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Typical differences between dissociative PTSD and hyperaroused PTSD

Typical differences between dissociative PTSD and hyperaroused PTSD
  Dissociative subtype of PTSD Hyperaroused PTSD
Etiology Likely to be more severe, chronic, repeated, usually childhood and adult trauma Likely to be later-occurring trauma and/or less cumulative trauma
Likely response when presented with traumatic narrative or triggers Dissociation, numbing Terror
Decreased, blunted autonomic arousal Increased autonomic arousal
Decreased heart rate Increased heart rate
Cortisol release is delayed Rapidly increased cortisol level
Decreased skin conductance Increased skin conductance
Brain areas activated that may over-control emotion and alter sense of self (eg, MPFC) Brain areas activated that may under-control emotion
PTSD: posttraumatic stress disorder; MPFC: medial prefrontal cortex.
Data from:
  1. Vermetten E, Dorahy MJ, Spiegel D. Traumatic Dissociation Neurobiology and Treatment, American Psychiatric Press, Washington DC, 2007.
  2. Brand B, Loewenstein RJ. Dissociative disorders: An overview of assessment, phenomenology and treatment, Psychiatric Times, 2010.
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