Neuropsychological deficits have been reported among trauma survivors with posttraumatic stress disorder (PTSD). It is often assumed that these cognitive difficulties are toxic consequences of trauma exposure. Alternatively, they may reflect preexisting characteristics that contribute to the likelihood of developing PTSD. To address this possibility, the authors evaluated cognitive performance in monozygotic twin pairs who were discordant for combat exposure. Pairs were grouped according to whether the combat-exposed brother developed PTSD. The combat-unexposed cotwins of combat veterans with PTSD largely displayed the same performance as their brothers, which was significantly lower than that of non-PTSD combat veterans and their brothers. The results support the notion that specific domains of cognitive function may serve as premorbid risk or protective factors in PTSD.

Researchers have proposed that depression and particular types of anxiety are associated with unique patterns of regional brain activation. The authors examined the relationship among posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms and frontal, temporal, and parietal EEG alpha asymmetry in female Vietnam War nurse veterans. The results indicate that PTSD arousal symptoms are associated with increased right-sided parietal activation. However, the combination of arousal, depression, and their interaction explain more than twice the variance in parietal asymmetry compared with arousal alone. The results support the contention that the association between anxiety and right-sided posterior activation is specific to the anxious arousal subtype. These findings underscore the importance of isolating, both theoretically and statistically, emotional subcomponents in studies of regional brain activation.

Background-A significant subgroup of individuals with posttraumatic stress disorder (PTSD) exhibits chronic, unremitting symptomatology that has also been associated with smaller hippocampal volume. The hippocampus plays a significant role in configural processing of contextual cues that facilitates context-appropriate extinction of conditioned fear. We test the hypothesis that hippocampus-based configural processing deficits are a pre-existing vulnerability factor for unremitting forms of PTSD.

This study examined whether witnessing death and injury could produce psychophysiologically responsive posttraumatic stress disorder (PTSD). Participants consisted of medication-free female Vietnam nurse veterans with a diagnosis of current PTSD (n = 17) and who never had PTSD (n = 21), related to their military service. Individualized scripts describing personal traumatic military nursing events, a standard military nursing event, and other life events were tape recorded and played back to the participant while heart rate, skin conductance, and facial electromyograms were recorded. Nurses with PTSD showed significantly larger physiologic responses than non-PTSD nurses only during imagery of military-related nursing events. The groups' self-reported emotional responses did not differ during imagery. Psychophysiologic results support the proposition that witnessing death and serious injury to others is sufficiently stressful to cause PTSD.

Individuals with posttraumatic stress disorder (PTSD) have been found to show several event-related brain potential (ERP) abnormalities including reduced target P3b amplitude, P50 suppression, and P2 amplitude/intensity slope. Female Vietnam nurse veterans with (n = 29) and without (n = 38) current PTSD completed P50 paired-click, three-tone "oddball" and four-tone stimulus-intensity modulation procedures. Opposite to previous findings, the current PTSD group had larger target P3b amplitudes and increased P2 amplitude/intensity slopes. Reduced P50 suppression was associated with increased severity of general psychopathology, but not with PTSD diagnosis. Findings suggest that target P3b amplitude and P2 amplitude/intensity slope abnormalities reflect different pathophysiological processes. Future research is needed to determine whether the opposite ERP abnormalities observed in this PTSD sample reflect gender-, trauma-, or sample-specific findings.

Posttraumatic stress disorder (PTSD) is associated with larger heart rate (HR), skin conductance (SC), and eyeblink responses to sudden, loud tones. The present study tested this association in female nurse veterans with PTSD related to witnessing patients' death, severe injury and/or suffering during their Vietnam service. Nurses with current, past but not current, or who never had PTSD listened to 15 consecutive 95-dB, 500-ms, 1000-Hz tones with sudden onsets, while HR, SC, and eyeblink responses were measured. Nurses with current PTSD produced significantly larger averaged HR, but not SC or eyeblink responses across tone trials. A larger HR response to loud tones is one of the most robust physiologic findings in PTSD and may reflect increased defensive responding.

It has been suggested that discrepant findings regarding low basal cortisol levels and enhanced suppression of cortisol in response to dexamethasone (DEX) administration in PTSD may reflect individual differences in gender, trauma type, stage of development at trauma occurrence (e.g., childhood vs. adulthood), early pre-traumatic risk factors, or other individual differences. This study examined salivary cortisol levels at 8:00 a.m. and 4:00 p.m. as well as cortisol response to 0.5 mg DEX in 40 female Vietnam nurse veterans who had current, chronic PTSD (Current) vs. 43 who never had PTSD (Never). Repeated measures analyses of covariance did not reveal significant group differences in cortisol levels or cortisol suppression. Given that nurses who served in Vietnam had similar exposures, ages at exposure, and duration since exposure to previously studied male Vietnam combat veterans, the present lack of evidence for low cortisol and cortisol hyper-suppression in nurses with PTSD suggests that previous findings of low cortisol and cortisol hyper-suppression in male Vietnam veterans, females sexually abused as children, and other populations may reflect risk factors beyond simply having PTSD.

Individuals with posttraumatic stress disorder (PTSD) have been found to show several event-related brain potential (ERP) abnormalities including reduced target P3b amplitude, P50 suppression, and P2 amplitude/intensity slope. Female Vietnam nurse veterans with (n = 29) and without (n = 38) current PTSD completed P50 paired-click, three-tone "oddball" and four-tone stimulus-intensity modulation procedures. Opposite to previous findings, the current PTSD group had larger target P3b amplitudes and increased P2 amplitude/intensity slopes. Reduced P50 suppression was associated with increased severity of general psychopathology, but not with PTSD diagnosis. Findings suggest that target P3b amplitude and P2 amplitude/intensity slope abnormalities reflect different pathophysiological processes. Future research is needed to determine whether the opposite ERP abnormalities observed in this PTSD sample reflect gender-, trauma-, or sample-specific findings.