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Article ; Online: Dissociation as a Distinct Peritraumatic Coping Response: a Preliminary Analysis.

Kecala, Natalia M / Goodman, Brittany F / Griffin, Michael G

Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)

2022 , Page(s) 1–16

Abstract: Research examining physiological responses to trauma cues in PTSD has identified a subset of "nonresponders" showing suppressed physiological reactivity. The defense cascade model posits that individuals respond to stressors by progressing through a ... ...

Abstract	Research examining physiological responses to trauma cues in PTSD has identified a subset of "nonresponders" showing suppressed physiological reactivity. The defense cascade model posits that individuals respond to stressors by progressing through a series of defensive reactions, with nonresponders having advanced to a shutdown response. It remains unclear whether dissociation is at the end of a continuum of passive behavior, indicating full shutdown, or if it comprises a distinct response. The present study aimed to address this uncertainty, using EFA to compare a two-factor (active, passive) and three-factor (active, passive, dissociative) model of defensive responding. Eighty-nine female physical and sexual assault survivors reported their peritraumatic reactions within 1 month of their assault, which were entered into the EFA. The three-factor model was superior, suggesting dissociation is a distinct category of peritraumatic coping. Peritraumatic use of both passive and dissociative coping strategies were each significantly associated with ongoing use of passive coping and increased PTSD symptoms 1-month posttrauma; surprisingly, the use of passive peritraumatic coping strategies was a better indicator than peritraumatic dissociation. The inclusion of depression as a covariate removed the association of passive (but not dissociative) coping with PTSD symptom severity. Active coping use was not significantly associated with any outcome, suggesting that the presence of shutdown responses is more informative than the presence or absence of any active coping. These findings highlight the importance of differentiating peritraumatic coping responses and the need for increased attention to the comparatively neglected topic of passive coping.
Language	English
Publishing date	2022-09-04
Publishing country	England
Document type	Journal Article
ISSN	1529-9740
ISSN (online)	1529-9740
DOI	10.1080/15299732.2022.2117262
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Article ; Online: Effect of PTSD treatment on cardiovascular reactivity during trauma memory recall and correspondence with symptom improvement.

Carpenter, Joseph K / Pineles, Suzanne L / Griffin, Michael G / Werner, Kimberly / Resick, Patricia A / Galovski, Tara E

European journal of psychotraumatology

2024 Volume 15, Issue 1, Page(s) 2335865

Abstract: ... ...

Abstract	ABSTRACT
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/psychology ; Mental Recall ; Imagery, Psychotherapy ; Life Change Events ; Violence/psychology
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008066.2024.2335865
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Article ; Online: Heart rate reactivity during trauma recall as a predictor of treatment outcome in cognitive processing therapy for PTSD.

Carpenter, Joseph K / Pineles, Suzanne L / Griffin, Michael G / Pandey, Shivani / Werner, Kimberly / Kecala, Natalia M / Resick, Patricia A / Galovski, Tara E

Behaviour research and therapy

2024 Volume 176, Page(s) 104519

Abstract: Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for ... ...

Abstract	Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for posttraumatic stress disorder (PTSD), but this has yet to be examined in a cognitively oriented treatment. This study examined whether pretreatment heart rate (HR) reactivity during trauma recall predicts PTSD symptom improvement and treatment dropout during Cognitive Processing Therapy (CPT) for PTSD. Participants were 142 women with PTSD secondary to interpersonal violence enrolled in one of two clinicals trials. HR reactivity reflected the mean increase in HR after listening to two 30-s scripts of the trauma memory prior to treatment. Linear mixed-effects models showed the effect of HR reactivity on change in total PTSD symptoms was not significant, but lower HR reactivity predicted less improvement in reexperiencing and avoidance and was associated with increased dropout. Findings suggest pretreatment physiological reactivity to the trauma memory may be a prognostic indicator of some elements of treatment response in CPT. Results tentatively support the importance of emotional activation during trauma recall in cognitive treatment of PTSD, though more research is needed to clarify how low HR reactivity impacts treatment.
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/psychology ; Heart Rate/physiology ; Treatment Outcome ; Psychotherapy/methods ; Cognitive Behavioral Therapy/methods
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	211997-3
ISSN	1873-622X ; 0005-7967
ISSN (online)	1873-622X
ISSN	0005-7967
DOI	10.1016/j.brat.2024.104519
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Article ; Online: Exploring Predictors of Sleep State Misperception in Women with Posttraumatic Stress Disorder.

