The function of image control in the psychophysiology of posttraumatic stress disorder

Abstract

The physiological response to trauma-related stimuli of up to one third of participants with posttraumatic stress disorder (PTSD) cannot be discriminated from that of controls. Psychophysiological measures (heart rate and blood pressure) of 22 PTSD and 23 control civilian participants, all exposed to missile attacks during the Gulf War, were recorded while listening to five scripts. The physiological response of PTSD subjects with high image control (IC) was lower than that of PTSD participants with low IC and similar to that of non-PTSD subjects. The physiological response poorly discriminated high IC PTSD participants from controls, but was successful in discriminating low IC PTSD subjects from controls with 91% specificity and 92% sensitivity. Image control is proposed as a function influencing physiological response in PTSD.

Imagery Rescripting in the Treatment of Posttraumatic Stress Disorder

“…These studies of imagery vividness and imagery control in PTSD imply that incorporating imagery control and vivid imagery work may improve treatment outcomes (Laor et al, 1998). The results are particularly relevant to a PTSD treatment utilizing imagery rescripting because this technique specifically focuses on the client manipulating and modifying images to reduce distress.…”

“…Some theorists indicate that imagery may be a conduit for effective therapeutic treatment of PTSD. The vivid activation of traumatic imagery in a safe setting can help survivors improve imagery control, habituate to trauma images and related physiological arousal, and identify and modify maladaptive schemas (Foa & Kozak, 1986;Lang, 1977;Laor et al, 1998;Grey, Young, & Holmes, 2002 ).…”

“…Empirical studies examining imagery vividness and ability to control imagery in PTSD suggest that these qualities may play an important role in understanding and treating the disorder (Bryant & Harvey, 1996;Laor et al, 1998;Laor et al, 1999;Stutman & Bliss, 1985). Evidence from these studies suggests that the imagery of PTSD participants with re-experiencing symptoms is more vivid than in other participants and that poor imagery control is associated with higher physiological arousal to trauma cues.…”

Vividness of mental imagery in Posttraumatic Stress Disorder (PTSD): The role of depression

“…Generally speaking, it can be challenging to treat traumatic mental images in people with PTSD and there is evidence to suggest that traumatic intrusive images could still be automatically triggered post-intervention (Hackmann, Ehlers, Speckens, & Clark, 2004). There is also evidence to suggest that cognitive capacity to control mental images can influence physiological responses (Laor et al, 1998) and emotional regulation in people with PTSD (Laor et al, 1999).…”

A Virtual Reality Exposure Therapy Application for Iraq War Post Traumatic Stress Disorder

“…Since past research is suggestive of differential patterns of physiological reactivity in soldiers with PTSD when exposed to combat-related stimuli [17,18], an initial procedure that integrates a VR PTSD application with psychophysiological monitoring could be of value. If indicators of such physiological reactivity are present during an initial VR exposure, a referral for continued assessment and/or care could be negotiated and/or suggested.…”