Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD

Background: Psychophysiological dysregulations and negative alterations in cognitions and mood characterize post traumatic stress disorder (PTSD) and complex PTSD (C-PTSD), contributing to an increased risk of disorder persistence and chronic health problems. However, understanding the differences i...

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Main Authors: Oswald D. Kothgassner, Sarah Macura, Andreas Goreis, Diana Klinger, Bettina Pfeffer, Sofia M. Oehlke, Karin Prillinger, Johanna X. Kafka, Heidi Elisabeth Zesch, Anna Felnhofer, Paul L. Plener
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:European Journal of Psychotraumatology
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Online Access:https://www.tandfonline.com/doi/10.1080/20008066.2025.2532273
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author Oswald D. Kothgassner
Sarah Macura
Andreas Goreis
Diana Klinger
Bettina Pfeffer
Sofia M. Oehlke
Karin Prillinger
Johanna X. Kafka
Heidi Elisabeth Zesch
Anna Felnhofer
Paul L. Plener
author_facet Oswald D. Kothgassner
Sarah Macura
Andreas Goreis
Diana Klinger
Bettina Pfeffer
Sofia M. Oehlke
Karin Prillinger
Johanna X. Kafka
Heidi Elisabeth Zesch
Anna Felnhofer
Paul L. Plener
author_sort Oswald D. Kothgassner
collection DOAJ
description Background: Psychophysiological dysregulations and negative alterations in cognitions and mood characterize post traumatic stress disorder (PTSD) and complex PTSD (C-PTSD), contributing to an increased risk of disorder persistence and chronic health problems. However, understanding the differences in physiological stress reactivity and negative cognitive-emotional patterns between adolescents with PTSD and C-PTSD remains a notable research gap.Objective: This study examined group differences in autonomic nervous system (ANS) reactivity during the sharing of a short trauma narrative, including resting and recovery phases, and compared subjective experiences of stress, shame, and guilt among adolescents with PTSD, C-PTSD, and trauma-exposed controls.Methods: In a repeated-measures design, 52 adolescents (14–18 years) with PTSD (n = 17), C-PTSD (n = 18), and a control group (n = 17) were assessed for heart rate, heart rate variability, and subjective experiences of stress, shame, and guilt during a standardized trauma interview, as well as during baseline and recovery phases.Results: Linear mixed-effects models revealed a significant interaction between group and time point (F = 4.134, p < .001). The C-PTSD group exhibited a significantly higher heart rate in the recovery phase compared to the PTSD (p = .010) and control groups (p = .036), alongside significantly higher subjective stress, guilt, and shame experiences. Main effects of group were identified for perceived stress (F = 7.543, p = .002), guilt (F = 21.779, p < .001), and shame (F = 19.309, p < .001), with the C-PTSD group exhibiting higher levels compared to PTSD and control groups across all conditions.Conclusions: Prolonged stress responses and elevated experiences of shame and guilt in adolescents with C-PTSD align with the diagnostic criteria of affective dysregulation and negative self-concept. Objective stress measures during trauma interviews may support the diagnosis of C-PTSD. Findings highlight the importance of phase-based trauma therapies that target emotional dysregulation, shame, and guilt.
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spelling doaj-art-6d0a0678136942c9a0463ba1f81f2baa2025-08-20T03:37:08ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2532273Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSDOswald D. Kothgassner0Sarah Macura1Andreas Goreis2Diana Klinger3Bettina Pfeffer4Sofia M. Oehlke5Karin Prillinger6Johanna X. Kafka7Heidi Elisabeth Zesch8Anna Felnhofer9Paul L. Plener10Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaComprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, AustriaDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, AustriaBackground: Psychophysiological dysregulations and negative alterations in cognitions and mood characterize post traumatic stress disorder (PTSD) and complex PTSD (C-PTSD), contributing to an increased risk of disorder persistence and chronic health problems. However, understanding the differences in physiological stress reactivity and negative cognitive-emotional patterns between adolescents with PTSD and C-PTSD remains a notable research gap.Objective: This study examined group differences in autonomic nervous system (ANS) reactivity during the sharing of a short trauma narrative, including resting and recovery phases, and compared subjective experiences of stress, shame, and guilt among adolescents with PTSD, C-PTSD, and trauma-exposed controls.Methods: In a repeated-measures design, 52 adolescents (14–18 years) with PTSD (n = 17), C-PTSD (n = 18), and a control group (n = 17) were assessed for heart rate, heart rate variability, and subjective experiences of stress, shame, and guilt during a standardized trauma interview, as well as during baseline and recovery phases.Results: Linear mixed-effects models revealed a significant interaction between group and time point (F = 4.134, p < .001). The C-PTSD group exhibited a significantly higher heart rate in the recovery phase compared to the PTSD (p = .010) and control groups (p = .036), alongside significantly higher subjective stress, guilt, and shame experiences. Main effects of group were identified for perceived stress (F = 7.543, p = .002), guilt (F = 21.779, p < .001), and shame (F = 19.309, p < .001), with the C-PTSD group exhibiting higher levels compared to PTSD and control groups across all conditions.Conclusions: Prolonged stress responses and elevated experiences of shame and guilt in adolescents with C-PTSD align with the diagnostic criteria of affective dysregulation and negative self-concept. Objective stress measures during trauma interviews may support the diagnosis of C-PTSD. Findings highlight the importance of phase-based trauma therapies that target emotional dysregulation, shame, and guilt.https://www.tandfonline.com/doi/10.1080/20008066.2025.2532273Post traumatic stressheart rateautonomic dysregulationshametrauma narrativeEstrés postraumático
spellingShingle Oswald D. Kothgassner
Sarah Macura
Andreas Goreis
Diana Klinger
Bettina Pfeffer
Sofia M. Oehlke
Karin Prillinger
Johanna X. Kafka
Heidi Elisabeth Zesch
Anna Felnhofer
Paul L. Plener
Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
European Journal of Psychotraumatology
Post traumatic stress
heart rate
autonomic dysregulation
shame
trauma narrative
Estrés postraumático
title Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
title_full Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
title_fullStr Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
title_full_unstemmed Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
title_short Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD
title_sort stress reactivity during short trauma narratives in adolescents with post traumatic stress disorder ptsd and complex ptsd
topic Post traumatic stress
heart rate
autonomic dysregulation
shame
trauma narrative
Estrés postraumático
url https://www.tandfonline.com/doi/10.1080/20008066.2025.2532273
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