DEPRESSION AND ANXIETY 26:550–556 (2009)

Research Article
HUMAN TONIC IMMOBILITY: MEASUREMENT
AND CORRELATES
Murray P. Abrams, B.A. Hons,1 R. Nicholas Carleton, M.A.,1 Steven Taylor, Ph.D.,2
and Gordon J.G. Asmundson, Ph.D.1

Background: Tonic immobility (TI) is a temporary state of motor inhibition

believed to be a response to situations involving extreme fear. Limited attention
has been directed to studying TI in humans; however, the phenomenon has been
well documented in the animal literature. In humans, TI is believed to occur
during sexual assault, and there have been reports of fear-induced freezing in
the contexts of air, naval, and other disasters. Methods: This study had three
main purposes: (1) to assess the factor structure of a new self-report measure—
the Tonic Immobility Questionnaire[1] —designed to assess human TI in a range
of traumatic events; (2) to explore associations among discovered TIQ factors
and a measure of posttraumatic symptoms in the context of trauma type; and (3)
to determine whether TI is related to suspected and empirically supported
predictors of posttraumatic stress disorder. Participants were a subset of
undergraduate students (n 5 78) who reported a TI experience in the context
of a traumatic event. Results: No differences were found in frequency or
severity of TI reported across trauma types. Exploratory factor analysis of Tonic
Immobility Questionnaire item responses resulted in a three-factor solution (i.e.,
physical immobility, fear, and dissociation). Significant positive correlations
were found between the Tonic Immobility Questionnaire and measures of
posttraumatic symptoms, dissociation, anxiety sensitivity, and absorption.
Regression analysis revealed that peritraumatic dissociation scores alone
accounted for 51% of the variance in TI scores. Conclusions: TI may represent
an extreme behavioral expression of trauma-induced peritraumatic dissociation.
Implications and directions for future research are discussed. Depression and
Anxiety 26:550–556, 2009. r 2009 Wiley-Liss, Inc.

Key words: tonic immobility; peritraumatic dissociation; trauma; PTSD;

posttraumatic stress

and Parkinsonian-like tremors.[5] Physiological corre-

INTRODUCTION
Tonic immobility (TI) is a temporary behavioral state
of motor inhibition thought to occur in response to
situations involving intense fear, such as sexual
assault,[2] or for animals, encounters with predators.[3,4]
TI presents as a stuporous catatonic-like immobility
with muscular hyper- or hypo-tonicity, odd postures,
suppression of vocalization, intermittent eye closure,
1 Accepted 4 December 2007
Anxiety and Illness Behaviours Laboratory, University of
Regina, Regina, Saskatchewan, Canada
2
Department of Psychiatry, University of British Columbia,
British Columbia, Canada
lates include decreases in heart rate and body
Contract grant sponsor: Canadian Institute of Health Research
Investigator’s Awards.
Correspondence to: Gordon J.G. Asmundson Ph.D., Anxiety and
Illness Behaviours Laboratory, University of Regina, Regina,
Saskatchewan, Canada S4S 0A2.
E-mail: gordon.asmundson@uregina.ca
Received for publication 28 June 2007; Revised 5 November 2007;
DOI 10.1002/da.20462
Published online 23 January 2009 in Wiley InterScience (www.
interscience.wiley.com).

r 2009 Wiley-Liss, Inc.

