Impact of Trauma Type on Startle Reactivity to Predictable and Unpredictable Threats
Open accessAbstract
Trauma exposure has been repeatedly linked to psychophysiological threat reactivity, although the directionality of this association has been inconsistent. Several factors likely contribute to inconsistent findings including type of trauma and threat paradigm. The present study therefore examined the impact of trauma type on psychophysiological reactivity to predictable (P-) and unpredictable (U-) threat in young adults (N = 112). Participants were classified into three groups: history of interpersonal or noninterpersonal trauma, or no history of trauma. Startle eyeblink potentiation was recorded during a well-validated threat-of-shock paradigm. Results indicated individuals with interpersonal trauma exposure displayed exaggerated startle reactivity to U-threat (only) compared with both other groups. In contrast, individuals with noninterpersonal trauma exhibited blunted startle reactivity to U-threat (only) compared with both other groups. Findings reveal that trauma and threat type influence threat reactivity and that those with a history of interpersonal trauma may uniquely display exaggerated sensitivity to stressors that are uncertain.
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Cites
Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective
Grupe, D. W., & Nitschke, J. B. (2013) · Nature Reviews Neuroscience · doi:10.1038/nrn3524 · Cited by 2,007 · see citing works
Phasic vs Sustained Fear in Rats and Humans: Role of the Extended Amygdala in Fear vs Anxiety
Davis, M., Walker, D. L., Miles, L., & Grillon, C. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.109 · Cited by 1,488 · cited 1× · see citing works
“In response to unpredictable (U-) threat, individuals display generalized apprehension and sustained hypervigilance (Davis et al., 2010).”
BackgroundUnraveling the mysteries of anxiety and its disorders from the perspective of emotion theory.
Barlow, D. H. (2000) · American Psychologist · doi:10.1037/0003-066x.55.11.1247 · Cited by 1,135 · see citing works
Watson, D., O’Hara, M. W., Naragon-Gainey, K., Koffel, E., Chmielewski, M., Kotov, R., Stasik, S. M., & Ruggero, C. J. (2012) · Assessment · doi:10.1177/1073191112449857 · Cited by 470 · see citing works
Norrholm, S. D., Jovanovic, T., Olin, I. W., Sands, L. A., Karapanou, I., Bradley, B., & Ressler, K. J. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.09.013 · Cited by 397 · see citing works
Anxious Responses to Predictable and Unpredictable Aversive Events.
Grillon, C., Baas, J. P., Lissek, S., Smith, K., & Milstein, J. (2004) · Behavioral Neuroscience · doi:10.1037/0735-7044.118.5.916 · Cited by 349 · see citing works
Anxiety sensitivity and intolerance of uncertainty: requisites of the fundamental fears?
Nicholas Carleton, R., Sharpe, D., & Asmundson, G. J. G. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.04.006 · Cited by 293 · cited 1× · see citing works
“Although uncertainty is inherent in everyday life, individuals who are overly reactive to uncertainty tend to exhibit high levels of chronic anticipatory anxiety (Carleton et al., 2007; Grupe and Nitschke, 2013).”
BackgroundTrauma, PTSD, and the Developing Brain
Herringa, R. J. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0825-3 · Cited by 248 · see citing works
Zaba, M., Kirmeier, T., Ionescu, I. A., Wollweber, B., Buell, D. R., Gall-Kleebach, D. J., Schubert, C. F., Novak, B., Huber, C., Köhler, K., et al. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.02.005 · Cited by 101 · see citing works
Gorka, S. M., Lieberman, L., Phan, K. L., & Shankman, S. A. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.04.034 · Cited by 47 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 38
- Berenz EC, Cho SB, Overstreet C, Kendler K, Amstadter AB, Dick DM (2016) Longitudinal investigation of interpersonal trauma exposure and alcohol use trajectories. Addict Behav. 53: 67– 73. 26454552 PMC4699169
- Blumenthal TD, Cuthbert BN, Filion DL, Hackley S, Lipp OV, Van Boxtel A (2005) Committee report: guidelines for human startle eyeblink electromyographic studies. Psychophysiol. 42: 1– 15. 15720576
