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Cited by 497Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesEvolutionary Psychology and Human BehaviorStress Responses and Cortisol

Freeze, Flight, Fight, Fright, Faint: Adaptationist Perspectives on the Acute Stress Response Spectrum

Bracha, H. Stefan·2004·CNS Spectrums
DOI 10.1017/s1092852900001954
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Abstract

This article reviews the existing evolutionary perspectives on the acute stress response habitual faintness and blood-injection-injury type-specific phobia (BIITS phobia). In this article, an alternative evolutionary perspective, based on recent advances in evolutionary psychology, is proposed. Specifically, that fear–induced faintness (eg, fainting following the sight of a syringe, blood, or following a trivial skin injury) is a distinct Homo sapiens -specific extreme-stress survival response to an inescapable threat. The article suggests that faintness evolved in response to middle paleolithic intra-group and inter-group violence (of con-specifics) rather than as a pan-mammalian defense response, as is presently assumed. Based on recent literature, freeze, flight, fight, fright, faint provides a more complete description of the human acute stress response sequence than current descriptions. Faintness, one of three primary physiological reactions involved in BIITS phobia, is extremely rare in other phobias. Since heritability estimates are higher for faintness than for fears or phobias, the author suggests that trait-faintness may be a useful complement to trait-anxiety as an endophenotype in research on the human fear circuitry. Some implications for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as well as for clinical, health services, and transcriptomic research are briefly discussed.

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  • An updated version of the classic general adaptation syndrome and the foundational stress response theory of Horowitz may provide a potential conceptual framework by postulating that stress reactions proceed through four hierarchical phases: freeze, flight, fight, and faint (or tonic immobility).

    “An updated version [10] of the classic general adaptation syndrome [152] and the foundational stress response theory of Horowitz [72], may provide a potential conceptual framework by postulating that stress reactions proceed through four hierarchical phases: freeze, flight, fight, and faint (or tonic immobility).”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [10]

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  • The function of tonic immobility is to deactivate the predator's killing reflex or to discourage consumption, as many predators are reluctant to eat dead meat.

    “Its function is to deactivate the predator’s killing reflex or to discourage consumption, as many predators are reluctant to eat dead meat (see Figure 4).16,45,52,85”

    From Fear and the Defense Cascade (2015) · cites this paper as [16]

    The Abstract (p. 2) says tonic immobility may help captured prey escape if a predator assumes it is dead and loosens its grip. It does not say that the response deactivates a killing reflex or that predators are reluctant to eat dead meat; it also presents the escape benefit as a possibility, not a definite function. (LLM, conf=0.86)

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  • Attentive immobility enables the animal to continue scanning the environment and readies the animal for an active response such as flight or fight.

    “Attentive immobility enables the animal to continue scanning the environment and readies the animal for an active response such as flight or fight.16,45,61”

    From Fear and the Defense Cascade (2015) · cites this paper as [16]

  • Collapsed immobility was first identified by Rivers nearly a century ago and was recently added to the human defense cascade by Bracha in 2004.

    “Collapsed immobility was first identified by Rivers7 nearly a century ago and was only recently (2004) added to the human defense cascade by Bracha.16”

    From Fear and the Defense Cascade (2015) · cites this paper as [16]

  • Hypo-arousal and decreased muscle tone occur during emotional shut-down or feign death as a passive defensive response to inescapable or prolonged threat.

    “Alternatively, hypo-arousal and decreased muscle tone occur during emotional shut-down or feign death as a passive defensive response to inescapable or prolonged threat ( Hofer, 1970 ; Depaulis et al., 1994 ; Bracha, 2004 ).”

    From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Bracha, 2004

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Research works printed but not linked: 5

  1. [18]18. Page AC, Martin NG. Testing a genetic structure of blood-injury-injection fears. Am J Med Genet . 1998;81:377-384.
  2. [24]24. Victor M, Ropper AH. Faintness and Syncope. Adams and Victor's Principles of Neurology . New York, NY: McGraw-Hill; 2001:390-403.
  3. [30]30. Merckelbach H, Muris P , de Jong PJ, de Jongh A. Disgust sensitivity, bloodinjection-injury fear, and dental anxiety. Clinical Psychology and Psychotherapy . 1999;6:279-285.
  4. [67]67. Marsella AJ, Friedman MJ, Gerrity E, Scurfield RM. Ethnocultural Aspects of Posttraumatic Stress and Related Stress Disorders . Washington, DC: American Psychological Association Press; 1996.
  5. [71]71. Bracha HS, Williams AE, Ralston TC. Criterion A3 for PTSD: incorporating a proposed diagnostic criterion into clinical practice. Current Psychiatry . In press.

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Authors
Bracha, H. S.
Affiliations
United States Department of Veterans Affairs (US)
Corresponding author
Bracha, H. Stefan
Venue
CNS Spectrums
Publisher
Cambridge University Press (CUP)
Published
2004-09
Volume
9
Issue
9
Pages
679-685
ISSN
  • 1092-8529 (ISSN-L)
  • 2165-6509
DOI
10.1017/s1092852900001954
OpenAlex
W2171440972
Cited by
497
References
82
Citations by year
2026: 45 · 2025: 34 · 2024: 26 · 2023: 27 · 2022: 51 · 2021: 32 · 2020: 71 · 2019: 29 · 2018: 18 · 2017: 22 · 2016: 16 · 2015: 19 · 2014: 18 · 2013: 21 · 2012: 13
FWCI
1.34
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 3719 d)
Locations
  • CNS Spectrums (publishedVersion)
  • PubMed (publishedVersion)
  • CogPrints (University of Southampton) (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Evolutionary Psychology and Human Behavior
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
acute stress response, evolutionary psychology, adaptationism, heritability, endophenotypes, trait anxiety, fear circuitry, DSM-5
MeSH terms
Adaptation, Psychological, Biological Evolution, Fear, Humans, Syncope, Stress Disorders, Traumatic, Acute, Immobility Response, Tonic

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