1081 Associations Among REM Density And Parasympathetic Activity, Nightmares, And Hyperarousal In Trauma-exposed Individuals

Abstract Introduction Individuals with posttraumatic stress disorder (PTSD) exhibit autonomic hyperarousal and nightmares. We hypothesized that REM density (REMD) and REM heart rate variability would predict self-reported hyperarousal, nightmares, and PTSD diagnosis in trauma-exposed individuals. Methods Ninety-nine individuals (aged 18-40, 68 females) exposed to a DSM-5 PTSD criterion-A trauma within the past two years (48 meeting PTSD criteria) completed a night of ambulatory polysomnography (PSG) preceded by an acclimation night. REMD in scored sleep recordings were computed using the Matlab program written by Benjamin Yetton. Indices of parasympathetic tone during REM were computed using Kubios software and included Average Root Mean Square of the Successive Differences (RMSSD) and High Frequency power (HFpower). Participants completed two weeks of sleep diaries with nightmare questionnaire and completed the Clinician-Administered PTSD Scale (CAPS-5) and the PTSD Checklist for DSM-5 (PCL-5). Hyperarousal-item scores were computed from the PCL-5 without the sleep item (PCLhyp) and from the CAPS-5 (CAPShyp), and these scores (with their sleep items) were combined into a Composite Hyperarousal Index (CHI). Nightmare rate was the proportion of sleep diaries reporting a nightmare. Simple regressions measured associations among REMD, REM parasympathetic indices, hyperarousal measures, and nightmare rate. Results REMD did not significantly predict PTSD diagnosis or hyperarousal scores but did predict decreased parasympathetic activity for both RMSSD (p= 0.002, R= -0.316) and HFpower (p= 0.016 R= -0.250). REMD predicted increased nightmare rate (p= 0.011 R= 0.262). Parasympathetic tone was negatively correlated with CAPShyp, PCLhyp, and CHI for both RMSSD (p= 0.04, 0.011, <0.000, respectively) and HFpower (p= 0.051, 0.021, 0.010, respectively). Lower parasympathetic tone also predicted PTSD diagnosis with both RMSSD (p=0.012, t=2.559) and HFpower (p=0.010, t=2.627), but did not predict nightmare rate. Conclusion REMD predicted decreased parasympathetic tone and higher nightmare rate. Parasympathetic tone, but not REMD, predicted hyperarousal and PTSD diagnosis. Support R01MH109638

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1080 Self-reported Hyperarousal Predicts Lower Parasympathetic Activity During Slow-Wave Sleep In Trauma-exposed Individuals

SLEEP ◽

10.1093/sleep/zsaa056.1076 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A411-A411

Author(s):

T L Ragas ◽

K I Oliver ◽

C Daffre ◽

J Seo ◽

K Gannon ◽

...

Keyword(s):

Slow Wave ◽

High Frequency ◽

Stress Disorder ◽

Slow Wave Sleep ◽

Parasympathetic Activity ◽

Negatively Associated ◽

Dsm 5 ◽

The Past ◽

Ptsd Checklist ◽

Ptsd Scale

Abstract Introduction Hyperarousal and abnormal autonomic functioning are among the core manifestations of posttraumatic stress disorder (PTSD). In this study, we examined the association of parasympathetic activity during slow wave sleep (SWS) with self-reported hyperarousal measures in recently traumatized individuals. Methods Individuals exposed to a PTSD Criterion-A trauma within the past 2 years (N=76) aged 18-40 (mean 24.06, SD 4.76), of whom 43% met DSM-5 criteria for PTSD, underwent a night of ambulatory polysomnography (PSG) following an acclimation night. ECG recordings during SWS-sleep periods of at least 5 min were analyzed for 2 parasympathetic indices: Root Mean Square of the Successive Differences (RMSSD) and High Frequency (0.14-0.4Hz) power (HF power) using Kubios software. Hyperarousal indices included the hyperarousal items from the PTSD Checklist for DSM-5 (PCL-5) excluding the sleep item #20 (PCLhyp), those from the Clinician-Administered PTSD Scale (CAPS-5) including sleep items (CAPShyp), as well as a published Hyperarousal Scale (HAS) and Hypervigilance Questionnaire (HVQ). In addition, a Composite Hyperarousal Index (CHI) was computed from combined hyperarousal items on the PCL-5 and the CAPS-5 as well as the HAS total score. Results SWS RMSSD was negatively associated with PCLhyp (R = -.244, p = 0.035), CAPShyp (R = -.250, p = 0.03), CHI (R = -.280, p = 0.014), and HAS (R = -.229, p = 0.049). SWS HF power was negatively associated with CHI (R = -.227, p = 0.049). Conclusion The hyperarousal (Criterion E) symptoms of PTSD are associated with lowered parasympathetic tone during SWS across the spectrum of posttraumatic severity from resilient individuals to those diagnosed with PTSD. Support R01MH109638

