Clausen Ashley N, Aupperle Robin L, Sisante Jason-Flor V, Wilson David R, Billinger Sandra A
Department of Psychology, University of Tulsa, Tulsa, OK, United States of America.
Laureate Institute for Brain Research, Tulsa, OK, United States of America.
PLoS One. 2016 Sep 8;11(9):e0162547. doi: 10.1371/journal.pone.0162547. eCollection 2016.
Posttraumatic stress disorder (PTSD), and combat-related PTSD in particular, has been associated with increased rates of cardiovascular disease, and cardiovascular-related death. However, less research has examined possible factors that may link PTSD to poorer cardiovascular health in combat veteran populations. The current pilot study investigated whether psychological symptomology and autonomic reactivity to emotional scripts would relate to poorer cardiovascular health in combat veterans without a current diagnosis of cardiovascular disease. Male veterans (N = 24), who served in combat since Operation Iraqi Freedom, completed a semi-structured interview and self-report measures to assess psychological symptomology. Autonomic reactivity, measured using heart rate variability (HRV; low to high frequency ratio), was obtained during script-driven imagery of emotional memories. Cardiovascular health was assessed using flow-mediated dilation (FMD) of the brachial artery. Correlational analyses and discriminant analysis were used to assess the relationship between psychological symptoms (PTSD, depression, anger, as measured via self-report), autonomic reactivity to emotional scripts (HRV), and FMD. Overall, veterans in the current study showed poor cardiovascular health despite their relatively young age and lack of behavioral risk factors, with 15/24 exhibiting impaired FMD (FMD < 5%). Psychological symptomology was not associated with FMD; whereas autonomic reactivity to emotional (compared to neutral) scripts was found to relate to FMD. Autonomic reactivity to negative scripts correctly classified 76.5% of veterans as having impaired versus normative FMD. Results from this pilot study highlight the importance of cardiovascular screening with combat veterans despite psychological diagnosis. Results also support the need for longitudinal research assessing the use of autonomic reactivity to emotionally valenced stimuli as a potential risk factor for poorer cardiovascular health.
创伤后应激障碍（PTSD），尤其是与战斗相关的PTSD，与心血管疾病发病率及心血管相关死亡率的增加有关。然而，较少有研究探讨可能将PTSD与退伍军人较差的心血管健康联系起来的因素。当前的这项初步研究调查了心理症状学以及对情感脚本的自主反应是否与未被诊断出患有心血管疾病的退伍军人较差的心血管健康有关。自伊拉克自由行动以来参加过战斗的男性退伍军人（N = 24）完成了一项半结构化访谈和自我报告测量，以评估心理症状学。在情感记忆的脚本驱动想象过程中，使用心率变异性（HRV；低频与高频比值）来测量自主反应。使用肱动脉的血流介导的血管舒张（FMD）来评估心血管健康。采用相关分析和判别分析来评估心理症状（通过自我报告测量的PTSD、抑郁、愤怒）、对情感脚本的自主反应（HRV）和FMD之间的关系。总体而言，尽管本研究中的退伍军人相对年轻且缺乏行为风险因素，但他们的心血管健康状况较差，24人中有15人表现出FMD受损（FMD < 5%）。心理症状学与FMD无关；而对情感（与中性相比）脚本的自主反应与FMD有关。对负面脚本的自主反应正确地将76.5%的退伍军人分类为FMD受损与正常。这项初步研究的结果凸显了对退伍军人进行心血管筛查的重要性，无论其心理诊断如何。结果还支持需要进行纵向研究，评估将对情绪效价刺激的自主反应作为心血管健康较差的潜在风险因素的情况。
