title: Neurologic soft signs in chronic posttraumatic stress disorder.
abstract: BACKGROUND
  Subtle neurologic impairment has been reported in several mental disorders. The goals of the present study were to evaluate neurologic status in patients of both sexes with chronic posttraumatic stress disorder (PTSD) from different traumatic experiences.
  
  
  METHODS
  Twenty-one adult women who were sexually abused as children (12 with PTSD, 9 without) and 38 male Vietnam War combat veterans (23 with PTSD, 15 without) underwent examination for 41 neurologic soft signs, which were scored by the examiner as well as a blind rater observing videotapes. Subject history was obtained with special attention to neurodevelopmental problems. Psychometrics included the Wender Utah Rating Scale for symptoms of childhood attention-deficit/hyperactivity disorder and the Michigan Alcoholism Screening Test. Veterans also completed the Combat Exposure Scale and subtests of the Wechsler Adult Intelligence Scale-Revised.
  
  
  RESULTS
  Average neurologic soft sign scores (interrater reliability = 0.74) of women with PTSD owing to sexual abuse in childhood (mean [SD], 0.77 [0.32]) and veteran men (0.72 [0.20]) with combat-related PTSD were comparable and significantly (P<.001) higher than those of women sexually abused as children (0.42 [0.10]) and combat veteran men (0.43 [0.17]) without PTSD. This effect could not be explained by a history of alcoholism or head injury. Subjects with PTSD reported more neurodevelopmental problems and more childhood attention-deficit/hyperactivity disorder symptoms and had lower IQs, all of which were significantly correlated with neurologic soft signs.
  
  
  CONCLUSIONS
  Neurologic compromise is evident from subject history and findings from physical examination in both women and men with chronic PTSD who had experienced different kinds of traumatic events in childhood and adulthood.
authors.affiliation: Veterans Affairs Medical Center, Manchester, NH, USA.
authors.forename: T V
authors.initials: TV
authors.lastname: Gurvits
authors.forename: M W
authors.initials: MW
authors.lastname: Gilbertson
authors.forename: N B
authors.initials: NB
authors.lastname: Lasko
authors.forename: A S
authors.initials: AS
authors.lastname: Tarhan
authors.forename: D
authors.initials: D
authors.lastname: Simeon
authors.forename: M L
authors.initials: ML
authors.lastname: Macklin
authors.forename: S P
authors.initials: SP
authors.lastname: Orr
authors.forename: R K
authors.initials: RK
authors.lastname: Pitman
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology; D009460:Neurologic Examination; D011581:Psychological Tests; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology