Objective assessment of peritraumatic dissociation: psychophysiological indicators

Griffin, Michael G.; Resick, Patricia A.; Mechanic, Mindy B.

doi:10.1176/ajp.154.8.1081

Cited by 277 publications

(66 citation statements)

References 24 publications

(17 reference statements)

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“…In one of the first studies to demonstrate this, Griffin, Resick, and Mechanic (1997) reported that rape victims with greater peri-traumatic depersonalisation/derealisation showed lower HR when verbally recalling their trauma. Similar associations were found in another study that recruited adolescents with childhood abuse experiences (Koopman et al, 2004).…”

Section: Heart Rate As An Index Of Different States Of Consciousnessmentioning

confidence: 96%

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Chou

Marca

Steptoe

et al. 2018

European Journal of Psychotraumatology

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Voluntary recall of trauma is a key element in exposure-based psychotherapies and can trigger spontaneous dissociative responses such as flashbacks, depersonalisation, and derealisation. In order to examine the associations between cardiovascular and psychological responses to voluntary recollection of trauma, individuals with PTSD recalled a traumatic memory. Heart rate and heart rate variability were recorded continuously and the episodes when different forms of dissociation were experienced during the recall were identified. A significant increase in parasympathetic activity was found during trauma recall, with greater parasympathetic dominance being indicative of greater state depersonalisation/derealisation. Whereas overall decreases in heart rate during trauma recall were associated with increased fear and perceived threat, flashbacks were accompanied by short-term increases in heart rate. These findings demonstrate different types of cardiovascular responses associated with different psychological experiences during trauma recall. Future research directions were discussed.

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Section: Heart Rate As An Index Of Different States Of Consciousnessmentioning

confidence: 96%

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Chou

Marca

Steptoe

et al. 2018

European Journal of Psychotraumatology

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show abstract

“…dissociation that occurs during the event: experiencing moments of losing track or blanking out, having an altered sense of time, feeling as if one is floating above the scene, feeling disconnected from one’s body) (Marmar et al, 1994). A proliferation of related research has been published since the middle of the 1990s (Ehlers, Mayou, & Bryant, 1998; Griffin, Resick, & Mechanic, 1997; Koopman, Classen, & Spiegel, 1994; Marmar, Weiss, Metzler, & Delucchi, 1996; Shalev, Peri, Canetti, & Schreiber, 1996). Several studies have provided evidence for an association between PD and symptoms of PTSD (Boelen, 2015; Boelen, Keijsers, & Van Den Hout, 2012; Bui et al, 2013).…”

mentioning

confidence: 99%

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Aho

Svedin

2017

European Journal of Psychotraumatology

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Background: Exposure to traumatic events is clearly associated with a diversity of subsequent mental health problems, with posttraumatic stress disorder (PTSD) as the most prevalent disorder. Epidemiologically, trauma exposure rates are more prevalent than PTSD, indicating that most trauma victims do not develop PTSD. More knowledge is needed to understand the development of the different posttraumatic pathways including the significance of pretraumatic, peritraumatic and posttraumatic risk factors. Objective: To study peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress and to enhance our understanding of peritraumatic reactions as mediators between trauma and later symptomatology. Method: The study was composed of a representative community sample of 5332 second year high school students (mean age 17.3 years) who completed the Juvenile Victimization Questionnaire (SAQ/JVQ), Trauma Symptom Checklist for Children (TSCC) and answered questions about peritraumatic reactions. Mediation effects of peritraumatic reactions on the trauma exposure relationship to symptoms was tested using the PROCESS macro for SPSS. Results: Traumatic events are common (84.1%) and are accompanied in three-quarters of the students with at least one form of peritraumatic reaction. Peritraumatic reactions, especially peritraumatic dissociative reactions, mediate the relationship between trauma exposure and symptoms, and gender moderates the effect of peritraumatic dissociation. This moderating effect was found to be larger for boys than for girls, indicating gender differences in response to trauma. Conclusions: The results indicate the need to screen for peritraumatic reactions as early as possible after a traumatic event in order to identify those at risk for PTSD.

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“…Failure to consider the presence of peritraumatic dissociation and time of day that cortisol was sampled have been hypothesized as factors possibly contributing to the inconsistent findings (Delahanty, Royer, Raimonde, & Spoonster, 2003; Griffin, Resick, & Mechanic, 1997; Meewisse, Reitsma, De Vries, Gersons, & Olff, 2007). However, research has yet to test the extent to which time of day and peritraumatic dissociation may impact the cortisol/PTSD link in the same study.…”

mentioning

confidence: 99%

“…Meta-analytic studies have found positive relationships between peritraumatic dissociation and subsequent PTSD symptoms, and peritraumatic dissociation has been found to be the strongest predictor of PTSD symptoms relative to other pre- and peritraumatic risk factors (Lensvelt-Mulders et al, 2008; Ozer, Best, Lipsey, & Weiss, 2003). Griffin and colleagues (Griffin, Resick, & Mechanic, 1997) found that rape victims reporting high levels of peritraumatic dissociation exhibited attenuated autonomic nervous system responses while talking about their rape two weeks after their victimization. Similarly, trauma victims with high levels of peritraumatic dissociation were found to be less physiologically reactive to the index event than victims with lower levels of peritraumatic dissociation (Delahanty, Royer, Raimonde, & Spoonster, 2003).…”

mentioning

confidence: 99%

“…These findings suggest that there may be a subgroup of at-risk PTSD patients who report high levels of peritraumatic dissociation and who are physiologically less responsive to trauma-related stimuli. It has been further speculated that inclusion of this physiologically less responsive subgroup of trauma victims in prior studies might have obscured results examining physiological characteristics of PTSD patients (Griffin, Resick, & Mechanic, 1997). …”

mentioning

confidence: 99%

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Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation.

Kobayashi

Delahanty

2014

Psychological Trauma: Theory, Research, Practice, and Policy

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Differences in the time of day that cortisol is sampled and failure to consider the impact of peritraumatic dissociation have been hypothesized as factors possibly contributing to the inconsistent findings in research examining associations between cortisol levels soon after trauma exposure and the subsequent development of posttraumatic stress disorder (PTSD). The present study examined associations between urinary cortisol levels during wake and sleep times soon after a serious injury and the subsequent development of PTSD in adult patients reporting low or high peritraumatic dissociative (PD) symptoms. Thirty-nine injury patients (20 with high and 19 with low PD symptoms) provided a 15-hour (6 PM to 9 AM) urine sample at 3-weeks post-injury and completed the Clinician Administered PTSD Scale at a 7-week follow-up. Participants collected their urine during wake and sleep times separately. Results showed that in the total sample and in the high PD group, wake, but not sleep, cortisol levels were lower in patients who developed PTSD compared to those who did not. A multiple linear regression analysis revealed a significant main effect of PD and a non-significant interaction between wake cortisol and PD in predicting PTSD symptom severity. In addition, results showed that PD was a better predictor of PTSD symptom severity than wake cortisol levels. These results were consistent with prior research indicating lower afternoon/evening cortisol levels in PTSD and strong associations between PD and PTSD, but did not support the existence of subgroups of PTSD patients (dissociators versus non-dissociators) who may differ in basal cortisol levels.

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Objective assessment of peritraumatic dissociation: psychophysiological indicators

Cited by 277 publications

References 24 publications

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation.

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