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The Sensory Profile of People With Post-


Traumatic Stress Symptoms
a b b
Batya Engel-Yeger , Dafna Palgy-Levin & Rachel Lev-Wiesel
a
Occupational Therapy Department, Faculty of Social Welfare &
Health Sciences , University of Haifa , Haifa , Israel
b
The Graduate School of Creative Art Therapies, Faculty of Social
Welfare & Health Sciences , University of Haifa , Haifa , Israel
Published online: 28 Aug 2013.

To cite this article: Batya Engel-Yeger , Dafna Palgy-Levin & Rachel Lev-Wiesel (2013) The Sensory
Profile of People With Post-Traumatic Stress Symptoms, Occupational Therapy in Mental Health, 29:3,
266-278, DOI: 10.1080/0164212X.2013.819466

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Occupational Therapy in Mental Health, 29:266–278, 2013
Copyright © Taylor & Francis Group, LLC
ISSN: 0164-212X print/1541-3101 online
DOI: 10.1080/0164212X.2013.819466

The Sensory Profile of People With


Post-Traumatic Stress Symptoms

BATYA ENGEL-YEGER
Occupational Therapy Department, Faculty of Social Welfare & Health Sciences,
University of Haifa, Haifa, Israel
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DAFNA PALGY-LEVIN and RACHEL LEV-WIESEL


The Graduate School of Creative Art Therapies, Faculty of Social Welfare
& Health Sciences, University of Haifa, Haifa, Israel

Thirty participants with post-traumatic stress (PTS) symptoms and


30 healthy controls completed the Post-Traumatic Stress Disorder
Symptom Scale (PSS-SR) and the Adolescent/Adult Sensory Profile
(AASP). Participants with PTS symptoms vacillated between sen-
sory sensitivity, sensation avoiding, and low registration. Sensation
avoiding and low registration correlated with intrusive thoughts
related to PTS. Discriminant Analysis classified 73% of the study
group and 80% of the controls. PTS may be related to hypersensitiv-
ity and low registration. Further studies about the sensory profile of
people with PTS symptoms may contribute to research and optimize
evaluation and intervention for people with PTSD.

KEYWORDS sensory processing, post-traumatic stress, sensory


sensitivity

INTRODUCTION

Traumatic Events and Post-Traumatic Stress


A traumatic event is an event in which “[a] person experienced, witnessed or
was confronted with an event or events that involved actual or threatened
death or serious injury, or threat to the physical integrity of self or others” and
“the person’s response involved intense fear, helplessness, or horror”

Address correspondence to Batya Engel-Yeger, PhD, Occupational Therapy Department,


Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, 31905 Haifa,
Israel. E-mail: batya@research.haifa.ac.il

266
Sensory Profile and Post-Traumatic Stress 267

(American Psychiatric Association, 2000, p. 467). According to the DSM-IV-TR


(American Psychiatric Association, 2000) the symptoms of post-traumatic
stress fall into three clusters: re-experiencing the event through intrusive
thoughts, nightmares, or flashbacks; avoidance of factors associated with the
event and emotional numbing; and increased arousal, such as hypervigilance
and irritability. For a diagnosis of post-traumatic stress to be considered a
disorder (post-traumatic stress disorder [PTSD]), symptoms must cause signifi-
cant distress and impairment and also must continue for longer than one
month. Note that most people who experienced traumatic events do not
exhibit full-blown PTSD but instead are considered to be suffering from post-
traumatic stress (PTS) symptomatology (Lev-Wiesel, Amir, & Besser, 2005).
Previous studies which focused on the relationship between traumatic
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life events such as physical or sexual abuse and the subsequent development
of PTS symptomatology indicated that people traumatized as children or
adults are vulnerable to the development of PTS symptoms, contingent on
their coping resources and social support. This phenomenon may be caused
by changes in their neurobiological system, mainly expressed in regulation
difficulties of biological stress systems (Collin-Vézina & Hébert, 2005) that
also influence sensory-processing abilities.

