learning and memory in combat veterans with posttraumatic stress disorder. The American Journal of Psychiatry 152(1): 137–139.

94.

Yuille

Cutshall

(1986) A case study of eyewitness memory of a crime. Journal of Applied Psychology 71(2): 291–301.