 Research Article: Human Tonic Immobility
temperature, increased respiration rate, and altered
electro-encephalograph patterns.[6,7] TI typically ter-
minates abruptly with either dramatic flight or
defensive attack.[4,44] The research literature on TI in
humans centers primarily on interpersonal trauma
involving sexual assault. For example, in a study
involving 35 rape victims, 37% of the sample reported
feeling paralyzed and unable to move, though not
restrained during the assault.[8] None of the survivors
reported a partial immobility response; that is, im-
mobility was either present or not. Based on these
findings, TI was posited as an unlearned physiological
response rather than an endpoint on a continuum of
resistance. Similarly, in a study of female university
undergraduate students and psychiatric inpatients
endorsing histories of childhood sexual abuse, 52% of
participants reported experiencing TI during episodes
of abuse.[9] Furthermore, TI was positively correlated
with current psychological impairment as assessed with
measures of depression [Beck Depression Inven-
tory[10]], anxiety [Spielberger Trait Anxiety Inven-
tory[11]], and posttraumatic stress symptoms
[Posttraumatic Diagnostic Scale[12]]. Although preli-
minary, these findings suggest that TI is common
during sexual assault and is associated with posttrauma
psychological impairment.
Currently available self-report instruments for TI
have focused exclusively on adult and childhood sexual
assault [e.g., Tonic Immobility Scale-Adult form,
TIS-A;[13]]. The measures typically comprised two
factors—physical immobility and fear.[14] The items are
not constructed to assess TI across trauma types. As
there are also reports of TI in non-interpersonal
trauma contexts [e.g., during air, naval, and other
disasters;[15]], a measure less specific to sexual assault is
required to assess TI in a range of traumatic events.
Taylor and colleagues[1] recently developed the Tonic
Immobility Questionnaire (TIQ) to allow for the
assessment of TI across a wide range of traumatic
events.
This study had three main purposes: (1) to assess the
factor structure of the TIQ; (2) to explore associations
among discovered TIQ factors and a measure designed
to assess posttraumatic symptoms [i.e., the Posttrau-
matic Stress Disorder (PTSD) Checklist-Civilian Ver-
sion, PCL-C[16] in the context of trauma type; and (3)
to determine whether TI is related to suspected and
empirically supported predictors of PTSD. These
predictors include dissociation[17–19], anxiety sensitiv-
ity,[20–22]] and absorption.[23]
Due to the postulated similarity between sexual
assault and predatory encounters,[24] TI frequency and
severity were expected to be higher in the context of
interpersonal trauma (e.g., sexual or physical assault)
relative to other traumatic events. Although examined
in an exploratory manner, a two-factor solution (i.e.,
physical immobility and fear) akin to the TIS-A was
expected for the TIQ across trauma types. Last,
positive correlations were expected between TIQ
551
scores and scores on measures of PTSD symptoms
and related constructs.
MATERIALS AND METHODS
PARTICIPANTS AND PROCEDURE
Participants were 78 undergraduate students who reported a TI
experience during a traumatic event. The sample was selected from a
larger group of participants recruited from the psychology participant
pool at the University of Regina (N 5 280, 75% women;
Meanage 5 20.6, SD 5 4.1) and comprised 17 males and 61 females
(Meanage 5 20.2, SD 5 2.8; Meanyears education 5 14.1, SD 5 1.5). The
group was predominantly Caucasian (91%) and, similar to the larger
sample from which they were selected, 78% were females.
Participants completed a web-delivered questionnaire package and
received bonus marks for their participation. The University of
Regina Research Ethics Board approved this study and informed
consent was obtained from all participants before their participation.
MEASURES
Tonic Immobility Questionnaire[1]. The TIQ was devel-
oped to allow for the assessment of TI across a wide range of
traumatic events. It is a 21-item measure that assesses the features of
TI as described in the animal and human literature. Items are rated
on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much).
Development was based, in part, on the item content of the TIS-A[13];
however, items were worded to be less specific to sexual assault
victims and generally applicable across a variety of traumatic events.
Additional questions were incorporated to assess (1) the duration of
the TI episode; (2) the psychological states during the experience; and
(3) whether alcohol and prescription or recreational drugs were used
before the experience. The psychometric properties of the TIQ are as
yet undetermined; however, the factor structure of the TIS-A has
been assessed. Exploratory (n 5 88) and confirmatory factor analysis
(n 5 191) of the TIS-A with samples of female sexual assault survivors
suggest a two-factor structure comprising Fear and Tonic Immobility;
reliability estimates reported for these subscales were .86 and .65,
respectively.[14] Reliability analysis of the TIQ for the current sample
resulted in scale standardized item a 5 .89.
Anxiety Sensitivity Index [25] [ASI]. The ASI is a 16-item
questionnaire designed to assess levels of anxiety sensitivity (AS),
which is the tendency to fear anxiety-related bodily sensations based
on the belief that they will have harmful consequences. For example,
a person with high AS who experiences heart palpitations may believe
these sensations signal impending heart attack, whereas a person with
low AS may view them as merely uncomfortable. Each item is rated
on a 5-point Likert scale ranging from 0 (very little) to 4 (very much).
Results from factor analytic investigations suggest that the ASI
comprises three internally consistent lower-order factors (i.e., fear of
somatic sensations, fear of cognitive dyscontrol, and fear of socially
observable anxiety reactions) all of which load on a single higher-
order factor.[26,27] For the current sample, reliability analysis of the
ASI resulted in scale standardized item a 5 .82.
Dissociative Experiences Scale-Revised [28] [DES-II]. The
DES-II is a 28-item self-report measure of trait dissociation, which
assesses experiences such as amnesia, depersonalization, derealiza-
tion, and absorption. The DES-II has good split-half reliability and
test–retest reliability, good construct validity (as demonstrated by the
high scores of patients with dissociative disorders), and good
convergent validity with other measures of trait dissociation [e.g.,
[28,29]
]. For the current sample, reliability analysis resulted in a scale
standardized item a 5 .93.
Depression and Anxiety
552 Abrams et al.

