Kalaf Juliana, Coutinho Evandro Silva Freire, Vilete Liliane Maria Pereira, Luz Mariana Pires, Berger William, Mendlowicz Mauro, Volchan Eliane, Andreoli Sergio Baxter, Quintana Maria Inês, de Jesus Mari Jair, Figueira Ivan
Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil.
Department of Epidemiology, Escola Nacional de Saúde Pública (ENSP-FIOCRUZ), Rio de Janeiro, RJ, Brazil.
J Affect Disord. 2017 Jun;215:71-76. doi: 10.1016/j.jad.2017.03.009. Epub 2017 Mar 7.
Tonic immobility is an involuntary motor and vocal inhibition reaction, considered the last-ditch response of the defensive cascade model. It is elicited in context of inescapable threat and perception of entrapment. Our aim was to investigate the association between different traumatic events and peritraumatic tonic immobility (PTI) in a representative sample of the general population.
This is a cross-sectional study of general population from Rio de Janeiro and São Paulo with 3231 victims of traumatic events aged 15-75 years who completed the Tonic Immobility Scale (TIS). We calculated the frequency of the different traumatic events and estimated the mean scores with 95% confidence intervals for each traumatic event, controlling for the potential confounders using multiple linear regression models. Finally, we calculated the proportion of individual scoring zero in TIS for the 16 traumatic events.
PTI scores in child sexual abuse and adult sexual violence were almost twice as high as in other types of traumatic events, even when controlled for gender and educational level. Torture and war also showed high PTI scores, but these were based on very small number of cases and need to be interpreted with caution. Furthermore, victims of sexual trauma had the lowest proportion of individuals with total absence of PTI symptoms.
This is a cross-sectional study and causal inferences must be drawn with caution.
Peritraumatic tonic immobility is more strongly associated with sexual trauma, particularly in childhood, than to other types of trauma in the general population.
强直性静止是一种非自主的运动和发声抑制反应，被认为是防御级联模型的最后一道防线。它在无法逃脱的威胁和被困感的情境中引发。我们的目的是在一般人群的代表性样本中调查不同创伤事件与创伤时强直性静止（PTI）之间的关联。
这是一项对来自里约热内卢和圣保罗的一般人群的横断面研究，有3231名年龄在15 - 75岁的创伤事件受害者完成了强直性静止量表（TIS）。我们计算了不同创伤事件的发生率，并使用多元线性回归模型控制潜在混杂因素，估计了每个创伤事件的平均得分及其95%置信区间。最后，我们计算了16种创伤事件中在TIS上得分为零的个体比例。
即使在控制了性别和教育水平之后，儿童性虐待和成人性暴力中的PTI得分几乎是其他类型创伤事件的两倍。酷刑和战争也显示出较高的PTI得分，但这些基于非常少的病例数，需要谨慎解释。此外，性创伤受害者中完全没有PTI症状的个体比例最低。
这是一项横断面研究，因果推断必须谨慎得出。
在一般人群中，创伤时强直性静止与性创伤，尤其是儿童期性创伤的关联比与其他类型创伤的关联更强。
