ReviewHarvard review of psychiatry
Fear and the Defense Cascade: Clinical Implications and Management.
Review in Harvard review of psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 144 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
144 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Nonverbal correlates of paranoid ideation - a systematic literature review.Psychological medicine · 2025Pooled it
- A Systematic Review of Evidence-Based Family Interventions for Trauma-Affected Refugees.International journal of environmental research and public health · 2022Pooled it
- Methods to induce dissociation and their effects on intrusions and memory: a randomized controlled trauma-film study.European journal of psychotraumatology · 2025Trial
- A randomized controlled trial of Deep Brain Reorienting: a neuroscientifically guided treatment for post-traumatic stress disorder.European journal of psychotraumatology · 2023Trial
- Connectivity differences between Gulf War Illness (GWI) phenotypes during a test of attention.PloS one · 2019Trial
- Stretch-Induced Muscle Responses Under Threat Versus Safety.The European journal of neuroscience · 2026Article
- Investigating the relationship between psychophysiological parameters and behavioral patterns in children aged 7-10 years during dental treatment.BMC research notes · 2026Article
- On the Coexistence of Monitoring and Dampening of Pain Perception During the Fight-or-Flight Response.Cureus · 2026Article
- Functionality of symptoms and interpersonal communication in home video recordings of functional/dissociative versus epileptic seizures.Epilepsia · 2026Article
- A corticothalamic circuit modulates pain sensitivity and mediates innate fear-induced analgesia in male mice.Nature communications · 2026Article
- Demographic predictors of trauma and depression in war-affected children from Poland and Ukraine: Implications for prevention of mental health problems.Preventive medicine reports · 2026Article
- Physical Freezing in Children and Adolescents with Selective Mutism.Behavioral sciences (Basel, Switzerland) · 2026Article
- Fight, Flight, Fawn, Freeze: Rethinking Substance Use Through a Stress Response Lens.Current addiction reports · 2026Review
- Racial Discrimination-Related Interoceptive Network Disruptions: A Pathway to Disconnection.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2026Article
- Many labels, shared threat processes: classifying domain-labelled anxieties by mechanism rather than context.Psychoradiology · 2026Review
- Generalized Isometric Sustained Contraction During Apnea Combined with Relaxation for Anxiety: A First Evaluation.Clinical practice and epidemiology in mental health : CP & EMH · 2026Article
- Joint latent profiles of death anxiety and treatment adherence in HCC patients.Frontiers in psychiatry · 2026Article
- Autonomic nervous system reactions to secondary exposure to disaster-related imagery.Frontiers in psychiatry · 2026Article
- A Pain Memory "Trace": Cumulative Pain Perception and Damping During Fight-or-Flight Response Modeled with a Lotka-Volterra-Style Coupled Feedback Control Loop System.Journal of pain research · 2026Article
- Reframing "flat affect" and withdrawal in severe mental illness: a within-subject, culture- and medication-sensitive heuristic for social psychiatry.Frontiers in psychiatry · 2026Article
84 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Evolution has endowed all humans with a continuum of innate, hard-wired, automatically activated defense behaviors, termed the defense cascade. Arousal is the first step in activating the defense cascade; flight or fight is an active defense response for dealing with threat; freezing is a flight-or-fight response put on hold; tonic immobility and collapsed immobility are responses of last resort to inescapable threat, when active defense responses have failed; and quiescent immobility is a state of quiescence that promotes rest and healing. Each of these defense reactions has a distinctive neural pattern mediated by a common neural pathway: activation and inhibition of particular functional components in the amygdala, hypothalamus, periaqueductal gray, and sympathetic and vagal nuclei. Unlike animals, which generally are able to restore their standard mode of functioning once the danger is past, humans often are not, and they may find themselves locked into the same, recurring pattern of response tied in with the original danger or trauma. Understanding the signature patterns of these innate responses--the particular components that combine to yield the given pattern of defense-is important for developing treatment interventions. Effective interventions aim to activate or deactivate one or more components of the signature neural pattern, thereby producing a shift in the neural pattern and, with it, in mind-body state. The process of shifting the neural pattern is the necessary first step in unlocking the patient's trauma response, in breaking the cycle of suffering, and in helping the patient to adapt to, and overcome, past trauma.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.