Am J Psychiatry 157:255-261, February 2000
© 2000 American Psychiatric Association
Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study
Arieh Y. Shalev, M.D.,
Tuvia Peri, Ph.D.,
Dalia Brandes, M.A.,
Sara Freedman, M.Sc.,
Scott P. Orr, Ph.D., and
Roger K. Pitman, M.D.
OBJECTIVE: Previous studies have shown elevated autonomic responses to startling tones in trauma survivors with chronic posttraumatic stress disorder (PTSD). The origin of these abnormal responses is obscure. The present study attempted to clarify this issue by prospectively evaluating responses to sudden, loud tones in individuals who arrived at a hospital emergency room after psychologically traumatic events. METHOD: By using a previously established protocol, autonomic and muscular responses to the tones were evaluated at 1 week, 1 month, and 4 months after the traumatic event. Structured diagnostic interviews performed at 4 months classified subjects into groups with (N=36) and without (N=182) PTSD, which were further subdivided according to the presence or absence of major depressive disorder as follows: neither PTSD nor depression (N=166), depression alone (N=16), PTSD alone (N=21), and both PTSD and depression (N=15). RESULTS: The groups showed comparable physiological responses to the tones at 1 week posttrauma. However, at 1 and 4 months posttrauma, the subjects with PTSD showed a greater heart rate response and required more stimulus trials to reach the criteria of skin conductance and orbicularis oculi electromyogram nonresponse. These findings were not significantly influenced by comorbid depression and were not explained by the severity of the traumatic event or by the intensity of the initial symptoms. CONCLUSIONS: Differences in physiological response to startling tones develop along with PTSD in the months that follow a traumatic event. This pattern supports the theories that associate PTSD with progressive neuronal sensitization.
This article has been cited by other articles:
|
|
|
|
 
D. Schiller, I. Levy, Y. Niv, J. E. LeDoux, and E. A. Phelps
From Fear to Safety and Back: Reversal of Fear in the Human Brain
J. Neurosci.,
November 5, 2008;
28(45):
11517 - 11525.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Buhlmann, S. Wilhelm, T. Deckersbach, S. L. Rauch, R. K. Pitman, and S. P. Orr
Physiologic Responses to Loud Tones in Individuals With Obsessive-Compulsive Disorder
Psychosom Med,
February 1, 2007;
69(2):
166 - 172.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Radley, C. M. Arias, and P. E. Sawchenko
Regional Differentiation of the Medial Prefrontal Cortex in Regulating Adaptive Responses to Acute Emotional Stress
J. Neurosci.,
December 13, 2006;
26(50):
12967 - 12976.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D L Whitehead, L Perkins-Porras, P C Strike, and A Steptoe
Post-traumatic stress disorder in patients with cardiac disease: predicting vulnerability from emotional responses during admission for acute coronary syndromes
Heart,
September 1, 2006;
92(9):
1225 - 1229.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Y. Shalev and S. Freedman
PTSD Following Terrorist Attacks: A Prospective Evaluation
Am J Psychiatry,
June 1, 2005;
162(6):
1188 - 1191.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R.-L. Punamaki, I. H. Komproe, S. Qouta, M. Elmasri, and J. T.V.M. de Jong
The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample
Am J Psychiatry,
March 1, 2005;
162(3):
545 - 551.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Guthrie and R. A. Bryant
Auditory Startle Response in Firefighters Before and After Trauma Exposure
Am J Psychiatry,
February 1, 2005;
162(2):
283 - 290.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R.T. Davidson, D. J. Stein, A. Y. Shalev, and R. Yehuda
Posttraumatic Stress Disorder: Acquisition, Recognition, Course, and Treatment
J Neuropsychiatry Clin Neurosci,
May 1, 2004;
16(2):
135 - 147.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gulinello and S. S. Smith
Anxiogenic Effects of Neurosteroid Exposure: Sex Differences and Altered GABAA Receptor Pharmacology in Adult Rats
J. Pharmacol. Exp. Ther.,
May 1, 2003;
305(2):
541 - 548.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. P. Orr, L. J. Metzger, N. B. Lasko, M. L. Macklin, F. B. Hu, A. Y. Shalev, R. K. Pitman, and for the Harvard/Veterans Affairs Post-traumatic St
Physiologic Responses to Sudden, Loud Tones in Monozygotic Twins Discordant for Combat Exposure: Association With Posttraumatic Stress Disorder
Arch Gen Psychiatry,
March 1, 2003;
60(3):
283 - 288.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. A. Mellman, V. Bustamante, A. I. Fins, W. R. Pigeon, and B. Nolan
REM Sleep and the Early Development of Posttraumatic Stress Disorder
Am J Psychiatry,
October 1, 2002;
159(10):
1696 - 1701.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Yehuda
Post-Traumatic Stress Disorder
N. Engl. J. Med.,
January 10, 2002;
346(2):
108 - 114.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Y Shalev, J. Cohen, S. J Ellis, A. Litva, G. J Devilly, T. Clark, C. Cabrera-Abreu, A. Hargrave, and D. Summerfield
Post-traumatic stress disorder
BMJ,
May 26, 2001;
322(7297):
1301 - 1301.
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 2000
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
