Peri-Traumatic Dissociation and Tonic Immobility as Severity Predictors of Posttraumatic Stress Disorder After Rape

Abstract

Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence ( R2 = .132; p = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster ( p = .058). PTD was strongly correlated with anxiety ( R2 = .619; p < .001) and depressive symptoms ( R2 = .547; p < .001). Multiple logistic regression showed that history of physical abuse (odds ratio [ OR]: 1.386; p = .011) and sexual abuse ( OR: 1.947; p = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study ( OR: 0.216; p = .016) and lower income ( OR: 7.403; p = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.

Peritraumatic dissociation and posttraumatic stress symptoms: the moderating role of perceived threat

“…Hence, neither perceived threat, PD, nor the interaction between them, predicted avoidance symptoms when all other factors were accounted for. Although research examining the relationship between peritraumatic responses and specific PTSD symptoms clusters has been scarce (Dewey et al, 2014 ), these findings are consistent with the few available studies (deMello et al, 2022 ; Massazza et al, 2021 ; van der Velden et al, 2006 ). For instance, a recent cross-sectional study by deMello et al ( 2022 ) revealed significant correlations between PD and all PTSD symptom clusters except for avoidance in women who had recently been sexually assaulted.…”

“…Although research examining the relationship between peritraumatic responses and specific PTSD symptoms clusters has been scarce (Dewey et al, 2014 ), these findings are consistent with the few available studies (deMello et al, 2022 ; Massazza et al, 2021 ; van der Velden et al, 2006 ). For instance, a recent cross-sectional study by deMello et al ( 2022 ) revealed significant correlations between PD and all PTSD symptom clusters except for avoidance in women who had recently been sexually assaulted. Moreover, Massazza et al ( 2021 ) investigated the factor structure of six well-known peritraumatic measures and their relationship with the four PTSD symptom clusters.…”

Psychophysiological reactions during the trauma-film paradigm and their predictive value for intrusions

“…Survivors describe the latter as an inability to move their body, despite having an intense urge to flee. These characteristics of the downregulation phase are especially reported by survivors of sexual assault (deMello et al, 2023 ; Gbahabo & Duma, 2021 ; TeBockhorst et al, 2015 ). The defence cascade model predicts post-traumatic reactions induced by certain trauma-associated triggers from responses during a life-threatening event (Schauer & Elbert, 2010 ), and hypothesizes that peritraumatic stages of the cascade are re-enacted with their physiologically and psychologically responses.…”

The Reality of Tonic Immobility in Victims of Sexual Violence: “I was Paralyzed, I Couldn’t Move”

“…The consequences of TI have been addressed in all the research reviewed, and in more than half of the studies (6 out of 11) a significant relationship with PTSD was found. In this regard, the results have shown that TI plays an important role in the subsequent symptomatology of PTSD in adulthood (Bovin et al, 2008; DeMello et al, 2023), including those who have experienced sexual violence in childhood (Humphreys et al, 2010). In the longitudinal study conducted by Möller et al, (2017) it was found that the prevalence of PTSD at 6 months was almost twice as high in women who had experienced extreme TI compared to women who had not experienced TI during the assault.…”