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Hopper, James

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Hopper

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James

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Hopper, James
Author's Publications: search.filters.isAuthorOfPublication.f6e973ef-e5b6-4e17-8563-9a030562e11f

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Now showing 1 - 7 of 7
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    Preliminary evidence of parasympathetic influence on basal heart rate in posttraumatic stress disorder
    (Elsevier BV, 2006) Hopper, James; Spinazzola, Joseph; Simpson, William B.; van der Kolk, Bessel A.
    OBJECTIVE: Evidence of elevated basal heart rate (HR) in posttraumatic stress disorder (PTSD) has been interpreted in terms of elevated sympathetic cardiac activity, as have possible increased cardiovascular disease risks and outcomes associated with elevated HR. Yet it is well-established that the parasympathetic branch of the autonomic nervous system not only influences HR independently of the sympathetic branch, but makes a greater contribution to HR, including resting HR. Additionally, abnormally low tonic parasympathetic activity on the heart has been implicated in cardiovascular disease and hypertension. This study addressed a potential parasympathetic contribution to elevated basal HR in PTSD. METHODS: We used a descriptive and subgroup differences approach to investigate relationships between parasympathetic activity and basal HR in 59 adults (50 females) with PTSD, all of whom were participants in a treatment outcome study and assessed prior to exposure to trauma-related script-driven imagery. Consistent with the well-known relationship between parasympathetic activity and HR, we hypothesized that basal respiratory sinus arrhythmia (RSA), a measure of parasympathetic cardiac activity, would be negatively correlated with basal HR. More important, we predicted that pathologically elevated HRs previously associated with PTSD would only characterize a low-RSA subgroup. Potential confounds of age, respiration rate, and aerobic fitness were addressed. RESULTS: As predicted, mean HR was 80.5 bpm in the low-RSA tercile group, similar to mean HRs of PTSD groups in prior research and significantly higher than 69 and 65 bpm in the middle- and high-RSA groups, respectively, which are typical of non-PTSD controls. CONCLUSION: These findings suggest that a substantial proportion of those with PTSD may not have elevated basal HRs. Furthermore, among those who do exhibit elevated HR, there may be a parasympathetic contribution that is independent of any sympathetic one. Only measuring both branches at once, ideally with autonomic blockades, can definitively address these issues.
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    Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: Symptom dimensions and emotion dysregulation in responses to script-driven trauma imagery
    (Wiley-Blackwell, 2007) Hopper, James; Frewen, Paul A.; van der Kolk, Bessel A.; Lanius, Ruth A.
    Research suggests that responses to script-driven trauma imagery in posttraumatic stress disorder (PTSD) include reexperiencing and dissociative symptom subtypes. This functional magnetic resonance imaging (fMRI) study employed a dimensional approach to characterizing script-driven imagery responses, using the Responses to Script-Driven Imagery Scale and correlational analyses of relationships between severity of state posttraumatic symptoms and neural activation. As predicted, state reexperiencing severity was associated positively with right anterior insula activity and negatively with right rostral anterior cingulate cortex (rACC). Avoidance correlated negatively with rACC and subcallosal anterior cingulate activity. In addition, as predicted, dissociation correlated positively with activity in the left medial prefrontal and right superior temporal cortices, and negatively with the left superior temporal cortex. Theoretical and clinical implications are discussed, particularly with respect to an emotion-dysregulation account of PTSD.
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    Incidence and patterns of polydrug use and craving for ecstasy in regular ecstasy users: An ecological momentary assessment study
    (Elsevier BV, 2006) Hopper, James; Su, Zhaohui; Looby, Alison R.; Ryan, Elizabeth; Penetar, David; Palmer, Christopher; Lukas, Scott
    Background: Previous studies employing retrospective assessments methods found that regular ecstasy users frequently use alcohol, marihuana and other drugs in combination with ecstasy. Methods: Twenty-two participants (13 males, 9 females) wore a wrist actigraph/data recorder to record real-time drug use and ecstasy craving for 6 weeks. Rates of alcohol and drug use on ecstasy use versus non-use nights, and before, during, and after ecstasy use were analyzed with generalized estimation equations (GEE). Craving was modeled with GEE and linear mixed models. Results: Approximately 70% of ecstasy uses occurred on Friday or Saturday nights. No drug was significantly more likely to be used on ecstasy use nights than comparison Friday and Saturday nights. On nights ecstasy was used, in general across all drugs assessed, use was more likely before and during than after ecstasy intoxication, while alcohol use was also more likely before than during ecstasy intoxication. Though low overall, craving for ecstasy increase over 24 h before use and was higher on Friday nights of weeks ecstasy was used on weekends than weeks it was not used. Conclusions: Use of ecstasy on a particular night may not be associated with any greater likelihood of using any other intoxicating drug, and use of other drugs on nights involving ecstasy use may simply reflect a “natural history” of drug-use nights that begins with alcohol, progresses to more intoxicating drugs, and ends with little drug use. Confirmation of these findings awaits further advances in the application of ecological momentary assessment methodologies.