Sensory Processing
Research demonstrated that each person processes sensory information in a
different way (Brown, 2001). Sensory processing refers to the ability to regis-
ter and modulate sensory information and to organize this sensory input to
respond to situational demands (Humphry, 2002).
Sensory-processing difficulties (SPD) can occur in some or all sensory
systems and are expressed by extreme behaviors in response to sensory
stimuli, ranging from hypersensitivity to hyposensitivity and sensory-seeking
behaviors (Miller, Anzalone, Lane, Cermak, & Osten, 2007).
Dunn (1997) developed a model about the relationship between the
person’s neurological thresholds and behavioral-self regulation strategies
continua (Brown, Tollefson, Dunn, Cromwell, & Filion, 2001). According to
this model, neurological thresholds exist on a continuum from low (little
stimulation to activate) to high (much stimulation for activation). In regard to
self- regulation strategies, people who use a passive strategy allow stimuli to
occur and then respond to them, while those people who use an active strat-
egy act to control the amount and type of sensory input that they receive
(Dunn, 2007). This model yielded four sensory-processing patterns:

PATTERNS RELATED TO HIGH NEUROLOGICAL THRESHOLD


(1) Low Registration—people who require high intensity stimuli to notice
sensory input and use a passive behavior strategy; and (2) Sensation
268 B. Engel-Yeger et al.

Seeking—people who use an active behavior strategy. These people actively


search for a rich sensory environment and behaviors that create sensation.

PATTERNS RELATED TO LOW NEUROLOGICAL THRESHOLD


(3) Sensation Avoiding—people who use an active strategy (i.e., engage in
behaviors to limit exposure to stimuli); and (4) Sensory Sensitivity—individuals
who use a passive behavior strategy and do not actively remove or eliminate
the disturbing stimuli (Dunn, 1997). Individuals with low neurological thresh-
olds are often described as showing irritability, inconsolability, anxiety, and
depression (see Engel-Yeger & Dunn, 2011; Hofmann & Bitran, 2007; Liss,
Mailloux, & Erchull, 2008).
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People on the edge of the continuum and who show extreme sensory-
processing patterns may have elevated emotional burdens which negatively
influence their affective status, behavior, and adjustment to environmental
situations (Fisher, Murray, & Bundy, 1991; Kinnealey & Fuiek, 1999; Neal,
Edelmann, & Glachan, 2002; Pfeiffer, Kinnealey, Reed, & Herzberg, 2005).
Similar characteristics such as extreme responses to sensory stimuli; negative
affect, and behavioral difficulties are common among people with PTSD.

PTS Symptoms and Sensory Processing


Several neurophysiological studies with PTS-affected people found that such
persons often exhibit extreme responses to sensory stimuli (see Attias, Bleich,
Furman, & Zinger, 1996; Shalev, Peri, Brandes, Freedman, Orr, & Pitman, 2000).
The relationship between the impact of the exaggeration of stimuli
apparent in a traumatic event and the person’s subsequent reactions to daily
sensory incidents (such as unexpected noise or unexpected touch) has rarely
been examined. Common psychophysiological characteristics, however,
exist when comparing people with SPD and people with PTSD. For exam-
ple: fluctuation between numbing of general responsiveness to sensory
hypersensitivity/avoidance of stimuli associated with the trauma. Patterns
related to hypersensitivity were reported to be accompanied by increased
arousal, hypervigilance, increased startle response, irritability, attention prob-
lems, and anxiety, “hyper-reactive” autonomic nervous system (Engel-Yeger
& Dunn, 2011; Kisley, Noecker, & Guinther, 2004; Shochat, Tzischinsky, &
Engel-Yeger, 2009). These reactions are frequently reported among both
people with SPD and with expressing PTSD.
Indeed, several neurophysiological studies on people with PTSD (see
Morgan & Grillon, 1999; Naatanen & Alho, 1995; Shalev et al., 2000) found
that such persons often demonstrate extreme sensory-processing patterns,
mainly expressed by sensory hypersensitivity associated with memories of
the traumatic event (such as specific sounds, images, touch stimulation) and
are mainly expressed as hypersensitivity.
Sensory Profile and Post-Traumatic Stress 269

Possible explanations for these common characteristics may be found


in previous studies which found that SPD among people with PTSD exist as
a result of abnormal processing at different levels of the central nervous
system. This includes for example the ascending reticular activating system
(RAS); enhanced activity of the limbic structures, amygdala, hypothalamus,
and the prefrontal cortex (Adenauer et al., 2010) or specific cortical sensory
areas (Ge, Wu, Sun, & Zhang, 2011). The abnormal processing may also
explain the elevated attention/consciousness of people with PTS symptoms.
For example, McFarlane, Weber, and Clark (1993) found that, according to
brain event-related potential (ERP), people with PTS symptoms have disturbed
perceptual evaluation of sensory stimuli as well as impaired concentration.
The abnormalities in pre-attentional, subconscious sensory processing among
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people with PTSD are associated with symptoms of hypervigilance and


