Is freezing an adaptive reaction to threat? Evidence from heart rate reactivity to emotional pictures in victims of war and torture

Adenauer, Hannah; Catani, Claudia; Keil, Julian; Aichinger, Hannah; Neuner, Frank

doi:10.1111/j.1469-8986.2009.00940.x

Cited by 56 publications

(60 citation statements)

References 30 publications

(36 reference statements)

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“…These differential correlations demonstrate the sensitivity of this technology to these constructs, while connecting them to familial PTSD symptoms in directions consistent with prior research (i.e., freezing behaviors in response to potential threat [24]; emotional dysregulation in the face of acute threat [25]).…”

Section: Discussionsupporting

confidence: 77%

Movements Indicate Threat Response Phases in Children at Risk for Anxiety

McGinnis

Muzik

et al. 2017

IEEE J. Biomed. Health Inform.

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Temporal phases of threat response including Potential Threat (Anxiety), Acute Threat (Startle, Fear), and Post-threat Response Modulation have been identified as underlying markers of anxiety disorders. Objective measures of response during these phases may help identify children at risk for anxiety, however the complexity of current assessment techniques prevent their adoption in many research and clinical contexts. We propose an alternative technology, an inertial measurement unit (IMU), that enables non-invasive measurement of the movements associated with threat response, and test its ability to detect threat response phases in young children at heightened risk for developing anxiety. We quantified the motion of 18 children (3–7 years old) during an anxiety/fear provoking behavioural task using an IMU. Specifically, measurements from a single IMU secured to the child’s waist were used to extract root-mean-square acceleration and angular velocity in the horizontal and vertical directions, and tilt and yaw range-of-motion during each threat response phase. IMU measurements detected expected differences in child motion by threat phase. Additionally, potential threat motion was positively correlated to familial anxiety risk, startle range of motion was positively correlated with child internalizing symptoms, and response modulation motion was negatively correlated to familial anxiety risk. Results suggest differential theory-driven threat response phases, and support previous literature connecting maternal child risk to anxiety with behavioural measures using more feasible objective methods. This is the first study demonstrating the utility of an IMU for characterizing the motion of young children to mark the phases of threat response modulation. The technique provides a novel and objective measure of threat response for mental health researchers.

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Section: Discussionsupporting

confidence: 77%

Movements Indicate Threat Response Phases in Children at Risk for Anxiety

McGinnis

Muzik

et al. 2017

IEEE J. Biomed. Health Inform.

View full text Add to dashboard Cite

show abstract

“…This enhanced fight/flight response might indicate reduced freezing as well. Also, although body sway was not assessed, the findings from Adenauer et al (37) are in line with those from Hagenaars et al (26), who found enhanced freezing in response to unpleasant pictures for healthy participants who had encountered multiple traumas but had not developed PTSD. Thus, enhanced freezing might indicate resilience.…”

Section: Introductionsupporting

confidence: 80%

“…Overall, our study demonstrates reduced freezing in PTSD measured by both its physical markers (reduced body sway and bradycardia). Together, these findings might indicate elevated fight–flight behavior and attenuated freezing in response to (laboratory) stressors (37). In addition, we replicated the HR pattern found by Hagenaars et al (14) in controls, with HR deceleration in the first half and a sustained reduced HR in the second half.…”

Section: Discussionmentioning

confidence: 95%

“…Each set comprised 20 pictures of neutral, pleasant, or unpleasant pictures. Similar pictures were used in previous studies (25, 26, 37, 40, 45) in order to facilitate comparisons across studies. Stimuli were presented full screen at eye-height on a 17″ height adjustable computer screen, approximately 1 m in front of the participant with a visual angle (height × width in degrees) of 15.5° × 10.8°.…”

Section: Methodsmentioning

confidence: 99%

“…There are just a few studies that measured objective immobility responses (i.e., body sway and/or HR) in PTSD patients. Adenauer et al (37) examined the risk assessment/orienting phase in PTSD while watching affective pictures. HR responses were recorded in war and torture exposed individuals with and without PTSD and healthy controls using a passive viewing paradigm with neutral, pleasant, and unpleasant pictures.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Freezing in Posttraumatic Stress Disorder Patients while Watching Affective Pictures

et al. 2017

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Besides fight and flight responses, animals and humans may respond to threat with freezing, a response characterized by bradycardia and physical immobility. Risk assessment is proposed to be enhanced during freezing to promote optimal decision making. Indeed, healthy participants showed freezing-like responses to threat cues. Posttraumatic stress disorder (PTSD) patients are characterized by hypervigilance and increased threat responsiveness. We propose that threat responses will be characterized by decreased freezing in PTSD, eliminating possibilities for rejecting cognitive distortions, such as harm expectancy, and thereby contributing to the maintenance of the disorder. However, freezing responses have hardly been investigated in PTSD. Using a stabilometric platform to assess body sway as an indicator of freezing-like behavior, we examined whether veterans with PTSD would show diminished freezing responses to unpleasant versus neutral and pleasant pictures. Fourteen PTSD patients and 14 healthy matched controls watched the pictures, while body sway and heart rate (HR) were continuously assessed. Replicating previous findings, healthy controls showed decreased body sway and HR in response to unpleasant pictures, indicative of freezing-like behavior. In contrast, this response pattern was not observed in PTSD patients. The results may indicate a reduced freezing response in PTSD. As reduced freezing may hinder appropriate risk assessment, it may be an important factor in the maintenance of PTSD. Future research might clarify whether impaired freezing is a PTSD-specific or a transdiagnostic symptom, being present in threat-related disorders.

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Differentiated processing of emotional cues in adolescents and young adults with ICD‐11 PTSD and complex PTSD after child abuse

et al. 2023

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Background The recent update of the International Classification of Diseases 11th revision (ICD‐11) introduced the diagnosis of complex posttraumatic stress disorder (CPTSD) as a distinct entity from posttraumatic stress disorder (PTSD). Because psychophysiological alterations are a core diagnostic feature of PTSD and CPTSD, the aim of the current study was to examine potential distinctive patterns in cortical and cardiac responses to emotional words in adolescent and young adult patients with PTSD and CPTSD. Method Event‐related potentials and heart rate responses were studied in 81 adolescent and young adult participants, of which 17 individuals were diagnosed with ICD‐11 PTSD and 32 individuals with CPTSD, each after childhood sexual and/or physical abuse. Thirty‐two individuals served as healthy controls. The paradigm consisted of a passive reading task with neutral, positive, physically threatening, and socially threatening words. Results Differentiated early processing of emotional words was indicated by differences on P1 and left EPN components. Additionally, PTSD and CPTSD patients presented with specific patterns of heart rate responses to emotional words. In CPTSD patients, heart rate reactions to emotional words were more variable than in PTSD patients. Conclusions These findings provide early evidence of differentiated cortical and cardiac response patterns in adolescent and young adult patients with CPTSD and PTSD, supporting a nosological distinction between PTSD and complex PTSD. However, due to small and unequal sample sizes, findings presented in the current study are preliminary and require future research.

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Is freezing an adaptive reaction to threat? Evidence from heart rate reactivity to emotional pictures in victims of war and torture

Cited by 56 publications

References 30 publications

Movements Indicate Threat Response Phases in Children at Risk for Anxiety

Movements Indicate Threat Response Phases in Children at Risk for Anxiety

Reduced Freezing in Posttraumatic Stress Disorder Patients while Watching Affective Pictures

Differentiated processing of emotional cues in adolescents and young adults with ICD‐11 PTSD and complex PTSD after child abuse

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