Peritraumatic Dissociative Experiences Questionnaire
[30]
[PDEQ]. The PDEQ is a 10-item questionnaire that
asks respondents to recall dissociative experiences (e.g., derealization,
depersonalization, amnesia, altered time perception) around
the time of a traumatic event. The PDEQ has good internal
consistency and convergent validity.[30] Reliability analysis of the
PDEQ for the current sample resulted in scale standardized item
a 5 .90.
PTSD Checklist-Civilian Version[16] [PCL-C]. The
PCL-C is a 17 item self-report measure that corresponds
to PTSD symptoms as described in the Diagnostic and
Statistical Manual of Mental Disorders[31] [DSM-IV-TR] and is
characterized by high diagnostic efficiency of .90[32] and strong
convergent validity with related measures of response to trauma.[33]
Respondents indicate the degree to which they have been bothered
by each trauma-related stress symptom over the past month on
a 5-point Likert scale ranging from 1 (not at all) to 5 (extremely).
The PCL-C was scored to derive indices reflective of PTSD
symptom clusters; avoidance and numbing were scored separately
to be consistent with recent evidence indicating that they are
distinct.[34] For the current sample, reliability analyses resulted in
scale standardized item a’s as follows: PCL-C total scale a 5 .91;
PCL-C Re-experiencing subscale (five items) a 5 .78; PCL-C
Avoidance subscale (two items) a 5 .59; PCL-C Numbing subscale
(five items) a 5 .76; and, PCL-C Hyperarousal subscale (five items)
a 5 .78.
Tellegen Absorption Scale [35] [TAS]. The TAS is a 34-
item questionnaire that measures levels of attentional involvement in
imaginative activity. The scale consistently correlates with hypnotiz-
ability[36] and has excellent internal consistency and 30-day test–retest
reliability[37,38]. Reliability analysis of the TAS for the current sample
resulted in scale standardized item a 5 .94.
The Lifetime Traumatic Events Checklist. The Life-
time Traumatic Events Checklist was developed by the Anxiety and
Illness Behaviours Laboratory at the University of Regina to assess a
wide range of possible traumatic events (e.g., sexual assault, physical
assault, combat exposure, motor vehicle accidents) commonly
reported in academic literature. Respondents are also asked to
indicate the most severe event and whether they have experienced an
event not listed.
ANALYSES
A w2 analysis was performed to assess for differences in frequency
of TI reports across different types of trauma. Participant descrip-
tions of the traumatic event associated with reported TI were
categorized into one of four groups for subsequent analyses. These
groups were as follows: (1) interpersonal trauma, which included sexual
assault as a child or adolescent, sexual assault as an adult, physical
assault as a child or adolescent, physical assault as an adult, torture,
and armed robbery; (2) accident-related trauma, which included motor
vehicle accidents, other serious accidents, and fire; (3) death exposure,
which included unexpected death of a loved one; and (4) other trauma,
which included a variety of traumatic experiences (e.g., natural
disasters). To address the possibility that some respondents may have
experienced multiple instances of TI, participants were instructed to
consider only the most severe event as indicated on the Traumatic
Events Checklist. Analysis of variance further assessed differences in
reported TI severity between the above described trauma groups with
TIQ mean scores as dependent measures.
Exploratory factor analysis was performed to delineate any factors
subsumed within the TIQ. Initial factor structures were assessed with
parallel analysis,[39] eigenvalues41, and Cattell’s scree test. The
intent was to find the primary factors and eliminate unstable items.
Item retention was based on recommendations of Costello and
Osborne,[40] including principal axis factoring with promax rotation
and Kaiser normalization; eigenvalues41.0; and items were removed
where communalitieso.40, loadingsr.45, and cross-loadingsZ.32.
At least half of the items in each of the final factors were required to
have loadingsZ.60 to support factor stability.[41]
Correlational analyses were performed to assess the relative
associations between TI, PTSD symptom clusters, and established
correlates of PTSD (anxiety sensitivity, absorption, trait dissociation,
and peritraumatic dissociation). Subsequent theory-based regression
analyses evaluated the relative predictive value of each PTSD
correlate of TIQ scores.

