Acute dissociation and cardiac reactivity to script-driven imagery in trauma-related disorders
Open accessAbstract
BACKGROUND: Potential acute protective functions of dissociation include modulation of stress-induced psychophysiological arousal. This study was designed to explore whether acute dissociative reactions during a stress experiment would override the effects of reexperiencing. METHODS: Psychophysiological reactions during exposure to script-driven trauma imagery were studied in relation to acute responses of reexperiencing and dissociative symptoms in 61 patients with histories of exposure to a variety of traumas. Acute symptomatic responses were assessed with the Responses to Script-Driven Imagery Scale (RSDI), and participants were divided into four groups by median splits of RSDI reexperiencing and dissociation subscale scores. RESULTS: In a comparison of the high RSDI reexperiencing groups with low versus high acute dissociative symptoms, the high dissociators exhibited significantly lower heart rate (HR) during trauma script and a significantly smaller script-induced decrease in parasympathetic cardiac activity. HR reactivity to the trauma script was negatively correlated with acute dissociative symptom severity. CONCLUSIONS: Acute dissociative reactions are a potential moderator of response to experimental paradigms investigating psychologically traumatized populations. We therefore suggest that future research on psychophysiological stress reactions in traumatized samples should routinely assess for acute dissociative symptoms.
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Experiencing acute dissociation during trauma recall (via personalized trauma audio-scripts) is associated with reduced heart rate in PTSD patients.
“a study of PTSD patients demonstrated that experiencing acute dissociation during trauma recall (via personalized trauma audio-scripts) is associated with reduced heart rate (Sack et al., 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 Sack et al., 2012
The Results passage reports that participants with high acute dissociation had lower heart rate during the trauma script, and the Methods describe personalized trauma scripts recorded on audiotape. However, the Participants section says only 42 of 61 participants (69%) had a PTSD diagnosis; the reported association is for the broader trauma-related sample, not specifically for PTSD patients. (LLM, conf=0.87)
Experimental — accuracy not yet measuredOther studies employed the term 'active suppression' to reflect significant heart rate deceleration or reduced heart rate reactivity concurrent with parasympathetic dominance.
“Meanwhile, other studies employed the term ‘active suppression’ to reflect significant heart rate deceleration (D'Andrea et al., 2013) or reduced heart rate reactivity (Sack et al., 2012) concurrent with parasympathetic dominance (Lanius et al., 2018; Schauer & Elbert, 2010).”
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 Sack et al., 2012
The authors observed lower autonomic activity in people with high acute dissociation, higher HR in those with high trait dissociation, and no physiologic effect in those with high peritraumatic dissociation.
“We observed lower autonomic activity in people with high acute dissociation (Sack et al., 2012), higher HR in those with high trait dissociation (Hyer et al., 1993), and no physiologic effect in those with high peritraumatic dissociation (Kaufman et al., 2002).”
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 Sack et al., 2012
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- Authors
- Sack, M., Cillien, M., & Hopper, J. W.
- Affiliations
- TUM Klinikum (DE)
- Cambridge Health Alliance (US)
- Corresponding author
- Sack, Martin
- ORCID
- Sack, Martin
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2012-11-27
- Volume
- 3
- Issue
- 1
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC3509425
- OpenAlex
- W2152240366
- Cited by
- 46
- References
- 44
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 6 · 2017: 1 · 2016: 3 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- dissociation, trauma-related disorders, script-driven imagery, re-experiencing, cardiac reactivity, heart rate, parasympathetic activity, psychophysiological stress response, trauma exposure, dissociative symptoms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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