Reflective thinking and mental imagery: A perspective on the development of posttraumatic stress disorder

Reflective thinking occurs when information stored in long-term memory (LTM) is not sufficient to allow one to respond “automatically” to an object or event. Instead, stored information must be entered into working memory and a novel response or solution produced. In this article I argue that mental imagery plays a central role in this process, and that over the course of normal cognitive development the process of reflective thinking “programs” LTM so that an increasingly large number of tasks can be performed without reflective thinking. Normal cognitive development thus results in a decreasing reliance on imagery. However, if highly emotional images are formed, additional retrieval cues can be entered into LTM, making such images more likely to occur in the future. Such images induce arousal, similar to that induced by the actual event. This line of thinking leads to a novel perspective on the neurocognitive deficits that underlie the development of posttraumatic stress disorder, and may also help to explain some symptoms seen in hyperactivity, impulsiveness, and difficulties in self-control.The work summarized in this paper was supported in part by NSF ROLE Grant REC-0106760 and NIH Grant 5 R01 MH60734. Portions of this article were adapted from a draft of Kosslyn (2005). I thank the Editors and Robin Rosenberg for helpful comments on earlier drafts.