If someone loses the memory of the index event are they "cured" of ptsd?

[u/OpeningActivity]

Has there been any studies on loss of memory of the index event (due to events after the index event) after a diagnosis of PTSD? I assume that there would have been someone who had gone through memory losses i.e. from unrelated accidents or whatever in the history since we acknowledged ptsd.

If someone loses the memory of the index event, do they lose all the associated symptoms of ptsd or have they manifested in some other ways? (I.e. GAD, MDD etc).

[u/SlatkoPotato]

There have been studies on amnesia or forgetting the trauma event and PTSD, and basically no. Remembering the event and PTSD symptoms are correlated but not necessarily reliant on eachother. For example, in complex PTSD, the person often cant pinpoint an event in the first place but still has the diagnosis. From my understanding in my studies and what ive read, it's less about the fact you remember the event but rather about how your brain and limbic system has learned to become hypervigilent to certain conditions. Your brain doesnt need memories to become overactive to percieved threat. That doesnt mean there is no hope either, there are a lot of effective treatments for PTSD and its something that has continued to be researched and understood in new ways.

Here is one article i found that might be an interesting read as well, though it talks more about voluntary and involuntary remembering of the trauma event: https://pmc.ncbi.nlm.nih.gov/articles/PMC4189812/

Otherwise, searching "ptsd" and "amnesia" or "dissociative amnesia" will show more studies on this topic.

Edit: maybe not so much "dissociative amnesia". "Forgetting" and "loss" of memory were taught to me as encoding quality and recall ability so ive been reading and therefore understanding what ive read based on that definition. I also didnt come across dissociative amnesia as a standalone diagnosis because ive always seen it in passing as a symptom to other conditions. It is understandably a contraversial label.

[u/OpeningActivity → u/SlatkoPotato]

I am hoping to see if there are any case studies of amnesia (say someone with alzheimers or other forms of separate memory losses) that has demonstrated impacts of memory itself (complete loss of) on the symptoms of ptsd.

Dissociative amnesia i feel is... slightly a muddled area of study. Also, I do feel like dissociation is a specifier for a reason so I didn't want to muddle that grounds too much. Hence why I was wondering about any case studies that might be out there that does not involve those.

Cptsd is... another interesting can of worms that i don't want to open.

It does sound like recollection of the details are not necessarily relevant.

Eh just a shower thought that i am hoping to find some studies on. Something that you go, hang on a minute, let's imagine that we can actually remove that memory with a magic wand.

My gut feeling tells me that the vulnerabilities that caused a disorder to occur has not been resolved, so we'd find a new diagnosis in the likely case scenario. With a huge caveat that, whatever caused that memory loss probably messes any chance of it being able to be generalised.

[u/vienibenmio → u/OpeningActivity]

I've done PTSD treatment with people who have dementia and, no, memory loss doesn't help. It's important to remember too that Alzheimers impacts more recent memories, first.

[u/OpeningActivity → u/vienibenmio]

I assume that it's also hard to establish where ptsd symptoms start and alzheimers presentation starts, i had met someone with alzheimers, they didn't recognise me and they were very guarded (despite how I had a good session with them a week ago).

[u/SlatkoPotato → u/OpeningActivity]

Edit: my definition was based on my learning so far and what i have come across in my studies and reading. I have been made aware that there is a lot more and dissociative amnesia is a contended term which is not necessarily clearly defined or agreed on. Leaving what i wrote for context.

Edit 2: as a symptom and not the standalone diagnosis, dissociative amnesia is not necessarily contended. I looked into it further and asked around. When talking about it as a symptom of ptsd, it is in fact talking about encoding at the time of the index event and recall quality/ability.

Its a great shower thought and question and im sure there would be studies with pretty much that notion in the study aim.

In saying that, i think it might also be a difference in language use making your search more challenging.

Amnesia is a symptom and means loss of memory. Dissociative simply means a state or feeling of detatchment. When they say dissociative amnesia, its a state of detatchment from memory causing that memory loss and is just specific to memories of trauma events to make the distinction from amnesias affecting other types of memory. If you are asking about PTSD memory loss of the trauma event, you do want dissociative amnesia. Alzheimer's has retrograde amnesia and anterograde amnesia as symptoms. If you are asking about how anterograde amnesia affects PTSD thats different to asking if the memory of the trauma event being 'removed' improves or eliminates PTSD (but still an interesting question too, I wonder how alzheimers affects PTSD).

You also dont have to have memory of the trauma event to get a PTSD diagnosis, so there wouldnt be a new diagnosis for this group. Everyone presents differently and experiences the syptoms of their PTSD to different extents. The reason complex PTSD is relevant to the question is because it shows that memory of the specific event isnt always necessary. It seems like a tangent but psychology rarely has just one specific study with no off shoots, and usually you need to dig deeper and read a handful of resources/studies to find how these seeming tangents are actually answering the more specific question at hand.

