Research hotspots and trends in the application of Chinese herbal medicine for cancer pain management: a bibliometric study.

Black individuals bear a disproportionate burden of posttraumatic stress disorder (PTSD) relative to other racial groups, with symptom severity persisting even after controlling for socioeconomic status and trauma exposure. In urban hospital settings, lifetime prevalence of PTSD in under-resourced Black communities can reach as high as 46.2%, significantly exceeding the general U.S. lifetime prevalence of approximately 7.8%. This elevated risk extends to pregnant Black women, who experience higher PTSD rates, with only a small proportion receiving treatment. Greater PTSD symptom burden is associated with numerous adverse perinatal outcomes like preterm birth, low birth weight, preeclampsia, and gestational diabetes. Beyond immediate obstetric complications, maternal PTSD also contributes to postpartum depression and anxiety, and impaired parent–infant bonding. The intergenerational transmission of trauma-related psychophysiology further compounds these concerns, as offspring of women with PTSD demonstrate altered stress reactivity and increased vulnerability to psychiatric disorders. Given these clinical implications, understanding how trauma and pregnancy intersect to influence fear responses is critical, as disruptions in fear processing are central to the development and maintenance of PTSD. Pregnancy is accompanied by substantial neuroendocrine and physiological adaptations that may alter how individuals acquire and extinguish fear. However, literature assessing how fear learning changes across pregnancy remains scarce. Experimental paradigms of fear conditioning provide a translational tool for examining these processes. In Pavlovian fear conditioning, individuals learn to associate a neutral cue (CS) with an aversive stimulus producing a conditioned fear response that can later be diminished through extinction learning when the cue previously associated with danger is repeatedly presented without threat. Fear-potentiated startle (FPS), a psychophysiological measure based on the acoustic startle reflex, offers a translational measure to assess fear acquisition and extinction processes. The FPS paradigm typically consists of three phases: habituation, acquisition, and extinction. During habituation, a neutral CS is presented alone. In the acquisition phase, the CS is repeatedly paired with an aversive US, such as an airblast, to induce a conditioned fear response. During extinction, the CS is repeatedly presented in the absence of the US, and reductions in startle magnitude over time are taken as an index of extinction learning. In the present study, the primary outcome measure, percent potentiation (PP), reflects the degree to which startle magnitude during CS presentation is amplified relative to baseline. Higher PP values indicate stronger conditioned fear responses and poorer extinction, while lower PP values indicate better suppression of conditioned fear. Individuals with PTSD characteristically exhibit heightened startle magnitudes, reduced discrimination between safety (CS−) and threat (CS+) cues, and delayed fear learning trajectories, patterns consistent with the hyperarousal and fear-generalization that characterize the disorder. In pregnancy, cross-sectional evidence similarly suggests altered fear regulation, as pregnant individuals exhibit elevated FPS responses, reduced safety discrimination, and greater hypervigilance compared with nonpregnant trauma-exposed controls, mirroring psychophysiological profiles observed in PTSD. Longitudinal studies are therefore needed to clarify how fear learning changes across gestation, particularly in trauma-exposed populations.