Psychophysiological Correlates of Peritraumatic Dissociative Responses in Survivors of Life-Threatening Cardiac Events
Abstract
The psychophysiological startle response pattern associated with peritraumatic dissociation (DISS) was studied in 103 survivors of a life-threatening cardiac event (mean age 61.0 years, SD 13.95). Mean time period since the cardiac event was 37 (79 IQD) months. All patients underwent a psychodiagnostic evaluation (including the Peritraumatic Dissociative Experiences Questionnaire) and a psychophysiological startle experience which comprised the delivery of 15 acoustic startle trials. Magnitude and habituation to trials were measured by means of electromyogram (EMG) and skin conductance responses (SCR). Thirty-two (31%) subjects were indexed as patients with a clinically significant level of DISS symptoms. High-level DISS was associated with a higher magnitude of SCR (ANOVA for repeated measures p = 0.017) and EMG (p = 0.055) and an impaired habituation (SCR slope p = 0.064; EMG slope p = 0.005) in comparison to subjects with no or low DISS. In a subgroup analysis, high-level DISS patients with severe post-traumatic stress disorder (PTSD; n = 11) in comparison to high-level DISS patients without subsequent PTSD (n = 19) exhibited higher EMG amplitudes during all trials (repeated measures analysis of variance F = 5.511, p = 0.026). The results demonstrate exaggerated startle responses in SCR and EMG measures – an abnormal defensive response to high-intensity stimuli which indicates a steady state of increased arousal. DISS patients without PTSD exhibited balanced autonomic responses to the startle trials. DISS may, therefore, unfold malignant properties only in combination with persistent physiological hyperarousability.
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When dissociation was high, the presence or absence of PTSD did not affect skin conductance response (p = .878, d = 0.17).
“Furthermore, when dissociation was high, the presence or absence of PTSD did not affect SCR (p = .878, d = 0.17).”
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 Ladwig et al. (2002)
Ladwig et al. (2002) found increased skin conductance response in participants with high levels of dissociation as compared to participants with no/low dissociation during an acoustic startle probe (p = .017, d = 0.42).
“Using general stress stimuli, Ladwig et al. (2002) found increased SCR in participants with high levels of dissociation as compared to participants with no/low dissociation during an acoustic startle probe (p = .017, d = 0.42).”
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 Ladwig et al. (2002)
Other studies showed a slight trend towards hyperarousal associated with retrospectively assessed dissociative reactions experienced during the initial traumatic event.
“Other studies showed a slight trend towards hyperarousal associated with the retrospectively assessed dissociative reactions experienced during the initial traumatic event (Hetzel-Riggin & Wilber, 2010; Ladwig et al., 2002; Sledjeski & Delahanty, 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 Ladwig et al., 2002
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“Other studies showed a slight trend towards hyperarousal associated with the retrospectively assessed dissociative reactions experienced during the initial traumatic event (Hetzel-Riggin & Wilber, 2010; Ladwig et al., 2002; Sledjeski & Delahanty, 2012).”
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- Authors
- Ladwig, K.-H., Marten-Mittag, B., Deisenhofer, I., Hofmann, B., Schapperer, J., Weyerbrock, S., Erazo, N., & Schmitt, C.
- Affiliations
- TUM Klinikum (DE)
- Deutsches Herzzentrum München (DE)
- Venue
- Psychopathology
- Publisher
- S. Karger AG
- Published
- 2002
- Volume
- 35
- Issue
- 4
- Pages
- 241-248
- ISSN
- 0254-4962 (ISSN-L)
- 1423-033X
- OpenAlex
- W2156433371
- Cited by
- 47
- References
- 7
- Citations by year
- 2022: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3 · 2014: 2 · 2012: 4
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
- Funders
- Technische Universität München
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- peritraumatic dissociation, cardiac arrest survivors, startle response, skin conductance response, electromyography, habituation, post-traumatic stress disorder, hyperarousal, autonomic arousal
- MeSH terms
- Dissociative Disorders, Electromyography, Humans, Psychometrics, Skin, Reflex, Startle, Stress Disorders, Post-Traumatic, Survivors
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