The relationship between tonic immobility and the development, severity, and course of posttraumatic stress disorder: Systematic and meta-analytic literature review

Coimbra, Bruno Messina; Hoeboer, Chris M.; Zuiden, Mirjam van; Williamson, Rachel E.; Delia, Ana; Mello, Andréa F.; Olff, Miranda

doi:10.1016/j.janxdis.2023.102730

Cited by 6 publications

(3 citation statements)

References 73 publications

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“…For instance, victims of physical/sexual violence or sexual abuse often experience a state of ‘freezing’, also known as ‘tonic immobility’ (TI) (Kalaf et al, 2017 ). Research has shown that victims frequently report TI as a perceived defense response during instances of sexual or physical violence (Hagenaars, 2016 ; Möller et al, 2017 ), and its presence during interpersonal trauma is linked to the severity of PTSD symptoms following trauma (Coimbra et al, 2023 ). Furthermore, according to Bracha ( 2004 ), the ‘fright’ and ‘faint’ responses are also considered defense responses.…”

Section: Introductionmentioning

confidence: 99%

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods

Knipschild,

Klip,

Winkelhorst

et al. 2024

European Journal of Psychotraumatology

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Background: Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment. Objective: This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse. Methods: Adolescents (12 – 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention. Conclusions: There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program. Trial Registration: Request is pending.

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Section: Introductionmentioning

confidence: 99%

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods

Knipschild,

Klip,

Winkelhorst

et al. 2024

European Journal of Psychotraumatology

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“…The relationship between tonic immobility and PTSD has been established in various studies. A meta-analytic study found out that tonic immobility mediates the influence of peritraumatic fear and observed inevitability on the severity of PTSD symptoms and that not the peritraumatic fear but the motoric tonic immobility was found to be the predictor of severity of the PTSD symptoms (Coimbra et al, 2023 ). Tonic immobility is accompanied by a suppression of the autonomic responses.…”

Section: Introductionmentioning

confidence: 99%

“…Since autonomic arousal is required for adequate fear extinction, it could be assumed that patients experiencing tonic immobility show decreased autonomic arousal during exposure to trauma cues and would therefore benefit less from IE. Two studies have already shown poorer recovery from PTSD in patients with higher peritraumatic tonic immobility after pharmacological treatment (Coimbra et al, 2023 ; Fiszman et al, 2008 ). To our knowledge there is no study to date that researched the recovery from PTSD in patients with high peritraumatic tonic immobility comparing IE to IR treatment.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder following childhood sexual and physical abuse: a study protocol for an 11-week randomised controlled trial comparing imaginal exposure and imagery rescripting

van Hemert,

de Jong,

Vanaerschot

et al. 2024

European Journal of Psychotraumatology

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Background: There is a vast amount of evidence supporting the effectiveness of trauma-focused cognitive-behavioral therapy in treating posttraumatic stress disorder (PTSD). However, it remains unclear which specific treatment is most effective for patients with PTSD following childhood sexual and physical abuse (CSPA). Although Imaginal Exposure (IE) has proven highly effective in treating PTSD and is widely acknowledged as a standard method, Imagery Rescripting (IR) may be more suitable for CSPA-related PTSD. IR not only addresses fear but also targets other emotions and cognitions associated with childhood maladaptive schemas. Preliminary findings suggest lower drop-out rates for IR compared to IE, but no Randomized Controlled Trial (RCT) currently assesses the effectiveness of IR for CSPA-related PTSD. Objective: This article presents a study protocol designed to investigate the optimal treatment (IE or IR) for individuals with CSPA-related PTSD and explore predictors of treatment success. Method: In our study protocol, we suggest the inclusion of 173 patients ( N = 64 in IR, N = 64 in IE, and N = 45 in the waitlist condition). The therapy procedures for both IE and IR will consist of 16 sessions lasting 90 min each, with treatment durations of 11 weeks. Measurements take place at baseline, at start of treatment, 11 weeks after the start of treatment (after 16 sessions) and at follow-up at 26 weeks after the last session. A mixed regression will be used to compare the three active conditions before and after measurement. Results: This article serves as a study protocol. The results are not yet available but they will be presented in a subsequent article. Conclusion: This study protocol outlines a RCT which will be the first to provide information on the effectiveness of IR versus IE versus a control group in CSPA-related PTSD. Trial registration: Netherlands Trial Register NTR 4817. Registered 26 September 2014.

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What is rape? Elements of rape and application of the criminal label

Augustyn,

Pinchevsky,

2024

J Exp Criminol

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The relationship between tonic immobility and the development, severity, and course of posttraumatic stress disorder: Systematic and meta-analytic literature review

Cited by 6 publications

References 73 publications

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods

Posttraumatic stress disorder following childhood sexual and physical abuse: a study protocol for an 11-week randomised controlled trial comparing imaginal exposure and imagery rescripting

What is rape? Elements of rape and application of the criminal label

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