feelings of being “on alert” (e.g., Morgan & Grillon, 1999).
Based on the above, people with PTSD may suffer from impaired per-
ception of sensory stimuli, abnormalities in pre-attentional, subconscious sen-
sory processing associated with symptoms of hypervigilance, and feelings of
being “on alert” (Morgan & Grillon, 1999). They also show similar psycho-
physical characteristics as do people with SPD such as exaggerated defense
mechanisms, hyper-arousal and poor self-regulation (Ge et al., 2011).
These findings raise questions regarding whether a common mechanism
underlies both phenomena and questions about the role and contribution of
SPD to PTS symptoms. Based on previous reports, the knowledge about the
relationship between SPD and PTS symptoms was examined in specific sensory
modalities (visual and auditory) and in laboratory settings. A lack of information
exists regarding the relationship between SPD and PTS symptoms, in regard to
all sensory modalities, and to the expression of SPD in daily living scenarios.
Such information is of most importance when creating the evaluation and inter-
vention process to fit a person’ s specific needs and life characteristics.
The purposes of the present study were to: (1) identify the sensory
profiles of people with PTS symptoms measured in all sensory modalities
and in behaviors related to daily living situations, and to compare them to
profiles and behaviors of healthy controls; and (2) examine the relationship
among the sub categories of PTS symptoms (intrusive thoughts, avoidance,
and hyper-arousal) and the various sensory-processing patterns.

METHOD

Participants
After the study was ethically approved by the managing board of the clinic
in which the study was performed, sixty adults aged 24–62 were recruited.
The study group consisted of 30 people who suffered from PTS symptoms
following past traumatic events and who were treated in several clinics in
270 B. Engel-Yeger et al.

TABLE 1 Socio-Demographic Information of the Participants in Both Cohorts

People without
PTS (N = 30) Controls (N = 30)

N % N % Chi-square/t-test

Gender Male 12 40% 12 40% X²(1) = 0.0


Female 18 60% 18 60%
Mean age (SD) 38 (10.37) 40.53 (10.9) t(58) = 0.92
Range 25–60 24–62
Familial status Single 8 26.7% 7 23.3% X²(2) = 0.76
Married 20 66.7% 19 63.3%
Divorced 2 6.7% 4 13.3%
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Years of education 16.37 (1.94) 14.32 (3.28) t43,21 = 2.87*


Means (SD)
Range 12–23 8–22

*p < 0.05.

Israel. The control group included 30 participants who were matched to the
study group by age, gender, and familial status but reported no history of
experiencing a traumatic event and did not have a diagnosis of PTSD or PTS
symptoms. Table 1 summarizes the socio-demographic information of the
participants in both cohorts.
An examination of Table 1 indicates no statistically significant differences
between cohorts regarding gender, age, and marital status. A significant differ-
ence was found with regard to years of education (t[43] = 2.87, p < 0.01) in that
the control group had more years of education (M = 16.37, SD = 1.94) than the
PTSD group (M = 14.32, SD = 3.28).
An examination of Table 2 shows that the participants in the PTS group
suffer from PTS symptoms following various traumatic events that occurred
at least a year ago, and more than half (56.7%) suffer from PTS symptoms
associated with traumatic events that occurred more than 10 years ago.

TABLE 2 Personal Background Characteristics of the PTS Cohort (N = 30)

Variable Values N %

Type of trauma Sexual abuse 6 20%


Car accident 7 23.3%
Work accident 1 3.3%
War 6 20%
Violent incident 3 10%
Other 7 23.3%
When did it take place? Between 1 and 10 years ago 13 43.3%
More than 10 years ago 17 56.7%
Psychological treatment Yes 20 66.7%
No 10 33.3%
Sensory Profile and Post-Traumatic Stress 271

Measures
POST-TRAUMATIC STRESS DISORDER SYMPTOM SCALE (PSS-SR; FOA,
RIGGS, DANCU, & ROTHBAUM, 1993)

This is a 17-item interview assessing the severity of each of the DSM-IV PTSD
symptoms during the previous week. Each symptom is rated on a 4-point
scale from 0 (not at all) to 3 (5 or more times in a week). Sub-scales scores
are calculated by summing items in each of the PTSD symptom clusters: re-
experiencing, avoidance, and arousal. The scale had high internal consis-
tency (Cronbach’s alpha = 0.88) at both the 1st and 2nd waves and moderate
to high correlations with other measures of psychopathology. The PSS-SR
has high test–retest reliability (r = 0.80) and inter-rater reliability (k = 0.91).
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Internal consistency among the 17 items in the current sample was high
(Cronbach’s alpha = 0.88).

