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      Physiological reactivity to nonideographic virtual reality stimuli in veterans with and without PTSD

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          Abstract

          Background

          Post-traumatic stress disorder (PTSD) currently is diagnosed via clinical interview in which subjective self reports of traumatic events and associated experiences are discussed with a mental health professional. The reliability and validity of diagnoses can be improved with the use of objective physiological measures.

          Methods

          In this study, physiological activity was recorded from 58 male veterans (PTSD Diagnosis =  16; Trauma Exposed/No PTSD Diagnosis: =  23; No Trauma/No PTSD Diagnosis: =  19) with and without PTSD and combat trauma exposure in response to emotionally evocative non-idiographic virtual reality stimuli.

          Results

          Statistically significant differences among the Control, Trauma, and PTSD groups were present during the viewing of two virtual reality videos. Skin conductance and interbeat interval features were extracted for each of ten video events (five events of increasing severity per video). These features were submitted to three stepwise discriminant function analyses to assess classification accuracy for Control versus Trauma, Control versus PTSD, and Trauma versus PTSD pairings of participant groups. Leave-one-out cross-validation classification accuracy was between 71 and 94%.

          Conclusions

          These results are promising and suggest the utility of objective physiological measures in assisting with PTSD diagnosis.

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          Most cited references36

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          Diagnostic and statistical manual of mental disorders.

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            The development of a Clinician-Administered PTSD Scale.

            Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.
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              Prevalence of traumatic events and post-traumatic psychological symptoms in a nonclinical sample of college students.

              The lifetime prevalence of traumatic events and their psychological impact were assessed in 440 undergraduate students. Eighty-four percent of the subjects reported experiencing at least one event of sufficient intensity potentially to elicit Post-Traumatic Stress Disorder (PTSD). One-third of the sample had experienced four or more traumatic events. Subjects who had experienced trauma reported higher levels of depression, anxiety, and PTSD symptomatology than nontraumatized subjects, and these symptoms were more intense in subjects who experienced multiple traumas. Events that were particularly negative in their impact included unwanted sexual experiences and events that subjects reported were too traumatic to discuss openly. Males and females differed in their probability of experiencing some types of events and in the psychological response to certain events.
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                Author and article information

                Journal
                Brain Behav
                Brain Behav
                brb3
                Brain and Behavior
                BlackWell Publishing Ltd (Oxford, UK )
                2162-3279
                2162-3279
                February 2015
                23 December 2014
                : 5
                : 2
                : e00304
                Affiliations
                [1 ]The Charles Stark Draper Laboratory Cambridge, Massachusetts
                [2 ]Department of Psychiatry, Rush University Medical Center Chicago, Illinois
                Author notes
                Correspondence Andrea K. Webb, 555 Technology Square, Cambridge, MA 02139., Tel: 617-258-4131; Fax: 617-258-3711;, E-mail: awebb@ 123456draper.com

                Funding Information This work was funded by The Charles Stark Draper Laboratory.

                Article
                10.1002/brb3.304
                4309895
                25642387
                b62350de-b637-469c-ad5a-44ef616d8bad
                © 2014 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 September 2014
                : 17 October 2014
                : 12 November 2014
                Categories
                Original Research

                Neurosciences
                post-traumatic stress disorder,diagnosis,skin conductance,interbeat interval,classification accuracy

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