TITLE

Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview

AUTHOR(S)
Kolassa, Iris-Tatjana; Eckart, Cindy; Ruf, Martina; Neuner, Frank; De Quervain, Dominique J. F.; Elbert, Thomas
PUB. DATE
January 2007
SOURCE
BMC Psychiatry;2007, Vol. 7, p54
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD) requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences. Methods: Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS) task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time. Results: Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s) and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD. Conclusion: A comprehensive diagnostic interview including questions about traumatic events does not trigger an HPA-axis based alarm response or changes in psychological measures, even for persons with severe PTSD, such as survivors of torture. Thus, addressing traumatic experiences within a safe and empathic environment appears to impose no unacceptable additional load to the patient.
ACCESSION #
29962964

 

Related Articles

  • Polne razlike kod �rtava ratne torture s obzirom na vrste mucenja i psiholo�ke posledice. �piric, �eljko; Opacic, Goran; Jovic, Vladimir; Samard�ic, Radomir; Kne�evic, Goran; Mandic-Gajic, Gordana; Todorovic, Milorad // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;May2010, Vol. 67 Issue 5, p411 

    Background/Aim. Torture for political reasons is an extreme violence in interpersonal relations resulting in not only acute psychiatric disorders but also very often in very severe and far reaching negative consequences for the overall psychosocial functioning of a victim. The aim of this study...

  • Somali and Oromo Refugees: Correlates of Torture and Trauma History. Jaranson, James M.; Butcher, James; Halcon, Linda; Johnson, David Robert; Robertson, Cheryl; Savik, Kay; Westermeyer, Joseph; Spring, Marline // American Journal of Public Health;Apr2004, Vol. 94 Issue 4, p591 

    Objectives. This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems. Methods. A comprehensive questionnaire was developed, then administered by trained ethnic...

  • Impact of torture on refugees displaced within the developing world. Shrestha, Nirakar Man; Sharma, Bhogendra; Van Ommeren, Mark; Regmi, Shyam; Makaju, Ramesh; Komproe, Ivan; Shrestha, Ganesh B.; De Jong, Joop T.V.M. // JAMA: Journal of the American Medical Association;8/5/98, Vol. 280 Issue 5, p443 

    Relates results of a case-control survey examining the impact of torture on Bhutanese refugees in Nepal. Design of survey; Setting; Participants; Main outcome measures; Results; Conclusions; Effects of depression, anxiety, and posttraumatic stress disorder; Predictors of prevalence of effects.

  • IMPACT OF MULTIDISCIPLINARY TREATMENT ON QUALITY OF LIFE AND POSTTRAUMATIC GROWTH WITHIN WAR TORTURE SURVIVORS. Salčić, Dubravka; Fadilpašić, Senadin; Mehmedbašić, Alma Bravo // Medical Journal;oct-dec2009, Vol. 15 Issue 4, p173 

    Aim of this article is to assess quality of life and the level of posttraumatic growth in posttraumatic society within war torture survivors included in multidisciplinary treatment. Research sample consisted of 128 clients from Canton Sarajevo and town Stolac. All clients experienced war torture...

  • FINDINGS FROM AROUND THE WORLD: Short- and Long-Term Effects on the Victims of Terror in Sri Lanka. Somasundaram, Daya; Danieli, Yael; Brom, Danny; Sills, Joe // Trauma of Terrorism: Sharing Knowledge & Shared Care, An Interna;2005, Vol. 10 Issue 1-4, p215 

    Due to two decades of ethnic war in Sri Lanka, victims of terror have been profoundly affected psychologically and socially. The impact is seen at the individual, family, and community levels. Epidemiological surveys show that civilians have experienced widespread traumatization, with high...

  • Brief mental health interventions in conflict and emergency settings: an overview of four Medecins Sans Frontieres - France programs. Coldiron, Matthew E.; Llosa, Augusto E.; Roederer, Thomas; Casas, German; Moro, Marie-Rose // Conflict & Health; 

    Introduction Mental health problems, particularly anxiety and mood disorders, are prevalent in the setting of humanitarian emergencies, both natural and man-made disasters. Evidence regarding best strategies for therapeutic interventions is sparse. Médecins Sans Frontières has been...

  • Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement. Onyut, Lamaro P.; Neuner, Frank; Schauer, Elisabeth; Ertl, Verena; Odenwald, Michael; Schauer, Maggie; Elbert, Thomas // BMC Psychiatry;2005, Vol. 5, p7 

    Background: Little data exists on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD) that has resulted from exposure to war or conflict-related violence, especially in non-industrialized countries. We created and evaluated the efficacy of...

  • MEDICINE AND THE MEDIA. Summerfield, Derek // BMJ: British Medical Journal (International Edition);11/12/94, Vol. 309 Issue 6964, p1309 

    Relates the experience of the author during the world war in Great Britain. Memories of the war; Development of post-traumatic stress; Need for a psychological counseling for war veterans.

  • Group crisis intervention for children during ongoing war conflict. Thabet, Abdel Aziz; Vostanis, Panos; Karim, Khalid // European Child & Adolescent Psychiatry;Aug2005, Vol. 14 Issue 5, p262 

    The aim of this study was to evaluate the short-term impact of a group crisis intervention for children aged 9–15 years from five refugee camps in the Gaza Strip during ongoing war conflict. Children were selected if they reported moderate to severe posttraumatic stress reactions, and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics