Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD)

Abstract Recent cross-sectional studies have shown that the inability to suppress fear under safe conditions is a key problem in people with posttraumatic stress disorder (PTSD). The current longitudinal study examined whether individual differences in fear inhibition predict the persistence of PTSD...

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Bibliographic Details
Published in:Journal of psychiatric research 2013-12, Vol.47 (12), p.1991-1997
Main Authors: Sijbrandij, Marit, Engelhard, Iris M, Lommen, Miriam J.J, Leer, Arne, Baas, Johanna M.P
Format: Article
Language:English
Subjects:
Acoustic startle
Acoustic Stimulation
Adolescent
Adult
Adult and adolescent clinical studies
Anxiety disorders. Neuroses
Biological and medical sciences
Classical conditioning
Conditional discrimination
Conditioning, Classical - physiology
Deployment
Fear
Fear - psychology
Fear inhibition
Female
Humans
Inhibition
Inhibition (Psychology)
Learning
Learning Disorders - diagnosis
Learning Disorders - etiology
Longitudinal Studies
Male
Medical sciences
Military
Military Personnel
Netherlands
Post-traumatic stress disorder
Posttraumatic stress disorder
Posttraumatic stress disorder (PTSD)
Predictive Value of Tests
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reaction Time - physiology
Reflex, Startle - physiology
Stress Disorders, Post-Traumatic - complications
Stress Disorders, Post-Traumatic - diagnosis
Symptoms
Young Adult
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Summary:Abstract Recent cross-sectional studies have shown that the inability to suppress fear under safe conditions is a key problem in people with posttraumatic stress disorder (PTSD). The current longitudinal study examined whether individual differences in fear inhibition predict the persistence of PTSD symptoms. Approximately 2 months after deployment to Afghanistan, 144 trauma-exposed Dutch soldiers were administered a conditional discrimination task (AX+/BX−). In this paradigm, A, B, and X are neutral stimuli. X combined with A is paired with a shock (AX+ trials); X combined with B is not (BX− trials). Fear inhibition was measured (AB trials). Startle electromyogram responses and shock expectancy ratings were recorded. PTSD symptoms were measured at 2 months and at 9 months after deployment. Results showed that greater startle responses during AB trials in individuals who discriminated between danger (AX+) and safety (BX−) during conditioning, predicted higher PTSD symptoms at 2 months and 9 months post-deployment. The predictive effect at 9 months remained significant after controlling for critical incidents during previous deployments and PTSD symptoms at 2 months. Responses to AX+ or BX− trials, or discrimination learning (AX+ minus BX−) did not predict PTSD symptoms. It is concluded that impaired fear inhibition learning seems to be involved in the persistence of PTSD symptoms.
ISSN:0022-3956
1879-1379
DOI:10.1016/j.jpsychires.2013.09.008