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Is Acoustic Startle a Viable Exposure Protocol for Posttraumatic Stress Disorder? A Clinical Case Study

机译：惊吓是创伤后应激障碍的可行暴露方案吗？临床案例研究

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Exaggerated startle is a common symptom (based on Diagnostic and Statistical Manual of Mental Disorders [fourth edition] Criterion D) for many patients with posttraumatic stress disorder (PTSD). Findings from previous studies suggest that exaggerated startle may be due to trauma exposure or pretrauma vulnerability factors for PTSD development. The present clinical case study reports on a patient with PTSD characterized by a very prominent startle response and preference against standard trauma-related exposure strategies. On the basis of recent findings that interoceptive exposure exercises (e.g. shaking head side to side, hyperventilation) elicit trauma-related memories (Wald & Taylor, 2008), the authors sought to determine whether repeated application of an acoustic startle stimulus would serve to diminish the prominent startle response and facilitate exposure and overall symptom reduction by eliciting trauma-related memories. The protocol was successful in eliciting vivid and distressing trauma-related memories. Over the course of seven exposure trials, the patient demonstrated a decrease in distress elicited during the protocol, improved mood, and reduced general anxiety and trauma-related distress. He also reported significantly decreased startle response to loud noises encountered during activities of daily living. Although preliminary, these finding suggest that the acoustic startle protocol may be a viable (interoceptive) exposure strategy for individuals with PTSD, particularly those with exaggerated startle responses and those who are not amenable to standard trauma-related exposure strategies.View full textDownload full textKeywordsposttraumatic stress disorder, trauma-related exposure therapy, interoceptive exposure, startle, treatment outcomeRelated var addthis_config = { ui_cobrand: "Taylor & Francis Online", services_compact: "citeulike,netvibes,twitter,technorati,delicious,linkedin,facebook,stumbleupon,digg,google,more", pubid: "ra-4dff56cd6bb1830b" }; Add to shortlist Link Permalink http://dx.doi.org/10.1080/16506073.2010.529938
机译：对于许多创伤后应激障碍（PTSD）患者，夸张的惊吓是一种常见症状（根据《精神障碍诊断和统计手册》 [第四版]标准D）。先前研究的发现表明，惊吓夸张可能是由于创伤后暴露或创伤后应激障碍发展所致的创伤前易损因素。本临床案例研究报告了PTSD患者，其特征是非常突出的惊吓反应和对标准创伤相关暴露策略的偏爱。根据最近的发现，即在接触中进行的接触性锻炼（例如，左右摇头，换气过度）会引起创伤相关的记忆（Wald＆Taylor，2008年），作者试图确定重复施加听觉惊吓刺激是否有助于减少惊吓。显着的惊吓反应，并通过引起创伤相关的记忆来促进暴露和减轻总体症状。该协议成功引发了生动而令人痛苦的创伤相关记忆。在七项暴露试验的过程中，患者表现出方案期间引起的痛苦减轻，情绪改善，以及一般性焦虑和与创伤有关的痛苦减少。他还报告说，对日常生活活动中遇到的大声响声，惊吓反应明显降低。尽管是初步的，但这些发现表明，对于患有PTSD的患者，尤其是惊吓反应过大的患者以及不适合标准创伤相关暴露策略的患者，听觉惊吓协议可能是一种可行的（感知性）暴露策略。压力障碍，与创伤有关的暴露疗法，感受性暴露，惊吓，治疗结果google，more“，发布号：” ra-4dff56cd6bb1830b“};添加到候选列表链接永久链接http://dx.doi.org/10.1080/16506073.2010.529938

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