- Britton JC, Phan KL, Taylor SF, Fig LM, Liberzon I (2005) Corticolimbic blood flow in posttraumatic stress disorder during script-driven imagery. Biol Psychiatry. 57: 832– 840. 15820703
- D’Andrea W, Pole N, DePierro J, Freed S, Wallace DB (2013) Heterogeneity of defensive responses after exposure to trauma: Blunted autonomic reactivity in response to startling sounds. Int J Psychophysiol. 90: 80– 89. 23896169
- Davidson RJ, McEwen BS (2012) Social influences on neuroplasticity: Stress and interventions to promote well-being. Nat Neurosci. 15: 689– 695. 22534579 PMC3491815
- Davis M (2006) Neural systems involved in fear and anxiety measured with fear-potentiated startle. Am. Psychol. 61: 741– 756. 17115806
- Enlow MB, Egeland B, Blood EA, Wright RO, Wright RJ (2012) Interpersonal trauma exposure and cognitive development in children to age 8 years: a longitudinal study. J Epidemiol Community Health. 66: 1005– 1010. 22493459 PMC3731065
- Forbes D, Fletcher S, Parslow R, Phelps A, O’Donnell M, Bryant RA, McFarlane A, Silove D, Creamer M (2012) Trauma at the hands of another: Longitudinal study of differences in the posttraumatic stress disorder symptom profile following interpersonal compared with noninterpersonal trauma. J Clin Psychiatry. 73: 372– 376. 22154900
- Gorka SM (2020) Interpersonal trauma exposure and startle reactivity to uncertain threat in individuals with alcohol use disorder. Drug Alcohol Depend. 206: 107727. 31734035 PMC6980731
- Gorka SM, Lieberman L, Shankman SA, Phan KL (2017) Startle potentiation to uncertain threat as a psychophysiological indicator of fear-based psychopathology: An examination across multiple internalizing disorders. J Abnorm Psychol. 126: 8. 27868423 PMC5215951
- Gorka SM, MacNamara A, Aase DM, Proescher E, Greenstein JE, Walters R, Passi H, Babione JM, Levy DM, Kennedy AE, DiGangi JA, Rabinak CA, Schroth C, Afshar K, Fitzgerald J, Hajcak G, Phan KL (2016b) Impact of alcohol use disorder comorbidity on defensive reactivity to errors in veterans with post- traumatic stress disorder. Psychol Addict Behav. 30: 733. 27786513 PMC5525136
- Gorka SM, Nelson BD, Shankman SA (2013) Startle response to unpredictable threat in comorbid panic disorder and alcohol dependence. Drug Alcohol Depend. 132: 216– 222. 23465734 PMC3679290
- Gorka SM, Shankman SA (2017) Preliminary evidence that reactivity to uncertain threat is an endophenotype for alcohol use disorder. Drug Alcohol Depend. 180: 265– 271. 28938184 PMC5679723
- Grillon C, Pine DS, Lissek S, Rabin S, Bonne O, Vythilingam M (2009) Increased anxiety during anticipation of unpredictable aversive stimuli in posttraumatic stress disorder but not in generalized anxiety disorder. Biol Psychiatry. 66: 47– 53. 19217076 PMC2696581
- Heim C, Newport DJ, Heit S, Graham YP, Wilcox M, Bonsall R, Miller AH, Nemeroff CB (2000) Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Jama. 284: 592– 597. 10918705
- Hyde J, Ryan KM, Waters AM (2019) Psychophysiological Markers of fear and anxiety. Curr Psychiatry Rep. 21: 56. 31161250
- Jovanovic T, Blanding NQ, Norrholm SD, Duncan E, Bradley B, Ressler KJ (2009) Childhood abuse is associated with increased startle reactivity in adulthood. Depress Anxiety. 26: 1018– 1026. 19691032 PMC2852033
- Jovanovic T, Norrholm SD, Fennell JE, Keyes M, Fiallos AM, Myers KM, Davis M, Duncan EJ (2009) Posttraumatic stress disorder may be associated with impaired fear inhibition: relation to symptom severity. Psychiatry Res. 167: 151– 160. 19345420 PMC2713500
- Jovanovic T, Norrholm SD, Blanding NQ, Davis M, Duncan E, Bradley B, Ressler KJ (2010) Impaired fear inhibition is a biomarker of PTSD but not depression. Depress Anxiety. 27: 244– 251. 20143428 PMC2841213
- Krupnick JL, Green BL, Stockton P, Goodman L, Corcoran C, Petty R (2004) Mental health effects of adolescent trauma exposure in a female college sample: Exploring differential outcomes based on experiences of unique trauma types and dimensions. Psychiatry. 67: 264– 279. 15491942
- Lewis MW, Jones RT, Davis MT (2020) Exploring the impact of trauma type and extent of exposure on posttraumatic alterations in 5-HT1A expression. Transl Psychiatry. 10: 1– 12. 32678079 PMC7366706