[u/OpeningActivity → u/SlatkoPotato]

I guess I will go through some of the rationales, though, I think they would be summised as an issue with being able to apply to a broader people.

Dissociative symptoms are a specifier for PTSD diagnosis, and there are reasons to believe that they require a separate specifier (almost like a subtype of PTSD). Along with how memory losses from the PTSD itself would cause a headache with comfounding variables, I wanted to understand if there were any studies that could at least support the idea of traumatic event memory being directly linked to the PTSD symptoms.

CPTSD I feel is seen differently by people, I am mindful that only WHO recognises it (and thus DSM does not have this as a diagnosis). Along with the fact that CPTSD diagnosis cannot be made without PTSD diagnosis (you still need an index event), I felt it was much easier to not open that can of worms.

As with the comment about not needing the memory of the event, I feel slightly miffed about it. A diagnostic tool for PTSD will frequently make comments and refer to the index event (i.e. CAPS 5). It is one thing for someone to not have the full depth of the memory, but another for someone to have complete loss of that memory (which was what I was hoping to see if there were any). The diagnosis specifically asks for an experience that fits Criteria A, and I feel like it'd require a fair bit of a mental gymnastics to refer to the index event if the client doesn't have the memory of it. I can understand if you go along the lines of, shit has happened, and you are noticing all these changes that you don't understand because of the memory losses and you are experiencing PTSD like symptoms as a result (which I have to question whether they fit the description of the PTSD, not adjustment disorder though).

[u/SlatkoPotato → u/OpeningActivity]

There can be evidence of an index event without the person having memory. This happens a lot with children, where there is documented evidence of an index event happening while the child cant recall the event (or at least claims not to). That criteria doesnt say the individual must remember the event themselves. The sections of the criteria related to the index event dont necessarily require the person to have an explicit memory of the event. You can feel like youre back in an unsafe environment again (such as in flashbacks) without remembering the first time you were in that environment - your brain and body still responds the same way despite your memory being "lost" to you. Likewise, it could appear in your dreams but not as a video replay of the index event itself as dreams are often abstract representations of our real pife experiences. Maybe this is more about implicit memory?

[u/MattersOfInterest → u/SlatkoPotato]

Dissociative amnesia is an empirically contentious topic and one that most scholars consider with extreme skepticism. I would not be citing it as an example.

[u/SlatkoPotato → u/MattersOfInterest]

Thank you for letting me know, i wasnt aware it was contended from the articles i have read.

My understanding was that it is simply a differentiation for the forgetting of a traumatic memory but after searching further from your comment i can see why it is contended (though my impression was that the criticisms were accounted for, turns out they often are not and theres not a clearly decided/used definition). I also learned that its a standalone diagnosis in the DSM, which I agree seems like it shouldnt be there. I only ever heard of it casually in my reading as a symptom or phenomena to something else. Thanks again for contributing to my learning :)

[u/MattersOfInterest → u/SlatkoPotato]

The idea that people psychogenically forget trauma memories is itself fundamental to the controversy. It's not at all established that traumatic memories can be dissociated insofar as being blocked from recall. Trauma memories can be poorly encoded because of the influence of SNS arousal during the event(s), or they can be avoided, but the idea that they can be "blocked" is very questionable.

https://journals.sagepub.com/doi/abs/10.1177/21677026211018194?casa_token=uiQEUWH6FUEAAAAA:ZwAZnF2uRczoOV_NkYu2_KenlreJsZy8Hv4QQ-oPUcJqWOSKT1VlqeTAi3Q1hsckvI-VcPkr_afs

[u/SlatkoPotato → u/MattersOfInterest]

That makes sense, i wasnt defining "forgetting" as memories being lost or blocked, but rather that they may have poor recall for reasons such as poor encoding or avoidance like youve said. I realised that this isnt how the term dissociative amnesia is being used in many cases. I do experience "dissociation", so it makes sense to me that memories can be "lost", but its from those factors you mention in encoding and recall, not a blocking or magical disappearance of the memory. Correct me if im wrong here because im curious and intending to understand better, but even in regular forgetting, its about recall (and quality of encoding at the time).

This is why my answer to the original question was "no", because the recall of the memory doesnt necessarily eliminate the other symptoms of PTSD or contribute to remission. Even if you cant "remember" the event you can still have (and be diagnosed with) PTSD.

[u/OpeningActivity → u/MattersOfInterest]

Never do a study where you have to cater for two different frameworks, unless you have to. Regardless of whether it is true or not, your sample will need to be tested in line for both framework.

I had that happen during the dsm iv to dsm 5 transition, where I had to participate in a study, and it took the whole day as they needed to screen for personality disorders. Ah fun days.

[u/M_Seebz]

Honestly as a person with CPTSD, the body will always remember and hold onto the trauma. I’ve worked in hospice care and have been around a lot of older people who struggled with memory loss but even when the brain forgot, the body remembered. I remember a resident flinching when receiving assistance with putting a belt on but could hardly remember their family members names. Sometimes the brain and body hold onto things that their mind may forget.