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Fear-potentiated startle and posttraumatic stress symptoms in urban police officers
Abstract
We studied the effects of increasing threat conditions on self‐reported emotion, eyeblink electromyogram, and skin conductance responses to startling sounds in 55 police officers who endorsed a range of PTSD (posttraumatic stress disorder) symptoms. We found that contextual threat affected both physiologic and self‐reported emotional responses. Greater PTSD symptom severity was related to greater physiologic responses under the low and medium but not under the high threat condition. The relationship between PTSD symptoms and physiologic responses was neither explained by self‐reported emotional responses nor preexisting reported exaggerated startle symptoms. Our results emphasize the importance of contextual threat and suggest that laboratory measures of startle improve upon self‐reported exaggerated startle alone in indexing PTSD symptom severity in urban police officers.
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Fear-potentiated startle can be dysregulated in PTSD.
“Studies in PTSD have shown that fear-potentiated startle can be dysregulated in PTSD (Jovanovic et al., 2010;Pole et al., 2003)”
From Physiological feelings (2019) · cites this paper as Pole et al., 2003
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Phasic vs Sustained Fear in Rats and Humans: Role of the Extended Amygdala in Fear vs Anxiety
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“Similarly, an association between PTSD symptoms severity in urban police officers and the level of contextual threat in a threat of shock experiment has been documented (Pole et al. 2003).”
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“For example, during experiments in which shocks were signaled by a threat cue, Vietnam veterans with posttraumatic stress disorder (PTSD) showed exaggerated startle responses throughout the testing procedure, including the periods when subjects were not at risk of receiving a shock (absence of the threat cue), compare…”
BackgroundResultInfluentialGrillon, C., Pine, D. S., Lissek, S., Rabin, S., Bonne, O., & Vythilingam, M. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.12.028 · Cited by 272
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“Similar to results from Grillon and colleagues (Grillon et al., 1998; Morgan et al., 1995) as well as Pole et al. (2003), acute threat of electric shock elicited equal levels of fear in all subjects and only when the level of threat was lower (due to the absence of threat cues or shock electrodes) did patients and con…”
Pace-Schott, E. F., Amole, M. C., Aue, T., Balconi, M., Bylsma, L. M., Critchley, H., Demaree, H. A., Friedman, B. H., Gooding, A. E. K., Gosseries, O., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.05.002 · Cited by 221
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Self-citationCerebral blood flow in immediate and sustained anxiety
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“Sustained responses to contextual cues and fear of specific threat cues may coexist in posttraumatic stress disorder (Pole et al., 2003).”
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“The cadets also participated in our startle procedure (13,25).”
InfluentialSelf-citationGrillon, C., Baas, J. M. P., Pine, D. S., Lissek, S., Lawley, M., Ellis, V., & Levine, J. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.11.027 · Cited by 157
“…individuals with posttraumatic stress disorder (PTSD) or with panic disorder display normal startle to explicit threat cues that signal a shock but display enhanced startle reactivity in the experimental context in which the shocks are administered (Grillon et al 1994, 1998b; Pole et al 2003).”
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“…& Vythilingam, 2009), attaching shock electrodes to subjects while mentioning that shocks would not be delivered until later (Grillon et al., 1998b; Pole et al., 2003), and assessing startle reactivity in two sessions in which mild electric shocks were administered in the first session (Grillon &…”
Families at high and low risk for depression: A three-generation startle study
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The brain orexin system and almorexant in fear-conditioned startle reactions in the rat
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“…emotional stimuli are also exaggerated in anxious rat strains (Steiner et al. 2011a) and in human anxiety patients, including post-traumatic stress disorder (PTSD) and panic disorder patients (Grillon et al. 1994; Grillon andMorgan 1999; Lissek et al. 2008; Morgan et al. 1995; Pole et al. 2003).”
Sensation Seeking and the Aversive Motivational System.
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Pole, N., Neylan, T. C., Otte, C., Metzler, T. J., Best, S. R., Henn‐Haase, C., & Marmar, C. R. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.2.352 · Cited by 72
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“response to unexpected alerting stimuli (as outlined in Pole et al., 2003). 240 M.E. Shaw et al. / Psychiatry Research: Neuroimaging 172 (2009) 235–241”
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“…controls found in several studies assessing startle potentiation to discrete, threatof-shock cues (Grillon and Morgan, 1999; Grillon et al., 1998; Pole et al., 2003) could be attributable to ceiling effects producing maximal outputs in the startle system among all participants, leaving little…”
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“…used a relatively long tone stimulus of 500 ms, which is comparable to some previous research with trauma survivors (e.g., Orr et al, 1995, 1997; Shalev et al., 2000), but that others have used a much shorter stimulus of 40 ms (e.g., Jovanovic et al., 2009; Morgan et al., 1995; Pole et al., 2003).”
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Self-citationStress Resilience Assessment Based on Physiological Features in Selection of Air Traffic Controllers
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“These include fear, anxiety, panic, reduced compliance with social norms, hyper-vigilance and sensitivity to environmental cues, as well as avoidance behavior (references [10, 12, 18]).”
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“, 1995) and earlier studies using various populations have shown individuals diagnosed with PTSD exhibit exaggerated physiologic response patterns compared to those without PTSD (Orr et al., 1995; Pole et al., 2003; Shalev et al., 1992).”
Self-citationSarapultsev, A., Komelkova, M. V., Lookin, O. N., Khatsko, S. L., Gusev, E., Трофимов, А. Н., Tokay, T., & Hu, D. (2024) · Pathophysiology · doi:10.3390/pathophysiology31040051 · Cited by 23
Stress and First Responders: The Need for a Multidimensional Approach to Stress Management
Reynolds, C. A., & Wagner, S. L. (2007) · International Journal of Disability Management · doi:10.1375/jdmr.2.2.27 · Cited by 23
Niles, A. N., Luxenberg, A., Neylan, T. C., Inslicht, S. S., Richards, A. L., Metzler, T. J., Hlavin, J. A., Deng, J., & O’Donovan, A. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22302 · Cited by 18
“…Galovski, & Veazey, 2002; Bryant, Harvey, Guthrie, & Moulds, 2000; Carson et al., 2007; Griffin, 2008; Macklin et al., 2012; Metzger et al., 1999; Pole et al., 2003; Shalev et al., 1998, 2000), and (d) examining the association between startle reactivity and trauma exposure independent of PTSD…”
BackgroundResultInfluentialSelf-citationMarx, B. P., Bovin, M. J., Suvak, M. K., Monson, C. M., Sloan, D. M., Fredman, S. J., Humphreys, K. L., Kaloupek, D. G., & Keane, T. M. (2012) · Journal of Traumatic Stress · doi:10.1002/jts.21729 · Cited by 17
“Without employing the sophisticated analyses utilized in the current study, past investigations (i.e., McDonagh-Coyle, 2001; Pole et al., 2003) may not have been able to detect even the presence of the concordance.”
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“Responsivity under conditions of low threat in PTSD has also been reported elsewhere [58,59].”
BackgroundThe orbitofrontal cortex and anxiety disorders
Milad, M. R., & Rauch, S. L. (2006) · The Orbitofrontal Cortex · doi:10.1093/acprof:oso/9780198565741.003.0020 · Cited by 11
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“A large body of literature has shown that individuals diagnosed with PTSD exhibit higher fear-potentiated physiological responses to sudden or threatening stimuli compared to those without a PTSD diagnosis, which suggests greater threat sensitivity (Grillon et al., 1998; Niles et al., 2018; Orr et al., 1995; Pole et a…”
BackgroundSelf-citationStauffer, C. S., Morrison, T. E., Meinzer, N. K., Leung, D., Buffington, J., Sheh, E. G., Neylan, T. C., O’Donovan, A., & Woolley, J. D. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114340 · Cited by 10
Self-citationModerators of PTSD‐Related Psychophysiological Effect Sizes
Pole, N. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1364.033 · Cited by 9
Self-citationGender and PTSD: What can we learn from female police officers?
Lilly, M. M., Pole, N., Best, S. R., Metzler, T. J., & Marmar, C. R. (2009) · PsycEXTRA Dataset · doi:10.1037/e717692011-016 · Cited by 9
Self-citationUsing experimental methodologies to assess posttraumatic stress
Jovanovic, T., Rauch, S. A., Rothbaum, A. O., & Rothbaum, B. O. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2016.10.001 · Cited by 5
Zoladz, P. R. (2008) · Digital Commons - University of South Florida (University of South Florida) · Cited by 5
Combat deployment and the returning police officer
(2008) · PsycEXTRA Dataset · doi:10.1037/e514162009-001 · Cited by 5
“Recent research, much of which has been conducted with police officers, includes studies of biological markers and symptoms associated with PTSD, as well as prospective studies18 of public safety professionals, which allow for an improved understanding of risk and resilience factors of PTSD development (Neylan et al.…”
BackgroundTraumatic Stress, World Assumptions, and Law Enforcement Officers
Green, D. W. (2016) · CUNY Academic Works (City University of New York) · Cited by 4
Electroconvulsive shocks exacerbate the heightened acoustic startle response in stressed rats.
