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Generalisation of fear in PTSD related to prolonged childhood maltreatment: an experimental study

Published online by Cambridge University Press:  28 December 2017

Janine Thome ,
Sophie Hauschild ,
Georgia Koppe ,
Lisa Liebke ,
Sophie Rausch ,
Julia I. Herzog ,
Meike Müller-Engelmann ,
Regina Steil ,
Kathlen Priebe  and
Dirk Hermans
...Show all authors
Janine Thome*
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Sophie Hauschild
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Georgia Koppe
Affiliation:
Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Lisa Liebke
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Sophie Rausch
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Julia I. Herzog
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Meike Müller-Engelmann
Affiliation:
Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
Regina Steil
Affiliation:
Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
Kathlen Priebe
Affiliation:
Department of Psychology, Faculty of Life Sciences, Humboldt University Berlin, Berlin, Germany
Dirk Hermans
Affiliation:
Faculty of Psychology and Educational Sciences, Leuven University, Leuven, Belgium
Christian Schmahl
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Martin Bohus
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Faculty of Health, Antwerp University, Antwerp, Belgium
Stefanie Lis
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
*
Author for correspondence: Janine Thome, E-mail: [email protected]
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Abstract

Background

Fear responses are particularly intense and persistent in post-traumatic stress disorder (PTSD), and can be evoked by unspecific cues that resemble the original traumatic event. Overgeneralisation of fear might be one of the underlying mechanisms. We investigated the generalisation and discrimination of fear in individuals with and without PTSD related to prolonged childhood maltreatment.

Methods

Sixty trauma-exposed women with (N = 30) and without (N = 30) PTSD and 30 healthy control participants (HC) underwent a fear conditioning and generalisation paradigm. In a contingency learning procedure, one of two circles of different sizes was associated with an electrical shock (danger cue), while the other circle represented a safety cue. During generalisation testing, online risk ratings, reaction times and fear-potentiated startle were measured in response to safety and danger cues as well as to eight generalisation stimuli, i.e. circles of parametrically varying size creating a continuum of similarity between the danger and safety cue.

Results

The increase in reaction times from the safety cue across the different generalisation classes to the danger cue was less pronounced in PTSD compared with HC. Moreover, PTSD participants expected higher risk of an aversive event independent of stimulus types and task.

Conclusions

Alterations in generalisation constitute one part of fear memory alterations in PTSD. Neither the accuracy of a risk judgement nor the strength of the induced fear was affected. Instead, processing times as an index of uncertainty during risk judgements suggested a reduced differentiation between safety and threat in PTSD.

Keywords

classical conditioningearly life maltreatmentfear generalisationfear-potentiated startleinterpersonal violencepost-traumatic stress disordersafety signals
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 13 , October 2018 , pp. 2223 - 2234
Copyright
Copyright © Cambridge University Press 2017 

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