Psychophysiological assessment of posttraumatic stress disorder imagery in World War II and Korean combat veterans.

Abstract

We assessed the heart rate, skin conductance, and left lateral frontalis electromyographic responses of World War II (WWII) and Korean War male veterans to recollection of their combat experiences by using a script-driven imagery technique previously validated in Vietnam veterans (Pitman et al., 1990;Pitman, Orr, Forgue, de Jong, & Claiborn, 1987). Medication-free subjects were classified on the basis of criteria from the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders into posttraumatic stress disorder (PTSD; n = 8) and non-PTSD (« = 12) groups, which did not differ in overall combat exposure or severity of personal combat events. PTSD subjects' physiological responses during personal combat imagery were markedly larger than those of non-PTSD subjects', even though the self-reported emotional responses of the two groups were comparable. A physiological discriminant function derived from Vietnam veterans (Orr et al., 1990) correctly classified 7 of the 8 PTSD subjects (sensitivity was 88%) and 12 of the 12 non-PTSD subjects (specificity was 100%; p < .001).Much of the impetus behind the inclusion of posttraumatic stress disorder (PTSD) in the modern psychiatric nomenclature (American Psychiatric Association, 1980) came from the recognition of the readjustment problems of Vietnam veterans during the decade following that conflict. Indeed, PTSD is sometimes misunderstood to be synonymous with the psychiatric problems of Vietnam veterans. Actually, PTSD can result from any combat or noncombat event that is "outside the range of usual human experience and that would be markedly distressing to almost anyone" (American Psychiatric Association, 1987, p. 250). The Vietnam War had no monopoly on such events. The psychiatric response to the stress of warfare has been recognized for centuries and has been variously described as irritable heart syndrome, shell shock, traumatic war neurosis, operational fatigue, and combat exhaustion (Schnurr, 1991;Trimble, 1984). Clinical evidence confirms the occurrence of Diagnostic and Statistical Manual of Mental Disorders (3rd ed.;

Objective assessment of peritraumatic dissociation: psychophysiological indicators

“…Lower physiological reactivity in the high dissociation group is surprising in light of the fact that most of the members of this group had PTSD symptoms. This finding contrasts with previous findings of generally higher physiological reactivity in subjects with PTSD (23)(24)(25)(26). The response of subjects in the high dissociation group may provide evidence of a specific PTSD subtype of highly dissociative individuals who may respond with a general physiological numbness.…”

Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: a preliminary report

“…A number of studies (Pitman et al, 1987(Pitman et al, , 1990Blanchard et al, 1982;McFall et al, 1990;Orr et al, 1993;Shin et al, 1999) have investigated psychophysiological reactivity to trauma-related scripts in patients with PTSD. In contrast to the present study, most former studies found more pronounced heart rate responses in PTSD.…”

“…We were not able to replicate the findings of larger heart rate responses to traumatic reminders in patients with PTSD. Heart rate differences in response to trauma-related imagery were found in combat-related PTSD in male veterans (Pitman et al, 1987(Pitman et al, , 1990Blanchard et al, 1982;McFall et al, 1990;Orr et al, 1993) and abuse-related PTSD in female patients (Shin et al, 1999;Carson et al, 2000;Orr et al, 1998).…”

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

“…Posttraumatic stress disorder (PTSD) involves learned fear (Rothbaum and Davis, 2003). Abnormally high psychophysiological conditioned responses to reminders of traumatic events can persist as long as 50 years following its cessation (Orr et al, 1993). These data suggest that a deficit in either extinction learning or retention of that learning may underlie failure to recover from the effects of the traumatic stressor (Rauch et al, 2006;Milad et al, 2006b;Davis et al, 2006;SotresBayon et al, 2004;Maren and Quirk, 2004).…”