Absence of memory or verbal recall for symptom acquisition in fear and trauma exposure, as well as absence of successful coping behavior for life events, is associated with a number of diagnoses, including traumatic brain injury, posttraumatic stress disorder, pain, and anxiety. The difficulty with diagnosis and treatment planning based on the absence of recall, memory, and successful coping behavior is threefold: (1) these assessments do not distinguish between disruption of behavior and lack of capacity, (2) the absence of verbal recall and memory complicates cognitive-based treatment, and (3) a confounding issue is the same absent behavior can be observed at different times and contexts. The absence of memory or lack of verbal recall does not rule out measurable physiological bodily responses for the initial trauma(s), nor does it help to establish the effects of subsequent experiences for symptom expression. Also, the absence of memory must include the prospect of fear-based learning without involvement of the cortex. It is suggested that fear conditioning and learned nonuse provides complementary illustrations of how the time and context of the initial trauma(s) and later experiences affect behavior, which is not dependent on the affected individual being able to provide a memory-based verbal report.
Volume 49 Number 8, 2012
Pages 1209 — 1220
Last Reviewed or Updated Tuesday, December 11, 2012 9:26 AM