Department of Psychology PO77, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
Psychosom Med. 2010 Apr;72(3):301-8. doi: 10.1097/PSY.0b013e3181d07db8. Epub 2010 Feb 2.
To investigate whether chronic posttraumatic stress disorder can be predicted by heart rate responses (HRR) and skin conductance responses (SCR) to standardized trauma-related pictures at 1 month after trauma has ocurred. Trauma survivors with PTSD report heightened physiological responses to a wide range of stimuli. It has been suggested that associative learning and stimulus generalization play a key role in the development of these symptoms. Some studies have found that trauma survivors with PTSD show greater physiological responses to individualized trauma reminders in the initial weeks after trauma than those without PTSD.
Survivors of motor vehicle accidents or physical assaults (n = 166) watched standardized trauma-related, generally threatening, and neutral pictures at 1 month post trauma, as their HRR and SCR were recorded. PTSD symptoms were assessed with structured clinical interviews at 1 month and 6 months; self-reports of fear responses and dissociation during trauma were obtained soon after the trauma.
At 1 month, trauma survivors with PTSD showed greater HRR to trauma-related pictures than those without PTSD, but not to general threat or neutral pictures. HRR to trauma-related pictures predicted PTSD severity at 1 month and 6 months, and were related to fear and dissociation during trauma. SCR were not related to PTSD.
HRR to standardized trauma reminders at 1 month after the trauma differentiate between trauma survivors with and without PTSD, and predict chronic PTSD. RESULTS are consistent with a role of associative learning in PTSD and suggest that early stimulus generalization may be an indicator of risk for chronic PTSD.
探讨创伤后 1 个月时，对标准化创伤相关图片的心率反应（HRR）和皮肤电导反应（SCR）是否可以预测慢性创伤后应激障碍（PTSD）。报告 PTSD 的创伤幸存者对广泛的刺激有更高的生理反应。有人认为，联想学习和刺激泛化在这些症状的发展中起着关键作用。一些研究发现，与 PTSD 相比，创伤后 PTSD 幸存者在创伤后最初几周对个体化创伤提示表现出更大的生理反应。
机动车事故或人身攻击幸存者（n=166）在创伤后 1 个月观看标准化的创伤相关、普遍威胁和中性图片，同时记录他们的 HRR 和 SCR。在 1 个月和 6 个月时使用结构化临床访谈评估 PTSD 症状；创伤后不久，获得对创伤期间恐惧反应和分离的自我报告。
在 1 个月时，与无 PTSD 的幸存者相比，有 PTSD 的幸存者对创伤相关图片的 HRR 更大，但对一般威胁或中性图片则没有。对创伤相关图片的 HRR 可预测 1 个月和 6 个月时 PTSD 的严重程度，并与创伤期间的恐惧和分离有关。SCR 与 PTSD 无关。
创伤后 1 个月时对标准化创伤提示的 HRR 可区分 PTSD 幸存者和非 PTSD 幸存者，并预测慢性 PTSD。结果与联想学习在 PTSD 中的作用一致，并表明早期刺激泛化可能是慢性 PTSD 的风险指标。