THE ADOLESCENT/ADULT SENSORY PROFILE (AASP; BROWN & DUNN, 2002)


This questionnaire is based on Dunn’s model of sensory processing (Dunn,
1997). In this self-reporting tool, respondents answer questions about their
responses to sensory experiences. The scale has 60 items, including ques-
tions pertaining to each of the sensory systems. For scoring, the 60 items are
sorted equally into four quadrants: Low Registration, Sensation Seeking,
Sensory Sensitivity, and Sensation Avoiding. Participants indicate how often
they respond to the sensory event in the manner described in the items using
a 5-point Likert scale (from 1 corresponding to “almost never” to 5 corre-
sponding to “almost always”). The resultant score for each quadrant ranges
from 5 to 75. Using national samples of 950 adolescents and adults (ages 11
through 90 years), the authors calculated cut scores which indicate when
scores are significantly different from their peers’ responses. Each age group
(11–17; 18–64; 65 and older) has its own norms. This questionnaire has good
internal consistency with coefficient alpha values of 0.692 for Low Registration,
0.639 for Sensation Seeking, 0.657 for Sensory Sensitivity, and 0.699 for
Sensation Avoiding (Pohl, Dunn, & Brown, 2003). This questionnaire was
translated to Hebrew and back translated into English by bilingual occupa-
tional therapists, in order to examine the validity of the translated form. The
current study has good internal consistency with coefficient alpha values: for
“Sensory Seeking,” 0.81; for “Sensory Sensitivity,” 0.82; for “Low Registration,”
0.86; and for “Sensory Avoidance,” 0.85.

Procedure
After providing their consent to participate in the study, participants were
asked to participate in the study. Subsequent to explanation of the study’s
aims and their signing a participation consent form, the study/control group
272 B. Engel-Yeger et al.

participants completed questionnaires and returned them to the data collector


via e-mail or in a stamped envelope addressed to the researcher.

Data Analysis
The Chi-square and t-test were used to examine the significance of differ-
ence between groups’ demographic data. A t-test was used to examine
whether significant differences exist between cohorts in AASP scores. The
relationship between AASP scores of people with PTS symptoms was exam-
ined using Pearson correlations.
A discriminant analysis was conducted in order to determine which
sensory-processing variables were the best predictors of group membership
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(i.e., people with PTS symptoms versus controls).


Probabilities at or below alpha = 0.05 were considered significant.

RESULTS

The Differences in Sensory-Processing Abilities Between


People With PTSD and Healthy Controls
As presented in Table 3, people with PTS symptoms showed significantly
greater tendencies for sensory sensitivity, sensory avoidance, and low regis-
tration and a lower tendency for sensory seeking, as compared to healthy
controls and to the AASP normal range values.

TABLE 3 Comparison of AASP Scores Between PTS Cohort (N = 30) and Healthy Controls
(N = 30)

Comparison % of participants
to the normal found above
Mean (SD) t-test df p AASP values typical range

Sensory sensitivity
PTS 48.22 (9.81) 4.69 58 <0.001 + 80.0
Controls 37.75 (7.28) = 26.7
Sensation avoiding
PTS 48.59 (10.13) 6.07 50 <0.001 + 83.3
Controls 35.19 (6.59) = 20.0
Low registration
PTS 38.65 (10.22) 3.78 48 <0.005 + 63.3
Controls 30.97 (4.44) = 20.0
Sensation seeking
PTS 40.38 (11.01) 2.98 38 <0.01 − 3.3
Controls 46.83 (4.43) = 0.0

Note. +“More than most people”: One standard deviation above AASP normal range; = “Similar to most
people”: Similar to AASP normal range; – “Less than most people”: One standard deviation below AASP
normal range
Sensory Profile and Post-Traumatic Stress 273

TABLE 4 Differences Between Cohorts in Sensory Processing Measured in Different


Modalities

Controls PTS

Modality Processing pattern Mean SD Mean SD F p

Taste Low registration 4.36 1.13 4.67 1.47 0.79 NS


Seeking 9.81 2.01 8.81 2.31 3.2 NS
Sensitivity 2.31 1.14 2.61 1.37 0.84 NS
Avoidance 5.66 1.54 6.16 1.53 1.5 NS
Movement Low registration 3.71 1.14 5.53 2.75 14.23 <0.0001
(Vestibular)
Seeking 7.31 1.32 8.98 3.29 10.07 0.002
Sensitivity 6.73 1.91 2.21 1.45 10.48 0.002
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Avoidance 1.47 0.67 4.46 2.09 7.52 0.008


