Costanzo Michelle E, Leaman Suzanne, Jovanovic Tanja, Norrholm Seth D, Rizzo Albert A, Taylor Patricia, Roy Michael J
From the Department of Medicine (M.E.C., S.L., M.J.R.), Uniformed Services University of the Health Sciences, Bethesda, Maryland; The Henry M. Jackson Foundation (M.E.C., P.T.), Bethesda, Maryland; Department of Psychiatry & Behavioral Sciences (T.J., S.D.N.), Emory University School of Medicine, Atlanta, Georgia; Mental Health Service Line (S.D.N.), Atlanta Veterans' Affairs Medical Center, Decatur, Georgia; and Exploratory Center for the Interdisciplinary Study of Neuroplasticity and Stroke Rehabilitation (A.A.R.), University of Southern California, Los Angeles, California.
Psychosom Med. 2014 Nov-Dec;76(9):670-7. doi: 10.1097/PSY.0000000000000109.
Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members.
Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables.
Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003).
Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.
阈下创伤后应激障碍(PTSD)近来受到关注,因为其症状会导致显著痛苦和功能损害,且发展为完全型PTSD的风险增加。然而,阈下PTSD的临床表现差异很大,因此定义不明确,也没有基于证据的治疗方法。因此,我们旨在通过报告在最近部署的美国现役军人样本中,使用虚拟战斗环境引发与PTSD症状相关的独特心理生理反应,来进一步了解阈下PTSD症状。
在三种独特的与战斗相关的虚拟现实场景中,监测了78名现役军人样本的心率、皮肤电导率、肌电图(惊吓反应)、呼吸频率和血压,作为评估阈下症状的一种新方法。采用临床医生管理的PTSD量表,并进行线性回归分析,以研究症状群与生理变量之间的关系。
在研究的一系列心理生理指标中,回归分析显示心率与基于临床医生管理的PTSD量表测量的过度觉醒(R = 0.11,p = .035)、重新体验(R = 0.24,p = .001)以及总体PTSD症状(R = 0.17,p = .003)关联最为密切。
我们的研究结果支持使用虚拟现实环境来引发与阈下PTSD症状相关的生理反应。