Lindauer Ramón T L, van Meijel Els P M, Jalink Margje, Olff Miranda, Carlier Ingrid V E, Gersons Berthold P R
Centre for Psychological Trauma, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.
Psychosom Med. 2006 Jan-Feb;68(1):33-40. doi: 10.1097/01.psy.0000188566.35902.e7.
Previous psychophysiological studies of posttraumatic stress disorder (PTSD) have found heightened physiological responsivity to trauma-specific stimuli, but mostly in combat veterans with high comorbidity rates and with psychiatric medication. Our aim was to investigate psychophysiological responses in two new populations while excluding those confounding influences and to assess the effects of psychotherapy on such responses.
Thirty-nine subjects with PTSD (24 civilian outpatients and 15 police officers) and 15 trauma-exposed, non-PTSD control subjects underwent psychophysiological assessment while listening to neutral, stressful, and trauma scripts. Psychophysiological measures were heart rate (HR) and blood pressure in combination with subjective anxiety ratings. In a randomized clinical trial, 20 of the civilians were then assigned to treatment or waitlist groups. Psychophysiological assessment was repeated on them after the treatment stage.
Both civilians and police with PTSD showed significantly higher HR responses to trauma scripts than the control subjects. After successful psychotherapy with the civilians, HR responsivity to the trauma scripts was significantly reduced, and it correlated positively with PTSD clinical symptoms.
We confirmed previous findings of heightened psychophysiological responses in PTSD for two new populations while minimizing comorbidity and medication as confounding factors. Successful psychotherapy normalized HR response to trauma imagery.
先前关于创伤后应激障碍（PTSD）的心理生理学研究发现，对创伤特异性刺激的生理反应增强，但大多出现在合并症发生率高且服用精神科药物的退伍军人身上。我们的目的是在排除这些混杂影响的情况下，调查两个新群体中的心理生理反应，并评估心理治疗对此类反应的影响。
39名患有创伤后应激障碍的受试者（24名门诊患者和15名警察）以及15名有过创伤经历、无创伤后应激障碍的对照受试者在听中性、应激性和创伤性脚本时接受了心理生理评估。心理生理测量指标为心率（HR）和血压，并结合主观焦虑评分。在一项随机临床试验中，随后将20名门诊患者分为治疗组或等待名单组。在治疗阶段结束后，对他们再次进行心理生理评估。
患有创伤后应激障碍的门诊患者和警察对创伤性脚本的心率反应均显著高于对照受试者。门诊患者成功接受心理治疗后，对创伤性脚本的心率反应显著降低，且与创伤后应激障碍临床症状呈正相关。
我们在将合并症和药物作为混杂因素降至最低的情况下，证实了先前关于两个新群体创伤后应激障碍中心理生理反应增强的研究结果。成功的心理治疗使对创伤意象的心率反应恢复正常。
