Citation

Ehlers A, Suendermann O, Boellinghaus I, Vossbeck-Elsebusch AN, Gamer M, Briddon E, Martin MW, Glucksman E. Int. J. Psychophysiol. 2010; 78(1): 27-34.

Affiliation

King's College London, Institute of Psychiatry, Department of Psychology, London, UK.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.ijpsycho.2010.04.009

PMID

20450940

PMCID

PMC2965012

Abstract

Physiological responses to trauma reminders are one of the core symptoms of posttraumatic stress disorder (PTSD). Nevertheless, screening measures for PTSD largely rely on symptom self-reports. It has been suggested that psychophysiological assessments may be useful in identifying trauma survivors with PTSD (Orr & Roth, 2000). This study investigated whether heart rate (HR) responses to standardized trauma-related pictures distinguish between trauma survivors with and without acute PTSD. Survivors of motor vehicle accidents or physical assaults (N=162) watched standardized trauma-related, generally threatening and neutral pictures at 1month post-trauma while their ECG was recorded. At 1 and 6months, structured clinical interviews assessed PTSD diagnoses. Participants completed self-report measures of PTSD severity and depression, peritraumatic responses, coping behaviors and appraisals. Trauma survivors with acute PTSD showed greater HR responses to trauma-related pictures than those without PTSD, as indicated by a less pronounced mean deceleration, greater peak responses, and a greater proportion showing HR acceleration of greater than 1 beat per minute. There were no group differences in HR responses to generally threatening or neutral pictures. HR responses to trauma-related pictures contributed to the prediction of PTSD diagnosis over and above what could be predicted from self-reports of PTSD and depression. HR responses to trauma-related pictures were related to fear and data-driven processing during the trauma, safety behaviours, suppression of trauma memories, and overgeneralized appraisals of danger. The results suggest that HR responses to standardized trauma-related pictures may help identify a subgroup of patients with acute PTSD who show generalized fear responses to trauma reminders. The early generalization of triggers of reexperiencing symptoms observed in this study is consistent with associative learning and cognitive models of PTSD.

Language: en