Psychophysiological Assessment of Stress-related Disorders

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Psychophysiological Assessment of Stress-related
Disorders
COST B27 ENOC Joint WGs Meeting
Swansea UK, 16-18 September 2006

• Dragica Kozaric-Kovacic, Tanja Jovanovic, Andrea
  Jambrošic-Sakoman, Slavica Esterajher
• University Hospital Dubrava, Croatian Ministry of
  Health Referral Center for the Stress-related
  Disorders, Regional Center for Psychotrauma

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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
• (age39.54.7 years)
• 12 male healthy control subjects
• (age41.310.7 years)
• Trials
• ACL 3 minutes acclimation periodno stimuli
• NA 7 startle probes, 108 dB A SPL, 40ms white
  noise burst

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Psychophysiology measures

• EDA from fingers for skin conductance response
  (SCR)

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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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(No Transcript)
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Results EDA
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EDA Higher SCR to startle probes in both groups,
controls habituate
NA1 VS. ACL5, controls, F(1,11)17.09, plt0.01
PTSD, F(1,14)10.40, plt0.01 NA1 TO NA7, controls,
linear F(1,11)11.67, plt0.01 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, plt0.05
PTSD, F(1,14)9.50, plt0.01 NA1 TO NA7, controls,
linear F(1,11)2.02, ns PTSD, linear
F(1,14)1.42, ns
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Results EKG
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EKG PTSD higher heart-rate than controls, no
effect of startle probes
CONTROLS VS. PTSD, F(1,25)7.56, p0.01
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RSA PTSD lower HR variability than controls, no
effect of probes
CONTROLS VS. PTSD, F(1,25)7.56, p0.01
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Thank you for your attention!