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Concordance between physiological arousal and subjective distress among vietnam combat veterans undergoing challenge testing for PTSD

Authors

  • Brian P. Marx,

    Corresponding author
    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
    • Correspondence concerning this article should be addressed to Brian P. Marx, National Center for PTSD, VA Boston Healthcare System (116B-4), 150 South Huntington Avenue, Boston, MA 02130.
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  • Michelle J. Bovin,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Michael K. Suvak,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychology, Suffolk University, Boston, Massachusetts, USA
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  • Candice M. Monson,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    Current affiliation:
    1. Ryerson University, Toronto, CA
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  • Denise M. Sloan,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
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  • Steffany J. Fredman,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
    Current affiliation:
    1. Massachusetts General Hospital, Boston, MA
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  • Kathryn L. Humphreys,

    1. Department of Psychology, University of California, Los Angeles, California, USA
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  • Danny G. Kaloupek,

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
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  • Terence M. Keane

    1. National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
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  • This research was supported by the VA Cooperative Studies Program of the Veterans Health Administration under designation CS-334.

Abstract

This study examined concordance between physiological arousal and subjective distress during a laboratory challenge task. Data were collected during the multisite VA Cooperative Study 334 in the early 1990s examining psychophysiological arousal among combat-exposed Vietnam veterans with (n = 775) and without (n = 369) posttraumatic stress disorder (PTSD). Study participants were presented with 6 standardized neutral scenes and 6 standardized combat scenes. Participants provided a subjective rating of distress after each slide. During the presentation, levels of heart rate (HR) and skin conductance (SC) were recorded. Using linear mixed effects modeling, both HR level and SC level exhibited significant positive associations with subjective distress ratings (pr = .33, p < .001 and pr = .19, p < .001, respectively). Individuals with PTSD demonstrated greater concordance between their distress ratings and SC level during exposure to combat slides than participants without PTSD (pr = .28, p < .001 vs. pr = .18, p < .001). Although a significant association was found between subjective distress and HR reactivity and SC reactivity, these findings were not moderated by PTSD status. The results of these analyses suggest that patients' reports of distress during exposure-based treatments might serve as approximate measures of actual physiological arousal.

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