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Aversive imagery in posttraumatic stress disorder: trauma recurrence, comorbidity, and physiological reactivity.
- Source :
-
Biological psychiatry [Biol Psychiatry] 2010 Feb 15; Vol. 67 (4), pp. 346-56. Date of Electronic Publication: 2009 Oct 28. - Publication Year :
- 2010
-
Abstract
- Background: Posttraumatic stress disorder (PTSD) is characterized as a disorder of exaggerated defensive physiological arousal. The novel aim of the present research was to investigate within PTSD a potential dose-response relationship between past trauma recurrence and current comorbidity and intensity of physiological reactions to imagery of trauma and other aversive scenarios.<br />Methods: A community sample of principal PTSD (n = 49; 22 single-trauma exposed, 27 multiple-trauma exposed) and control (n = 76; 46 never-trauma exposed, 30 trauma exposed) participants imagined threatening and neutral events while acoustic startle probes were presented and the eye-blink response (orbicularis occuli) was recorded. Changes in heart rate, skin conductance level, and facial expressivity were also indexed.<br />Results: Overall, PTSD patients exceeded control participants in startle reflex, autonomic responding, and facial expressivity during idiographic trauma imagery and, though less pronounced, showed heightened reactivity to standard anger, panic, and physical danger imagery. Concerning subgroups, control participants with and without trauma exposure showed isomorphic patterns. Within PTSD, only the single-trauma patients evinced robust startle and autonomic responses, exceeding both control participants and multiple-trauma PTSD. Despite greater reported arousal, the multiple-trauma relative to single-trauma PTSD group showed blunted defensive reactivity associated with more chronic and severe PTSD, greater mood and anxiety disorder comorbidity, and more pervasive dimensional dysphoria (e.g., depression, trait anxiety).<br />Conclusions: Whereas PTSD patients generally show marked physiological arousal during aversive imagery, concordant with self-reported distress, the most symptomatic patients with histories of severe, cumulative traumatization show discordant physiological hyporeactivity, perhaps attributable to sustained high stress and an egregious, persistent negative affectivity that ultimately compromises defensive responding.<br /> (2010 Society of Biological Psychiatry. All rights reserved.)
- Subjects :
- Adolescent
Adult
Autonomic Nervous System physiology
Blinking physiology
Child
Comorbidity
Electromyography methods
Facial Expression
Female
Galvanic Skin Response physiology
Humans
Male
Stress Disorders, Post-Traumatic classification
Surveys and Questionnaires
Trauma Severity Indices
Young Adult
Emotions physiology
Imagination physiology
Stress Disorders, Post-Traumatic epidemiology
Stress Disorders, Post-Traumatic physiopathology
Stress Disorders, Post-Traumatic psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2402
- Volume :
- 67
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Biological psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 19875104
- Full Text :
- https://doi.org/10.1016/j.biopsych.2009.08.023