TABLE 1. TIQ item descriptive statistics

Mean SD CITC a Skew (SE) Kurtosis (SE)

Physical immobility
9. My legs felt paralyzed 1.75 1.36 0.76 0.88 0.11 (0.27) 1.2 (0.54)
8. My arms felt paralyzed 1.78 1.38 0.79 0.88 0.13 (0.27) 1.19 (0.54)
7. My muscles felt weak 2.32 1.34 0.69 0.88 0.41 (0.27) 0.89 (0.54)
6. My body felt frozen 2.56 1.15 0.68 0.88 0.29 (0.27) 0.98 (0.54)
10. My voice was weak (e.g., I had difficulty calling for help) 1.70 1.43 0.53 0.89 0.19 (0.27) 1.27 (0.54)
Fear
4. I felt horrified 2.78 1.27 0.54 0.89 0.80 (0.27) 0.51 (0.54)
2. I felt frightened 3.10 1.10 0.63 0.89 1.23 (0.27) 0.85 (0.54)
3. I felt helpless 2.94 1.18 0.55 0.89 1.05 (0.27) 0.39 (0.54)
Dissociation
16. I had trouble keeping my eyes open 0.78 1.22 0.41 0.89 1.48 (0.27) 1.08 (0.54)
17. I felt faint or light-headed 1.63 1.42 0.57 0.89 0.30 (0.27) 1.28 (0.54)
13. My ability to feel pain was diminished 1.64 1.51 0.55 0.89 0.25 (0.28) 1.41 (0.55)
11. My body felt cold 1.37 1.42 0.63 0.89 0.43 (0.28) 1.30 (0.55)

TIQ=Tonic Immobility Questionnaire; SD=standard deviation; CITC=corrected item total correlations; a=scale a if item deleted; SE=standard
error.
TIQ Total scale a 5 .89; Mean 5 24.11; SD 5 10.75.
TIQ Physical immobility subscale a 5 .89; Mean 5 10.01; SD 5 5.53.
TIQ Fear subscale a 5 .81; Mean 5 8.82; SD 5 3.03.
TIQ Dissociation subscale a 5 .79; Mean 5 5.41; SD 5 4.38.

