PROSPECTIVE PSYCHOPHYSIOLOGIC STUDY OF RISK FOR PTSD

创伤后应激障碍 (PTSD) 风险的前瞻性心理生理学研究

• 批准号: 6392628
• 负责人: SCOTT P. ORR
• 金额: $ 45.28万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-17 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6392628
• 关键词: behavioral /social science research tag; clinical research; conditioning; dexamethasone suppression test; disease /disorder proneness /risk; emergency health services; human subject; hypothalamic pituitary adrenal axis; police; posttraumatic stress disorder; psychometrics; psychophysiology; startle reaction

There are no generally accepted methods for prospectively identifying individuals at risk for post-traumatic stress disorder (PTSD) after a traumatic event. However, several individual difference variables show promise as pre-trauma risk factors. Recent findings from the PI's differential conditioning study indicate that a conditioned skin conductance response is acquired more strongly and extinguishes more slowly in PTSD than in non-PTSD, trauma-exposed control subjects, i.e., that PTSD subjects are more "conditionable." Given that many PTSD symptoms may be conceptualized as conditioned responses (CRs), it is plausible that individuals who are more prone to acquire CRs in the first place would be more likely to develop this disorder. The proposed project will examine a promising set of pre-trauma psychophysiologic, endocrinologic, and psychometric measures for their ability to predict the occurrence and severity of PTSD following exposure to traumatic events in firefighter/EMT and police recruits. It is hypothesized that the selected pre-trauma measures will predict PTSD following an index traumatic event. Prior to receiving their recruitment training, subjects will undergo a battery of psychometric questionnaires. A Pavlovian differential conditioning procedure which pairs colored circles with a mildly aversive UCS will be administered. Other psychophysiologic tests found useful in measuring PTSD, e.g., startle response, and suppression of salivary cortisol by a low (0.5 mg) dose of dexamethasone, will also be measured. After the pre-trauma assessment, subjects will be closely followed for the occurrence of a traumatic event that meets the DSM-IV PTSD A.1 criterion. Three months after such an event, the trauma-exposed subject will return for psychodiagnostic, psychometric, and psychophysiologic assessment of PTSD. Logistic and multiple regression techniques will be used to examine the relationship between psychophysiologic, endocrinologic, and psychometric predictor measures and categorical and continuous PTSD outcome measures.

创伤事件发生后，没有一种普遍接受的方法可以预期识别有创伤后应激障碍（PTSD）风险的人。 但是，几个个体差异变量显示出有望作为创伤前风险因素。 PI的差异条件研究的最新发现表明，与非PTSD，暴露于创伤的对照受试者（即PTSD受试者）相比，在PTSD中获得条件性皮肤电导反应的响应更慢，并且PTSD受试者更慢。 鉴于许多PTSD症状可能被概念化为条件反应（CRS），因此首先更容易获得CRS的个人更有可能患上这种疾病。拟议的项目将研究一套有希望的创伤前心理生理，内分泌学和心理测量指标，以预测消防员/EMT和警察招募的创伤事件后PTSD发生的能力和严重性。 假设所选的术前措施将在索引创伤事件后预测PTSD。在接受招聘培训之前，受试者将接受一系列心理测量问卷。 将施用彩色圆圈与轻度厌恶UCS配对的帕夫洛维亚差异调节程序。 其他心理生理测试发现，也将测量其他低（0.5 mg）剂量的地塞米松对PTSD的测量，例如惊吓反应，并抑制唾液皮质醇。经过创伤前评估后，将紧随受试者的发生，以符合符合DSM-IV PTSD A.1标准的创伤事件。 发生此类事件三个月后，受创伤的受试者将返回PTSD的心理诊断，心理测量和心理生理学评估。 逻辑和多元回归技术将用于检查心理生理，内分泌学和心理测量预测指标以及分类和连续的PTSD结局指标之间的关系。