More interesting research on risk for PTSD

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Bill Glasheen
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More interesting research on risk for PTSD

Post by Bill Glasheen »

This is one of many threads addressing the mind-body issues in martial arts. Aspects of this are often topics on Van's Mindset forum. I endorse his interest in the field, and have done quite a bit of reading on the subject.

I highly recommend reading the works of Grossman and Goleman on the subject.

Here's a neat article from the Wall Street Journal about people doing cutting edge research on the ability to manage the stress of combat - both during and afterwards. Note the mention of LeDoux, a researcher often mentioned by Grossman and Laur.

- Bill
Valiant in Combat, Jittery at Home
A Scientist Pursues Theories
About Combat Performance
And Post-Traumatic Stress

May 16, 2007

Editor's Note: Lab Journal is a new Online Journal science column written by Journal editor Peter Landers. Each column introduces readers to a scientist working on intriguing problems in health and related fields.

Amid the rows of data in his lecture slides, Deane Aikins includes a picture of his late grandfather, a gunner on a U.S. Army plane in World War I who was shot down over enemy territory. The dashing Sgt. First Class Aikins sneaked across no-man's land to the Western Front and made it back home to Philadelphia with hardly a scratch.

But his hair turned shock-white and later in life, the distinguished soldier was an ornery character who clashed often with his sons, says Dr. Aikins, a psychologist and assistant professor at Yale University.

What explains the extraordinary performance of many soldiers in war -- and the emotional turmoil some experience upon their return? These are the puzzles that intrigue the 37-year-old scientist. His research has taken him to elite military training camps and to a VA hospital studying soldiers recently returned from Iraq.

Dr. Aikins has some noteworthy insights to show for his efforts. One new finding, which he plans to publish shortly, suggests that the fundamental problem in post-traumatic stress disorder is the brain improperly sending out alarm bells when there's nothing to be afraid of. He isn't the first to suggest this, but the theory goes against an alternative notion that those with PTSD are overreacting to fearful stimuli. Another study that he and colleagues published this year suggests that something as mundane as heart-rate variability has a surprising correlation to performance in the stress of combat.

PTSD is likely to be a public-health issue for decades to come. A study published last year in the Journal of the American Medical Association found that 9.8% of military personnel returning from Iraq in the year ending April 30, 2004, screened positive for PTSD. The rate was only 2.1% for those who hadn't served in either Iraq or Afghanistan.

While some have noted a reluctance to tackle PTSD among the military brass, Dr. Aikins says the rank-and-file also often shun mention of it. "They don't want to be sick," he says. "It's like talking to a high-school football team about prostate exams."

Dr. Aikins didn't serve in the military himself. After a doctorate in psychology at Penn State and a stint at the University of California, Los Angeles, he came to Yale's psychiatry department. Dr. Aikins's salary and research funding come mostly from the National Center for Posttraumatic Stress Disorder, a unit of the U.S. Department of Veterans Affairs that has a research branch in West Haven, Conn., near the Yale campus.

Some of Dr. Aikins's research centers on predictions of the performance of soldiers and sailors. One of his favorite measures is heart-rate variability. He and senior colleague Andy Morgan, an associate clinical professor at Yale, studied sailors at an elite Navy training school in Maine who spend days in the wilderness scrounging for food and shelter, get "captured" and undergo interrogation as a prisoner of war would.

Drs. Morgan and Aikins and colleagues reported this year in the journal Psychophysiology that sailors whose heart rates stayed steady prior to the exercise tended to get better grades in the test. The scientists repeated the experiment twice and found a statistically significant correlation each time. It seems that those able to keep their hearts beating in a regular tick-tock rhythm can concentrate better on their tasks than those whose heart rhythms vary under stress.

That's surprising, Dr. Aikins says, because a metronomic heart beat can indicate a person is insensitive to the environment -- often a signal of psychological problems. Dr. Aikins thinks the high-performing sailors in his study may have the ability to suppress a racing heart during short periods of high stress. But he isn't completely sure. Though the navy allowed him to study its sailors, he had just five minutes to test them just prior to their training exercise. "We are this intrusive bunch of eggheads" to them, he says, apologetically. Still, he thinks if the findings can be confirmed, soldiers and sailors might be taught to control their responses to stress, for example through breathing techniques or meditation, and improve their performance under fire.

For the moment, Dr. Aikins has turned his attention to PTSD. In a recent study, he and colleagues examined soldiers returned from Iraq with and without PTSD. The researchers used a measure of electrical conductance of soldiers' skin to see how they responded to two flashing lights -- one signaling a coming painful electric shock, the other a benign signal.

The well-adapting soldiers quickly learned not to react when they saw the benign flash. But those with PTSD got aroused even when they saw that flash. The difference suggests the traumatized veterans were having trouble responding to normal events of daily life. Dr. Aikins thinks after the trauma of war their brains' higher regions were unable to inhibit alarm signals in the amygdala, the almond-sized fear center, even when nothing alarming was happening.

The theory corresponds to anecdotes soldiers tell him of going bonkers over minor annoyances. Those who suffer from PTSD "are not screw-ups," he says. "You're resilient on the job, but what about resilient with your girlfriend, with your kids? Can you turn it off?"

Next for Dr. Aikins is doing something about the problem. He's teaming up with eminent neuroscientist Joseph LeDoux and his colleague Jacek Debiec, both of New York University, to study the beta-blocker propanalol, a drug normally used for high blood pressure, as a treatment for PTSD. Earlier experiments tried giving the drug immediately after a traumatic experience. But the LeDoux-Aikins team plans to test the drug long afterwards, while the patient is reliving the traumatic memory. The drug appears to help scramble the frightening recollection each time the brain puts it back into storage. "We've done this many, many times in rats," Dr. LeDoux says. "It greatly attenuates the fear." Soon they hope to learn if the approach can help people.

Write to Peter Landers at peter.landers@wsj.com
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