Toward a Psychobiology of Posttraumatic Self‐Dysregulation: Reexperiencing, Hyperarousal, Dissociation, and Emotional Numbing

FREWEN, PAUL A.; LANIUS, RUTH A.

doi:10.1196/annals.1364.010

Cited by 306Posttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology ResearchTraumatic Brain Injury Research

Toward a Psychobiology of Posttraumatic Self‐Dysregulation: Reexperiencing, Hyperarousal, Dissociation, and Emotional Numbing

FREWEN, PAUL A., LANIUS, RUTH A.·2006·Annals of the New York Academy of Sciences

DOI 10.1196/annals.1364.010

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Abstract

In this article we propose a psychobiological model that construes PTSD fundamentally as a disorder of affect arousal regulation. Neuroimaging studies of emotion regulation in psychologically healthy populations are initially reviewed as a framework for interpreting the results of previously published investigations of the neural correlates of PTSD reexperiencing and dissociation. We then apply the emotion regulation framework toward understanding other perturbed affective states in PTSD. We conclude by discussing the clinical significance of this framework for psychological assessment and treatment of posttrauma psychopathology.

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Individuals with PTSD with high levels of dissociative symptomatology show distinct patterns of neural activity.
“Evidence of distinct patterns of neural activity (Frewen and Lanius, 2006;Lanius et al., 2010Lanius et al., , 2012) )”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Frewen and Lanius, 2006
PTSD has been conceptualized as fundamentally a disorder of affect arousal regulation, such that dysregulated arousal can lead to altered or dissociative states.
“Within this literature, PTSD has been conceptualized as fundamentally a disorder of affect arousal regulation [53], such that dysregulated arousal can lead to altered or dissociative states.”
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 [53]
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 [53]
Approximately 14-30% of traumatized individuals present with the dissociative subtype of PTSD, characterized by additional depersonalization and derealization symptoms associated with emotional detachment.
“Notably, approximately 14–30% of traumatized individuals present with the dissociative subtype of PTSD characterized by additional depersonalization and derealization symptoms associated with emotional detachment (Bremner and Southwick, 1992; Sierra and Berrios, 1998; Frewen and Lanius, 2006; Lanius et al., 2010; Pain et al., 2010; Steuwe et al., 2012; Wolf et al., 2012; Stein et al., 2013; Armour”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Frewen and Lanius, 2006
PTSD is characterized by a strongly impaired capability to regulate emotions.
“On the behavioral and symptomatic level the disorder is characterized by a strongly impaired capability to regulate emotions (Etkin and Wager, 2007), which may contribute to the manifestation of other characteristic symptoms of the disorder – particularly hyperarousal or avoidance of trauma-related stimuli (Frewen and Lanius, 2006).”
From Rt-fMRI neurofeedback-guided cognitive reappraisal training modulates amygdala responsivity in posttraumatic stress disorder (2020) · cites this paper as Frewen and Lanius, 2006

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The traumatic stress response in child maltreatment and resultant neuropsychological effects
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How understanding the neurobiology of complex post-traumatic stress disorder can inform clinical practice: a social cognitive and affective neuroscience approach: Neurobiology of PTSD and clinical practice
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The brain-body disconnect: A somatic sensory basis for trauma-related disorders
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“Alternatively, decreased arousal may contribute toward the dampened emotionality and hypo-responsivity to stimuli evident in the dissociative subtype (Frewen and Lanius, 2006; Ludäscher et al., 2007; Sack et al., 2012; D’Andrea et al., 2013; Thome et al., 2019).”
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UNDERSTANDING HETEROGENEITY IN PTSD: FEAR, DYSPHORIA, AND DISTRESS
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Emotion Regulatory Flexibility Sheds Light on the Elusive Relationship Between Repeated Traumatic Exposure and Posttraumatic Stress Disorder Symptoms
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A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions
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“Building on this seminal work, Lanius et al. (2010) proposed a neurobiological model of PTSD-DS, characterized primarily by symptoms of derealization, depersonalization, and tonic hypoarousal that contrasted with the more typical symptoms of re-experiencing and hyperarousal that feature predominately in the majority o…”
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The influence of shame on posttrauma disorders: have we failed to see the obvious?
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Intrinsic connectivity networks in post-traumatic stress disorder during sub- and supraliminal processing of threat-related stimuli
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Anterior cingulate activity to salient stimuli is modulated by autonomic arousal in Posttraumatic Stress Disorder
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“…the disorder is characterized by a strongly impaired capability to regulate emotions (Etkin and Wager, 2007), which may contribute to the manifestation of other characteristic symptoms of the disorder – particularly hyperarousal or avoidance of trauma-related stimuli (Frewen and Lanius, 2006).”
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Maternal reflective functioning, interpersonal violence-related posttraumatic stress disorder, and risk for psychopathology in early childhood
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and Emotional Numbing
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Authors: FREWEN, P. A., & LANIUS, R. A.
Affiliations: Western University (CA)
Corresponding author: LANIUS, RUTH A.
ORCID: FREWEN, PAUL A.
LANIUS, RUTH A.
Venue: Annals of the New York Academy of Sciences
Publisher: Wiley
Published: 2006-07
Volume: 1071
Issue: 1
Pages: 110-124
ISSN: 0077-8923 (ISSN-L)
1749-6632
DOI: 10.1196/annals.1364.010
OpenAlex: W2104622135
Cited by: 306
References: 58
Citations by year: 2026: 13 · 2025: 18 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 15 · 2020: 25 · 2019: 15 · 2018: 14 · 2017: 16 · 2016: 15 · 2015: 28 · 2014: 15 · 2013: 14 · 2012: 13
FWCI: 1.72
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 25 d)
Locations: Annals of the New York Academy of Sciences (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords: post-traumatic stress disorder, emotion regulation, psychobiological model, re-experiencing, dissociation, neural correlates, psychological assessment, PTSD treatment
MeSH terms: Adaptation, Psychological, Arousal, Dissociative Disorders, Emotions, Humans, Magnetic Resonance Imaging, Mental Recall, Stress Disorders, Post-Traumatic, Wounds and Injuries

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Toward a Psychobiology of Posttraumatic Self‐Dysregulation: Reexperiencing, Hyperarousal, Dissociation, and Emotional Numbing

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