Visual Low registration 3.83 1.21 4.47 2.09 2.05 NS
Seeking 5.53 1.45 4.91 2.01 1.95 NS
Sensitivity 8.43 2.54 10.66 2.55 11.54 0.001
Avoidance 6.73 2.01 9.41 3.16 15.12 <0.0001
Touch Low registration 5.73 1.14 6.51 2.38 2.51 NS
Seeking 9.56 1.79 8.03 3.26 5.08 0.028
Sensitivity 9.91 2.18 11.56 3.34 7.28 0.009
Avoidance 6.91 1.58 9.96 2.97 24.82 <0.0001
Activity Level Low registration 6.46 1.57 8.71 2.69 15.41 <0.0001
Seeking 8.53 1.43 8.55 2.71 0.001 NS
Sensitivity 2.83 0.98 3.53 1.16 6.31 0.015
Avoidance 7.63 2.12 10.13 2.58 16.76 <0.0001
Auditory Low registration 6.8 1.75 8.8 2.45 13.02 0.001
Seeking 6.01 1.34 4.56 1.96 10.94 0.002
Sensitivity 7.43 2.25 10.56 3.09 20.11 <0.0001
Avoidance 6.8 2.2 10.46 2.82 31.42 <0.0001

Differences between the cohorts were also manifested in the various


sensory modalities (see Table 4). A higher number of significant differences
were found in the vestibular modality (movement), tactile modality, auditory
modality, and in the activity levels for individuals with PTS symptoms show-
ing greater sensitivity, lower registration, and lower sensation seeking.

Correlation Between Sensory-Processing Patterns and


PTSD Clusters
When referring to SPD as related to low neurological threshold, a higher
tendency for sensation avoidance was positively correlated with intrusive
thoughts (r = 0.37, p = 0.045). When referring to SPD as related to high
neurological threshold, lower registration of sensory input was positively
correlated with intrusive thoughts (r = 0.38, p = 0.04). Higher tendency for
sensation seeking was negatively correlated with avoidance (r = –0.6,
p ≤ 0.0001) and with arousal (r = –0.34, p ≤ 0.0001).
Among the study cohort, further analysis referred to the correlations
between PTS clusters and SPD in all sensory modalities. Intrusive thoughts
274 B. Engel-Yeger et al.

significantly correlated with higher avoidance to touch (r = 0.37, p = 0.043),


lower registration of auditory input (r = 0.62, p ≤ 0.0001) and lower tendency
for seeking vestibular stimuli (r = –0.56, p = 0.001) and touch stimuli (r = –0.48,
p = 0.008). Greater arousal significantly correlated with lower tendency for
seeking touch stimuli (r = –0.51, p = 0.005) and with lower registration of
auditory input (r = 0.37, p = 0.047). Avoidance significantly correlated with
lower tendency for seeking visual stimuli (r = –0.52, p = 0.003) and touch
stimuli (r = –0.63, p ≤ 0.0001).

Discriminant Analysis
One function predicted the categorization of participants with PTS symp-
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toms when compared with controls (Wilks’ Lambda = 0.59; p < 0.001). This
one function discriminated between participants with PTS symptoms while
they had higher scores (–0.8) and controls having lower scores (0.8).
The variable which made the greatest contribution to group member-
ship was Sensation Avoiding (loading = 0.98), followed by Sensory Sensitivity
(loading = 0.75) and Low Registration (loading = –0.61). The “Sensory Seeking”
loading was –0.48.
Based on this function, 77% of the participants overall, 73% of the
participants with PTS symptoms, and 80% of the controls were correctly
classified. A Kappa value of 0.53 (p < 0.001) was calculated, demonstrating
that the classification did not occur by chance.

DISCUSSION

This study characterized the sensory profiles of people with PTS symptoms
PTS symptoms.

