Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma
Date
2011
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Publisher
Journal of Psychopharmacology
Abstract
This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model
which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety
disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system
which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray
mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in
longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the
associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce
changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the
pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering
from the chronic sequelae of traumatic experiences.
Description
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Keywords
complex trauma, window of tolerance, Ascending dopamine systems, autonomic dysregulation, dysfunctional behaviours
Citation
Corrigan, F. M., Fisher, J. J., & Nutt, D. J. (2011). Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25(1), 17-25.