Depression and Anxiety

 Research Article: Human Tonic Immobility 553

RESULTS where woman scored higher than men, MeanD 5 2.25,

SE 5 .80, t(76) 5 2.83, Po.01, r2 5 .10.
TIQ AND TRAUMA TYPE
Contrary to expectation, there were no significant
differences in frequency of TI reports between the TIQ AND PTSD
groups, w2(3, n 5 78) 5 2.51, P 5.47; there were also no Statistically significant positive correlations were
significant sex differences in TI reporting between found between TIQ scores and PCL-C scores; see
groups, w2(3, n 5 78) 5 1.19, P 5.76. Furthermore, the Table 2. The strongest associations were found for
results revealed no significant between-group differ- TIQ total scores and scores on the PCL-C re-
ences in TI severity as measured by TIQ scores, F(3, experiencing and hyperarousal subscales. Statistically
74) 5 1.20, P 5.32, Z2 5 .05. This suggests that the significant positive correlations were found for TIQ
occurrence of TI is neither more likely nor more severe total scores with all included measures of predictors of
in interpersonal trauma than other trauma contexts. PTSD (see Table 3). A moderately strong correlation
Therefore, all trauma types were collapsed into one was found between PDEQ and TI scores (TIQ),
group for subsequent TIQ analyses. suggestive of a systematic relationship between these
constructs. The multiple regression analysis was based
TIQ FACTOR STRUCTURE on theoretical and statistical associations between TI
Descriptive statistics for each item are presented in
Table 1. The exploratory factor analysis resulted in a TABLE 2. TIQ and PCL-C total and subscale
12-item, three-factor solution, accounting for 69% of correlations
the variance, with factors conceptualized as physical
immobility, fear, and dissociation. The physical im- PCL-C PCL-C PCL-C PCL-C PCL-C
mobility factor (43% of the variance) comprised items Total RE AV NU HA
paralleling TI features described in animal research TIQ Total .44 .42 .26 .33 .37
(e.g., ‘‘My legs felt paralyzed’’; ‘‘My body felt frozen’’; n 5 78 n 5 77 n 5 77 n 5 78 n 5 78
‘‘My voice was weak’’). The fear factor (8% of the TIQ Physical .33 .32 .16 .22 .31
variance) included items such as ‘‘I felt horrified’’ and ‘‘I Immobility n 5 76 n 5 75 n 5 75 n 5 76 n 5 76
felt helpless’’. The dissociation factor (9% of the TIQ Fear .33 .34 .24 .21 .32
variance) included items such as ‘‘I felt faint or light- n 5 78 n 5 77 n 5 77 n 5 78 n 5 78
headed’’ and ‘‘My ability to feel pain was diminished’’. TIQ Dissociation .41 .43 .25 .33 .30
The TIQ factor loadings and subscale correlations are n 5 74 n 5 73 n 5 73 n 5 74 n 5 74
graphically presented in Figure 1. Because the sample Correlation significant at the 0.05 level (two tailed).
was not balanced for sex (78% female) independent t Correlation significant at the 0.01 level (two tailed).
tests were conducted on TIQ factor and total scores to TIQ=Tonic Immobility Questionnaire; PCL-C=PTSD Checklist-
assess for differences. No significant differences were Civilian Version; PCL-C RE=re-experiencing; PCL-C AV=avoid-
found for sex, with the exception of the fear subscale ance; PCL-C NU=numbing; PCL-C HA=hyperarousal.

Figure 1. TIQ factor loadings and subscale intercorrelations.

