PTSD, as defined by DSM-III-R, is an anxiety disorder involving both somatic and psychological symptoms which occur in response to severe trauma, including combat, natural and man-made disasters, hostage situations, rape and assault. The disorder is notoriously difficult to diagnose and treat due to the severity and recurrent nature of the syndrome and the frequent concurrent diagnoses of depression, anxiety disorder, and/or substance abuse. The results of the Principal Investigator's (PI's) previous studies have suggested that combat veterans with chronic PTSD can be differentiated from other groups of psychiatric patients on the basis of differences in several neuroendocrine and neurotransmitter measures, including urinary, cortisol, norepinephrine, epinephrine, dopamine, and testosterone. The PI has been able to utilize the statistical techniques of Stepwise Discriminant Analysis and Multidimensional Scaling to correctly classify Vietnam Veterans with PTSD from other diagnostic groups.She has also found associations between many of the hormonal changes and severity of specific PTSD symptom clusters. Given the distinct constellation of hormonal changes in war-related PTSD, the findings have implications as a biological approach which may offer information relevant to the definition and differential diagnosis of this disorder in symptomatic individuals. The proposed study is designed to explore the generalizability of this hormone profile in other stressed populations with chronic PTSD by applying the same methodology utilized in studies of combat veterans to the study of Holocaust survivors. The hypothesis is that the Holocaust survivors with PTSD will manifest stable, hormonal changes similar to those observed in combat veterans, even 45 years following chronic stress exposure. To test this hypothesis, hormonal assessments will be made in Holocaust survivors and in a group of demographically matched controls. Two Holocaust survivor groups, one with PTSD and one without PTSD, will be used in order to examine whether the hormonal changes observed are a reflection of exposure to stress, or rather are indications of a traumatic stress disorder, and as such can be diagnostically useful. Furthermore, both males and females will be studied in order to test the applicability of the hormone methodology to the study of women with PTSD.
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