1 psychophysiological assessment of stress-related disorders dragica kozarić-kovačić, tanja...
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Psychophysiological Assessment of Stress-related
DisordersDragica 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
COST B27 ENOC Joint WGs Meeting Swansea UK, 16-18 September 2006
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Why measure psychophysiology?
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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
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• 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.
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Psychophysiology of fear
From Lang, Davis & Öhman (2000), J. Affective Disorders
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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
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Baseline psychophysiology
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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
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• EDA from fingers for skin conductance response (SCR)
Psychophysiology measures
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• EMG of the obicularis oculi for startle
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• EKG for heart-rate and respiration for RSA
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Apparatus
• Acquisition: Biopac MP150 for Windows (Biopac Systems, Inc.)
• Stimulus presentation: SuperLab 3.0 (Cedrus, Inc.)
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Results: EDA
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EDA: Higher SCR to startle probes in both groups, controls habituate
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0.2
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0.6
0.8
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1.2
1.4
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ACL1 ACL2 ACL3 ACL4 ACL5 NA1 NA2 NA3 NA4 NA5 NA6 NA7
TRIALS
SC
R (
MIC
RO
SIE
ME
NS
)
CONTROL PTSD
NA1 VS. ACL5, controls, F(1,11)=17.09, p<0.01; PTSD, F(1,14)=10.40, p<0.01NA1 TO NA7, controls, linear F(1,11)=11.67, p<0.01; PTSD, linear F(1,14)=2.44, ns
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Results: EMG
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EMG: no group differences in startle, no habituation
NA1 VS. ACL5, controls, F(1,11)=5.01, p<0.05; PTSD, F(1,14)=9.50, p<0.01NA1 TO NA7, controls, linear F(1,11)=2.02, ns; PTSD, linear F(1,14)=1.42, ns
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5
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ACL1 ACL2 ACL3 ACL4 ACL5 NA1 NA2 NA3 NA4 NA5 NA6 NA7
TRIALS
ST
AR
TL
E
(MIC
RO
VO
LT
S)
CONTROL PTSD
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Results: EKG
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EKG: PTSD higher heart-rate than controls, no effect of startle probes
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ACL1 ACL2 ACL3 ACL4 ACL5 NA1 NA2 NA3 NA4 NA5 NA6 NA7
TRIALS
HE
AR
T R
AT
E (
BP
M)
CONTROL PTSD
CONTROLS VS. PTSD, F(1,25)=7.56, p=0.01
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RSA: PTSD lower HR variability than controls, no effect of probes
0.00
1.00
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ACL1 ACL2 ACL3 ACL4 ACL5 NA1 NA2 NA3 NA4 NA5 NA6 NA7
TRIALS
CONTROL PTSD
CONTROLS VS. PTSD, F(1,25)=7.56, p=0.01
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Thank you for your attention!
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