Heart rate response to fear conditioning and virtual reality in subthreshold PTSD

Michael J. Roy*, Michelle E. Costanzo, Tanja Jovanovic, Suzanne Leaman, Patricia Taylor, Seth D. Norrholm, Albert A. Rizzo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Posttraumatic stress disorder (PTSD) is a significant health concern for U.S. military service members (SMs) returning from Afghanistan and Iraq. Early intervention to prevent chronic disability requires greater understanding of subthreshold PTSD symptoms, which are associated with impaired physical health, mental health, and risk for delayed onset PTSD. We report a comparison of physiologic responses for recently deployed SMs with high and low subthreshold PTSD symptoms, respectively, to a fear conditioning task and novel virtual reality paradigm (Virtual Iraq). The high symptom group demonstrated elevated heart rate (HR) response during fear conditioning. Virtual reality sequences evoked significant HR responses which predicted variance of the PTSD Checklist-Military Version self-report. Our results support the value of physiologic assessment during fear conditioning and combat-related virtual reality exposure as complementary tools in detecting subthreshold PTSD symptoms in Veterans.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalAnnual Review of CyberTherapy and Telemedicine
StatePublished - 2013
Externally publishedYes


  • Fear conditioning
  • Heart rate
  • Subthreshold posttraumatic stress disorder
  • Virtual reality


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