Symptoms of Posttraumatic Stress Rather Than Mild Traumatic Brain Injury Best Account for Altered Emotional Responses in Military Veterans

• Published in: Journal of traumatic stress 2018-02, Vol.31 (1), p.114-124
• Main Authors: Marquardt, Craig A., Goldman, Daniel J., Cuthbert, Bruce N., Lissek, Shmuel, Sponheim, Scott R.
• Format: Article
• Language: English
• Subjects: Armed forces; Emotions; Post traumatic stress disorder; Psychopathology; Traumatic brain injury; Veterans
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22259

Emotional dysfunction is evident in posttraumatic stress disorder (PTSD), yet it is unclear what aspects of the disorder most directly relate to aberrant emotional responding. Also, the frequent co‐occurrence of blast‐related mild traumatic brain injuries (mTBIs) among recently deployed U.S. military personnel complicates efforts to understand the basis for emotional disruption. We studied a cross‐sectional sample (enriched for PTSD and mTBI) of 123 U.S. veterans of wars in Iraq and Afghanistan. We measured subjective affective evaluations and peripheral psychophysiological responses to images with pleasant, neutral, unpleasant, and combat‐related aversive content. When compared with other postdeployment participants, those who had combat‐related PTSD rated pleasant image content as less positive (ηp2 = .04) and less arousing (ηp2 = .06), and exhibited heightened physiological responsivity to combat image content (ηp2 = .07). Symptoms of PTSD were associated with elevated skin conductance responses (β = .28), reduced heart rate deceleration (β = .44 to .47), and increased corrugator facial muscle electromyography (β = .47). No effects for blast‐related mTBI were observed across any affective modulation measures. These findings point to a greater impact of PTSD symptomatology than blast‐related mTBI on emotional functioning and highlight the utility of dimensional assessments of psychopathology for understanding the effects of combat‐stress conditions on adjustment to civilian life. Resumen Spanish s by the Asociación Chilena de Estrés Traumático (ACET) Los Síntomas de Estrés Postraumático en lugar de las Lesiones Cerebrales Traumáticas Leves dan cuenta de las Respuestas Emocionales Alteradas en Veteranos Militares EFECTOS DEL TEPT EN LAS EMOCIONES La disfunción emocional es evidente en el Trastorno de Estrés Postraumático (TEPT), aunque no está claro qué aspectos del trastorno se relacionan de forma más directa a la respuesta emocional aberrante. Además, la frecuente co‐ocurrencia de lesiones cerebrales traumáticas leves (mTBI) relacionadas a explosiones entre el personal militar estadounidense recientemente desplegado, complica los esfuerzos para comprender las bases de la disrupción emocional. Estudiamos una muestra transversal (enriquecida para TEPT y mTBI) de 123 veteranos estadounidenses de las guerras de Iraq y Afganistán. Medimos evaluaciones afectivas subjetivas y respuestas psicofisiológicas periféricas a imágenes con contenido agradable, neutral,