{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:44:19Z","timestamp":1786999459124,"version":"build-2736575974"},"reference-count":79,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291721002075_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). This strong association may reflect a shared pathophysiology in the form of altered autonomic activity and increased reactivity. Using an acoustic startle paradigm, we investigated the interrelationships of psychophysiological measures during wakefulness and PTSD diagnosis, posttraumatic nightmares, and nontraumatic nightmares.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721002075_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A community sample of 122 trauma survivors were presented with a series of brief loud tones, while heart rate (HRR), skin conductance (SCR), and orbicularis oculi electromyogram (EMGR) responses were measured. Prior to the tone presentations, resting heart rate variability (HRV) was assessed. Nightmares were measured using nightmare logs. Three dichotomous groupings of participants were compared: (1) current PTSD diagnosis (\n                      <jats:italic>n<\/jats:italic>\n                      = 59), no PTSD diagnosis (\n                      <jats:italic>n<\/jats:italic>\n                      = 63), (2) those with (\n                      <jats:italic>n<\/jats:italic>\n                      = 26) or without (\n                      <jats:italic>n<\/jats:italic>\n                      = 96) frequent posttraumatic nightmares, and (3) those with (\n                      <jats:italic>n<\/jats:italic>\n                      = 22) or without (\n                      <jats:italic>n<\/jats:italic>\n                      = 100) frequent nontraumatic nightmares.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721002075_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PTSD diagnosis was associated with posttraumatic but not with nontraumatic nightmares. Both PTSD and posttraumatic nightmares were associated with a larger mean HRR to loud tones, whereas nontraumatic nightmare frequency was associated with a larger SCR. EMGR and resting HRV were not associated with PTSD diagnosis or nightmares.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721002075_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest a shared pathophysiology between PTSD and posttraumatic nightmares in the form of increased HR reactivity to startling tones, which might reflect reduced parasympathetic tone. This shared pathophysiology could explain why PTSD is more strongly related to posttraumatic than nontraumatic nightmares, which could have important clinical implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291721002075","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:42:04Z","timestamp":1623717724000},"page":"731-740","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":24,"title":["Autonomic activity, posttraumatic and nontraumatic nightmares, and PTSD after trauma exposure"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7921-4746","authenticated-orcid":false,"given":"Thomas","family":"M\u00e4der","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn I.","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Daffre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott P.","family":"Orr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha B.","family":"Lasko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeehye","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Kleim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Franz","family":"Pace-Schott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"S0033291721002075_ref54","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1056\/NEJMoa1507598","article-title":"Trial of prazosin for post-traumatic stress disorder in military veterans","volume":"378","author":"Raskind","year":"2018","journal-title":"New England Journal of Medicine"},{"key":"S0033291721002075_ref56","doi-asserted-by":"crossref","first-page":"409","DOI":"10.5665\/sleep.3426","article-title":"Thematic and content analysis of idiopathic nightmares and bad dreams","volume":"37","author":"Robert","year":"2014","journal-title":"Sleep"},{"key":"S0033291721002075_ref45","first-page":"753","volume-title":"Principles and practice of sleep medicine","author":"Nielsen","year":"2000"},{"key":"S0033291721002075_ref58","doi-asserted-by":"crossref","first-page":"259","DOI":"10.4321\/S0213-61632013000400004","article-title":"Seeking professional help for nightmares: A representative study","volume":"27","author":"Schredl","year":"2013","journal-title":"The European Journal of Psychiatry"},{"key":"S0033291721002075_ref76","unstructured":"Weathers, F. 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