Table 3.

Trait dissociation – Study characteristics and results.

									HR		HRV					BP	SC
Study	N	Patients	Mean age	Sex distribution (% women)	Dissociation measurement	Physiological parameter	Symptom provocation	Comparison Specification	HR	PEP	RMSSD	HF	LF	LF/HF-ratio	RSA	BP (s/d)	SCL	SCR	NSCF
Personalized trauma stimuli
Bichescu-Burian et al. (2017)	21	BPD patients with comorbid PTSD	23.86	100	DES	HR, SCRa, SCRf	Personalized trauma-content	Correlation	•*									•
Castro-Chapman et al. (2018)	134	Veterans with combat exposure (on average moderate PTSD symptom severity)	37.64	8	DES	HR	Personalized trauma-content	Correlation	•*
Halligan et al. (2006)	61a	Assault survivors (41% met criteria for PTSD)	39.0	46	TDQ	HR	Personalized trauma-content	Correlation – full sample (n = 54)	•*
								Correlation – females (n = 25)	•*
								Correlation – males (n = 29)	•*
Hauschildt et al. (2011)	70	n = 26 trauma-exposed with PTSD, n = 26 trauma-exposed without PTSD, n = 18 non-exposed controls	32.7b	71	DES	RMSSD, HF-HRV, LF-HRV	Video with emotional valence (neutral, negative, positive, trauma-related)	Correlation			•	•	•
Hyer et al. (1993)	57 (n = 19 low diss., n = 17 medium diss., n = 21 high diss.)	Veterans with chronic PTSD	40.2	0	DES	HR	Personalized trauma-content	High vs. medium dissociation	↑ •*
								High vs. low dissociation	• •*
Rhudy et al. (2008)	28	Trauma-exposed with chronic nightmares (32% current PTSD, 46% lifetime PTSD)	39.0	68	DES	HR, SCL	Personal nightmare scripts	Correlation	•*								•*
Schmahl et al. (2004)	14	PTSD patients with history of sexual & /or physical abuse	36.2	100	DES	HR, BP, NSCF	Personalized trauma-content	Correlation	•*							↑*/•*			•*
Vermes et al. (2020)	21	PTSD patients	34.7	95	DES	SCR	Personalized trauma-content	Correlation										•
General stress stimuli
Powers et al. (2021)	19	Trauma-exposed with diabetes	46.95	100	MDI	HR, LF/HF-ratio, RSA	Trier Social Stress Test	Correlation	↓					•	•
Schäflein et al. (2018)	18	DDNOS patients with comorbid PTSD	41.7	94	DES	HR, lnRMSSD, PEP	mirror confrontation (only, or combined with positive or negative cognitions)	Correlation	•	•	•
Schalinski et al. (2013)	31	Refugees with multiple traumatic experiences & PTSD (6% did not meet the avoidance criterion)	36.45	100	Shut-D	HR	White noise	Correlation	•
Seligowski et al. (2019)	19	General medical hospital in-patients with PTSD	37.68	100	MDI	HR, RSA, SCR	Fear-potentiated startle paradigm	Correlation	•*					•c*				↓d
	20	Psychiatric hospital in-patients with PTSD	39.75	100	MID			Correlation	•*					•c*				↑e
Simeon et al. (2008)	21	New York City residents highly exposed to 9/11 (33% met criteria for PTSD)	40.4	38	DES	HR, BP	Trier Social Stress Test	Correlation	↓							• /•

Note: Arrow directions indicate increase ↑ or decrease ↓ during provocation condition, parentheses indicate non-significant results, * = results indicated by change score, • = no effect. If studies reported results during condition and change scores, both are presented in the table; BP (s/d): (systolic or diastolic) blood pressure, BPD: Borderline Personality Disorder, DDNOS: Dissociative Disorder Not Otherwise Specified, DES: Dissociative Experience Scale, HF-HRV: high frequency heart rate variability, HR: heart rate, HRV: heart rate variability, LF-HRV: low frequency heart rate variability, LF/HF-ratio: ratio of low frequency to high frequency heart rate variability, lnRMSSD: natural logarithm of root mean square successive difference; MDI: Multiscale Dissociation Inventory, MID: Multidimensional Inventory of Dissociation, NSCF: number of skin conductance fluctuations, PEP: pre-ejection period, PTSD: Posttraumatic-Stress Disorder, RMSSD: root mean square successive difference, RSA: respiratory sinus arrhythmia, SC: skin conductance, SCL: skin conductance level, SCR: skin conductance response, SCRa: amplitude of skin conductance response, SCRf: frequency of skin conductance response, Shut-D: Shutdown Dissociation Scale, TDQ: Trait Dissociation Questionnaire.

^a Correlation with trait dissociation is available for 54 participants.

^bN-adjusted mean value weighted by size of subgroups.

^cSignificant positive correlations were only found in trait dissociation subscales of depersonalization in the general hospital sample and derealization in the psychiatric sample.

^dFor danger signal.

^eFor safety signal.