Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event

被引:325
作者
Yehuda, R
McFarlane, AC
Shalev, AY
机构
[1] Bronx Vet Affairs Hosp, Mt Sinai Sch Med, Dept Psychiat, New York, NY USA
[2] Univ Adelaide, Dept Psychiat, Adelaide, SA, Australia
[3] Hadassah Med Ctr, Dept Psychiat, IL-91120 Jerusalem, Israel
关键词
posttraumatic stress disorder; animal models; startle; cortisol; acute stress response; longitudinal studies;
D O I
10.1016/S0006-3223(98)00276-5
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Posttraumatic stress disorder (PTSD) is a psychiatric condition that is directly precipitated by an event that threatens a person's life or physical integrity and that invokes a response of fear, helplessness, or horror. In recent years it has become clear that only a proportion of those exposed to fear-producing events develop or sustain PTSD. Thus, it seems that an important challenge is to elucidate aberrations in the normal fear response that might precipitate trauma-related psychiatric disorder. This paper summarizes the findings from recent studies that examined the acute and longer term biological response to traumatic stress in people appearing to the emergency room immediately following trauma exposure. In the aggregate, these studies have demonstrated increased heart rate and lower cortisol levels at the time of the traumatic event in those who have PTSD at a follow-up time compared to those who do not. In contrast, certain features associated with PTSD, such as intrusive symptoms and exaggerated startle responses, are only manifest weeks after the trauma. The findings suggest that the development of PTSD may be facilitated by an atypical biological response in the immediate aftermath of a traumatic event, which in turn leads to a maladaptive psychological state. Biol Psychiatry 1998;44:1305-1313 (C) 1998 Society of Biological Psychiatry.
引用
收藏
页码:1305 / 1313
页数:9
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