title: Startle reactivity in the long-term after severe accidental injury: preliminary data.
abstract: An exaggerated startle response is one of the core hyperarousal symptoms of posttraumatic stress disorder (PTSD). Heightened startle eye-blink magnitude and reduced habituation of this response in PTSD patients have been reported in several studies. However, it is unclear whether this is an enduring characteristic of individuals vulnerable for PTSD or to which degree trauma-exposed individuals who do not develop PTSD also show exaggerated startle. Thirteen accident survivors with remitted PTSD, 12 trauma controls, and 16 non-trauma controls were examined. Four measures of startle reactivity were analyzed in response to 15 bursts of white noise (95 dB, 50 ms): eye-blink magnitude, eye-blink onset latency, skin conductance response, and heart rate response. The eye-blink reflex was measured over the left musculus orbicularis oculi. Reactivity and habituation were analyzed using linear mixed models. Remitted PTSD subjects did not differ from non-trauma controls regarding any of the startle reactivity or habituation measures. Unexpectedly, trauma controls showed larger eye-blink magnitude than non-trauma controls. These results suggest that the exaggerated startle response disappears after remission from PTSD. Further, they suggest that psychologically resilient trauma survivors might show a PTSD-like pattern of exaggerated physiological startle even many years after a traumatic event.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland. Electronic address: sonja.schumacher@usz.ch.
authors.forename: Sonja
authors.initials: S
authors.lastname: Schumacher
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.forename: Michael
authors.initials: M
authors.lastname: Furrer
authors.forename: Christoph
authors.initials: C
authors.lastname: Mueller-Pfeiffer
authors.forename: Frank H
authors.initials: FH
authors.lastname: Wilhelm
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Moergeli
authors.forename: Misari
authors.initials: M
authors.lastname: Oe
authors.forename: Chantal
authors.initials: C
authors.lastname: Martin-Soelch
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D001767:Blinking / Q000502:physiology; D004576:Electromyography; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006185:Habituation, Psychophysiologic / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D013216:Reflex, Startle / Q000502:physiology*; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D017741:Survivors / Q000523:psychology; D015599:Trauma Severity Indices
keywords: Post-traumatic stress disorder (PTSD); Psychophysiology; Startle; Trauma