Am J Psychiatry 1996; 153:71-82
Copyright © 1996 by American Psychiatric Association
Neural Mechanisms in dissociative amnesia for childhood abuse: relevance to the current controversy surrounding the "false memory syndrome"
JD Bremner, JH Krystal, DS Charney and SM Southwick
Department of Psychiatry, Yale University School of Medicine, New Haven, Conn, USA.
OBJECTIVE: There is considerable controversy about delayed recall of
childhood abuse. Some authors have claimed that there is a "false memory
syndrome," in which therapists suggest to patients events that never
actually occurred. These authors point to findings that suggest that memory
traces are susceptible to modification. The purpose of this paper is to
review the literature on the potential vulnerability of memory traces to
modification and on the effects of stress on the neurobiology of memory.
METHOD: The authors review findings on mechanisms involved in normal memory
function, effects of stress on memory in normal persons, children's memory
of stressful events, and alterations of memory function in psychiatric
disorders. The effects of stress on specific brain regions and brain
chemistry are also examined. RESULTS: Neuropeptides and neurotransmitters
released during stress can modulate memory function, acting at the level of
the hippocampus, amygdala, and other brain regions involved in memory. Such
release may interfere with the laying down of memory traces for incidents
of childhood abuse. Also, childhood abuse may result in long-term
alterations in the function of these neuromodulators. CONCLUSIONS: John
Nemiah pointed out several years ago that alterations in memory in the form
of dissociative amnesia are an important part of exposure to traumatic
stressors, such as childhood abuse. The studies reviewed here show that
extreme stress has long-term effects on memory. These findings may provide
a model for understanding the mechanisms involved in dissociative amnesia,
as well as a rationale for phenomena such as delayed recall of childhood
abuse.
