Psychophysiology Of Posttraumatic Stress Disorder Research Articles

Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women.

This study aimed to determine the relationship between stages of the menopause transition (premenopausal, perimenopausal, and postmenopausal) on symptoms of posttraumatic stress disorder (PTSD) and depression in trauma-exposed women. A cross-sectional study conducted between 2005 and 2017 recruited and enrolled an urban community sample (n = 6,093) from nonpsychiatric medical clinic waiting rooms of Grady Memorial Hospital, a public safety net hospital in Atlanta, Georgia. Participants were female, 18 to 65 years old, and predominantly Black/African American. Of the 6,093 participants, 93.8% were Black/African American, 2.5% were White, and 3.8% were of all other races (Hispanic/Latino, Asian, multiracial). Participants younger than 40 years were categorized as premenopausal (n = 3,166), between 40 and 55 years of age were categorized as perimenopausal (n = 2,127), and older than 55 years were categorized as postmenopausal (n = 790). Menopause status was associated with total PTSD symptom severity ( F2,5416 = 9.61, P < 0.001), symptom severity within all three PTSD symptom clusters (avoidance/numbing symptoms: F2,5416 = 7.10, P < 0.001; intrusive symptoms: F2,5416 = 7.04, P < 0.001; hyperarousal symptoms: F2,5409 = 8.31, P < 0.001), and depression symptom severity ( F2,5148 = 11.4, P < 0.001). Compared with both premenopausal and postmenopausal women, perimenopausal women reported significantly worse total PTSD symptoms, symptoms in the hyperarousal cluster, and depressive symptoms. The current cross-sectional data show that symptoms of PTSD and depression in women are associated with reproductive age, such that perimenopausal women show higher symptom severity than premenopausal and postmenopausal women. Future longitudinal studies can reveal how changes in hormones over the course of the menopause transition impact the symptoms, neurobiology, and psychophysiology of PTSD.

Heart Rate Variability and Posttraumatic Stress Disorder

The psychophysiology of posttraumatic stress disorder (PTSD) points towards autonomic dysregulation—specifically, elevated sympathetic response and attenuated parasympathetic response. In view of this, heart rate variability (HRV) biofeedback has been applied and tested as a treatment for PTSD. Review of existing published research suggests that HRV biofeedback seems promising as a treatment for PTSD, both in significantly alleviating the symptoms and in improving cognition for those suffering from PTSD. Drop-out rate is low, and inexpensive and portable HRV biofeedback devices such as the Stress Eraser make it a viable alternative to traditional treatment such as prolonged exposure therapy (PET), cognitive behavior therapy (CBT) and cognitive processing therapy (CPT). More recent research has also shown that combining HRV biofeedback with CBT, PET, and Acceptance and Commitment Therapy (ACT) improved the efficacy of these therapies in treating PTSD. More larger-scale and rigorous controlled trials are needed to confirm these outcomes.

Mechanism and strategies for preventing post-traumatic stress disorder in forensic workers responding to mass fatality incidents

Mass fatality incidents (MFIs) expose medical examiners/coroners and associated staff to circumstances that may increase their risk for developing post-traumatic stress disorder (PTSD). The aim of this paper is to provide guidance for efforts to prevent the development of PTSD in forensic teams who respond to mass disasters. We present a model of the paths through which exposure to mass fatality incidents may lead to PTSD symptoms in forensic and recovery workers. The model is based on current research in stress and coping and the psychophysiology of PTSD and is used to generate worksite intervention strategies to reduce the risk for PTSD.

Psychophysiology of post-traumatic stress disorder

In general, the results of psychophysiologic research on PTSD support the presence of a variety of autonomic, sensory, and cognitive processing differences between individuals with and without the disorder. The findings are diverse and include heightened responsiveness to trauma reminders; exaggerated startle; increased conditionability and autonomic responsiveness to aversive, high-intensity stimuli; and elevated tonic or baseline physiologic activity. Increased sensitivity of the central nervous system is suggested by electrophysiologic evidence for a failure to habituate to redundant information, over-responsiveness to novel information, and reduced cortical responsiveness to overstimulation. Cognitive processing abnormalities are suggested by electrophysiologic evidence for a reduced ability to attend to task-relevant information and increased attention to task-irrelevant, trauma-related information in individuals with PTSD. Some findings, such as the heightened physiologic and P300 response amplitude responses to trauma-related stimuli and increased HR response to loud tones, have been highly replicable and appear to be as reliable as any biologic finding in the psychiatric literature. Other findings, such as increased eye-blink startle responses and tonic or baseline physiologic activity, have been less consistently replicated and have led investigators to explore how stressful or threatening experimental contexts might produce phasic alterations in the psychophysiology of individuals with PTSD. We hope that the broad range of psychophysiologic investigations and findings in PTSD will inspire others to consider possible applications of these methodologies to their own clinical and research endeavors.

The function of image control in the psychophysiology of posttraumatic stress disorder.

The physiological response to trauma-related stimuli of up to one third of participants with posttraumatic stress disorder (PTSD) cannot be discriminated from that of controls. Psychophysiological measures (heart rate and blood pressure) of 22 PTSD and 23 control civilian participants, all exposed to missile attacks during the Gulf War, were recorded while listening to five scripts. The physiological response of PTSD subjects with high image control (IC) was lower than that of PTSD participants with low IC and similar to that of non-PTSD subjects. The physiological response poorly discriminated high IC PTSD participants from controls, but was successful in discriminating low IC PTSD subjects from controls with 91% specificity and 92% sensitivity. Image control is proposed as a function influencing physiological response in PTSD.

Psychophysiology of the posttraumatic stress disorder: from sulfur fumes to behavioral genetics.

Neurophysiological hypotheses regarding the body-mind relationship in stress disorders have been formulated more than 300 years ago. In 1941 Abraham Kardiner ascribed the name "physioneurosis" to the condition known today as posttraumatic stress disorder (PTSD). Psychophysiological studies of PTSD started with the demonstration of increased responsiveness to external stimuli reminiscent of the traumatic event. Later, abnormal responses to mental imagery were studied, and these studies have resulted in new tools for the assessment and diagnosis of the disorder. Recent studies focus on responses to elementary stimulation, such as the auditory startle reflex, thereby exploring basic CNS routines of habituation and stimulus-discrimination. This article reviews the rapidly expanding literature on the psychophysiology of PTSD. Special emphasis is given to recent studies of the auditory startle and to their implications for the neurobiology of PTSD.