Past research has shown that 37% to 52% of sexual assault survivors report experiencing a set of peritraumatic responses, which include gross motor inhibition, analgesia, and fixed or unfocused staring. This response set closely resembles a set of unconditioned responses, collectively known as Tonic Immobility (TI). This study examined TI among childhood sexual abuse (CSA) survivors and its relation to PTSD symptomatology. Participants were 131 female college undergraduates who completed questionnaires assessing sexual abuse history, TI, and PTSD symptom severity. Results showed that TI partially mediated the relation between peritraumatic fear and overall PTSD symptom severity and completely mediated the relation between fear and the PTSD reexperiencing symptoms. Although peritraumatic fear is associated with TI, the mediation findings provide evidence for the notion that these responses are separate from one another. These results suggest that TI during CSA may play an important role in the subsequent PTSD symptomatology in adulthood.
Afifi, A., Clark, V.A., & May, S. ( 2004). Computer-aided multivariate analysis (4th ed.). Boca Raton, FL: Chapman & Hall/CRC.
2.
Baron, R., & Kenny, D. ( 1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations . Journal of Personality and Social Psychology, 51, 1173-1182.
3.
Birmes, P., Brunet, A., Carreras, D., Ducassé, J., Charlet, J., Lauque, D., et al. (2003). The predictive power of peritraumatic dissociation and acute stress symptoms for posttraumatic stress symptoms: A three-month prospective study. American Journal of Psychiatry, 160, 1337-1339.
4.
Bovin, M.J., Jager-Hyman, S., Marx, B.P., Gold, S.D., & Sloan, D.M. ( 2008). Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among adult sexual assault survivors. Journal of Traumatic Stress, 21, 402-409.
5.
Briere, J. ( 1997). Methodological issues in the study of sexual abuse effects . Journal of Consulting and Clinical Psychology, 60, 196-203.
6.
Fanselow, M.S. ( 1994). Neural organization of the defensive behavior system responsible for fear. Psychonomic Bulletin & Review, 1, 429-438.
7.
Foa, E.B. ( 1996). Posttraumatic Stress Diagnostic Scale: Administration, scoring, and procedures manual. Minneapolis, MN: National Computer Systems.
8.
Foa, E.B., Cashman, L., Jaycox, L., & Perry, K. ( 1997). The validation of a self-report measure of posttraumatic stress disorder: The posttraumatic stress diagnostic scale. Psychological Assessment, 9, 445-451.
Fusé, T., Forsyth, J., Marx, B., Gallup, G., & Weaver, S. ( 2007). Factor structure of the Tonic Immobility Scale in female sexual assault survivors: An exploratory and confirmatory factor analysis . Journal of Anxiety Disorders, 21, 265-283.
11.
Galliano, G., Noble, L., Travis, L.A., & Puechl, C. ( 1993). Victim reactions during rape/ sexual assault: A preliminary study of the immobility response and its correlates. Journal of Interpersonal Violence, 8, 109-114.
12.
Gallup, G. ( 1977). Tonic immobility: The role of fear and predation. Psychological Record, 27, 41-61.
13.
Gallup, G.G., Jr., & Rager, D.R. ( 1996). Tonic immobility as a model of extreme states of behavioral inhibition: Issues of methodology and measurement. In P. R. Sanberg, K. P. Ossenkopp, & M. Kavaliers, (Eds.), Motor activity and movement disorders: Research issues and applications (pp. 57-80). Totowa, NJ: Humana Press.
14.
Griffin, M.G., Resick, P.A., & Mechanic, M.B. (1997). Objective assessment of peritraumatic dissocation: Psychophysiological indicators. American Journal of Psychiatry, 154, 1081-1088.
15.
Heidt, J., Marx, B., & Forsyth, J. ( 2005). Tonic immobility and childhood sexual abuse: A preliminary report evaluating the sequela of rape-induced paralysis. Behaviour Research and Therapy, 43, 1157-1171.
16.
Lanius, R.A., Williamson, P.C., & Boksman, K. ( 2002). Brain activation during script-driven imagery induced dissociative responses in PTSD: A functional magnetic resonance imaging investigation . Biological Psychiatry, 52, 305-311.
