Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder
Open accessAbstract
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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With regards to acute post-traumatic dissociation, findings were similarly inconsistent, although there was some evidence of an attenuated response based on heart rate, heart rate variability and skin conductance.
“With regards to acute post-traumatic dissociation, findings were similarly inconsistent, although there was some evidence of an attenuated response (based on heart rate, heart rate variability and skin conductance) (Chou et al., 2018; D'Andrea et al., 2013; Krause-Utz et al., 2018; Sack et al., 2012).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Chou et al., 2018
The Discussion’s “Changes in HRV” section reports that greater state depersonalisation/derealisation was associated with a lower LF/HF ratio, suggesting parasympathetic dominance; this supports some evidence of an attenuated response. But “Changes in HR” reports no significant association with depersonalisation/derealisation and an increase in heart rate during flashbacks. The paper does not report skin-conductance findings; that component of the multi-citation sentence is not supported by Chou et al. (Page numbers are unavailable in our copy.) (LLM, conf=0.86)
Experimental — accuracy not yet measuredSeveral studies investigating acute post-traumatic dissociation depicted a tendency towards a hypoaroused autonomic reactivity.
“Contrary to this, several studies investigating acute post-traumatic dissociation depicted a tendency towards a hypoaroused autonomic reactivity (Chou et al., 2018; D'Andrea et al., 2013; Krause-Utz et al., 2018; Sack et al., 2012)”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Chou et al., 2018
In a recent study of voluntary recall of trauma memories by a PTSD sample, heart rate gradually reduced over time, but flashbacks were accompanied by momentary increases in heart rate.
“A recent study of the voluntary recall of trauma memories by a PTSD sample, mimicking what happens in exposure therapy, found that whereas heart rate gradually reduced over time, flashbacks were accompanied by momentary increases in heart rate [39].”
From Memory and Forgetting (2018) · cites this paper as [39]
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Cited by
Sorted by citations
The effects of trauma on brain and body: A unifying role for the midbrain periaqueductal gray
Terpou, B. A., Harricharan, S., McKinnon, M. C., Frewen, P., Jetly, R., & Lanius, R. A. (2019) · Journal of Neuroscience Research · doi:10.1002/jnr.24447 · Cited by 82 · see citing works
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“…regards to acute post-traumatic dissociation, findings were similarly inconsistent, although there was some evidence of an attenuated response (based on heart rate, heart rate variability and skin conductance) (Chou et al., 2018; D’Andrea et al., 2013; KrauseUtz et al., 2018; Sack et al., 2012).”
BackgroundResultInfluentialBrewin, C. R. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0950-7 · Cited by 70 · see citing works
Self-citation
- Authors
- Chou, C.-Y., La Marca, R., Steptoe, A., & Brewin, C. R.
- Affiliations
- University College London (GB)
- Department of Psychology, Universität Zürich, Zürich, Switzerland
- Corresponding author
- Brewin, Chris R.
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2018-01-01
- Volume
- 9
- Issue
- 1
- Pages
- 1472988-1472988
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC5990938
- OpenAlex
- W2806999381
- Cited by
- 21
- References
- 14
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2015: 1
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- post-traumatic stress disorder, dissociation, flashbacks, depersonalization, derealization, heart rate, heart rate variability, parasympathetic activity, fear, threat perception
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