title: Heart rate responsivity to script-driven imagery in posttraumatic stress disorder: specificity of response and effects of psychotherapy.
abstract: OBJECTIVE
  Previous psychophysiological studies of posttraumatic stress disorder (PTSD) have found heightened physiological responsivity to trauma-specific stimuli, but mostly in combat veterans with high comorbidity rates and with psychiatric medication. Our aim was to investigate psychophysiological responses in two new populations while excluding those confounding influences and to assess the effects of psychotherapy on such responses.
  
  
  METHODS
  Thirty-nine subjects with PTSD (24 civilian outpatients and 15 police officers) and 15 trauma-exposed, non-PTSD control subjects underwent psychophysiological assessment while listening to neutral, stressful, and trauma scripts. Psychophysiological measures were heart rate (HR) and blood pressure in combination with subjective anxiety ratings. In a randomized clinical trial, 20 of the civilians were then assigned to treatment or waitlist groups. Psychophysiological assessment was repeated on them after the treatment stage.
  
  
  RESULTS
  Both civilians and police with PTSD showed significantly higher HR responses to trauma scripts than the control subjects. After successful psychotherapy with the civilians, HR responsivity to the trauma scripts was significantly reduced, and it correlated positively with PTSD clinical symptoms.
  
  
  CONCLUSIONS
  We confirmed previous findings of heightened psychophysiological responses in PTSD for two new populations while minimizing comorbidity and medication as confounding factors. Successful psychotherapy normalized HR response to trauma imagery.
authors.affiliation: Centre for Psychological Trauma, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands. R.J.Lindauer@amc.uva.nl
authors.forename: Ramón T L
authors.initials: RT
authors.lastname: Lindauer
authors.forename: Els P M
authors.initials: EP
authors.lastname: van Meijel
authors.forename: Margje
authors.initials: M
authors.lastname: Jalink
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
authors.forename: Ingrid V E
authors.initials: IV
authors.lastname: Carlier
authors.forename: Berthold P R
authors.initials: BP
authors.lastname: Gersons
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011613:Psychotherapy; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy*