title: Posttraumatic stress disorder: do electrical startle responses and thyroid function usefully supplement self-report? A study of Vietnam War veterans.
abstract: OBJECTIVE
  To investigate the usefulness of electrical startle responses and thyroid function as supplements to self-report measures of posttraumatic stress disorder (PTSD).
  
  
  METHODS
  Invitations were sent to all New Zealand Vietnam War veterans known to be living in North Canterbury; 50 responded and the 35 living in or near Christchurch were included. Self-report measures of PTSD (the Davidson Trauma Scale (DTS) and the Symptom Check List (SCL-90-R) ), an eye blink electrical startle response and thyroid function were measured. The DTS was re-administered one to two weeks later to assess short-term test-retest reliability. Six months later the DTS and the electrical startle response were measured again.
  
  
  RESULTS
  The veterans reported a wide range of PTSD severity, with 15/35 reporting prior diagnosis of PTSD. The DTS showed high short-term test-retest reliability (r = 0.93) and a moderate correlation after 6 months (r = 0.73). It also showed sensitivity to change; in one to two weeks the scores increased by nearly half a standard deviation, possibly because of an imminent "homecoming" march. The DTS and a PTSD scale from the SCL-90-R were highly correlated (r = 0.89). The total triiodothyronine (T3) to free thyroxine (T4) ratio measure of thyroid function correlated poorly with self-report (r < or = 0.27). The electrical startle response also correlated poorly with self-report (r < or = 0.26), showed low internal consistency between left and right sides (r = 0.43), and correlated 0.39 over six months. It was disliked by the veterans and had increased slightly at 6 month follow-up, perhaps because of sensitization.
  
  
  CONCLUSIONS
  The DTS was reliable and correlated highly with the SCL-90-R PTSD scale. Neither thyroid function nor eye blink electrical startle correlated with each other or with self-report, and reliability was not good for electrical startle. These two measures do not appear to add anything useful to the assessment of PTSD.
authors.affiliation: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. elisabeth.wells@chmeds.ac.nz
authors.forename: J Elisabeth
authors.initials: JE
authors.lastname: Wells
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Williams
authors.forename: Alastair D
authors.initials: AD
authors.lastname: Macleod
authors.forename: Grant J
authors.initials: GJ
authors.lastname: Carroll
mesh_terms: D000368:Aged; D001767:Blinking; D004558:Electric Stimulation; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D013216:Reflex, Startle; D012647:Self-Assessment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000503:physiopathology*; D014728:Veterans / Q000523:psychology