The Sensory Profile Characteristics of People With


PTS Symptoms
The results confirmed the existence of SPD among people with PTS symp-
toms, expressed in exaggerated responses in sensory patterns related to low
threshold (i.e., sensory sensitivity, sensation avoiding) and lower responses
in sensory patterns related to high threshold (i.e., sensory registration and
sensory seeking). A comparison of these results to those found in previous
studies revealed that previous research which elucidated the sensory hyper-
sensitivity among people with PTS symptoms (Morgan & Grillon, 1999;
Naatanen & Alho, 1995; Shalev et al., 2000), referred to specific modalities
and mainly used neuro-physiological techniques. The present study con-
firmed the unique SPD of people with PTS symptoms in various sensory
modalities, using the AASP. The AASP was found to be sensitive in profiling
SPD also in regard to self-regulation strategies—not under laboratory
Sensory Profile and Post-Traumatic Stress 275

conditions, but as expressed in daily living scenarios, in the participants’


natural environments.
The patterns related to low neurological threshold strengthen the expla-
nation about hyper-arousability, including the inefficient regulation and inhi-
bition of the central nervous system (e.g., Mangeot et al., 2001). Yet, while
most existing information is about PTS symptoms and sensory sensitivity
(related to low neurological threshold), the present study elucidated that
people with PTS symptoms may also show a greater tendency for low regis-
tration and sensation seeking (related to high neurological threshold). As
presented by Jerome and Liss (2005), low registration may result from an
under-aroused system but also may indicate an extremely over-aroused
system that compensates by shutting down and causing people to seem
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under-sensitive. Paige, Reid, Allen, and Newton (1990) stated that, when
people with PTS symptoms face intense stimuli, they enter a state of protec-
tive inhibition in which the central nervous system responses and the intense
stimuli are dampened down to render them more tolerable. The low ten-
dency for registering and seeking sensations may support the numbness that
people with PTS symptoms may experience, and that was also reported in
brain imaging studies ( Jatzko, Schmitt, Demirakca, Weimer, & Braus, 2006).
The SPD of people with PTS symptoms, including inefficient modula-
tion and regulation of sensory input, may also explain their emotional out-
comes (Frewen & Lanius, 2006). According to the Emotional Processing
Theory (Foa & Kozak, 1986) post-traumatic symptoms express the inability
to sufficiently process the traumatic event, leading to pathological fear, which
includes: exaggerated responses, unrealistic representations and percep-
tions, negative image and stimulation avoidance. Foa, Ehlers, Clark, Tolin
and Orsillo (1999) described three cognitive schemes characterizing people
with PTS symptoms: “I am guilty,” “The world is dangerous,” and “I am
incompetent.” These schemes may cause the person to limit motivation to be
exposed to “the world,” including its sensory stimuli. These non-adaptive
cognitive responses and the greater reactivity to stimuli in participants with
PTS symptoms (McFarlane et  al., 1993) coupled with the defect in early
stimulus gating (“shut down” mechanism) may be related to their impaired
perceptual evaluation of stimuli expressed via withdrawal from sensory stim-
uli or in a lower interest to meet sensory stimuli (lower seeking).Yet, when
meeting sensory stimuli, people either react with exaggerated responses
caused by hypersensitivity or reduced responses related to “shut down”
mechanisms and thus show low registration. It may be suggested that the
SPD among people with PTS symptoms contribute to pathological emotional
responses, some of which (for example, fear and higher anxiety level) were
reported to be closely related to SPD (Kinnealey & Fuiek, 1999; Meyer &
Carver, 2000; Neal et al., 2002).
These explanations are strengthened by the results of the discriminant
analysis as well as by the correlations found between sensory-processing
276 B. Engel-Yeger et al.

patterns and PTS clusters. For example, avoidance and intrusive thoughts
were mainly correlated with lower sensation seeking. The visual, auditory
and tactile modalities that were already found to be impaired in the sensory
processing of people with PTSD (Bleich, Attias, & Furman, 1996; Hendler
et al., 2003; McFarlane et al., 1993; McNamara, Lisembee, & Lifshitz, 2010)
were found to play a significant role in these correlations.
In summary, this study enriches the knowledge regarding SPD involve-
ment in the pathogenesis of PTS symptoms. The results illuminate the need
to further study the relationship between SPD and the emotional aspects of
people with PTS symptoms and also to apply this new knowledge to the
development and implementation of intervention programs and techniques.
This holistic viewpoint may increase treatment success and enhance abilities
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to optimally function and participate in activities which include intensive


sensory stimulations; thus, such empirically based interventions may indeed
elevate quality of life.
Since sensory processing plays a crucial role in the way we perceive the
world, connect with others, and function, elaborating the knowledge about
behavioral daily expressions of SPD among people with PTSD may enhance
the application of intervention processes. Intervention will then be based on
the persons’ specific needs, including sensory needs, and will assist people
with PTSD to optimize their ability to perceive stimulations from their envi-
ronment and improve their emotional status and their relationships with
others, thus elevating their self-esteem and well-being.

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