James W. Hopper

Recall of emotional states in posttraumatic stress disorder: an fMRI investigation

BACKGROUND The goal of this study was to examine the neuronal circuitry underlying different emotional states (neutral, sad, anxious, and traumatic) in posttraumatic stress disorder (PTSD) in traumatized subjects versus traumatized subjects without PTSD. METHODS Traumatized subjects with (n = 10) and without (n = 10) PTSD were studied using the script-driven symptom provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4 Tesla field strength. RESULTS Compared to the trauma-exposed comparison group, PTSD subjects showed significantly less activation of the thalamus and the anterior cingulate gyrus (area 32) in all three emotional states (sad, anxious, and traumatic). CONCLUSION These findings suggest thalamic and anterior cingulate dysfunction in the recollection of traumatic as well as other negative events. Thalamic and anterior cingulate dysfunction may underlie emotion dysregulation often observed clinically in PTSD.

Factors in the cycle of violence: Gender rigidity and emotional constriction

A sample of 595 men were administered self-report assessments of childhood sexual and physical abuse, perpetration history, gender rigidity and emotional constriction. Including noncontact forms of sexual abuse, 11% of the men reported sexual abuse alone, 17% reported physical abuse alone, and 17% reported both sexual and physical abuse. Of the 257 men in the sample who reported some form of childhood abuse, 38% reported some form of perpetration themselves, either sexual or physical; of the 126 perpetrators, 70% reported having been abused in childhood. Thus, most perpetrators were abused, but most abused men did not perpetrate. Both sexually and physically abused men who perpetrated manifested significantly more gender rigidity and emotional constriction than abused nonperpetrators. Men who reported abuse but not perpetration demonstrated significantly less gender rigidity, less homophobia and less emotional constriction than nonabused men.

Low respiratory sinus arrhythmia and prolonged psychophysiological arousal in posttraumatic stress disorder: heart rate dynamics and individual differences in arousal regulation

BACKGROUND There is extensive evidence that the parasympathetic branch of the autonomic nervous system can modulate psychophysiological arousal. To date, no studies have investigated associations between cardiac vagal tone and the time course of arousal during exposure to trauma-related stimuli in posttraumatic stress disorder (PTSD). METHODS Thirty-one subjects, 29 with PTSD and 2 with partial PTSD, had electrocardiograms recorded during baseline and 2-minute traumatic and neutral script-driven imagery periods. Heart rate, respiratory sinus arrhythmia (RSA), and heart rate half-recovery to the trauma script were quantified, and subjects were divided into low and high baseline RSA groups. RESULTS Across all participants, heart rate significantly increased from the neutral to the trauma script and RSA significantly decreased from baseline to trauma script (p < .05). As predicted, low RSA subjects had more prolonged heart rate increases to the trauma script than high RSA subjects (p < .001), and heart rate half-recovery was negatively correlated to baseline RSA (r = -.50, p =.005). CONCLUSIONS This study is the first to find decreased RSA in response to a traumatic reminder and an association between low baseline RSA and sustained conditioned arousal in PTSD. Low vagal tone may account for deficient arousal and emotion regulation capacities often observed in PTSD.

Clinical and Neural Correlates of Alexithymia in Posttraumatic Stress Disorder

Individuals with posttraumatic stress disorder (PTSD) often exhibit deficits in emotional experience and expression, which suggests that certain individuals with PTSD may be alexithymic. In this study, in a sample of 105 individuals with PTSD, clinical correlates of alexithymia included reexperiencing, hyperarousal, numbing, dissociative symptoms, and retrospectively reported experiences of childhood emotional neglect. In a subsample of 26 individuals with PTSD related to a motor vehicle accident, functional neural responses to trauma-script imagery were associated with severity of alexithymia, including increased right posterior-insula and ventral posterior-cingulate activation and decreased bilateral ventral anterior-cingulate, ventromedial prefrontal, anterior-insula, and right inferior frontal cortex activation. Clinical and theoretical implications and future research directions are discussed.

Exploring the nature of traumatic memory: Combining clinical knowledge with laboratory methods

Summary For over 100 years clinicians have observed and described the unusual nature of traumatic memories. It has been repeatedly and consistently observed that these memories are characterized by fragmentary and intense sensations and affects, often with little or no verbal narrative content. Yet, possibly because traumatic memories cannot be precipitated under laboratory conditions, the organization of traumatic memories has received little systematic scientific investigation. In our laboratory we have developed an instrument, the Traumatic Memory Inventory (TMI), which systematically assesses the ways that memories of traumatic experience are organized and retrieved over time. In this article we report findings from our third study using the TMI, of 16 subjects who had the traumatic experience of awakening from general anesthesia during surgery. We assessed changes in traumatic memory characteristics over time and differences between memories of subjects with and without current Post-Traumatic Stress Disorder. Our findings suggest the need for more rigorous methods for the assessment of the evolution of traumatic memories. In order to develop a comprehensive and integrated understanding of the nature of traumatic memory, we need to combine careful clinical observations with repli-cable laboratory methods, including those of cognitive science and neuroscience.

Acute dissociation and cardiac reactivity to script-driven imagery in trauma-related disorders.

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. For the abstract or full text in other languages, please see Supplementary files under Reading Tools online