The Phenomenology and Correlates of Flashbacks in Individuals With Posttraumatic Stress Symptoms

Reexperiencing symptoms are a hallmark of posttraumatic stress disorder (PTSD). Relatively little research has examined flashbacks in individuals with PTSD, and theoretical attempts to define and conceptualize flashbacks continue to be marked by considerable controversy. We compared individuals with PTSD or subthreshold PTSD symptoms (PTSS) with (n = 45) and without flashbacks (n = 32) to trauma-exposed controls (n = 33) and control participants without trauma exposure (n = 33). We compared the qualities of flashbacks of individuals with PTSS to those simulated by individuals without flashbacks. As predicted, individuals with PTSS reported significantly greater sleep disturbances, experiential avoidance, and lower trait mindfulness than those without PTSS. Individuals without PTSS underestimated the vividness, emotional intensity, distress, and functional impact associated with flashbacks. Consistent with basic-mechanisms theory, we did not find evidence of fragmentation of flashbacks in individuals with PTSS. Additional implications and future directions are discussed