Original Article
A psychophysiological investigation of emotion regulation in chronic severe posttraumatic stress disorder
Steven H. Woodward,
Ashley A. Shurick,
Jennifer Alvarez,
Janice Kuo,
Yuliana Nonyieva,
Jens Blechert,
Kateri McRae,
James J. Gross,
Corresponding Author
Steven H. Woodward
National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
Address correspondence to: Steven H. Woodward, Ph.D., NCPTSD, VA Palo Alto HCS, 3801 Miranda Ave., Palo Alto, CA 94304, USA. E-mail: [email protected]Search for more papers by this authorAshley A. Shurick
Department of Psychology, Stanford University, Stanford, California, USA
Search for more papers by this authorJennifer Alvarez
Trauma Recovery Programs, VA Palo Alto Health Care System, Palo Alto, California, USA
Search for more papers by this authorJanice Kuo
Psychology Department, Ryerson University, Toronto, Ontario, Canada
Search for more papers by this authorYuliana Nonyieva
Palo Alto University, Palo Alto, California, USA
Search for more papers by this authorJens Blechert
Division of Clinical Psychology, Psychotherapy, Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria
Search for more papers by this authorKateri McRae
Department of Psychology, University of Denver, Denver, Colorado, USA
Search for more papers by this authorJames J. Gross
Department of Psychology, Stanford University, Stanford, California, USA
Search for more papers by this author
Steven H. Woodward,
Ashley A. Shurick,
Jennifer Alvarez,
Janice Kuo,
Yuliana Nonyieva,
Jens Blechert,
Kateri McRae,
James J. Gross,
Corresponding Author
Steven H. Woodward
National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
Address correspondence to: Steven H. Woodward, Ph.D., NCPTSD, VA Palo Alto HCS, 3801 Miranda Ave., Palo Alto, CA 94304, USA. E-mail: [email protected]Search for more papers by this authorAshley A. Shurick
Department of Psychology, Stanford University, Stanford, California, USA
Search for more papers by this authorJennifer Alvarez
Trauma Recovery Programs, VA Palo Alto Health Care System, Palo Alto, California, USA
Search for more papers by this authorJanice Kuo
Psychology Department, Ryerson University, Toronto, Ontario, Canada
Search for more papers by this authorYuliana Nonyieva
Palo Alto University, Palo Alto, California, USA
Search for more papers by this authorJens Blechert
Division of Clinical Psychology, Psychotherapy, Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria
Search for more papers by this authorKateri McRae
Department of Psychology, University of Denver, Denver, Colorado, USA
Search for more papers by this authorJames J. Gross
Department of Psychology, Stanford University, Stanford, California, USA
Search for more papers by this author
The authors wish to acknowledge N. J. Arsenault, J. Gauthier, and T. Bredesen for assistance with data collection and data analysis. We are especially indebted to Tyson Holmes for his guidance regarding the statistical challenges posed by our experimental design. We are also grateful for the useful comments provided by Lisa McTeague. Finally, we are grateful for the support of the patients and staff of the Men's Trauma Recovery Program, VA Palo Alto Health Care System.
Abstract
There have been few direct examinations of the volitional control of emotional responses to provocative stimuli in PTSD. To address this gap, an emotion regulation task was administered to 27 Operation Enduring Freedom/Operation Iraqi Freedom combat veterans and 23 healthy controls. Neutral and aversive photographs were presented to participants who did or did not employ emotion regulation strategies. Objective indices included corrugator electromyogram, the late positive potential, and the electrocardiogram. On uninstructed trials, participants with PTSD exhibited blunted cardiac reactivity rather than the exaggerated cardioacceleratory responses seen in trauma cue reactivity studies. On interleaved regulation trials, no measure evidenced group differences in voluntary emotion regulation. Persons with PTSD may not differ from normals in their capacity to voluntarily regulate normative emotional responses to provocative stimuli in the laboratory, though they may nevertheless respond differentially on uninstructed trials and endorse symptoms of dyscontrol pathognomonic of the disorder outside of the laboratory.
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