PROSPECTIVE PSYCHOPHYSIOLOGIC STUDY OF RISK FOR PTSD

目前还没有普遍接受的方法来前瞻性地识别创伤后应激障碍(PTSD)的风险个体。然而，一些个体差异变量显示出作为创伤前风险因素的前景。PI的差异性条件反射研究的最新发现表明，与非创伤后应激障碍的对照组受试者相比，创伤后应激障碍患者获得的条件性皮肤电导反应更强烈，消退更慢，也就是说，创伤后应激障碍受试者更容易受到限制。鉴于许多PTSD症状可能被概念化为条件性反应(CRS)，似乎更容易患上CRS的人更有可能发展为这种疾病。这项拟议的项目将检验一套有希望的创伤前心理生理学、内分泌学和心理测量学测量方法，以检验它们预测消防员/EMT和警察新兵暴露于创伤事件后创伤后应激障碍的发生和严重程度的能力。这是假设，选定的创伤前测量将预测创伤后应激障碍的指标性事件。在接受招募培训之前，受试者将接受一系列心理测量问卷。将实施巴甫洛夫微分条件反射程序，将彩色圆圈与轻度厌恶的UCS配对。其他有助于测量创伤后应激障碍的心理生理学测试，例如惊吓反应，以及低剂量(0.5毫克)地塞米松对唾液皮质醇的抑制，也将被测量。在创伤前评估后，将密切跟踪受试者是否发生符合DSM-IV创伤后应激障碍A.1标准的创伤事件。在这样的事件发生三个月后，暴露在创伤中的受试者将返回接受创伤后应激障碍的心理诊断、心理测量和心理生理学评估。Logistic和多元回归技术将被用来检验心理生理学、内分泌学和心理测量学预测指标与分类和连续性创伤后应激障碍结果指标之间的关系。

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.