Depression and Anxiety

554
TABLE 3. TIQ total and subscale correlations with
PTSD-related measures
ASI DES-II PDEQ
TIQ Total .36 .31 .72
n 5 65 n 5 63 n 5 78
TIQ Physical Immobility .16 .37 .50
n 5 64 n 5 62 n 5 76
TIQ Fear .38 .18 .50
n 5 65 n 5 63 n 5 78
TIQ Dissociation .37 .14 .68
n 5 61 n 5 59 n 5 74
Correlation significant at the 0.05 level (two tailed).
Correlation significant at the 0.01 level (two tailed).
TIQ=Tonic Immobility Questionnaire; ASI=Anxiety Sensitivity
Index; DES-II=Dissociative Experiences Scale-Revised; PDEQ=Per-
itraumatic Dissociative Experiences Questionnaire; TAS=Tellegen
Absorption Scale.
and peritraumatic dissociation. The PDEQ was en-
tered on the first step, with the remaining variables
(i.e., ASI, DES-II, TAS, and the PCL-C) entered on
the second step. PDEQ scores alone significantly
predicted TIQ scores, b 5 .72, t 5 7.48, Po.01, and
explained the greatest proportion of the variance,
adjusted R2 5 .51, F(1, 51) 5 55.88, Po.01. None of
the other predictors contributed significantly to the
model
DISCUSSION
Researchers studying TI currently view the phenom-
enon as an evolved defensive response to animal
predation.[42] Predatory encounters typically involve
violent physical contact and high levels of fear. We
believe that interpersonal trauma, such as sexual or
physical assault, is analogous to such situations.
Therefore, it was hypothesized that TI would be more
likely and more severe in interpersonal trauma relative
to other trauma situations. The current data did not
support this expectation. On the other hand, our results
do support the idea that high levels of fear and
peritraumatic dissociation may be the most salient
variables associated with TI in humans. Although these
states are pervasive aspects of interpersonal victimiza-
tion,[43] the results of the present study indicate that
they are not limited to such contexts. Other traumatic
events not involving interpersonal violence, such as air
or naval disasters,[15] may also provoke levels of fear
and dissociation of sufficient intensity to induce TI.
Previous exploratory and confirmatory factor ana-
lyses of TIS-A items with sexual assault survivors
revealed a two-factor solution involving TI and fear.[14]
Sexual assault, which involves high levels of fear and
physical restraint, is believed to be strikingly similar to
the circumstances that induce TI in animals [i.e., fear
and physical restraint[24]]. In the current sample, which
Depression and Anxiety
Abrams et al.
included a range of traumatic events, it appears that
factors other than fear and physical restraint are
associated with TI. Specifically, the TIQ items could
TAS
be conceptualized as tapping three factors, including
.38 not only physical immobility and fear but also
n 5 76 peritraumatic dissociation, which is considered in more
.35 detail below.
n 5 74 TIQ scores were also associated with PTSD
.18 symptoms. Substantial correlations were found be-
n 5 76 tween TIQ scores and PCL-C scores—the strongest
.38 associations were between TIQ scores and PCL-C
n 5 72
reexperiencing and hyperarousal subscales. Associa-
tions between TIQ scores and PCL-C avoidance and
numbing subscales were comparatively less pro-
nounced. Persons who report TI-like behavioral
inhibition are generally able to vividly recall details of
the event. This capacity to remember—while being
unable to escape or resist—may contribute to worsened
re-experiencing symptoms. Indeed, experiences of
immobility have been linked to higher levels of guilt
and self-blame arising from the belief that the survivor
could have, or should have, done more.[24,44,45] For
patients who report a TI experience during a traumatic
event, understanding the involuntary nature of TI may
be of critical clinical significance—learning that an
inability to act was not volitional but rather an
involuntary reflexive response may provide substantial
relief from guilt and self-blame.
Associations found between TIQ scores and PCL-C
hyperarousal subscale scores suggest that a TI experi-
ence may facilitate subsequent symptoms of increased
arousal (e.g., exaggerated startle response, difficulty
falling or staying asleep). The relationship between the
TIQ dissociation subscale and reported symptoms of
numbing may be indicative of a cognitive protective
response—an attempt to disengage from the emotional
agitation caused by the trauma. Posttraumatic numbing
may thus be a dimension of dissociative responding
with neurobiological correlates related to TI. Specifi-
cally, emotional numbing may be related to dissocia-
tion and mediated by biological mechanisms
resembling those that underlie freezing behavior in
animals.[46] Taken together these associations are
consistent with previous findings linking TI to greater
psychological impairment.[9]
Measures of several PTSD-related constructs (i.e.,
peritraumatic dissociation, AS, absorption, trait dis-
sociation) were all moderately correlated with TIQ
total scores. In particular, the results suggested a
systematic relationship between TI and peritraumatic
