In reference to Summerfield's idea that PTSD is an invented disorder
constructed by society we would like to refer to the following findings.
Heart rate was found to be higher in 20 out of 86 emergency room
patients on admission and 1 week later, in those who were subsequently
diagnosed with PTSD at 4 months as oppose to those who did not develop
PTSD. The difference in heart rate was not related to physical injury,
trauma severity or to the intensity of the initial reaction. (Heart rate
did not predict subsequent depression or PTSD at 1 month) (Shalev, Sahar,
Freedman et al, 1998).
Lower levels of cortisol immediately subsequent to the time of trauma
were also found in victims later diagnosed with PTSD compared to those not
so diagnosed (Yehuda, McFarlane & Shakev, 1998).
Reduced hippocampal volume in individuals diagnosed with PTSD has
been replicated in four studies (Bremner, Randall, Scott et al,1995;
Bremner, Randall, Vermetten et al, 1997; Stein, Hanna, Koverola et al,
1997; Gurvitz, Shenton, Hokama et al, 1996) with the latter study clearly
demonstrating trauma-exposed individuals without PTSD do not have
significantly smaller hippocampal volumes compared with normal subjects.
These findings suggest that there is a physiological basis for the
diagnosis of PTSD independent of subjective account or social demand.
Fiona Eaton, PhD Student, Department of Psychology,
University of Stirling.
Ian Tierney, Chartered Clincial Psychologist, The Keil Centre,
Edinburgh
Reference List
Bremner D., Randall, P., Scott, T. N., & et al. (1995). MRI-based
measurements of hippocampal volume in combat-related posttraumatic stress
disorder. American Journal of Psychiatry., 152, 973-981.
Bremner, D., Randall, P., Vermetten, E., & et al. (1997). MRI-based
measurements of hippocampal volume in posttraumatic stress disorder
related to childhood physical and sexual abuse: a preliminary report.
Biological Psychiatry, 41, 23-32.
Gurvitz, T. V., Shenton, M. E., & Hokama, H. e. a. (1996). Magnetic
resonance imaging study of hippocampal volume in chronic, combat-related
posttraumatic stress disorder. Biological Psychiatry, 40, 1091-1099.
Shalev, A. Y., Sahar, T., Freedman, S., Peri, T., Glick, N., Brandes, D.,
Orr, S., & Pitman, R. K. (1998). A Prospective Study of Heart Rate
Response Following Trauma and the Subsequent Development of Posttraumatic
Stress Disorder. Archives of General Psychiatry. 55(6), 553-559.
Stein, M. B., Hanna, C., Koverola, C., Torchia, M., & McClarty, B.
(1997). Structural Brain Changes in PTSD. R. Yehuda, & A. C.
McFarlane (Eds.), Psychobiology of Posttraumatic Stress Disorder. (pp. 76-
82). New York.: New York Academy of Sciences.
Yehuda, R., McFarlane, AC., & Shalev, A. (1998). Predicting the
development of Posttraumatic Stress Disorder from the Acute Response to a
Traumatic Event. Biological Psychiatry., 44, 1305-1313.
Rapid Response:
Physical Correlates of PTSD
In reference to Summerfield's idea that PTSD is an invented disorder
constructed by society we would like to refer to the following findings.
Heart rate was found to be higher in 20 out of 86 emergency room
patients on admission and 1 week later, in those who were subsequently
diagnosed with PTSD at 4 months as oppose to those who did not develop
PTSD. The difference in heart rate was not related to physical injury,
trauma severity or to the intensity of the initial reaction. (Heart rate
did not predict subsequent depression or PTSD at 1 month) (Shalev, Sahar,
Freedman et al, 1998).
Lower levels of cortisol immediately subsequent to the time of trauma
were also found in victims later diagnosed with PTSD compared to those not
so diagnosed (Yehuda, McFarlane & Shakev, 1998).
Reduced hippocampal volume in individuals diagnosed with PTSD has
been replicated in four studies (Bremner, Randall, Scott et al,1995;
Bremner, Randall, Vermetten et al, 1997; Stein, Hanna, Koverola et al,
1997; Gurvitz, Shenton, Hokama et al, 1996) with the latter study clearly
demonstrating trauma-exposed individuals without PTSD do not have
significantly smaller hippocampal volumes compared with normal subjects.
These findings suggest that there is a physiological basis for the
diagnosis of PTSD independent of subjective account or social demand.
Fiona Eaton,
PhD Student,
Department of Psychology,
University of Stirling.
Ian Tierney,
Chartered Clincial Psychologist,
The Keil Centre,
Edinburgh
Reference List
Bremner D., Randall, P., Scott, T. N., & et al. (1995). MRI-based
measurements of hippocampal volume in combat-related posttraumatic stress
disorder. American Journal of Psychiatry., 152, 973-981.
Bremner, D., Randall, P., Vermetten, E., & et al. (1997). MRI-based
measurements of hippocampal volume in posttraumatic stress disorder
related to childhood physical and sexual abuse: a preliminary report.
Biological Psychiatry, 41, 23-32.
Gurvitz, T. V., Shenton, M. E., & Hokama, H. e. a. (1996). Magnetic
resonance imaging study of hippocampal volume in chronic, combat-related
posttraumatic stress disorder. Biological Psychiatry, 40, 1091-1099.
Shalev, A. Y., Sahar, T., Freedman, S., Peri, T., Glick, N., Brandes, D.,
Orr, S., & Pitman, R. K. (1998). A Prospective Study of Heart Rate
Response Following Trauma and the Subsequent Development of Posttraumatic
Stress Disorder. Archives of General Psychiatry. 55(6), 553-559.
Stein, M. B., Hanna, C., Koverola, C., Torchia, M., & McClarty, B.
(1997). Structural Brain Changes in PTSD. R. Yehuda, & A. C.
McFarlane (Eds.), Psychobiology of Posttraumatic Stress Disorder. (pp. 76-
82). New York.: New York Academy of Sciences.
Yehuda, R., McFarlane, AC., & Shalev, A. (1998). Predicting the
development of Posttraumatic Stress Disorder from the Acute Response to a
Traumatic Event. Biological Psychiatry., 44, 1305-1313.
Competing interests: No competing interests