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Biomedical subjects

A Y Shalev

Publications and source records attributed to A Y Shalev.

59 records · Page 4Linked to original sources

Auditory startle response during exposure to war stress.

This report describes the immediate effect of war stress on physiological measures of the auditory startle responses (ASRs). Ten healthy Israeli subjects were examined 4 months before the Gulf war, during a missile alert on the first day of the war, and 8 months after the war. The magnitude and rate of habituation of orbicularis oculi electromyogram (EMG), heart rate (HR), and skin conductance (SC) responses to 15 consecutive presentations of 95-dB, 0-rise time, 1,000-Hz pure tones were recorded on each occasion, along with self-reports of anxiety. The group's anxiety scores were significantly higher during the war. ASRs, in contrast, remained stable across exposure conditions. However, a decrease in SC habituation was observed in few individuals during the war, and may illustrate a distinctive vulnerability to stress. The results are discussed in light of recent findings of abnormal startle response in posttraumatic stress disorder (PTSD).

Acoustic Stimulation↗

Psychophysiologic assessment of mental imagery of stressful events in Israeli civilian posttraumatic stress disorder patients.

This study explored the physiological responses of posttraumatic stress disorder (PTSD) patients to reminders of a stressful event that had preceded the onset of their illness and was not related to its cause: the SCUD missile alarms of the Gulf War. A mental-imagery technique used in previous studies of PTSD was used. Three 30-second audiotapes were presented to each subject, including (1) the Gulf War's missile alarm, (2) a radio announcement of a terrorist attack, and (3) a standardized relaxing scene. Subjects were instructed to imagine each event as vividly as possible while heart rate (HR), skin conductance (SC), and left lateral frontalis electromyogram (EMG) responses were measured. The responses of 12 outpatients with PTSD were compared with those of panic disorder patients (n = 11), survivors of traumatic events who had not developed PTSD (n = 9), and mentally healthy subjects with no lifetime history of major trauma (n = 19). Multivariate analysis of variance (MANOVA) for the three physiological measures showed a significant group difference during imagery of the Gulf War alarm, with PTSD subjects showing higher SC and EMG responses than the others. The differences remained significant when age, level of distress during the war, and concurrent anxiety were controlled for. There were no group differences in responses to the other stimuli. We conclude that, PTSD patients may either acquire and maintain prolonged conditioned responses to various stressors during their life span or become sensitized to reminders of past traumata following the onset of their illness. Heightened conditionability may be expressed before the trauma in subjects who are liable to develop PTSD.

Adult↗

The impact of parental death versus separation from parents on the mental health of Israeli adolescents.

Early research suggested that the loss of a parent during childhood can lead to depression and other psychopathology in children and adults. More recent research has differentiated between loss due to death and separation from parents and has questioned the link between early parental death and psychopathology. We examined the hypothesis that separation from parents has a more detrimental effect than the death of a parent on the mental health of adolescents in the community. Israeli adolescents (N = 844) with a mean age of 16.7 +/- 1.0 years (mean +/- SD) participated in this study. Seventy reported that a parent did not live at home during one of three 5-year periods until they reached the age of 15; 37 reported the death of a parent and 777 were from intact families. All participants completed the Brief Symptom Inventory (BSI), General Well Being Schedule (GWB), Parental Bonding Instrument (PBI), and Perceived Social Support Family/ Friends Scales (PSS-Fam and PSS-Fr). Adolescents who had experienced separation from parents had more psychiatric symptoms (BSI), expressed a lower sense of well-being (GWB), experienced less support from their family (PSS-Fam), and felt less cared for and more controlled by their parents (PBI) compared with those belonging to intact families. The death of a parent was not associated with significantly different scores on these variables. When we controlled for parental bonding (PBI) and perceived social support from family (PSS-Fam), the differences between the separation group and the intact family group were no longer significant. The psychological impact of separation from parents involves a greater risk for psychopathology than the death of a parent. The quality of the relationship with the parents moderates the negative impact of separation from them.

Adolescent↗

Psychophysiology of the posttraumatic stress disorder: from sulfur fumes to behavioral genetics.

Neurophysiological hypotheses regarding the body-mind relationship in stress disorders have been formulated more than 300 years ago. In 1941 Abraham Kardiner ascribed the name "physioneurosis" to the condition known today as posttraumatic stress disorder (PTSD). Psychophysiological studies of PTSD started with the demonstration of increased responsiveness to external stimuli reminiscent of the traumatic event. Later, abnormal responses to mental imagery were studied, and these studies have resulted in new tools for the assessment and diagnosis of the disorder. Recent studies focus on responses to elementary stimulation, such as the auditory startle reflex, thereby exploring basic CNS routines of habituation and stimulus-discrimination. This article reviews the rapidly expanding literature on the psychophysiology of PTSD. Special emphasis is given to recent studies of the auditory startle and to their implications for the neurobiology of PTSD.

Humans↗

Treatment of posttraumatic stress disorder: a review.

This article analyzes the literature on the treatment of posttraumatic stress disorder (PTSD). It briefly exposes the theoretical basis for each treatment modality and extensively examines pharmacological, behavioral, cognitive, and psychodynamic therapies, as well as group and family therapies, hypnosis, inpatient treatment, and rehabilitation. Articles were identified by scanning Medline and PsychLit for all papers in English reporting treatment of PTSD. Anecdotal case reports were, then, excluded. Eighty one articles were identified and categorized as either biological or psychological, with the latter category further divided into behavioral, cognitive, psychodynamic, and other treatment modalities. Information regarding the type of trauma, the sample studied, the treatment method, and the results of the treatment has been extracted from each article and is presented briefly. A synthesis of findings in each area is provided. Most studies explored a single treatment modality (e.g., pharmacological, behavioral). The cumulated evidence from these studies suggests that several treatment protocols reduce PTSD symptoms and improve the patient's quality of life. The magnitude of the results, however, is often limited, and remission is rarely achieved. Given the shortcoming of unidimensional treatment of PTSD, it is suggested that combining biological, psychological, and psychosocial treatment may yield better results. It is further argued that rehabilitative goals should replace curative techniques in those patients with chronic PTSD. A framework for identifying targets for each treatment modality is presented.

Behavior Therapy↗