TWIN STUDY OF BIOLOGIC MARKERS FOR PTSD

描述(改编自申请者的摘要)：这个项目将采取 利用越南时代带来的独特机遇 (VET)注册以评估家族性疾病的潜在生物标志物 易患创伤后应激障碍。研究对象将包括双胞胎 不和谐的战斗暴露。几个已知的生物创伤后应激障碍标志物 通过比较他们在(高危)未接触者中的存在来进行评估 与战斗相关的创伤后应激障碍暴露的双胞胎中的同卵双胞胎 与(低风险)未暴露的Mz同卵双胞胎的对比 与战斗相关的创伤后应激障碍。未暴露的(中高风险)有限样本 与战斗相关的创伤后应激障碍暴露双胞胎的双卵(DZ)同卵双胞胎将 被招募来测试是否有任何已确定的家族性生物 创伤后应激障碍的易感性因素代表了遗传的产物。一个 另一个目的是检查精神障碍的易感性 家族性的，可能是遗传的，创伤后应激障碍的易感性因素 对设计中的受试者进行全面的心理诊断访谈 与创伤后应激障碍生物标记物使用的方法平行。另一个目标 是评估潜在的获得性生物创伤后应激障碍症状 暴露的创伤后应激障碍双胞胎和他们未暴露的Mz同卵双胞胎。 因变量包括：(A)自主神经和肌肉惊厥 反应及其习惯化；(B)P3事件相关反应的波幅 目标辨别任务中的潜在(ERP)成分；(C)斜率 作为刺激中音调强度函数的P2ERP分量 强度调制实验；和(D)抑制唾液 小剂量口服地塞米松后皮质醇。每一标记均须为 研究是非侵入性的；可以在动态的基础上测量；有 在之前发表的同行评议研究中显示了 显著区分创伤后应激障碍和非创伤后应激障碍受试者； 能够从建议中获得的数据中获得信息 项目。 受试者将由现场心理学家使用临床医生进行诊断- 实施创伤后应激障碍量表、DSM-IV结构化临床访谈，以及 其他乐器。因变量将在旅行中测量 在退伍军人医学中心或兽医中心设立野战心理生理学实验室 在受试者家附近的中心。将进行统计显著性检验 通过单因素方差分析和多元方差分析 对关键组别进行协方差和独立t检验，并选定 子组。预计结果将促进我们对 创伤后应激障碍生物异常的体质性与获得性 以及这种疾病的发病机制。结果也将是 对高危人群进行预防性筛查的影响 暴露于军事战斗或其他严重创伤后的创伤后应激障碍 压力源。

DESCRIPTION (Adapted from applicant's abstract): This project will take advantage of the unique opportunity presented by the Vietnam Era Twin (VET) Registry to evaluate potential biologic markers for familial vulnerability to the development of PTSD. Subjects will include twins discordant for combat exposure. Several know biologic PTSD markers will be evaluated by comparing their presence in the (high-risk) unexposed monozygotic (Mz) co-twins of exposed twins with combat-related PTSd versus the (low-risk) unexposed Mz co- twins of exposed twins without combat-related PTSD. A limited sample of (medium-high-risk) unexposed dizygotic (Dz) co-twins of exposed twins with combat-related PTSD will be recruited in order to test whether any identified familial biologic vulnerability factor for PTSD represents the produce of heredity. An additional aim is to examine susceptibility to mental disorder as a familial, possibly inherited, vulnerability factor for PTSD by performing comprehensive psychodiagnostic interviews on subjects in an design parallel to that employed for the PTSD biologic markers. Another aim is to evaluate potential acquired biologic PTSD signs by comparing exposed PTSD twins versus their unexposed Mz co-twins. Dependent variables will include (a) autonomic and muscular startle responses and their habituation; (b) amplitude of the P3 event-related potential (ERP) component in a target discrimination task; (c) slope of the P2 ERP component as a function f tone intensity in a stimulus intensity modulation experiment; and (d) suppression of salivary cortisol following low-dose oral dexamethasone. Each marker to be studied is non-invasive; can be measured on an ambulatory basis; has been shown in previous, published, peer-reviewed research to significantly differentiate PTSD and non-PTSD subject groups; and is capable of being informed by the data to be obtained in the proposed project. Subjects will be diagnosed by a field psychologist using the Clinician- Administered PTSD Scale, Structured Clinical Interview for DSM-IV, and other instruments. Dependent variables will be measured at a traveling field psychophysiology laboratory set up at a VA Medical Center or Vet Center near the subject's home. Statistical significance will be tested by means of univariate and multivariate analyses of variance and covariance and independent t-tests performed on key groups, and selected subgroups. Results are expected to advance our understanding of the constitutional versus acquired nature of biologic abnormalities in PTSD and the pathogenesis of this disorder. Results will also have implications for the prophylactic screening of persons at high risk for the development of PTSD upon exposure to military combat or other severe stressors.