Posttraumatic Stress Symptom Dimensions and Brain Responses to Startling Auditory Stimuli in Combat Veterans

Craig A. Marquardt, Victor Pokorny, Seung Suk Kang, Bruce N. Cuthbert, Scott R. Sponheim

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Posttraumatic stress disorder (PTSD) is marked by alterations in emotional functioning, physiological reactivity, and attention. Neural reactivity to acoustic startle stimuli can be used to understand brain functions related to these alterations. Investigations of startle reactivity in PTSD have yielded inconsistent findings, which may reflect the heterogeneity of the disorder. Furthermore, little is known of how the common cooccurrence of mild traumatic brain injury (mTBI; i.e., concussion) may influence neural reactivity. We examined the event-related potentials (ERPs) of combat veterans (n = 102) to acoustic startle probes delivered during viewing of pleasant, neutral, unpleasant, and combat-related pictures. Interview-based assessments yielded dimensional characterizations of PTSD and mTBI. The P3 ERP response to startle probes was reduced during all affective relative to neutral pictures but failed to be associated with a PTSD diagnosis. However, two separable domains of PTSD symptomatology were associated with startle ERPs regardless of the picture conditions. Maladaptive avoidance was associated with smaller N1, P2, and P3 amplitudes, while intrusive reexperiencing was associated with larger P2 amplitudes. There were no main effects of mTBI. Findings suggest that level of symptomatology rather than a formal diagnosis of PTSD better explains alterations in neural reactivity after traumatic events, while mild brain injuries have little impact. Avoidance symptoms of PTSD may dampen neural functions that facilitate reorientation to threat while intrusive reexperiencing of traumatic events appears to heighten sensory reactivity. Considering specific aspects of symptomatology provides insight into the neural basis of trauma-related psychopathology and may help guide individualization of clinical interventions.

Original languageEnglish (US)
Pages (from-to)455-467
Number of pages13
JournalJournal of abnormal psychology
Issue number5
StatePublished - 2021

Bibliographical note

Funding Information:
Scott R. Sponheim’s main affiliation is the Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, United States. Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation (Craig A. Marquardt, Grant 00039202), or the Departments of Defense (Scott R. Sponheim, Grant PT074550), Veterans Affairs, or Health and Human Services. We thank Julie Flannery and Daniel Goldman for assistance with data preprocessing, Abraham Van Voorhis for guidance regarding the figures, and Kevin Roberts and Russell Bacon for assistance with selection of the combat images. The authors are indebted to the U.S. military veteran participants whose involvement made this work possible.

Publisher Copyright:
© 2021, Journal of Abnormal Psychology. All Rights Reserved.


  • Eeg
  • Mtbi
  • Ptsd
  • Startle
  • Veterans

PubMed: MeSH publication types

  • Journal Article


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