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    Individual Differences in a Husband and Wife Who Developed PTSD After a Motor Vehicle Accident: A Functional MRI Case Study
    (American Psychiatric Publishing, 2003) Lanius, Ruth A.; Hopper, James; Menon, Ravi S.
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    Low respiratory sinus arrhythmia and prolonged psychophysiological arousal in posttraumatic stress disorder: heart rate dynamics and individual differences in arousal regulation
    (Elsevier BV, 2004) Sack, Martin; Hopper, James; Lamprecht, Friedhelm
    Background: There is extensive evidence that the parasympathetic branch of the autonomic nervous system can modulate psychophysiological arousal. To date, no studies have investigated associations between cardiac vagal tone and the time course of arousal during exposure to trauma-related stimuli in posttraumatic stress disorder (PTSD). Methods: Thirty-one subjects, 29 with PTSD and 2 with partial PTSD, had electrocardiograms recorded during baseline and 2-minute traumatic and neutral script-driven imagery periods. Heart rate, respiratory sinus arrhythmia (RSA), and heart rate half-recovery to the trauma script were quantified, and subjects were divided into low and high baseline RSA groups. Results: Across all participants, heart rate significantly increased from the neutral to the trauma script and RSA significantly decreased from baseline to trauma script (p < .05). As predicted, low RSA subjects had more prolonged heart rate increases to the trauma script than high RSA subjects (p < .001), and heart rate half-recovery was negatively correlated to baseline RSA (r = -.50, p = .005). Conclusions: This study is the first to find decreased RSA in response to a traumatic reminder and an association between low baseline RSA and sustained conditioned arousal in PTSD. Low vagal tone may account for deficient arousal and emotion regulation capacities often observed in PTSD.
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    Probing reward function in posttraumatic stress disorder: Expectancy and satisfaction with monetary gains and losses
    (Elsevier BV, 2008) Hopper, James; Pitman, Roger; Su, Zhaohui; Heyman, Gene; Lasko, Natasha; Macklin, Michael L.; Orr, Scott; Lukas, Scott; Elman, Igor
    Background: Posttraumatic stress disorder (PTSD) may be associated with dysfunctional reward processing. The present study assessed for such dysfunction in both the expectancy and outcome phases of reward processing. Methods: Male Vietnam veterans with (n = 15) and without (n = 11) combat-related PTSD were administered a wheel of fortune-type gambling task. Self-reported ratings of expectancy and satisfaction were collected respectively before and after each experience of monetary gain or loss. Results: PTSD participants reported both lower expectancy of reward and lower satisfaction with reward when it was received. The latter result was manifest in a failure of PTSD participants to show the greater satisfaction that normally accompanies rewards received under conditions of low expectancy. Conclusion: These results suggest reward function impairment in PTSD related to expectancy, satisfaction, and the expectancy-satisfaction relationship.
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    Acute Dissociation and Cardiac Reactivity to Script-Driven Imagery in Trauma-Related Disorders
    (Co-Action Publishing, 2012) Sack, Martin; Cillien, Melanie; Hopper, James
    Background: Potential acute protective functions of dissociation include modulation of stress-induced psychophysiological arousal. This study was designed to explore whether acute dissociative reactions during a stress experiment would override the effects of reexperiencing. Methods: Psychophysiological reactions during exposure to script-driven trauma imagery were studied in relation to acute responses of reexperiencing and dissociative symptoms in 61 patients with histories of exposure to a variety of traumas. Acute symptomatic responses were assessed with the Responses to Script-Driven Imagery Scale (RSDI), and participants were divided into four groups by median splits of RSDI reexperiencing and dissociation subscale scores. Results: In a comparison of the high RSDI reexperiencing groups with low versus high acute dissociative symptoms, the high dissociators exhibited significantly lower heart rate (HR) during trauma script and a significantly smaller script-induced decrease in parasympathetic cardiac activity. HR reactivity to the trauma script was negatively correlated with acute dissociative symptom severity. Conclusions: Acute dissociative reactions are a potential moderator of response to experimental paradigms investigating psychologically traumatized populations. We therefore suggest that future research on psychophysiological stress reactions in traumatized samples should routinely assess for acute dissociative symptoms.