Investigating the phenomenology of imagery following traumatic burn injuries

Intrusive images related to adverse experiences are an important feature of a number of psychological disorders and a hallmark symptom of posttraumatic stress disorder (PTSD). Depression, anxiety, and PTSD are all common reactions following a burn injury. However, the nature of burn-related trauma memories and associated intrusions and their contribution to psychological disorders is not well understood. The aim of the study was to take a broad look at the nature of imagery experienced by people who have sustained a burn injury. Nineteen participants completed self-report questionnaires assessing depression, anxiety, and PTSD symptoms and were administered a semi-structured interview which explored the characteristics (vividness, sensory modalities, intrusions, emotion intensity) of imagery formed in relation to their burn injuries. Ongoing intrusive imagery was reported by over half the participants and there were significant correlations between frequency of intrusive images and posttraumatic symptoms, and between intensity of emotions associated with intrusive images and depression and posttraumatic symptoms. A thematic analysis of the memory narratives revealed four main themes: threat to self, view of the world, view of others, and positive psychological change. These results are discussed in relation to existing trauma theory and burn injury literature. Implications for clinical practice and recommendations for further research are proposed.