Posttraumatic stress disorder may be associated with impaired fear inhibition: relation to symptom severity

Psychiatry Res. 2009 May 15;167(1-2):151-60. doi: 10.1016/j.psychres.2007.12.014. Epub 2009 Apr 5.


One of the central problems in posttraumatic stress disorder (PTSD) is the inability to suppress fear even under safe conditions. The neural underpinnings of fear are clinically relevant but poorly understood. This study assessed fear potentiation and fear inhibition using fear-potentiated startle in a conditional discrimination procedure (AX+/BX-). We hypothesized that patients with PTSD would show normal fear potentiation and impaired fear inhibition. Subjects comprised 28 healthy volunteers and 27 PTSD patients (14 with low current symptoms, 13 with high current symptoms) who were presented with one set of colored lights (AX trials) paired with aversive air blasts to the throat, and a different series of lights (BX trials) presented without air blasts. We then presented A and B together (AB trials) to see whether B would inhibit fear potentiation to A. All groups showed robust fear potentiation in that they had significantly greater startle magnitude on AX trials than on noise-alone trials. However, the high-symptom PTSD group did not show fear inhibition: these subjects had significantly greater fear potentiation on the AB trials than both the controls and the low-symptom PTSD patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acoustic Stimulation
  • Color Perception / physiology
  • Conditioning, Classical / physiology
  • Discrimination, Psychological / physiology
  • Electromyography
  • Fear / physiology*
  • Galvanic Skin Response / physiology
  • Humans
  • Inhibition, Psychological*
  • Male
  • Middle Aged
  • Photic Stimulation
  • Reflex, Startle / physiology*
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / physiopathology