Arditte Hall, Kimberly A / Werner, Kimberly B / Griffin, Michael G / Galovski, Tara E

Behavioral sleep medicine

2022 Volume 21, Issue 1, Page(s) 22–32

Abstract: Objectives: Insomnia is a common symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line cognitive behavioral interventions. However, research suggests that, among individuals with PTSD, self-reported sleep impairment is ... ...

Abstract	Objectives: Insomnia is a common symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line cognitive behavioral interventions. However, research suggests that, among individuals with PTSD, self-reported sleep impairment is typically more severe than what is objectively observed, a phenomenon termed Method: During a baseline assessment, participants' PTSD symptoms were assessed using a clinical interview and their sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Objective sleep, self-reported sleep, and PTSD symptoms were then assessed over a 1-week period using actigraphy and daily diaries. Results: Consistent with previous research, women in the study exhibited total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) sleep state misperception. For TST and SE, but not SOL, discrepancies between actigraphy and the PSQI were associated with each clinician-rated PTSD symptom cluster, whereas discrepancies between actigraphy and daily diary were only associated with clinician-rated reexperiencing symptoms. The only self-reported PTSD symptom that was uniquely associated with sleep state misperception was nightmares. This association was no longer significant after controlling for sleep-related anxiety. Conclusions: Results suggest that women with more severe reexperiencing symptoms of PTSD, particularly nightmares, may be more likely to exhibit TST and SE sleep state misperception, perhaps due to associated sleep-related anxiety.
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/psychology ; Sleep ; Dreams/psychology ; Sleep Initiation and Maintenance Disorders/complications ; Actigraphy/methods
Language	English
Publishing date	2022-01-10
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2099743-7
ISSN	1540-2010 ; 1540-2002
ISSN (online)	1540-2010
ISSN	1540-2002
DOI	10.1080/15402002.2021.2024193
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Article ; Online: Prospectively predicting PTSD status with heart rate reactivity and recovery in interpersonal violence survivors.

Goodman, Brittany F / Griffin, Michael G

Psychiatry research

2017 Volume 259, Page(s) 270–276

Abstract: The current study used heart rate (HR) reactivity to personalized trauma cues and HR recovery to predict later Posttraumatic Stress Disorder (PTSD) status in female interpersonal violence survivors. A scripted imagery paradigm was used to assess initial ( ...

Abstract	The current study used heart rate (HR) reactivity to personalized trauma cues and HR recovery to predict later Posttraumatic Stress Disorder (PTSD) status in female interpersonal violence survivors. A scripted imagery paradigm was used to assess initial (M = 1 month posttrauma) HR reactivity during exposure to and recovery following idiographic trauma cues. In addition, follow-up PTSD status (M = 8 months posttrauma) was assessed with the Clinician Administered PTSD scale (CAPS). A logistic regression was used to predict PTSD status at the follow-up assessment with HR reactivity during exposure to a personalized trauma audio script and recovery periods at initial assessment entered hierarchically. Script HR reactivity alone did not significantly predict PTSD status. However, after adding HR recovery, the model was significant. Higher HR during recovery was significantly positively associated with PTSD-positive status while script HR reactivity remained a non-significant predictor. The model correctly classified 70% of cases with PTSD. A second logistic regression with initial CAPS severity as a covariate showed that HR recovery added predictive value beyond acute PTSD symptoms. These results suggest that HR recovery following trauma cue exposure is an important predictor of PTSD development.
MeSH term(s)	Adaptation, Psychological/physiology ; Adult ; Cues ; Female ; Heart Rate/physiology ; Humans ; Imagery (Psychotherapy) ; Logistic Models ; Predictive Value of Tests ; Prospective Studies ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/physiopathology ; Survivors/psychology ; Violence/psychology
Language	English
Publishing date	2017-10-24
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2017.10.036
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Zs.A 1541: Show issues

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Article ; Online: The effects of cognitive processing therapy + hypnosis on objective sleep quality in women with posttraumatic stress disorder.

Arditte Hall, Kimberly A / Werner, Kimberly B / Griffin, Michael G / Galovski, Tara E

Psychological trauma : theory, research, practice and policy

2020 Volume 13, Issue 6, Page(s) 652–656

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Cognitive Behavioral Therapy/methods ; Female ; Humans ; Hypnosis ; Sleep ; Sleep Initiation and Maintenance Disorders/therapy ; Sleep Quality ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/psychology ; Stress Disorders, Post-Traumatic/therapy
Language	English
Publishing date	2020-09-10
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000970
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Article: A prospective assessment of auditory startle alterations in rape and physical assault survivors.