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Supplemental Material for Reliable and Clinically Significant Change in the Clinician-Administered PTSD Scale for DSM-5 and PTSD Checklist for DSM-5 Among Male Veterans

Psychological Assessment ◽

10.1037/pas0001098.supp ◽

2021 ◽

Keyword(s):

Clinically Significant Change ◽

Dsm 5 ◽

Male Veterans ◽

Ptsd Checklist ◽

Ptsd Scale ◽

Significant Change ◽

Clinically Significant

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Reliable and clinically significant change in the clinician-administered PTSD Scale for DSM-5 and PTSD Checklist for DSM-5 among male veterans.

Psychological Assessment ◽

10.1037/pas0001098 ◽

2021 ◽

Author(s):

Brian P. Marx ◽

Daniel J. Lee ◽

Sonya B. Norman ◽

Michelle J. Bovin ◽

Denise M. Sloan ◽

...

Keyword(s):

Clinically Significant Change ◽

Dsm 5 ◽

Male Veterans ◽

Ptsd Checklist ◽

Ptsd Scale ◽

Significant Change ◽

Clinically Significant

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Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796014000365 ◽

2014 ◽

Vol 24 (5) ◽

pp. 415-422 ◽

Cited By ~ 11

Author(s):

K. Magruder ◽

D. Yeager ◽

J. Goldberg ◽

C. Forsberg ◽

B. Litz ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Diagnostic Performance ◽

Self Report ◽

Post Traumatic Stress ◽

Predictive Values ◽

Ptsd Diagnosis ◽

Twin Registry ◽

Vietnam Era ◽

Ptsd Checklist ◽

Ptsd Scale

Aims.Self-report questionnaires are frequently used in clinical and epidemiologic studies to assess post-traumatic stress disorder (PTSD). A number of studies have evaluated these scales relative to clinician administered structured interviews; however, there has been no formal evaluation of their performance relative to non-clinician administered epidemiologic assessments such as the Composite International Diagnostic Interview (CIDI). We examined the diagnostic performance of two self-report PTSD scales, the PTSD checklist (PCL) and the Vietnam Era Twin Registry (VET-R) PTSD scale, compared to the CIDI.Methods.Data were derived from a large epidemiologic follow-up study of PTSD in 5141 Vietnam Era Veterans. Measures included the PCL, VET-R PTSD scale and CIDI. For both the PCL and VET-R PTSD scale, ROC curves, areas under the curve (AUC), sensitivity, specificity, % correctly classified, likelihood ratios, predictive values and quality estimates were generated based on the CIDI PTSD diagnosis.Results.For the PCL and VET-R PTSD scale the AUCs were 89.0 and 87.7%, respectively. Optimal PCL cutpoints varied from the 31–33 range (when considering sensitivity and specificity) to the 36–56 range (when considering quality estimates). Similar variations were found for the VET-R PTSD, ranging from 31 (when considering sensitivity and specificity) to the 37–42 range (when considering quality estimates).Conclusions.The PCL and VET-R PTSD scale performed similarly using a CIDI PTSD diagnosis as the criterion. There was a range of acceptable cutpoints, depending on the metric used, but most metrics suggested a lower PCL cutpoint than in previous studies in Veteran populations.

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