Manion, S. T., Figueiredo, T. H., Aroniadou‐Anderjaska, V., & Braga, M. F. M. (2010) · Behavioral Neuroscience · doi:10.1037/a0018258 · Cited by 3
Perceived security: An experimental study of security doors
Sinico, M. (2021) · Safety Science · doi:10.1016/j.ssci.2021.105252 · Cited by 3
Basedau, N. (2007) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg) · Cited by 3
Didn’t Even Blink: Dissociation, Complex Trauma Exposure and Decreased Startle Reactivity
D'Andrea, W. M., Freed, S., DePierro, J. M., Nelson, B. D., Seemann, C., McKernan, S. M., Wilson, T. E., & Pole, N. (2024) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2024.2429445 · Cited by 3
“Eyeblink following startling sounds is the primary means of assessing startle responses and has been investigated as a biomarker for PTSD (Pole et al., 2003); the startle paradigm’s utility is in creating a standardized stimulus, whereas other paradigms (e.g., script-driven imagery) may confound…”
Self-citation13. State of the Art in Technology-Supported Resilience Training For Military Professionals
Favié, J., Vanessa Vakili, A., Brinkman, W., Nexhmedin Morina, B., & Neerincx, M. A. (2015) · doi:10.1515/9783110471137-013 · Cited by 2
Brain and behaviour in functional retrograde amnesia
Fujiwara, E. (2004) · PUB – Publications at Bielefeld University (Bielefeld University) · Cited by 2
Brunner, L.-M., Maurer, F., Weber, K., Weigl, J., Milenkovic, V. M., Rupprecht, R., Nothdurfter, C., & Mühlberger, A. (2022) · Psychopharmacology · doi:10.1007/s00213-022-06111-x · Cited by 1
Diggs, H. A., Rabinovich, N. E., & Gilbert, D. G. (2022) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2853 · Cited by 1
“The electrical stimulator used has been used in a variety of conditioning paradigms with humans (Holt et al., 2009; Orr et al., 2000; Otto et al., 2007; Pole et al., 2003).”
BackgroundGoodman, R. J. (2014) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/t2zz-1h21 · Cited by 1
A study of the effectiveness of a death notification training seminar for law enforcement officers
Register, B. J. (2010) · Cited by 1
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Zoladz, P. R. (2006) · Digital Commons - University of South Florida (University of South Florida)
Halonen, J. D. (2009) · Digital Commons - University of South Florida (University of South Florida)
Careers and ethical issues in the traumatic stress field
Ford, J. D., Grasso, D. J., Elhai, J. D., & Courtois, C. A. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-801288-8.00012-1
Maabela, S. M. (2015) · Unisa Institutional Repository (University of South Africa)
The Progress of Startle Paradigm in the Clinical Studies of PTSD: Hyperarousal and Fear Inhibition
Xinwen, D. O. N. G., Chaoyi, W. A. N. G., Changli, W. A. N. G., & Li, Y. (2013) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2013.00965
Empirically Supported Conceptualizations and Treatments of Post‐traumatic Stress Disorder
Green, J. D., Marx, B. P., & Keane, T. M. (2017) · Wiley eBooks · doi:10.1002/9781118877142.ch9
A cognitive theory of the etiology of fear.
Armfield, J. M. (2008) · Adelaide Research & Scholarship (AR&S) (University of Adelaide)
(2009) · Elsevier eBooks · doi:10.1016/b978-0-12-374462-3.00014-9
The Breeding Ground for Institutional Racism: Policing Others and Racial Capitalism in Europe.
Vrăbiescu, I. (2026) · Springer eBooks · doi:10.1007/978-3-032-02242-4_22
Metadata
- Authors
- Pole, N., Neylan, T. C., Best, S. R., Orr, S. P., & Marmar, C. R.
- Affiliations
- University of California, San Francisco (US)
- San Francisco VA Medical Center (US)
- Corresponding author
- Pole, Nnamdi
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2003-10
- Volume
- 16
- Issue
- 5
- Pages
- 471-479
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- OpenAlex
- W2133212283
- Cited by
- 79
- References
- 36
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 4 · 2015: 5 · 2014: 2 · 2013: 2 · 2012: 5
- FWCI
- 5.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH056350, R01 MH56350-03)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- fear-potentiated startle, post-traumatic stress disorder, police officers, skin conductance, self-reported emotion, PTSD symptom severity, occupational injuries
- MeSH terms
- Adult, Blinking, Electromyography, Emotions, Fear, Female, Galvanic Skin Response, Humans, Male, Reflex, Startle, Stress Disorders, Post-Traumatic, Urban Population, Reproducibility of Results, Police
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