ABSTRACT
This multisite study tested the ability of psychophysiological responding to predict posttraumatic stress disorder (PTSD) diagnosis (current, lifetime, or never) in a large sample of male Vietnam veterans. Predictor variables for a logistic regression equation were drawn from a challenge task involving scenes of combat. The equation was tested and cross-validated demonstrating correct classification of approximately 2/3 of the current and never PTSD participants. Results replicate the finding of heightened psychophysiological responding to trauma-related cues by individuals with current PTSD, as well as differences in a variety of other domains between groups with and without the disorder. Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt. Discussion addresses the value of psychophysiological measures for assessment of PTSD.
Subject(s)
Imagery, Psychotherapy/methods , Stress Disorders, Post-Traumatic/diagnosis , Veterans/psychology , Adolescent , Adult , Blood Pressure/physiology , Demography , Electromyography , Galvanic Skin Response/physiology , Heart Rate/physiology , Humans , Logistic Models , Male , Middle Aged , Psychometrics/methods , Psychometrics/standards , Selection Bias , Stress Disorders, Post-Traumatic/physiopathology , United States , VietnamABSTRACT
Plasma norepinephrine samples were obtained before and after exposure to auditory stimuli reminiscent of combat from two groups of male Vietnam veterans with combat experience: one with diagnoses of PTSD (N = 15) and one with no mental disorder (N = 6). Results showed a significant 30% rise in plasma norepinephrine for the PTSD group, with no change in the comparison group.
Subject(s)
Acoustic Stimulation , Norepinephrine/blood , Stress Disorders, Post-Traumatic/blood , Warfare , Adult , Diagnosis, Differential , Humans , Male , Memory , Posture , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Tape Recording , Veterans/psychology , VietnamABSTRACT
In one sample of 104 male Vietnam combat veterans, we found that five heart rate parameters from a psychophysiological assessment could correctly discriminate 75% of the sample into those with PTSD and those without it. Using a stepwise approach, we found adding 10 blood pressure parameters increased discrimination to 80%, while adding five parameters from frontal electromyograms did not increase discrimination. Cross-validation of the heart rate parameters on a new sample of 96 veterans resulted in 83% correct discrimination.
Subject(s)
Blood Pressure , Heart Rate , Stress Disorders, Post-Traumatic/diagnosis , Adult , Bayes Theorem , Electromyography , Humans , Male , Psychiatric Status Rating Scales , Sensitivity and Specificity , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/physiopathology , Veterans/psychologyABSTRACT
The author reports findings from recent psychophysiological and biochemical research on Vietnam combat veterans with chronic posttraumatic stress disorder. Applying these data and the analogy of the known functional and structural defects in the peripheral (cranial) sensory system consequent to high-intensity stimulation, he hypothesizes that cortical neuronal and synaptic changes occur in posttraumatic stress disorder as the consequence of excessive and prolonged sensitizing stimulation leading to depression of habituating learning. He postulates that the "constant" symptoms of the disorder are due to the changes in the agonistic neuronal system which impair cortical control of hindbrain structures concerned with aggressive expression and the sleep-dream cycle.
Subject(s)
Cerebral Cortex/physiopathology , Combat Disorders/etiology , Habituation, Psychophysiologic/physiology , Learning/physiology , Stress Disorders, Post-Traumatic/etiology , Aggression/physiology , Combat Disorders/physiopathology , Humans , Memory/physiology , Models, Neurological , Neural Pathways/physiopathology , Rhombencephalon/physiopathologyABSTRACT
Of 225 patients referred to a Veterans Administration pain clinic for treatment of chronic pain, 22 (10%) were later diagnosed as having posttraumatic stress disorder. Many of the 22 also had current or past histories of depression, anxiety, or substance abuse.