Griffin, Michael G

Journal of traumatic stress

2008 Volume 21, Issue 1, Page(s) 91–99

Abstract: This study used a prospective design to investigate startle reactivity following trauma exposure. Startle response was evaluated using loud tones during which measures of eyeblink electromyogram (EMG) and heart rate (HR) were collected. Participants were ...

Abstract	This study used a prospective design to investigate startle reactivity following trauma exposure. Startle response was evaluated using loud tones during which measures of eyeblink electromyogram (EMG) and heart rate (HR) were collected. Participants were 40 female sexual or physical assault survivors assessed at 1 month and 6 months postassault. There were no significant differences in startle reactivity between posttraumatic stress disorder (PTSD) and non-PTSD groups at the initial assessment. However, at 6 months postassault there was a significantly greater EMG and HR response in the PTSD group as well as a significant increase in startle reactivity from 1 month to 6 months postassault. The findings lend support to a sensitization model of trauma reactivity in which startle response develops over time along with PTSD symptoms.
MeSH term(s)	Adolescent ; Adult ; Auditory Perceptual Disorders/etiology ; Crime Victims/psychology ; Crime Victims/statistics & numerical data ; Female ; Humans ; Prospective Studies ; Psychometrics ; Rape/psychology ; Reflex, Startle/physiology ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Surveys and Questionnaires ; Violence
Language	English
Publishing date	2008-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639478-4
ISSN	0894-9867
ISSN	0894-9867
DOI	10.1002/jts.20300
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Zs.A 2386: Show issues

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Article ; Online: Objective and subjective measurement of sleep disturbance in female trauma survivors with posttraumatic stress disorder.

Werner, Kimberly B / Griffin, Michael G / Galovski, Tara E

Psychiatry research

2016 Volume 240, Page(s) 234–240

Abstract: Sleep disturbance may be the most often endorsed symptom of posttraumatic stress disorder (PTSD). Much of this research is based on subjective reports from trauma survivors; however, objective measures of sleep-related impairment have yielded findings ... ...

Abstract	Sleep disturbance may be the most often endorsed symptom of posttraumatic stress disorder (PTSD). Much of this research is based on subjective reports from trauma survivors; however, objective measures of sleep-related impairment have yielded findings inconsistent with self-report data. More studies investigating subjective and objective assessments concordantly are needed to understand sleep impairment in PTSD. The current study examined PTSD-related sleep disturbance in a female interpersonal violence cohort with full PTSD diagnoses (N=51) assessing subjective (global and daily diary measures) and objective (actigraphy) sleep measures concurrently. PTSD severity was positively associated with global, subjective reports of sleep impairment and insomnia. Subjective measures of sleep (including global sleep impairment, insomnia, and daily sleep diary reports of total sleep time, sleep efficiency, and sleep onset latency) were moderately to strongly correlated. However, no significant correlations between subjective and objective reports of sleep impairment were found in this cohort. Analyses demonstrated an overall elevation in subjectively reported sleep impairment when compared to objective measurement assessed concurrently. Findings demonstrate a lack of agreement between subjective and objective measurements of sleep in a PTSD-positive female cohort, suggesting objective and subjective sleep impairments are distinct sleep parameters that do not necessarily directly co-vary.
MeSH term(s)	Actigraphy ; Adolescent ; Adult ; Diagnostic Self Evaluation ; Female ; Humans ; Middle Aged ; Sleep/physiology ; Sleep Wake Disorders/physiopathology ; Sleep Wake Disorders/psychology ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/physiopathology ; Stress Disorders, Post-Traumatic/psychology ; Surveys and Questionnaires ; Survivors/psychology ; Violence/psychology ; Young Adult
Language	English
Publishing date	2016--30
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2016.04.039
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Article ; Online: Predicting Attentional Impairment in Women With Posttraumatic Stress Disorder Using Self-Reported and Objective Measures of Sleep.

Werner, Kimberly B / Arditte Hall, Kimberly A / Griffin, Michael G / Galovski, Tara E

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

2019 Volume 15, Issue 9, Page(s) 1329–1336

Abstract: Study objectives: There is growing evidence to support sleep impairment as a core feature of posttraumatic stress disorder (PTSD). Sleep impairment in PTSD is associated with severe distress and poorer treatment outcomes. Therefore, specific attention ... ...

