Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

Andressa A Magalhaes,1 Camila MF Gama,1 Raquel M Gonçalves,1 Liana CL Portugal,2 Isabel A David,1 Fernanda Serpeloni,3 Liana Wernersbach Pinto,3 Simone G Assis,3,4 Joviana Q Avanci,3 Eliane Volchan,5 Ivan Figueira,6 Liliane MP Vilete,6 Mariana P Luz,6 William Berger,6 Fatima S Erthal,5 Mauro V Mendlowicz,7 Izabela Mocaiber,8 Mirtes G Pereira,1 Leticia de Oliveira1 1Biomedical Institute, Fluminense Federal University, Niterói, RJ, 24210-130, Brazil; 2Department of Physiological Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, 20550-170, Brazil; 3Department of Violence and Health Studies, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040-900, Brazil; 4The Neurology Postgraduate Program, Hospital Gaffrée and Guinle, Unirio, RJ, 20270-901, Brazil; 5Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brazil; 6Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 22290-140, Brazil; 7Department of Psychiatry and Mental Health, Fluminense Federal University, Niterói, RJ, 24030-215, Brazil; 8Institute of Humanities and Health, Federal Fluminense University, Rio das Ostras, RJ, 28890-000, BrazilCorrespondence: Leticia de OliveiraBiomedical Institute, Fluminense Federal University, 101 Hernani Mello, Niterói, RJ, 24210-130, BrazilTel +55 21 2629-2446Email oliveira_leticia@id.uff.brPurpose: 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.Keyswords: post-traumatic stress disorder, adolescence, youth, peritraumatic reaction, psychometry, traum