The DOI matches its Crossref record; 80 of the 82 references it cites were found in a registry or an index.
Freeze, Flight, Fight, Fright, Faint: Adaptationist Perspectives on the Acute Stress Response Spectrum
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 [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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“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]
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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.16,45,61”
From Fear and the Defense Cascade (2015) · cites this paper as [16]
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“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]
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“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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Cites
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- Victor, 2001, Faintness and Syncope. Adams and Victor's Principles of Neurology, 390
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The habenula: from stress evasion to value-based decision-making
Hikosaka, O. (2010) · Nature Reviews Neuroscience · doi:10.1038/nrn2866 · Cited by 955
Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis
Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000010 · Cited by 572
Jones, M., & Love, B. C. (2011) · Behavioral and Brain Sciences · doi:10.1017/s0140525x10003134 · Cited by 533
Castaldo, R., Melillo, P., Bracale, U. M., Caserta, M., Triassi, M., & Pecchia, L. (2015) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2015.02.012 · Cited by 574
Evolutionary psychology: Controversies, questions, prospects, and limitations.
Confer, J. C., Easton, J. A., Fleischman, D. S., Goetz, C. D., Lewis, D. M. G., Perilloux, C., & Buss, D. M. (2010) · American Psychologist · doi:10.1037/a0018413 · Cited by 482
Metadata
- 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
- 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
- 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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