17.
Levine, P. ( 1997). Waking the tiger: Healing trauma. Berkeley, CA: North Atlantic Books.
18.
Lewis-Beck, M. ( 1980). Applied regression: An introduction. Beverly Hills, CA: Sage.
19.
Long, P.J. ( 1999). Assessing a history of childhood sexual abuse in adults: The life experiences questionnaire. Oklahoma State University . Unpublished manuscript.
20.
MacKinnon, D., Lockwood, C., & Williams, J. ( 2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99-128.
21.
Mallinckrodt, B., Abraham, W., Wei, M., & Russell, D. ( 2006). Advances in testing the statistical significance of mediation effects. Journal of Counseling Psychology, 53, 372-378.
22.
Marx, B.P., Forsyth, J.P., Gallup, G.G., Lexington, J.M., & Fusé, T. (2008). Tonic immobility as an evolved predator defense: Implications for sexual assault survivors. Clinical Psychology: Science and Practice, 15, 74-90.
23.
Messman-Moore, T.L., & Long, P.J. ( 2000). Child sexual abuse and revictimization in the form of adult sexual abuse, adult physical abuse, and adult psychological maltreatment . Journal of Interpersonal Violence, 15, 489-502.
24.
Messman-Moore, T.L., & Long, P.J. ( 2003). The role of childhood sexual abuse sequelae in sexual revictimization: An empirical review and theoretical reformulation. Clinical Psychology Review, 23, 537-571.
25.
Metzger, D. ( 1976). It is always the woman who is raped. American Journal of Psychiatry, 133, 405-408.
26.
Mezey, G.C., & Taylor, P.J. ( 1988). Psychological reactions of women who have been raped: A descriptive and comparative study. British Journal of Psychiatry , 152, 330-339.
27.
Ogden, P., & Minton, K. ( 2002). Sensorimotor approach to processing traumatic memory . In C. R. Figley (Ed.), Brief treatments for the traumatized (pp. 125-147). Westport, CT : Greenwood Press.
28.
O’Toole, B.I., Marshall, R.P., Schureck, R.J., & Dobson, M. ( 1999). Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans. Journal of Traumatic Stress , 12, 625-640.
29.
Ozer, E., Best, S., Lipsey, T., & Weiss, D. ( 2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52-73.
30.
Preacher, K.J., & Hayes, A. ( 2004a). SPSS and SAS macros for bootstrapping indirect effects in multiple mediator models. Retrieved August 17, 2006, from http://www.comm.ohio-state.edu/ahayes/SPSS%20programs/indirect.htm
31.
Preacher, K.J., & Hayes, A. ( 2004b). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717-731.
32.
Preacher, K.J., & Hayes, A.F. (in press). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods.
33.
Ratner, S.C. ( 1967) Comparative aspects of hypnosis. In J. E. Gordon (Ed.), Handbook of clinical and experimental hypnosis (pp. 550-587). New York: Macmillan.
34.
Rizvi, S.L., Kaysen, D., Gutner, C.A., Griffin, M.G., & Resick, P.A. ( 2008). Beyond fear: The role of peritraumatic responses in posttraumatic stress and depressive symptoms among female crime victims. Journal of Interpersonal Violence, 23, 853-867.
35.
Sobel, M.E. ( 1982). Asymptotic confidence intervals for indirect effects in structural equations models. In S. Leinhart (Ed.), Sociological methodology 1982 (pp. 290-312). San Francisco: Jossey-Bass.
36.
Spitzer, R.L., Williams, J.B.W., Gibbon, M., & First, M.B. ( 1990). Structured clinical interview for DSM-III-R-patient edition (with psychotic screen; SCID-P). Washington, DC: American Psychiatric Press.
37.
Suarez, S., & Gallup, G. ( 1979). Tonic immobility as a response to rape in humans: A theoretical note. Psychological Record, 29, 315-320.
38.
Zoellner, L. ( 2008). Translational challenges with tonic immobility. Clinical Psychology: Science and Practice, 15, 98-101.
