Sunday, October 20, 2013

Best Predictor of PTSD Diagnosis Is Trauma-Related Psychophysiologic Reactivity

 

Researchers from Boston University School of Medicine, the National Center for PSTD, VA Boston Healthcare System, Suffolk University, Massachusetts General Hospital, Harvard University, and other institutions conducted a meta-analysis of five prior studies with 150 study participants (78 diagnosed with PTSD and 72 who had experienced trauma but did not develop PTSD) and found that "psychophysiologic reactivity to trauma-related, script-driven imagery procedures" is a potential "biological predictor of a post-traumatic stress disorder (PTSD) diagnosis."

A summary of the research findings Medical News Today is below, followed by the abstract from the original article (which is behind a paywall).

Full Citation:
Pineles, SL, Suvak, MK, Liverant, GI, Gregor, K, Wisco, BE, Pitman, RK, and Orr, SP.  (2013, Aug). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychology, Vol 122(3), 635-644. doi: 10.1037/a0033942

Best predictor of PTSD diagnosis is trauma-related psychophysiologic reactivity


Sunday 13 October 2013

Researchers from Boston University School of Medicine (BUSM) and several other institutions including the National Center for PSTD, VA Boston Healthcare System, Suffolk University, Massachusetts General Hospital and Harvard University, have determined that psychophysiologic reactivity to trauma-related, script-driven imagery procedures is a promising biological predictor of a post-traumatic stress disorder (PTSD) diagnosis. These findings appear online in the Journal of Abnormal Psychology.

Approximately seven to 12 percent of the general adult population in the U.S. suffers with PTSD. This disease develops after an inciting trauma. PTSD commonly affects military personnel who have faced combat, victims of sexual assault, people from conflict-ridden areas of the world, and patients who have survived intensive care unit admissions.

The researchers analyzed data from five prior studies with 150 study participants: 78 diagnosed with PTSD and 72 who had experienced trauma but did not develop PTSD. Researchers studied four main predictor classes including the measurement of psychophysiologic reactivity to trauma-related scripts; psychophysiologic reactivity to other stressful but non-trauma related scripts; self-reported distress in response to trauma-related scripts; and self-reported distress to other stressful but non-trauma-related scripts. Of the four indices examined, psychophysiologic reactivity to trauma-related cues appeared to be the most robust predictor of PTSD.

The researchers believe that these findings have significant implications for the field of psychiatry. "Psychophysiologic reactivity to script-driven imagery is a potential experimental paradigm that could be used to index an individual's fear response," explained principal investigator Suzanne Pineles, PhD, assistant professor of psychiatry at BUSM and clinical psychologist at the National Center for PTSD at the VA Boston Healthcare System. "Future research may extend the use of this paradigm to other populations. For example, it is possible that individuals with other fear-based disorders, such as phobias or panic disorder, would exhibit similar patterns of reactivity to scripts describing their fear."

* * * * *

Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis



Abstract


Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.

Post a Comment