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Access Type

WSU Access

Date of Award

January 2022

Degree Type


Degree Name



Psychiatry and Behavioral Neurosciences

First Advisor

Tanja Jovanovic

Second Advisor

Arash Javanbakht


Exposure to stress and trauma activates key adaptive pathways, including the sympathetic adrenomedullary system and the immune system, which can result in long-term health impacts of trauma especially when experienced during sensitive developmental periods. Alterations in these systems are measurable through non-invasive methods including skin conductance response (SCR), fear potentiated startle (FPS), and inflammation. Research regarding the impact of trauma, and more specifically posttraumatic stress disorder, has primarily focused on adults, and there is a paucity of neurobiological research in displaced populations—like refugees—who may experience higher rates of trauma exposure and related psychopathology. The present study measured SCR to a trauma interview, FPS to threat and safety cues in a fear conditioning/extinction learning paradigm, and pro-inflammatory C-reactive protein (CRP) and interleukin 18 (IL-18) in a sample of youth resettled as refugees of Syria. The present work highlighted that measuring psychophysiological data such as SCR, FPS, and inflammation is feasible in refugee youth across a variety of settings. We found that SCR to trauma interview was associated with trauma exposure and predictive of total posttraumatic stress as well as re-experiencing symptoms. We also found that increased FPS to both threat and safety cues was associated with greater trauma exposure, and that individuals with a probable diagnosis of PTSD failed to extinguish learned fear compared to those without such a diagnosis, replicating in youth for the first time a largely reproduced finding in adults that seems to indicate PTSD as, in part, a disorder of fear extinction rather than fear learning. Finally, we did not find any significant associations linking trauma, related psychopathology, and inflammation in youth resettled as refugees. Our findings highlight the ways in which trauma affects the developing nervous systems of youth, and how creative arts and movement-based interventions such as art therapy and dance/movement therapy may be effective in addressing trauma-related psychopathology, as well as associated pathophysiology. This work has provided initial evidence for plausible biomarkers of trauma-related psychopathology in Syrian refugee youth and related interventions to support this largely underrepresented group in mental health research and treatment.

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