title: Psychophysiological characteristics of pediatric posttraumatic stress disorder during script-driven traumatic imagery.
abstract: BACKGROUND
  Psychophysiological alterations such as elevated baseline levels and hyperresponsivity in cardiac, electrodermal, and facial muscle activity have been observed in adults with posttraumatic stress disorder (PTSD). There are only few, inconclusive studies investigating psychophysiological responses in children and adolescents with PTSD.
  
  
  OBJECTIVE
  This cross-sectional study sought to examine if autonomic variables, facial electromyography (EMG), and self-reported anxiety at baseline, while listening to neutral and idiosyncratic trauma scripts, differ between minors with a trauma history and PTSD, and a traumatized control (TC) group without PTSD. A better understanding of psychophysiological reactions in trauma-exposed children and adolescents could improve differential assessment and treatment decisions.
  
  
  METHODS
  PTSD was assessed using the Clinician Administered PTSD Scale for Children and Adolescents in 6- to 17-year-old trauma-exposed children, resulting in a group with PTSD according to DSM-IV (n=16) and a TC group without PTSD (n=18). Facial EMG, (para-)sympathetic measures (heart rate, electrodermal activity, respiratory sinus arrhythmia), and self-reported anxiety were measured during 5-min baseline, 3-min neutral script, and 3-min idiosyncratic trauma script. Baseline, reactivity (trauma minus baseline), and script contrast (trauma minus neutral) were analyzed by multivariate analyses of variance.
  
  
  RESULTS
  Children and adolescents with PTSD reported more anxiety compared to TC for baseline, reactivity, and script contrast (ps<0.021, ds>0.59), and showed elevated corrugator supercilii muscle activity for script contrast (p<0.05, d=0.79). No group differences emerged for sympathetic or parasympathetic measures.
  
  
  CONCLUSIONS
  Children and adolescents with PTSD experienced elevated anxiety at baseline and elevated anxiety and facial corrugator muscle response to an idiosyncratic trauma narrative. Autonomic hyperreactivity, typical for adult PTSD samples, did not figure prominently.
authors: Clinic for Child and Adolescence Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany; lutz.goldbeck@uniklinik-ulm.de.
authors: Veronica
authors: V
authors: Kirsch
authors: Department of Psychology, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
authors: Frank H
authors: FH
authors: Wilhelm
authors: Clinic for Child and Adolescence Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
authors: Lutz
authors: L
authors: Goldbeck
keywords: Psychophysiology; autonomic nervous system; electromyography; idiosyncratic trauma script; posttraumatic stress disorder; trauma