Article| Volume 27, ISSUE 10, P1165-1175, May 15, 1990

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Autonomic responses to stress in Vietnam combat veterans with posttraumatic stress disorder

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      This study tested the hypothesis that combat veterans with posttraumatic stress disorder (PTSD) experience sympathetic nervous system activation in response to war-related laboratory stimuli. Circulating plasma catecholamines, vital signs, and affect ratings were measured in 10 Vietnam combat veterans with PTSD and 11 control subjects, during and after viewing combat and noncombat stress films. PTSD subjects responded more strongly than controls to the combat film, with greater increases in plasma epinephrine, pulse, blood pressure, and subjective distress. The increases in autonomic activity of PTSD subjects was more pronounced and long lasting in response to the combat film than to the noncombat film, but type of film had no systematic effect on control subjects' responses. These findings are consistent with biological models that posit sympathoadrenal activation in response to memory-evoking cues of traumatic events in PTSD.
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        • American Psychiatric Association
        ed 3, revised. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association Press, Washington, DC1987: 247-251
        • Best J.D.
        • Halter J.B.
        Release and clearance rates of epinephrine in man: Importance of arterial measurements.
        J Clin Endocrinol Metab. 1982; 55: 263-268
        • Best J.D.
        • Halter J.B.
        Blood pressure and norepinephrine spillover during propanolol infusion in man.
        Am J Physiol. 1985; 248: R400-406
        • Blanchard E.B.
        • Kolb L.C.
        • Gerardi R.J.
        • Ryan P.
        • Pallmeyer T.P.
        Cardiac response to relevant stimuli as an adjunctive tool for diagnosing post-traumatic stress disorder in Vietnam veterans.
        Behavior Therapy. 1986; 17: 592-606
        • Blanchard E.B.
        • Kolb L.C.
        • Pallmeyer T.P.
        • Gerardi B.A.
        A psychophysiological study of post traumatic stress disorder in Vietnam veterans.
        Psychiatr Q. 1982; 54: 220-229
        • Davidson L.M.
        • Baum A.
        Chronic stress and posttraumatic stress disorders.
        J Consult Clin Psychol. 1986; 54: 303-308
        • Delius W.
        • Hagbarth K.E.
        • Hongell A.
        • Wallin B.G.
        Maneuvers affecting sympathetic outflow in human muscle nerves.
        Acta Physiol Scand. 1972; 84: 82-94
        • Esler M.
        Assessment of sympathetic nervous function in humans from noradrenaline plasma kinetics.
        Clin Sci. 1982; 62: 247-254
        • Evans M.I.
        • Halter J.B.
        • Porte Jr., D.
        Comparisons of double- and single-isotope enzymatic derivative methods for measuring catecholamines in human plasma.
        Clin Chem. 1978; 24: 567
        • Folkow B.
        Introductory remarks: Plasma catecholamines as markers for sympathoadrenal activity in man.
        Acta Physiol Scand. 1984; 527 (Suppl): 7-9
        • Goldstein D.S.
        • Eisenhofer G.
        • Sax F.L.
        • Keiser H.R.
        • Kopin I.J.
        Plasma norepinephrine pharmacokinetics during mental challenge.
        Psychosom Med. 1987; 49: 591-605
        • Halter J.B.
        • Stratton J.R.
        • Pfeifer M.A.
        Plasma catecholamines and hemodynamic responses to stress states in man.
        Acta Physiol Scand. 1984; 527 (Suppl): 31-38
        • Hjemdahl P.
        • Freyschuss U.
        • Juhlin-Dannfelt A.
        • Linda B.
        Differentiated sympathetic activation during mental stress evoked by the Stroop test.
        Acta Physiol Scand. 1984; 527 (Suppl): 25-29
        • Horowitz M.J.
        • Becker S.S.
        • Malone P.
        Stress: Different effects on patients and nonpatients.
        J Abnorm Psychol. 1973; 82: 547-551
        • Keane T.M.
        • Caddell J.M.
        • Taylor K.L.
