Characterisation of intrusive memories and prediction from memory-related genes and cognitive and emotional factors

Frontline caregivers, such as nurses and physicians, face heightened risk of intrusive memories, a core symptom of posttraumatic stress disorder. Understanding intrusions is key to protecting workers' mental health and sustaining effective patient care. Emergency department (ED) staff (N = 331) were assessed before starting ED work and three and six months later. Baseline measures included demographics, prior trauma, cognitive and emotional processing, and polymorphisms of the memory-related NR3C1, KIBRA, and ADRA2B genes as predictors of intrusions at three months, i.e., peak ED stress exposure. We examined intrusion occurrence, frequency, distress, and content, and investigated whether experiencing intrusions moderated changes in mental health from baseline to follow-ups. Intrusions were prevalent and often concerned potential patient care errors. Being a carrier of the G allele of the BCL1 polymorphism of the NR3C1 gene and ruminating were associated with intrusions at three months, while cognitive flexibility, emotional suppression, and emotion-focused positive rumination appeared protective. From baseline to three and six months, participants' anxiety increased, and those experiencing intrusions reported significantly lower work performance and engagement. Our results underline the psychological costs of high-stakes ED settings and suggest improvements to error culture and emotion regulation training as promising avenues to support staff and ultimately patients.