Startle modulation in children with posttraumatic stress disorder

Article Abstract:

Exaggerated startle responses in children suffering from posttraumatic stress disorder (PTSD) were observed in conjunction with the examination of systemic neurophysiologic response. Posttraumatic stress disorder is a condition which occurs as a result of a traumatic event outside the realm of normal life experience. This does not include life events such as bereavement, chronic illness, or domestic conflicts. It typically involves an event where one's life or the life of a loved one is directly threatened with little immediate opportunity for resolution, and, for diagnostic purposes, post-trauma symptoms must last for more than one month. Common symptoms of this condition include persistent agitation accompanied by insomnia, hyperactivity, and exaggerated or abnormal startle responses. Experimental startle modulation tests were performed on children with PTSD. Startle reactions were recorded when sudden bursts of white noise were administered and blink reflexes were recorded as the reaction to this stimuli. White noise is a form of noise in which virtually all wavelengths are present; for example, the noise that can be heard in between radio stations. The group consisted of six children (two boys and four girls) ranging between the ages of eight to 12 years old who had experienced a sniper attack. The children were tested and compared to a control group of six normal children approximately 17 to 21 months after the event. It is known that the inhibitory startle modulation is a function that is acquired as a part of development, namely the ability to delay and thus control the startle response to external stimuli. The children in the control group tested within normal ranges for their age but those in the PTSD group tested at five-year old levels. This indicates that normal brainstem function had been compromised. Another study involving a seven-year-old boy who had witnessed his father's murder was conducted over a two-year period. When his reactions were compared to a control group of normal eight-year-olds, it was found that the child had experienced a loss of normal inhibitory modulation. However, this appeared to improve over time, suggesting that an ameliorating process did gradually occur after the event.

Research, Testing, Neurology, Child development deviations, Developmental disabilities, Stress in children, Post-traumatic stress disorder in children, Childhood post-traumatic stress disorder, Reflexes, Childhood stress (Psychology), Reflex tests

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Physiological evidence of exaggerated startle response in a subgroup of Vietnam veterans with combat-related PTSD

Article Abstract:

In the last 10 years, posttraumatic stress disorder (PTSD) has received increased recognition, and recent studies suggest that Vietnam combat veterans are at increased risk for this condition. Two of the symptoms that are included in the criteria for PTSD are an exaggerated startle response and physiological reactivity when exposed to stimuli similar to the original traumatic event. These two characteristics of PTSD, unlike some of the other symptoms, do not require self-reported measures for confirmation. One method that has been developed to assess startle response is to measure eyeblink responses to startling stimuli like loud noises or unexpected touch. It was hypothesized that veterans with PTSD would exhibit measurable startle responses at lower sound intensities than veterans without PTSD. Out of a total of 56 Vietnam veterans who were screened for the study, 20 met the criteria for chronic PTSD; 18 individuals who did not meet the criteria were used as control subjects. Additionally, subjects who did not exhibit an eyeblink response to startle stimuli were excluded from the study. No difference in this responsivity was detected between the two groups. Thirteen individuals with PTSD and 12 subjects in the control group participated in the experiment. The results showed that there were significant differences between the startle responses of the PTSD group and the controls. At intermediate intensities of acoustic stimuli, the 13 PTSD subjects had a significantly greater startle response than the 12 controls. The PTSD subjects also had a tendency to have more symptoms of the syndrome than the control group. The existence of a subgroup of patients with chronic combat-related PTSD who are characterized by exaggerated startle response and perceptual aberrations is postulated on the basis of these results. Implications of the data and other factors which may be influential in PTSD are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Vietnam veterans, Combat

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Characterization of depression in war-related posttraumatic stress disorder

Article Abstract:

Combat veterans with war-related posttraumatic stress disorder (PTSD) often meet the criteria for major depressive disorder, or have related symptoms, such as social withdrawal, suicidal fantasies, sleep disturbance, poor appetite and low self-esteem. In order to clarify the emotional components of PTSD, 45 male psychiatric inpatients at a Veterans' Administration hospital were studied. Twenty-eight were Vietnam veterans diagnosed with PTSD. The other 17 patients were diagnosed with major depressive disorder. All patients completed the 66-item Depressive Experiences Questionnaire, which contains three distinct scales to measure dependency, self-criticism and self-efficacy. Patients were also rated for depression and underwent diagnostic interviews. The PTSD group was then divided into those who did or did not meet criteria for major depressive disorder. Patients with PTSD had significantly higher scores on the self-criticism scale than patients with major depressive disorder. No differences between groups were found in terms of dependency or self-efficacy. Patients with PTSD and major depressive disorder had slightly higher scores on most rating items for depression than patients with PTSD only. PTSD patients scored significantly higher on an item related to somatic (bodily) anxiety, and tended to have more problems with insomnia, anxiety, daily mood fluctuations and hypochondria than patients with major depression. Results indicate that many veterans with combat-related PTSD suffer from guilt and self-criticism, which may lead to depression. It is posited that years of feeling guilty about experiences in Vietnam may begin to generalize to other life experiences and eventually lead to negatively altered self-evaluations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Evaluation, Causes of, Depression, Mental, Depression (Mood disorder), Psychiatric disability evaluation

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