Posttraumatic stress disorder: a theoretical model of the hyperarousal subtype

Weston, Charles Stewart E.

doi:10.3389/fpsyt.2014.00037

Cited by 114Posttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology ResearchTraumatic Brain Injury Research

Posttraumatic stress disorder: a theoretical model of the hyperarousal subtype

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Weston, Charles Stewart E.·2014·Frontiers in Psychiatry

DOI 10.3389/fpsyt.2014.00037PMC PMC3983492

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Abstract

Posttraumatic stress disorder (PTSD) is a frequent and distressing mental disorder, about which much remains to be learned. It is a heterogeneous disorder; the hyperarousal subtype (about 70% of occurrences and simply termed PTSD in this paper) is the topic of this article, but the dissociative subtype (about 30% of occurrences and likely involving quite different brain mechanisms) is outside its scope. A theoretical model is presented that integrates neuroscience data on diverse brain regions known to be involved in PTSD, and extensive psychiatric findings on the disorder. Specifically, the amygdala is a multifunctional brain region that is crucial to PTSD, and processes peritraumatic hyperarousal on grounded cognition principles to produce hyperarousal symptoms. Amygdala activity also modulates hippocampal function, which is supported by a large body of evidence, and likewise amygdala activity modulates several brainstem regions, visual cortex, rostral anterior cingulate cortex (rACC), and medial orbitofrontal cortex (mOFC), to produce diverse startle, visual, memory, numbing, anger, and recklessness symptoms. Additional brain regions process other aspects of peritraumatic responses to produce further symptoms. These contentions are supported by neuroimaging, neuropsychological, neuroanatomical, physiological, cognitive, and behavioral evidence. Collectively, the model offers an account of how responses at the time of trauma are transformed into an extensive array of the 20 PTSD symptoms that are specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. It elucidates the neural mechanisms of a specific form of psychopathology, and accords with the Research Domain Criteria framework.

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Given that baseline levels of arousal tend to already be elevated within traumatized individuals, a meditation-related increase in attention and arousal could especially result in hyperaroused states for individuals who have experienced significant trauma.
“Given that baseline levels of arousal tend to already be elevated within traumatized individuals [55], a meditation-related increase in attention and arousal could especially result in hyperaroused states for individuals who have experienced significant trauma.”
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 [55]
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Neural circuitry that includes the amygdaloid complex can be associated with at least 14 symptoms of PTSD.
“neural circuitry that includes the amygdaloid complex can be associated with at least 14 symptoms of PTSD and, as such, there remains compelling interest in developing and utilizing translational paradigms that index these circuits”
From Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors (2014) · cites this paper as [13]

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Authors: Weston, C. S. E.
Corresponding author: Weston, Charles Stewart E.
ORCID: Weston, Charles Stewart E.
Venue: Frontiers in Psychiatry
Publisher: Frontiers Media SA
Published: 2014-04-04
Volume: 5
Pages: 37-37
ISSN: 1664-0640 (ISSN-L)
DOI: 10.3389/fpsyt.2014.00037
PMC: PMC3983492
OpenAlex: W2082109620
Cited by: 114
References: 304
Citations by year: 2026: 8 · 2025: 10 · 2024: 14 · 2023: 9 · 2022: 10 · 2021: 7 · 2020: 13 · 2019: 7 · 2018: 7 · 2017: 6 · 2016: 13 · 2015: 6 · 2014: 3
FWCI: 1.41
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Frontiers in Psychiatry (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, amygdala, hippocampus, brainstem, rostral anterior cingulate cortex, medial orbitofrontal cortex, grounded cognition, posttraumatic stress symptoms, Research Domain Criteria

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Posttraumatic stress disorder: a theoretical model of the hyperarousal subtype

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