Abstract	Study objectives: There is growing evidence to support sleep impairment as a core feature of posttraumatic stress disorder (PTSD). Sleep impairment in PTSD is associated with severe distress and poorer treatment outcomes. Therefore, specific attention to this symptom of PTSD is warranted and accurate assessment of sleep impairment is critical. The current study investigated the association between self-reported and objective assessment of sleep and sustained attention in women with PTSD. Methods: Study participants include 50 treatment-seeking, female, interpersonal violence survivors who have PTSD. Nocturnal sleep duration was measured with self-report sleep diaries and objective actigraphy assessment over the course of 7 nights. Sustained attention during daytime was measured by the Psychomotor Vigilance Task (PVT). Results: Results indicated that self-reported nocturnal sleep duration, but not objective or global sleep quality measures, best predicted attentional deficits as indicated by lapses and inverse reaction time on the PVT. Daily sleep diaries predicted 19% and 14% of the variance in attentional lapses and inverse reaction time, respectively. Conclusions: In a sample of women with PTSD, self-reported nocturnal sleep duration predicted deficits in sustained attention. Conversely, sleep duration as measured by actigraphy and global sleep quality, did not predict sustained attention. Findings suggest that assessing sleep impairment on a daily basis may provide clinically relevant information in evaluating daytime symptoms and provide guidance in targeting this particularly troublesome symptom in the treatment of PTSD. Citation: Werner KB, Arditte Hall KA, Griffin MG, Galovski TE. Predicting attentional impairment in women with posttraumatic stress disorder using self-reported and objective measures of sleep. J Clin Sleep Med. 2019;15(9):1329-1336.
MeSH term(s)	Actigraphy/methods ; Adolescent ; Adult ; Attention/physiology ; Female ; Humans ; Middle Aged ; Reaction Time/physiology ; Self Report ; Sleep Deprivation/complications ; Sleep Deprivation/diagnosis ; Sleep Deprivation/physiopathology ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/physiopathology ; Young Adult
Language	English
Publishing date	2019-09-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2397213-0
ISSN	1550-9397 ; 1550-9389
ISSN (online)	1550-9397
ISSN	1550-9389
DOI	10.5664/jcsm.7930
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Article ; Online: Peritraumatic and persistent dissociation as predictors of PTSD symptoms in a female cohort.

Werner, Kimberly B / Griffin, Michael G

Journal of traumatic stress

2012 Volume 25, Issue 4, Page(s) 401–407

Abstract: Recent research has investigated peritraumatic and persistent dissociation as a possible predictive factor for posttraumatic stress disorder (PTSD). The current study aimed to add to this literature by examining dissociative responses in female assault ... ...

Abstract	Recent research has investigated peritraumatic and persistent dissociation as a possible predictive factor for posttraumatic stress disorder (PTSD). The current study aimed to add to this literature by examining dissociative responses in female assault survivors (N = 92 at initial assessment; n = 62 at follow-up). Dissociative symptoms experienced at 3 time points were assessed: peritraumatic dissociation (PD), persistent dissociation-initial (M = 28.2 days posttrauma) and follow-up (M = 224.9 days posttrauma), as well as initial and follow-up PTSD symptoms. We hypothesized that PD and persistent dissociative symptoms would predict chronic PTSD symptoms at the follow-up assessment with initial PTSD symptoms and assault type in the model. Hierarchical regression resulted in a significant model predicting 39% of the variance in follow-up PTSD symptom scores (p < .001). Both peritraumatic and follow-up persistent dissociative symptoms significantly and uniquely added to the variance explained in follow-up PTSD symptom score contributing 4% (p = .05) and 8% (p = .008) of the variance, respectively. Results support the predictive value of peritraumatic and persistent dissociative symptoms, and the findings suggest that persistent dissociation may contribute to the development and continuation of PTSD symptoms. We discuss the implications for assessment and possible treatment of PTSD as well as future directions.
MeSH term(s)	Adolescent ; Adult ; Aged ; Chi-Square Distribution ; Crime Victims/psychology ; Dissociative Disorders/complications ; Dissociative Disorders/psychology ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Middle Aged ; Predictive Value of Tests ; Psychiatric Status Rating Scales ; Sex Offenses/psychology ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/psychology ; Surveys and Questionnaires ; Time Factors ; Violence/psychology ; Young Adult
Language	English
Publishing date	2012-07-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639478-4
ISSN	1573-6598 ; 0894-9867
ISSN (online)	1573-6598
ISSN	0894-9867
DOI	10.1002/jts.21725
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