Changes in trauma-potentiated startle, skin conductance, and heart rate within prolonged exposure therapy for PTSD in high and low treatment responders

•Psychophysiological data are important indices for investigating treatment response.•We tested startle, heart rate, and skin conductance in exposure therapy for PTSD.•Trauma-potentiated startle demonstrated differences in high and low responders. While exposure-based psychotherapy is recommended as...

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Published in:Journal of anxiety disorders 2019-12, Vol.68, p.102147-102147, Article 102147
Main Authors: Maples-Keller, Jessica L., Rauch, Sheila A.M., Jovanovic, Tanja, Yasinski, Carly W., Goodnight, Jessica Morgan, Sherrill, Andrew, Black, Kathryn, Michopoulos, Vasiliki, Dunlop, Boadie W., Rothbaum, Barbara Olasov, Norrholm, Seth Davin
Format: Article
Language:English
Subjects:
Exposure therapy
Prolonged exposure
Psychophysiology
PTSD
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Summary:•Psychophysiological data are important indices for investigating treatment response.•We tested startle, heart rate, and skin conductance in exposure therapy for PTSD.•Trauma-potentiated startle demonstrated differences in high and low responders. While exposure-based psychotherapy is recommended as a first-line treatment for posttraumatic stress disorder (PTSD) given strong evidence for its effectiveness, some patients fail to receive full benefit. Psychophysiological data may be important complementary indices for investigating variability in treatment response and changes over the course of treatment. The focus of the present investigation was to examine change in psychophysiological indices pre- to post-treatment and to investigate if changes differed for high versus low PTSD treatment responders. Participants included veterans with primary PTSD diagnoses who received a two-week intensive prolonged exposure (PE) treatment. Psychophysiological assessment included trauma-potentiated startle, heart rate, and skin conductance recordings during presentation of three standard virtual reality (VR)-based, trauma-relevant scenes presented through a head mounted display. Results indicate that 48.6% were classified as high treatment responders (≥50% reduction in PCL-5 from baseline). Trauma-potentiated startle was observed in all patients at pre-treatment, F = 13.58, p 
ISSN:0887-6185
1873-7897
DOI:10.1016/j.janxdis.2019.102147