        Mississippi scale for combat-related posttraumatic stress disorder: Three studies in reliability and validity.
        J Consult Clin Psychol. 1988; 56: 85-90
        • Keane T.M.
        • Zimmering R.T.
        • Caddell J.M.
        A behavioral formulation of post traumatic stress disorder in Vietnam veterans.
        Behavior Therapist. 1985; 8: 9-12
        • Kolb L.C.
        A neuropsychological hypothesis explaining posttraumatic stress disorders.
        Am J Psychiatry. 1987; 144: 989-995
        • Kosten T.R.
        • Mason J.W.
        • Giller E.L.
        • Ostroff R.B.
        • Harkness L.
        Sustained urinary norepinephrine and epinephrine elevation in post-traumatic stress disorder.
        Psychoneuroendocrinology. 1987; 12: 12-20
        • Laufer R.S.
        • Frey-Wouters E.
        • Donnellan J.
        • Yager T.
        Legacies of Vietnam, Vol. III, Post War Trauma: Social and Psychological Problems of Vietnam Veterans and their Peers.
        in: US Government Printing Office, Washington DC1981: 125-129
        • Malloy P.F.
        • Fairbank J.A.
        • Keane T.M.
        Validation of a multimethod assessment of posttraumatic stress disorder in Vietnam veterans.
        J Consul Clin Psychol. 1983; 51: 488-494
        • Mason J.W.
        Organization of psychoendocrine mechanisms.
        in: Handbook of Psychophysiology. Holt, Rinehart, & Winston, New York1972
        • McFall M.E.
        • Murburg M.M.
        • Roszell D.K.
        • Veith R.C.
        Psychophysiologic and neuroendocrine findings in post-traumatic stress disorder: A review of theory and research.
        J Anxiety Disorders. 1989; 3: 243-257
        • Perry B.D.
        • Southwick S.M.
        • Giller E.L.
        Adrenergic receptor regulation in PTSD.
        in: Proc 141st Ann Meeting of the American Psychiatric Association. American Psychiatric Association, Montreal, Quebec, Canada1988: 148
        • Pitman R.K.
        • Orr S.P.
        • Forgue D.F.
        • de Jong J.B.
        • Clairborn J.M.
        Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans.
        Arch Gen Psychiatry. 1987; 44: 970-975
        • Robertson D.
        • Johnson G.A.
        • Robertson R.M.
        • Nies A.
        • Shand D.G.
        • Oates J.A.
        Comparative assessment of stimuli that release neuronal and adrenomedullary catecholamines in man.
        Circulation. 1979; 59: 637-643
        • Spitzer R.L.
        • Williams J.B.W.
        • Gibbon M.
        Structured Clinical Interview for DSM-III-R—Patient Version (SCID-P, 4-1-87).
        New York State Psychiatric Institute, New York1987
        • Veith R.C.
        • Best J.D.
        • Halter B.
        Dose-dependent suppression of norepinephrine appearance rate in plasma by clonidine in man.
        J Clin Endocrinol Metab. 1984; 59: 151-155
        • Veith R.C.
        • Featherstone J.A.
        • Linares O.A.
        • Halter J.B.
        Age differences in plasma norepinephrine kinetics in humans.
        J Gerontol. 1986; 41: 319-324
        • Villacres E.C.
        • Hollifield M.
        • Katon W.J.
        • Wilkinson C.W.
        • Veith R.C.
        Sympathetic nervous system activity in panic disorder.
        Psychiatry Res. 1987; 21: 313-321
        • Ward M.M.
        • Meford I.N.
        • Parker S.D.
        • Chesney M.A.
        • Taylor C.B.
        • Keegan D.L.
        • Barchas J.D.
        Epinephrine and norepinephrine responses in continuously collected human plasma to a series of stressors.
        Psychosom Med. 1983; 45: 471-486
        • Zilberg N.J.
        • Weiss D.S.
        • Horowitz M.J.
        Impact of event scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes.
        J Consult Clin Psychol. 1982; 50: 407-414