Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

Andressa A Magalhaes; Camila M F Gama; Raquel M Gonçalves; Liana C L Portugal; Isabel A David; Fernanda Serpeloni; Liana Wernersbach Pinto; Simone G Assis; Joviana Q Avanci; Eliane Volchan; Ivan Figueira; Liliane M P Vilete; Mariana P Luz; William Berger; Fatima S Erthal; Mauro V Mendlowicz; Izabela Mocaiber; Mirtes G Pereira; Leticia de Oliveira

doi:10.2147/PRBM.S317343

Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

Psychol Res Behav Manag. 2021 Sep 1:14:1359-1369. doi: 10.2147/PRBM.S317343. eCollection 2021.

Authors

Andressa A Magalhaes¹, Camila M F Gama¹, Raquel M Gonçalves¹, Liana C L Portugal², Isabel A David¹, Fernanda Serpeloni³, Liana Wernersbach Pinto³, Simone G Assis^{3

4}, Joviana Q Avanci³, Eliane Volchan⁵, Ivan Figueira⁶, Liliane M P Vilete⁶, Mariana P Luz⁶, William Berger⁶, Fatima S Erthal⁵, Mauro V Mendlowicz⁷, Izabela Mocaiber⁸, Mirtes G Pereira¹, Leticia de Oliveira¹

Affiliations

¹ Biomedical Institute, Fluminense Federal University, Niterói, RJ, 24210-130, Brazil.
² Department of Physiological Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, 20550-170, Brazil.
³ Department of Violence and Health Studies, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040-900, Brazil.
⁴ The Neurology Postgraduate Program, Hospital Gaffrée and Guinle, Unirio, RJ, 20270-901, Brazil.
⁵ Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brazil.
⁶ Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 22290-140, Brazil.
⁷ Department of Psychiatry and Mental Health, Fluminense Federal University, Niterói, RJ, 24030-215, Brazil.
⁸ Institute of Humanities and Health, Federal Fluminense University, Rio das Ostras, RJ, 28890-000, Brazil.

Abstract

Purpose: Growing evidence suggests that peritraumatic tonic immobility, an involuntary defensive response that involves extreme physical immobility and the perceived inability to escape, is a significant predictor of post-traumatic stress disorder (PTSD) symptomatology. However, this issue has not been specifically addressed in adolescents. Here, we investigated whether tonic immobility response experienced during the worst childhood or adolescent trauma is associated with PTSD symptom severity in a non-clinical student sample.

Methods: The sample was composed of students in 9th grade who were attending public and private schools. Symptoms of post-traumatic stress and tonic immobility were assessed using questionnaires. We performed bivariate and multivariate negative binomial regressions to examine whether tonic immobility was associated with PTSD symptomatology after controlling for confounders (peritraumatic dissociation, peritraumatic panic reactions, gender, age and time since trauma).

Results: We found an association between tonic immobility and PTSD symptom severity, even after controlling for confounders. Therefore, tonic immobility is associated with PTSD symptoms in trauma-exposed adolescents.

Conclusion: These findings highlight tonic immobility as a possible risk factor that could be used to provide direction for more targeted trauma interventions for individuals, particularly those at risk for developing PTSD. Therefore, it contributes to preventing and reducing the psychiatric burden in adolescence and later in life.

Keywords: adolescence; peritraumatic reaction; post-traumatic stress disorder; psychometry; trauma; youth.

Grants and funding

This work was supported by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Finance Code 001; CAPES/PRINT); CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico); and FAPERJ (Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro).