Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma
Abstract
This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering from the chronic sequelae of traumatic experiences.
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These findings are in line with established research on relationships between altered or dissociative states of consciousness and a history of childhood trauma and/or current trauma symptoms.
“These findings are in line with established research on relationships between altered or dissociative states of consciousness and a history of childhood trauma and/or current trauma symptoms [27, 51–53].”
From Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression (2025) · cites this paper as [52]
The most common MRSE and negative valence MRAE experiences were perceptual hypersensitivity, vivid imagery and thoughts, somatosensory changes, traumatic reexperiencing, anxiety and panic, affective lability, and agitation-all forms of nervous system hyperarousal.
“The most common MRSE and negative valence MRAE experiences, as reported in detail in Britton, Lindahl [18], were perceptual hypersensitivity, vivid imagery and thoughts, somatosensory changes, traumatic reexperiencing, anxiety and panic, affective lability, and agitation–all forms of nervous system hyperarousal [52].”
From Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression (2025) · cites this paper as [52]
The window of tolerance model states that trauma, particularly prolonged childhood trauma, can result in high autonomic sensitivity towards stressors and an imbalance in the dopaminergic system associated with rapid, uncontrolled shifting between two distress dipoles.
“The window of tolerance model (Corrigan et al., 2011; Ogden et al., 2006; Siegel, 1999) states that trauma, particularly prolonged childhood trauma, can result in high autonomic sensitivity towards stressors and an imbalance in the dopaminergic system associated with rapid, uncontrolled shifting between two distress dipoles”
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 Corrigan et al., 2011
The window of tolerance represents a zone of psychological and autonomic flexibility: a balanced psychophysiological state allowing for flexible shifting, regulation, and integration of emotions.
“the window of tolerance represents a zone of psychological and autonomic flexibility: a balanced psychophysiological state allowing for flexible shifting, regulation, and integration of emotions, so they become tolerable.”
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 Corrigan et al., 2011
Emotion dysregulation is recognized as a core psychopathological factor in many psychological disorders such as borderline personality disorder, emotional trauma, ADHD, bipolar disorder, and anorexia and bulimia nervosa.
“Emotion dysregulation has been recognized as a core psychopathological factor in many other psychological disorders such as borderline personality disorder (BPD; Linehan, 1993; Schore, 2003), emotional trauma (Corrigan et al., 2011), attention deficit hyperactivity disorder (ADHD; Shaw et al., 2014), bipolar disorder (Van Rheenen et al., 2015), and anorexia and bulimia nervosa (Lavender et al., 2”
From Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies (2017) · cites this paper as Corrigan et al., 2011
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- Authors
- Corrigan, F., Fisher, J., & Nutt, D.
- Affiliations
- Argyll and Bute Hospital (GB)
- Center for Integrative Healing, Watertown, Massachusetts, USA.
- Department of Neuropsychopharmacology and Molecular Imaging, Imperial College, London, UK.
- Corresponding author
- Corrigan, FM
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2010-01-21
- Volume
- 25
- Issue
- 1
- Pages
- 17-25
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W2132653311
- Cited by
- 195
- References
- 66
- Citations by year
- 2026: 19 · 2025: 52 · 2024: 16 · 2023: 24 · 2022: 13 · 2021: 14 · 2020: 8 · 2019: 12 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 5
- FWCI
- 0.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- window of tolerance, autonomic dysfunction, childhood abuse, post-traumatic stress disorder, self-harm, substance abuse, periaqueductal gray, dopaminergic system, mesolimbic dopamine system, mesocortical dopamine, social defeat, animal models of depression, emotion regulation, pharmacotherapy
- MeSH terms
- Adult, Affect, Animals, Arousal, Autonomic Nervous System, Child, Child Abuse, Cognition Disorders, Dangerous Behavior, Defense Mechanisms, Depressive Disorder, Disease Models, Animal, Dopamine, Humans, Periaqueductal Gray, Stress Disorders, Post-Traumatic, Sympathomimetics, Time Factors
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