Hyperarousal plays a crucial role in mental health, heavily influencing the severity of insomnia, depression, anxiety, post-traumatic stress disorder (PTSD), and ADHD.
However, researchers have historically lacked a consistent definition for this overwhelming sense of tension. Now, researchers at the Netherlands Institute for Neuroscience have discovered that hyperarousal is not a single sensation, but actually consists of seven distinct types.
Published in the journal eClinicalMedicine, the study breaks down hyperarousal into seven specific dimensions: anxious, somatic, sensitive, sleep-related, irritable, vigilant, and sudomotor. The researchers found that while almost every type of tension occurred across multiple disorders, the relative severity of each type differed significantly depending on an individual’s specific mental health conditions.
First author Tom Bresser explained the motivation behind the research: “Within sleep research, we already know a great deal about the role of hyperarousal in insomnia. But hyperarousal also plays a major role in many other mental disorders.”
Bresser added: “If we better understand what hyperarousal really is, we can also better understand insomnia, anxiety, and depression.”
Mapping the mind
To gain this unprecedented insight, the research team combined 221 questions from 18 mental health questionnaires into a single comprehensive survey. The survey was completed by 467 adult participants recruited primarily through the Netherlands Sleep Registry.
Based on the results, the researchers developed the Transdiagnostic Hyperarousal Dimensions Questionnaire (THDQ), a new, concise 27-item tool designed to reliably measure the different types of hyperarousal.
Bresser noted: “Instead of having to search for the right combination of questionnaires, researchers can now use this tool to map hyperarousal much more easily and comprehensively.”
Better, targeted treatments
The team is already deploying the new questionnaire in sleep lab studies, with Bresser actively investigating how the different types of hyperarousal map to specific brain regions.
He explained: “We hope to better understand which brain regions are involved in which type of hyperarousal.”
Ultimately, the researchers hope the THDQ will become a standard tool in everyday clinical practice.
Bresser pointed out the diagnostic benefits: “Often someone comes to a psychologist with disorder A, but it turns out they also have a predisposition for disorder B or C. By using the combined questionnaire, the underlying forms of hyperarousal can hopefully become clearer.”
By identifying exactly which forms of tension a patient is experiencing, psychologists could provide far more targeted treatment plans that address an individual’s specific needs simultaneously.
Bresser concluded: “We therefore hope that healthcare professionals will be willing to try out the questionnaire in practice.”
