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，一些个体差异变量显示出作为创伤前风险因素的希望。 PI的差异条件反射研究的最新发现表明，与非创伤后应激障碍、创伤暴露的对照受试者相比，创伤后应激障碍患者获得的条件皮肤电导反应更强，消失更慢，即，创伤后应激障碍患者更容易“适应”“鉴于许多创伤后应激障碍症状可能被概念化为条件反应（CR），更容易首先获得CR的个体更有可能发展这种疾病是合理的。拟议的项目将研究一套有前途的创伤前心理生理，内分泌和心理测量的措施，他们的能力，以预测创伤后应激障碍的发生和严重程度暴露于创伤事件的消防员/EMT和警察新兵。 据推测，选定的创伤前措施将预测创伤后应激障碍指数创伤事件。在接受招募培训之前，受试者将接受一系列心理测量问卷。 将进行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。 其他心理生理学测试在测量PTSD中发现有用，例如，还将测量惊吓反应和低剂量（0.5mg）地塞米松对唾液皮质醇的抑制。创伤前评估后，将密切随访受试者是否发生符合DSM-IV PTSD A.1标准的创伤事件。 在这样的事件发生后三个月，暴露于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评估。 逻辑和多元回归技术将被用来检查心理生理学，内分泌学和心理测量预测措施和分类和连续的PTSD结果的措施之间的关系。

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.