This project's objective is to test the validity of the post-traumatic stress disorder (PTSD) diagnosis as the result of childhood sexual abuse, by utilizing an assessment method that has been validated in PTSD arising from other (military and civilian) sources in four previous studies, viz., measurement of physiologic responses during personal, script-driven imagery. The responses of medication-free, adult women during imagery of their personal sexual abuse experiences as children will be measured. Subjects will be diagnosed into PTSD, past-PTSD, and non-PTSD groups. Thirty- second """"""""scripts"""""""" will be prepared with the aid of the subject describing various past life experiences, including specific episodes of child sexual abuse. The scripts will incorporate subjective visceral and muscular reactions that the subject remembered accompanied each experience. The scripts will be recorded for playback in the psychophysiology laboratory, where the subject will be instructed to imagine the events the scripts portray, while heart rate, skin conductance, and facial muscle electromyograms are recorded. The data will be analyzed by means of multivariate analysis of variance (MANOVA) and discriminant function analysis. The role of potentially confounding variables will be assessed by means of multivariate analysis of covariance (MANCOVA), with factors such as overall trauma exposure, face severity of the specific abuse episodes studied, anxiety, depression, dissociation, and hypnotic suggestibility used as covariates. Data from a subset of subjects with substantiated abuse episodes will be examined separately and the results compared with those from the full data set. In addition, the physiologic responses of the child abuse subjects will be compared with the responses of military and civilian, PTSD and non-PTSD trauma victims already studied with the same methodology. The success of a discriminant function derived from published studies with earlier subjects in classifying PTSD and non-PTSD child abuse subjects will be examined.
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