Memory Reconsolidation and Social Anxiety Disorder

 

Social anxiety disorder (SAD) is a commonly diagnosed psychological disorder in the US. Treatment for SAD includes medication and therapy, however, not everyone responds to each treatment the same and remains with the same symptoms following treatment. This has stimulated the interest in pharmacotherapy in response to SAD. From previous research, MDMA has been tested as a measure to modulate psychotherapy for social anxiety in adults with autism. MDMA affects serotonin, norepinephrine, and dopamine systems, and has been noted in its effect of reducing fear and increasing trust, thus having the potential to enhance therapeutic approaches in healing psychological trauma and emotional disorders.

In the article, "Potential processes of change in MDMA-Assisted therapy for social anxiety disorder: Enhanced memory reconsolidation, self-transcendence, and therapeutic relationships ", Jason B. Luoma et al. explore how MDMA-AT can guide processes of change to then maximize therapeutic outcomes. In the article, they explore the possibility that MDMA could potentially enhance memory reconsolidation in SAD. It is found that those with SAD exhibit an enhanced retrieval of negative memories compared to a reduced retrieval of positive memories. In addition, positive memories that were recalled by those with SAD recalled them with little detail, whereas negative memories were reported in greater detail. Early research has suggested that negative self-imagery is linked to memory and could be a factor in maintaining SAD. Thus, it is implicated that targeting these memories and altering their meaning and intrusiveness could help with the treatment of SAD. Through experiment studies of fear conditioning in rodents, findings suggest that MDMA could facilitate memory reconsolidation of fear memories. The effects of MDMA in those with SAD are likely to include pleasant feelings, such as peace and safety, and thus foster a strong prediction error which can facilitate memory reconsolidation. A prediction error is where the expected event and current event do not match, thus reconsolidation is expected to occur. So, a strong prediction error is believed to send an update in the memory trace, where pleasant emotions elicited by MDMA would counter the negative expectations of people with SAD.

The researchers of this article hypothesize that MDMA-AT can promote new emotional experiences that can lead to memory reconsolidation. Stephani L Grella et al. explore the modulation of fear through manipulating memory consolidation in their article, Odor modulates the temporal dynamics of fear memory consolidation. The goal was to update the negative fear memory with positive contextual elements to make the memory less negative during reconsolidation. Through her research, there is evidence that original memory, where fear was conditioned, did not merge, but was significantly altered following reinstatement. Her findings can be implicated in reducing fear and negative emotions for those with PTSD. Her findings also bring more evidence that memory reconsolidation can be modulated, and negative emotions can be altered to more positive ones, which can be used to understand how certain medications and drugs alter the brain, especially with disorders such as PTSD and SAD. For both topics in this field, it is important to understand that there's a possibility that reconsolidation-based approaches can cause unwanted memory deficits, such as permanent memory erasure. Other cognitive and behavioral processes could also be disrupted and are unknown, thus there need to be more robust clinical studies on memory reconsolidation. Otherwise, both findings can be useful in providing alternative therapeutic approaches for psychological disorders and providing a better understanding of the relationship between memory and mental health.

References

Grella, Stephanie L., et al. “Odor Modulates the Temporal Dynamics of Fear Memory Consolidation.” 2019, https://doi.org/10.1101/2019.12.19.881615.

Luoma, Jason B., et al. “Potential Processes of Change in MDMA‐Assisted Therapy for Social Anxiety Disorder: Enhanced Memory Reconsolidation, Self‐Transcendence, and Therapeutic Relationships.” Human Psychopharmacology: Clinical and Experimental, 2021, https://doi.org/10.1002/hup.2824.