dissociation. Multiple regression analyses revealed that
peritraumatic dissociation alone significantly predicted
TI, accounting for more than half of the variance.
Several previous studies have also linked peritraumatic
dissociation with exacerbated posttraumatic symptoms
and psychological impairment.[17,19,47,48] Moreover, the
consistent association between TI and high levels
of peritraumatic dissociation suggests that reported
TI may signal significant vulnerability for the
 Research Article: Human Tonic Immobility
development of posttraumatic symptoms. The finding
that TI and peritraumatic dissociation appear intri-
cately related suggests that TI and peritraumatic
dissociation may differ dimensionally rather than being
categorically distinct phenomena. Although the animal
literature presents TI as a discrete and distinct response
to stressful situations, animal research (by its very
nature) cannot provide insight into the psychological
states that precede and accompany TI. It may be that
TI is a behavioral manifestation of extreme levels of
peritraumatic dissociation; however, this is speculative
and requires further study.
Correlations with the remaining PTSD-related
constructs (i.e., AS, absorption, trait dissociation) were
not robust across the TIQ subscales. The inconsistency
suggests some specificity for the TIQ subscales. For
example, the correlation between the physical immo-
bility subscale of the TIQ and AS was low and not
statistically significant. The low correlation is reason-
able, given that the TIQ physical immobility subscale
items are specific to peritraumatic experiences of
immobility and should have little or no association
with AS. Conversely, the nonsignificant correlations
between the fear and dissociation subscales of the TIQ
and trait dissociation were counterintuitive. It is
possible that trait dissociation—as measured by the
DES-II—has little bearing on levels of peritraumatic
dissociation—as measured by the PDEQ—in the
context of a traumatic event, but this speculation
requires further study. Furthermore, there was no
association between the TIQ fear subscale and
absorption. This finding is also reasonable as peritrau-
matic fear should have little or no relationship with the
trait of absorption.
This study has some limitations that warrant men-
tion. First, this sample was high functioning (despite
reporting a TI experience), 75% female, primarily
comprised individuals with a very narrow age range,
and each individual was tested only once. Future
research should strive for samples that are more
representative of the general population and explore
test–retest reliability. Second, all of the results are
based on self-report measures with no objective
method to confirm TI (e.g., third-party corroboration).
Third, under-representation of traumas may have
resulted in an insufficient sample size to detect
differences between trauma types; thus, future studies
incorporating larger samples of people reporting TI
are warranted. Notwithstanding these limitations, the
findings provide some preliminary insight into human
TI and, in doing so, suggest a number of future
research directions. First, the notion of differential TI
responding based on trauma type warrants re-examina-
tion with a larger, more diverse sample. Second, the
three-factor solution for TIQ items requires replica-
tion and confirmation in both clinical and non-clinical
samples. Third, the relationship between peritraumatic
dissociation and TI requires further investigation to
delineate the nature of the dimensional relationship. As
555
established in the animal literature, it is possible that a
taxonomic threshold may exist for humans wherein
dissociation becomes TI. Finally, as TI, similar to
peritraumatic dissociation, appears related to PTSD
symptom severity, future investigations should focus on
unraveling potentially common vulnerabilities that
underlie maladaptive responses to trauma [e.g., PTSD,
chronic pain[49]].
The evidence so far supports reported TI during a
traumatic event as signaling significant vulnerability for
worsened posttraumatic symptom severity. Similarly,
TI-like immobilization in the context of panic disorder
has been associated with a more severe course of
illness.[50] Also intriguing is a comorbid association
between panic attacks and sleep paralysis—a rapid eye
movement event that, similar to TI, is characterized by
frightening immobilization, muscle atonia, and (unlike
TI) frightening hallucinations.[51] The results of the
current investigation add to the growing body of
research that suggests TI may play a pervasive role
within several anxiety disorders. Further investigation
of TI in such contexts may provide important
information for understanding the development and
treatment of anxiety-related psychopathology.
Acknowledgments. Dr. Asmundson is supported
by Canadian Institute of Health Research (CIHR)
Investigator’s Award. R.N. Carleton and M. Abrams
are supported by CIHR Graduate Scholarship Awards.
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