Psychophysiological assessment of stress related disorders
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COST B27 ENOC Joint WGs Meeting Swansea UK, 16-18 September 2006. Psychophysiological Assessment of Stress-related Disorders. Dragica Kozari ć -Kova č i ć , Tanja Jovanovi ć , Andrea Jambro š i ć -Sakoman, Slavica Esterajher

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Psychophysiological assessment of stress related disorders

COST B27 ENOC Joint WGs Meeting Swansea UK, 16-18 September 2006

Psychophysiological Assessment of Stress-related Disorders

Dragica Kozarić-Kovačić, Tanja Jovanović, Andrea Jambrošić-Sakoman, Slavica Esterajher

University Hospital Dubrava, Croatian Ministry of Health Referral Center for the Stress-related Disorders, Regional Center for Psychotrauma



Rationale
Rationale

  • Posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) can develop after exposure to traumatic events

  • Due to the fact that the diagnosis is based on the patients' self-report of symptoms, a diagnosis of PTSD is difficult to make with certainty, and can be malingered

  • There is a need to include more objective assessment techniques in a multimodal approach


  • The psychophysiological reaction to stressful stimuli is under the control of the sympathetic nervous system and is difficult to malinger

  • In ASD and PTSD reminders of the traumatic experience induce exaggerated fear and subsequent physiological symptoms.


Psychophysiology of fear
Psychophysiology of fear

From Lang, Davis & Öhman (2000), J. Affective Disorders


Aims of the project
Aims of the project

  • To see whether PTSD patients have increased psychophysiological arousal to trauma stimuli compared to controls

  • To see whether psychophysiological response in ASD will be related to the development of PTSD

  • To see whether a lack of association between arousal and PTSD symptoms will be correlated with malingering



Methods
Methods

  • Participants:

    • 15 male subjects with chronic PTSD

      • (age=39.5±4.7 years)

    • 12 male healthy control subjects

      • (age=41.3±10.7 years)

  • Trials:

    • ACL: 3 minutes acclimation period—no stimuli

    • NA: 7 startle probes, 108 dB [A] SPL, 40ms white noise burst


Psychophysiology measures
Psychophysiology measures

  • EDA from fingers for skin conductance response (SCR)




Apparatus
Apparatus

  • Acquisition: Biopac MP150 for Windows (Biopac Systems, Inc.)

  • Stimulus presentation: SuperLab 3.0 (Cedrus, Inc.)



Eda higher scr to startle probes in both groups controls habituate
EDA: Higher SCR to startle probes in both groups, controls habituate

NA1 VS. ACL5, controls, F(1,11)=17.09, p<0.01; PTSD, F(1,14)=10.40, p<0.01

NA1 TO NA7, controls, linear F(1,11)=11.67, p<0.01; PTSD, linear F(1,14)=2.44, ns


Results emg
Results: EMG habituate


Emg no group differences in startle no habituation
EMG: no group differences in startle, no habituation habituate

NA1 VS. ACL5, controls, F(1,11)=5.01, p<0.05; PTSD, F(1,14)=9.50, p<0.01

NA1 TO NA7, controls, linear F(1,11)=2.02, ns; PTSD, linear F(1,14)=1.42, ns


Results ekg
Results: EKG habituate


Ekg ptsd higher heart rate than controls no effect of startle probes
EKG: PTSD higher heart-rate than controls, no effect of startle probes

CONTROLS VS. PTSD, F(1,25)=7.56, p=0.01


Rsa ptsd lower hr variability than controls no effect of probes
RSA: PTSD lower HR variability than controls, no effect of probes

CONTROLS VS. PTSD, F(1,25)=7.56, p=0.01



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