When stress becomes the new normal: Alterations in attention and autonomic reactivity in repeated traumatization

J Trauma Dissociation. May-Jun 2018;19(3):362-381. doi: 10.1080/15299732.2018.1441356.


There is need for further work clarifying attention-physiology interactions by degree of exposure to early victimization, as it is clear that cumulative trauma in childhood, that is, polyvictimization, may have lasting effects on the stress response that differ from those of acute traumatization. The present study examined relationships between baseline and task-related physiology (indexed by respiratory sinus arrhythmia [RSA] and heart rate [HR], respectively), and attention biases (via the dot probe task), in 63 community-dwelling adult women stratified on the basis of self-reported exposure to multiple types of childhood interpersonal victimization (i.e., sexual, physical, and emotional abuse). Consistent with hypotheses, a pattern of threat hypervigilance was found in the single victimization group, while threat avoidance was found in the polyvictimization group. Additionally, avoidance of threat in the polyvictimized group was associated with lower baseline RSA. Moderation analyses indicated that condition-wise HR moderated the relationship between level of exposure and attention biases in the high-threat condition. The present findings may clarify basic regulatory mechanisms that play a role in lifetime revictimization in individuals with cumulative childhood trauma exposure and may have implications for their prognostic and therapeutic outcomes.

Keywords: Polyvictimization; attention bias; childhood trauma; heart rate variability; threat avoidance.

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Attention / physiology*
  • Autonomic Nervous System / physiopathology*
  • Avoidance Learning / physiology*
  • Crime Victims / psychology*
  • Dissociative Disorders / psychology
  • Female
  • Heart Rate / physiology
  • Humans
  • Middle Aged
  • Reaction Time / physiology
  • Respiratory Sinus Arrhythmia / physiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Surveys and Questionnaires