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Impairments in mechanisms underlying early information processing have been reported in posttraumatic stress disorder (PTSD); however, findings in the existing literature are inconsistent. This current study capitalizes on technological advancements of research on electroencephalographic event-related potential and applies it to a novel PTSD population consisting of trauma-affected refugees.
A total of 25 trauma-affected refugees with PTSD and 20 healthy refugee controls matched on age, gender, and country of origin completed the study. In two distinct auditory paradigms sensory gating, indexed as P50 suppression, and sensorimotor gating, indexed as prepulse inhibition (PPI), startle reactivity, and habituation of the eye-blink startle response were examined. Within the P50 paradigm, N100 and P200 amplitudes were also assessed. In addition, correlations between psychophysiological and clinical measures were investigated.
PTSD patients demonstrated significantly elevated stimuli responses across the two paradigms, reflected in both increased amplitude of the eye-blink startle response, and increased N100 and P200 amplitudes relative to healthy refugee controls. We found a trend toward reduced habituation in the patients, while the groups did not differ in PPI and P50 suppression. Among correlations, we found that eye-blink startle responses were associated with higher overall illness severity and lower levels of functioning.
Fundamental gating mechanisms appeared intact, while the pattern of deficits in trauma-affected refugees with PTSD point toward a different form of sensory overload, an overall neural hypersensitivity and disrupted the ability to down-regulate stimuli responses. This study represents an initial step toward elucidating sensory processing deficits in a PTSD subgroup.
Little evidence exists on the treatment of traumatised refugees.
To estimate treatment effects of flexible cognitive–behavioural therapy
(CBT) and antidepressants (sertraline and mianserin) in traumatised
Randomised controlled clinical trial with 2×2 factorial design
(registered with Clinicaltrials.gov, NCT00917397, EUDRACT no.
2008-006714-15). Participants were refugees with war-related traumatic
experiences, post-traumatic stress disorder (PTSD) and without psychotic
disorder. Treatment was weekly sessions with a physician and/or
psychologist over 6 months.
A total of 217 of 280 patients completed treatment (78%). There was no
effect on PTSD symptoms, no effect of psychotherapy and no interaction
between psychotherapy and medicine. A small but significant effect of
treatment with antidepressants was found on depression.
In a pragmatic clinical setting, there was no effect of flexible CBT and
antidepressants on PTSD, and there was a small-to-moderate effect of
antidepressants and psychoeducation on depression in traumatised
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