- Lieberman L, Funkhouser CJ, Gorka SM, Liu H, Correa KA, Berenz EC, Phan KL, Shankman SA (2020) The Relation Between Posttraumatic Stress Symptom Severity and Startle Potentiation to Predictable and Unpredictable Threat. J Nerv Ment. 208: 397– 402. PMC10627509 32053566
- Lissek S, van Meurs B (2015) Learning models of PTSD: Theoretical accounts and psychobiological evidence. Int J Psychophysiol. 98: 594– 605. 25462219 PMC4809259
- MacNamara A, Post D, Kennedy AE, Rabinak CA, Phan KL (2013) Electrocortical processing of social signals of threat in combat-related post-traumatic stress disorder. Biol Psychiatry. 94: 441– 449. 24025760
- Marshall RD, Olfson M, Hellman F, Blanco C, Guardino M, Struening EL (2001) Comorbidity, impairment, and suicidality in subthreshold PTSD. Am J Psychiatry. 158: 1467– 1473. 11532733
- McLaughlin KA, Lambert HK (2017) Child trauma exposure and psychopathology: mechanisms of risk and resilience. Curr Opin Psychol. 14: 29– 34. 27868085 PMC5111863
- Nelson BD, Hajcak G (2017) Defensive motivation and attention in anticipation of different types of predictable and unpredictable threat: A startle and event-related potential investigation. Psychophysiology. 54: 1180– 1194. 28370078 PMC5507715
- Nelson GH, O’Hara MW, Watson D (2018) National norms for the expanded version of the inventory of depression and anxiety symptoms (IDAS-II). J Clin Psychol. 74: 953– 968. 29327338
- Nemeroff CB (2004) Neurobiological consequences of childhood trauma. J Clin Psychiatry. 14728093
- Norrholm SD, Jovanovic T (2018) Fear processing, psychophysiology, and PTSD. Harv Rev Psychiatry. 26: 129– 141. 29734227
- Pine DS (2003) Developmental psychobiology and response to threats: relevance to trauma in children and adolescents. Biol Psychiatry. 53: 796– 808. 12725972
- Schmitz A, Grillon C (2012) Assessing fear and anxiety in humans using the threat of predictable and unpredictable aversive events (the NPU-threat test). Nat Protoc. 7: 527. 22362158 PMC3446242
- Stevens ES, Lieberman L, Funkhouser CJ, Correa KA, Shankman SA (2019) Startle during threat longitudinally predicts functional impairment independent of DSM diagnoses. Psychiatry Res. 279: 207– 215. 30853118 PMC6713600
- Van der Kolk B (2000) Posttraumatic stress disorder and the nature of trauma. Dialogues Clin Neurosci. 2: 7. 22034447 PMC3181584
- Wamser-Nanney R, Howell KH, Schwartz LE, Hasselle AJ (2018) The moderating role of trauma type on the relationship between event centrality of the traumatic experience and mental health outcomes. Psychol Trauma. 10: 499. 29154596
- Watson D, O’Hara MW, Chmielewski M, McDade-Montez EA, Koffel E, Naragon K, Stuart S (2008) Further validation of the IDAS: evidence of convergent, discriminant, criterion, and incremental validity. Psychol. Assess 20(3): 248. 18778161
- Watson D, O’Hara MW, Simms LJ, Kotov R, Chmielewski M, McDade-Montez EA, (2007) Development and validation of the Inventory of Depression and Anxiety Symptoms (IDAS). Psychol. Assess. 19(3): 253. 17845118
- Wieser MJ, Reicherts P, Juravle G, von Leupoldt A (2016) Attention mechanisms during predictable and unpredictable threat—A steady-state visual evoked potential approach. NeuroImage. 139: 167– 175. 27318217
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Kurtoğlu, M. B. (2026) · Journal of Health Psychology · doi:10.1177/13591053261464387
- Authors
- Kreutzer, K. A., & Gorka, S. M.
- Affiliations
- The Ohio State University (US)
- Corresponding author
- Kreutzer, Kayla A.
- Gorka, Stephanie M.
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2021-12
- Volume
- 209
- Issue
- 12
- Pages
- 899-904
- ISSN
- 0022-3018 (ISSN-L)
- 1539-736X
- PMC
- PMC8633038
- OpenAlex
- W3187119004
- Cited by
- 19
- References
- 10
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 5 · 2023: 6
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K23AA025111)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- trauma type, startle reactivity, threat reactivity, unpredictable threat, interpersonal trauma, psychophysiological reactivity, uncertainty sensitivity, trauma exposure
- MeSH terms
- Psychological Trauma, Adolescent, Adult, Fear, Female, Humans, Interpersonal Relations, Male, Reflex, Startle, Violence, Young Adult, Anticipation, Psychological
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