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遭受性侵犯相关创伤后应激障碍女性的惊吓反射异常

Startle reflex abnormalities in women with sexual assault-related posttraumatic stress disorder.

作者信息

Morgan C A, Grillon C, Lubin H, Southwick S M

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, Conn, USA.

出版信息

Am J Psychiatry. 1997 Aug;154(8):1076-80. doi: 10.1176/ajp.154.8.1076.

Abstract

OBJECTIVE

This investigation was designed to assess the acoustic startle response in treatment-seeking women with sexual assault-related posttraumatic stress disorder (PTSD).

METHOD

Thirteen patients with sexual assault-related PTSD and 16 healthy female comparison subjects were recruited for participation in the study. Each patient met the full criteria for PTSD according to the Structured Clinical Interview for DSM-III-R. All subjects in the study were right-handed. The acoustic stimuli were bursts of white noise (92 dB and 102 dB) with a nearly instantaneous onset delivered binaurally through headphones.

RESULTS

The magnitude of the startle response (eye blink) to the first stimulus was asymmetrically distributed in the PTSD patients but not in the comparison subjects: it was greater for the left eye than the right eye in the PTSD patients only. There was a differential asymmetry of startle response in the two subgroups of patients (recent PTSD and long-standing PTSD): the startle reflex was larger for the left eye than the right in the subgroup with recent PTSD but not in the group with long-standing PTSD.

CONCLUSIONS

This study provides the first objective evidence of startle abnormalities in women with PTSD. The significantly greater startle responses for the left eye compared with the right in the PTSD subjects suggest a laterality effect. As suggested by the preclinical model of shock sensitization, it is possible that in a subgroup of individuals with PTSD, trauma may sensitize the startle reflex. This model may hold true in humans and is supported by the findings of greater startle response in the patients with recent-onset PTSD.

摘要

目的

本研究旨在评估寻求治疗的患有与性侵犯相关创伤后应激障碍(PTSD)的女性的听觉惊吓反应。

方法

招募了13名患有与性侵犯相关PTSD的患者和16名健康女性对照受试者参与研究。根据DSM-III-R结构化临床访谈,每位患者均符合PTSD的全部标准。研究中的所有受试者均为右利手。听觉刺激为通过耳机双耳传递的突发白噪声(92分贝和102分贝),起始几乎是瞬间的。

结果

PTSD患者对首次刺激的惊吓反应(眨眼)幅度呈不对称分布,而对照受试者中则没有:仅在PTSD患者中,左眼的反应大于右眼。在两个患者亚组(近期PTSD和长期PTSD)中,惊吓反应存在差异不对称性:在近期PTSD亚组中,左眼的惊吓反射大于右眼,而在长期PTSD组中则不然。

结论

本研究为患有PTSD的女性存在惊吓异常提供了首个客观证据。PTSD受试者中左眼的惊吓反应明显大于右眼,提示存在偏侧性效应。如休克敏感化的临床前模型所示,在一部分PTSD个体中,创伤可能会使惊吓反射敏感化。该模型可能适用于人类,并得到近期发病PTSD患者中惊吓反应更大这一研究结果的支持。

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