Influence of emotional engagement and habituation on exposure therapy for PTSD.

Jaycox, Lisa H.; Foa, Edna B.; Morral, Andrew R.

doi:10.1037/0022-006x.66.1.185

Cited by 388 publications

(359 citation statements)

References 21 publications

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“…The current work also suggests a potential mechanism by which re-exposure to trauma-related cues might disrupt the formation of more complex associations, such as those required by extinction, and thus undermine the efficacy of exposure therapy in some individuals with PTSD (Jaycox et al 1998). It is also intriguing to consider the possibility that acute stress-induced decreases in hippocampal BDNF mRNA may prevent the initial encoding of contextual material associated with a traumatic experience.…”

Section: Discussionmentioning

confidence: 90%

Downregulation of BDNF mRNA in the Hippocampal Dentate Gyrus after Re-exposure to Cues Previously Associated with Footshock,

Rasmusson

Shi

Duman

2002

Neuropsychopharmacology

235

109

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This study examined the effects of footshock stress and reexposure to cues previously associated with footshock on expression of brain-derived neurotrophic factor (BDNF) mRNA in the hippocampus of male rats. Exposure to twenty 0.5-s 0.4-mA footshocks co-terminating withBrain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family of growth factors, which also includes nerve growth factor and neurotrophins 3 and 4. BDNF as well as these other neurotrophins, plays an important role in neuronal growth and differentiation during development, and also contributes to the survival, function, and plasticity of neurons in the adult brain (Lewin and Barde 1996). Thus, through a variety of mechanisms in different brain regions, BDNF has been implicated in emergent phenomena such as learning and memory (Patterson et al. 1996;Mu et al. 1999) and even contributes to the modulation of overt behaviors such as aggression (Lyons et al. 1999). The ability of BDNF to influence these processes is related, in part, to the activity dependent regulation of BDNF expression in adult brain (Lewin and Barde 1996).BDNF is also thought to play a role in the cellular and behavioral responses to stress (Duman et al. , 2000. Exposure to physical stress, such as immobilization, downregulates BDNF expression in the hippocampus (Smith et al. 1995, Vaidya et al. 1997 (Duman et al. , 2000. Moreover, downregulation of BDNF could contribute to the hippocampal pathology observed in psychiatric disorders such as post-traumatic stress disorder (PTSD) and depression (Bremner et al. 2000;Mervaala et al. 2000;Vakili et al. 2000). This possibility is supported by the observation that these disorders are sensitive to stressful experiences (Breslau et al. 1995;Kendler et al. 2000). Based on these observations and findings, we became interested in determining whether psychological stress has a measurable impact on hippocampal BDNF expression similar to the effects of physical stressors that have been reported.We therefore tested the effects of psychological stress produced by exposures to cues previously paired with footshock on BDNF mRNA levels in the dentate gyrus of the hippocampus. We hypothesized that re-exposure to cues associated with footshock stress, as well as footshock itself, would decrease BDNF mRNA in the dentate gyrus. The results demonstrate that this type of psychological stress produces a heightened sensitivity to previously neutral cues that results in downregulation of BDNF, and suggest that psychological stress, such as that experienced in association with PTSD and depression, as well as other disorders, could result in decreased neurotrophic support of the hippocampus. MATERIAL AND METHODS AnimalsAdult male Sprague-Dawley rats were kept in a 12:12 h light-dark cycle (lights on at 7:00 A . M .) for 7-10 days before each experiment. The animals were housed two or three per cage and fed ad libitum. Experiments were conducted between 9:00 A . M . and 6:00 P . M . To control for possible effects of diurnal variation on hippoca...

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Section: Discussionmentioning

confidence: 90%

Downregulation of BDNF mRNA in the Hippocampal Dentate Gyrus after Re-exposure to Cues Previously Associated with Footshock,

Rasmusson

Shi

Duman

2002

Neuropsychopharmacology

235

109

View full text Add to dashboard Cite

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“…Anestis & Joiner, 2012; Bonn-Miller, Vujanovic, Boden, & Gross, 2011; Gaher, Hofman, Simons, & Hunsaker, 2013). Distress tolerance difficulties may motivate avoidance strategies that maintain symptoms and, since cognitive and/or emotional processing of distressing trauma-related material is a key therapy target in PTSD, may reduce treatment compliance (Ehlers & Clark, 2000; Jaycox, Foa, & Morral, 1998). Accordingly, this study manipulated perceived controllability of an aversive stimulus in participants with and without PTSD symptoms, and indexed their subsequent avoidance of distressing stimuli.…”

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confidence: 99%

Perceived control and avoidance in posttraumatic stress

Hancock

Bryant

2018

European Journal of Psychotraumatology

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Despite much evidence concerning the importance of control over stressors in animal models of adaptation to stress, there is a dearth of experimental evidence for the role of controllability in posttraumatic stress disorder (PTSD). This study investigated whether perceived control over aversive stimuli influenced subsequent avoidance in a female community sample with and without PTSD symptomatology. Female participants (N = 145) with high or low PTSD symptoms were randomized to receive instructions indicating either controllable or uncontrollable offset of aversive, positive, and neutral images; despite this perception, the actual duration of presentations was standardized in both conditions. Participants subsequently completed an emotional avoidance task. There was a significant group × condition interaction effect, such that those with PTSD symptoms who were told they lacked control displayed greater avoidance of the subsequent stressor relative to those told they had control. This pattern was not observed in those without PTSD symptoms. This finding suggests that ongoing experiences of uncontrollability may heighten psychological vulnerabilities implicated in PTSD.

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“…The Interapy treatment is firmly rooted in research into posttraumatic stress and includes elements from established therapies for posttraumatic stress. Two mechanisms are widely considered to be crucial in overcoming traumatic events: (a) habituation to the aversive stimuli, which is achieved by exposure to the traumatic memories and avoided stimuli (e.g., Jaycox, Foa, & Morral, 1998), and (b) cognitive reappraisal of the traumatic experiences (e.g., Ehlers & Clark, 2000). Imaginary exposure (self-confrontation) is used to help patients confront the sensory perceptions, emotions, and thoughts that they usually avoid.…”

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confidence: 99%