Neural, Psychophysiological, and Behavioral Markers of Fear Processing in PTSD: A Review of the Literature

  • Erel Shvil
  • Heather L. Rusch
  • Gregory M. Sullivan
  • Yuval Neria
Anxiety Disorders (DJ Stein, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Anxiety Disorders


As presently defined, post-traumatic stress disorder (PTSD) is an amalgam of symptoms falling into: re-experiencing of the trauma, avoidance of reminders of it, emotional numbing and hyperarousal. PTSD has a well-known proximate cause, commonly occurring after a life-threatening event that induces a response of intense fear, horror, and helplessness. Much of the advancement in understanding of the neurobiology of PTSD has emerged from conceptualizing the disorder as one that involves substantial dysfunction in fear processing. This article reviews recent knowledge of fear processing markers in PTSD. A systematic search was performed of reports within the specific three-year publication time period of January 2010 to December 2012. We identified a total of 31 studies reporting fear processing markers in PTSD. We further categorized them according to the following classification: (1) neural-activation markers (n = 10), (2) psychophysiological markers (n = 14), and (3) behavioral markers (n = 7). Across most studies reviewed here, significant differences between individuals with PTSD and healthy controls were shown. Methodological, theoretical and clinical implications were discussed.


Posttraumatic stress disorder (PTSD) Trauma Fear processing Emotional regulation ACTH Cortisol Electromyogram Emotional reactivity Fear conditioning Fear-potentiated startle Heart rate response Heart rate variability HPA Hydrocortisone Psychophysiological Skin conductance response Functional MRI (fMRI) Activation Attentional bias Dot-probe Emotional stroop Eye tracking 


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erel Shvil
    • 1
    • 2
  • Heather L. Rusch
    • 1
  • Gregory M. Sullivan
    • 1
    • 2
  • Yuval Neria
    • 1
    • 2
    • 3
  1. 1.Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  2. 2.New York State Psychiatric InstituteNew YorkUSA
  3. 3.Department of Epidemiology & College of Physicians and SurgeonsColumbia UniversityNew YorkUSA

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