National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
J Trauma Stress. 2012 Aug;25(4):416-25. doi: 10.1002/jts.21729. Epub 2012 Jul 27.
This study examined concordance between physiological arousal and subjective distress during a laboratory challenge task. Data were collected during the multisite VA Cooperative Study 334 in the early 1990s examining psychophysiological arousal among combat-exposed Vietnam veterans with (n = 775) and without (n = 369) posttraumatic stress disorder (PTSD). Study participants were presented with 6 standardized neutral scenes and 6 standardized combat scenes. Participants provided a subjective rating of distress after each slide. During the presentation, levels of heart rate (HR) and skin conductance (SC) were recorded. Using linear mixed effects modeling, both HR level and SC level exhibited significant positive associations with subjective distress ratings (pr = .33, p < .001 and pr = .19, p < .001, respectively). Individuals with PTSD demonstrated greater concordance between their distress ratings and SC level during exposure to combat slides than participants without PTSD (pr = .28, p < .001 vs. pr = .18, p < .001). Although a significant association was found between subjective distress and HR reactivity and SC reactivity, these findings were not moderated by PTSD status. The results of these analyses suggest that patients' reports of distress during exposure-based treatments might serve as approximate measures of actual physiological arousal.
本研究考察了在实验室挑战任务中生理唤醒与主观不适之间的一致性。本研究数据来自 20 世纪 90 年代初多地点退伍军人事务部合作研究 334 号，研究对象为经历过越南战争的、患有（n = 775）和未患有（n = 369）创伤后应激障碍（PTSD）的退伍军人，旨在检验战斗暴露退伍军人的生理唤醒。研究参与者观看了 6 个标准化中性场景和 6 个标准化战斗场景，并在每个幻灯片结束后对自身的不适程度进行主观评分。在呈现幻灯片的过程中，记录参与者的心率（HR）和皮肤电传导（SC）水平。线性混合效应模型显示，HR 水平和 SC 水平与主观不适评分均呈显著正相关（pr =.33，p <.001 和 pr =.19，p <.001）。与无 PTSD 的参与者相比，患有 PTSD 的个体在观看战斗场景时，其不适评分与 SC 水平之间的一致性更高（pr =.28，p <.001 比 pr =.18，p <.001）。尽管在主观不适与 HR 反应性和 SC 反应性之间存在显著关联，但 PTSD 状态并未调节这些关联。这些分析结果表明，患者在暴露治疗期间报告的不适可能是其实际生理唤醒的近似测量。
