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: 6784710
• 负责人: SCOTT P. ORR
• 金额: $ 42.43万
• 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 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6784710
• 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.

目前还没有普遍接受的方法来前瞻性地识别在创伤事件后有创伤后应激障碍 (PTSD) 风险的个体。 然而，一些个体差异变量有望成为创伤前危险因素。 PI 差异调节研究的最新发现表明，与非 PTSD、遭受创伤的对照受试者相比，PTSD 患者获得的条件性皮肤电导反应更强烈，且消失得更慢，即 PTSD 受试者更“有条件调节”。 鉴于许多 PTSD 症状可能被概念化为条件反应 (CR)，因此，那些一开始就更容易获得 CR 的个体更有可能患上这种疾病，这是合理的。拟议的项目将研究一套有前途的创伤前心理生理学、内分泌学和心理测量测量方法，以预测消防员/急救人员和新招募警察在经历创伤事件后 PTSD 的发生和严重程度。 假设所选的创伤前措施将预测索引创伤事件后的 PTSD。在接受招募培训之前，受试者将接受一系列心理测量问卷。 将实施巴甫洛夫差异调节程序，将彩色圆圈与轻度厌恶的 UCS 配对。 还将测量其他有助于测量 PTSD 的心理生理学测试，例如惊吓反应和低剂量（0.5 毫克）地塞米松对唾液皮质醇的抑制。创伤前评估后，将密切跟踪受试者是否发生符合 DSM-IV PTSD A.1 标准的创伤事件。 此类事件发生三个月后，遭受创伤的受试者将返回进行 PTSD 的心理诊断、心理测量和心理生理学评估。 将使用逻辑和多元回归技术来检查心理生理学、内分泌学和心理测量预测指标与分类和连续 PTSD 结果指标之间的关系。

项目成果

An alternative scoring method for skin conductance responding in a differential fear conditioning paradigm with a long-duration conditioned stimulus.

• DOI: 10.1111/j.1469-8986.2009.00852.x
• 发表时间: 2009-09
• 期刊: Psychophysiology
• 影响因子: 3.7
• 作者: Pineles SL;Orr MR;Orr SP
• 通讯作者: Orr SP

Predicting emotional responses to potentially traumatic events from pre-exposure waking cortisol levels: a longitudinal study of police and firefighters.

根据暴露前清醒皮质醇水平预测对潜在创伤事件的情绪反应：对警察和消防员的纵向研究。

• DOI: 10.1080/10615806.2012.672976
• 发表时间: 2013
• 期刊: Anxiety, stress, and coping
• 作者: Pineles,SuzanneL;Rasmusson,AnnM;Yehuda,Rachel;Lasko,NatashaB;Macklin,MichaelL;Pitman,RogerK;Orr,ScottP
• 通讯作者: Orr,ScottP