Olfaction as a Traumatic Reminder in Posttraumatic Stress Disorder: Case Reports and Review
J Clin Psychiatry 2003;64:202-207
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Memory for odors that are associated
with intense emotional experiences is often strongly engraved.
Odors are claimed to be more closely connected to affect than
other sensory experiences. They can serve as potent contextual
cues for memory formation and emotional conditioning and can also
serve as cues for olfactory flashbacks. Though trauma-related
smells have long been noted by clinicians to be precipitants of
traumatic memories in patients with posttraumatic stress disorder
(PTSD), very few reports have been published that document this.
Case reports: We review olfactory memories and
olfactory flashbacks by presenting 3 cases that illustrate the
role of olfaction in PTSD. In these cases olfaction is either a
precipitant of PTSD symptoms or an important component of
Discussion: In PTSD, seemingly nonspecific cues
have the potential to precipitate traumatic memories with strong
emotional components. These conditioned responses in PTSD are
hypothesized to be mediated by specific brain areas, i.e.,
amygdala, hippocampus, and orbitofrontal cortex. Questions about
smells as a traumatic reminder should be part of the routine
assessment of intrusive memories in PTSD. In addition, smells may
have the potential to provide cues to exposure situations in
therapy or to facilitate de novo conditioning.