title: The effect of nicotine and trauma context on acoustic startle in smokers with and without posttraumatic stress disorder.
abstract: BACKGROUND
  Exaggerated startle response is a prominent feature of posttraumatic stress disorder (PTSD) although results examining differences in the acoustic startle response (ASR) between those with and without PTSD are mixed. One variable that may affect ASR among persons with PTSD is smoking. Individuals with PTSD are more likely to smoke and have greater difficulty quitting smoking. While smokers with PTSD report that smoking provides significant relief of negative affect and PTSD symptoms, the effects of smoking or nicotine deprivation on startle reactivity among smokers with PTSD are unknown.
  
  
  OBJECTIVE
  The purposes of the current study were to (1) examine baseline acoustic startle response (ASR) in smokers with and without PTSD under conditions of overnight abstinence, (2) evaluate the effect of smoking on ASR, and (3) evaluate the contextual effects of trauma versus neutral script presentations.
  
  
  METHODS
  ASR was measured among 48 smokers with and without PTSD in the context of a 2 (group: PTSD vs. non-PTSD) x 2 (context: trauma vs. neutral) x 3 (smoking condition: usual brand cigarette vs. denicotinized cigarette vs. no smoking) design.
  
  
  RESULTS
  Effects of modest size indicated that (1) PTSD participants demonstrated higher ASR (2) compared to non-PTSD participants, PTSD participants reported greater negative affect following a trauma-related script, and (3) following a trauma-related script and smoking a usual brand cigarette, PTSD participants demonstrated higher ASR.
  
  
  CONCLUSIONS
  Although many smokers with PTSD report that smoking reduces PTSD symptoms, results suggest that smoking may actually potentiate or maintain an exaggerated startle response.
authors.affiliation: VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA. Patrick.calhoun2@va.gov
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.forename: F Joseph
authors.initials: FJ
authors.lastname: McClernon
authors.forename: Sherman
authors.initials: S
authors.lastname: Lee
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Dennis
authors.forename: Scott R
authors.initials: SR
authors.lastname: Vrana
authors.forename: Carolina P
authors.initials: CP
authors.lastname: Clancy
authors.forename: Claire F
authors.initials: CF
authors.lastname: Collie
authors.forename: Yashika C
authors.initials: YC
authors.lastname: Johnson
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D002248:Carbon Monoxide / Q000378:metabolism; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000494:pharmacology*; D018722:Nicotinic Agonists / Q000494:pharmacology*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D013216:Reflex, Startle / Q000187:drug effects*; D055139:Sensory Gating / Q000187:drug effects / Q000502:physiology*; D012720:Severity of Illness Index; D012907:Smoking / Q000503:physiopathology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine; D002248:Carbon Monoxide