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Protocol - Baseline and Trauma Challenge Physiology

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Description:

The Baseline and Trauma Challenge Psychophysiological Recordings protocol consists of a Baseline phase and a Trauma Challenge (trauma interview and trauma imagery) phase. During the baseline phase, skin conductance and heart rate are monitored continuously for 5 minutes while the participant rests quietly without talking. During the first part of the Trauma Challenge, heart rate and skin conductance are continuously measured while the participant is administered a 21-question, open-ended trauma interview. After the interview, skin conductance and heart rate are monitored continuously for 60 seconds while the participant is asked to think about and imagine the traumatic event.

Derived scores include average skin conductance and heart rate calculated for baseline, trauma interview, and trauma imagery as well as the difference in heart rate and skin conductance between (1) trauma interview and baseline, (2) trauma imagery and baseline, and (3-5) the first and last minutes within each measurement period (baseline, trauma interview, and trauma imagery).

Protocol:

BASELINE AND TRAUMA CHALLENGE PSYCHOPHYSIOLOGICAL RECORDINGS PROTOCOL

Have the individual sit comfortably in a chair.

Skin conductance (SC): Any device that records continuously at a rate of 5 samples per second or higher. Add isotonic paste to metal part of electrodes and attach them to fingers.

Heart rate (HR): Any device that records continuously at a rate of 20 samples per second or higher. Attach to finger (devices such as pulse oximeters) or wrist (for watch devices).

Once device is attached, verify that data is being recorded (either by visual or numerical representation of the data).

BASELINE

Ask individual to rest quietly without talking for 5 minutes. Record SC and HR continuously for 5 minutes. Mark the end of the 5-minute period or stop and save the data as "Baseline."

TRAUMA INTERVIEW (Adapted from Standardized Trauma Interview, Foa & Rothbaum, 1998)

Start recording data and ask the following questions:

1. Please briefly describe the event that happened to you

2. What time of day did it happen?

3. Where did it happen?

4. How long did this event last? That is, how long was it from the moment you first felt like you were in danger until you felt safe again?

5. How long ago did it happen?

6. How much have you slept since it happened?

7. What is your relationship with the perpetrator (if applicable)?

8. Was anyone under the influence of drugs or alcohol when it happened?

9. Was anyone else with you?

10. Did you have any injuries? What were they?

11. Do you anticipate long-term physical problems as a result of this event?

12. Was anyone else injured?

13. Was anyone killed?

14. Did you see other people’s injury or death?

15. At the time of the incident, did you think you would be seriously injured or killed?

16. During the event, how helpless did you feel?

17. During the event, how horrified or shocked did you feel?

18. During the event, how terrified or afraid did you feel?

19. During the event, how much control did you feel?

20. Have you ever experienced a similar event before?

21. How many times?

Mark the end of the interview of stop and save the data as "Trauma interview"

TRAUMA IMAGERY

Start recording data and ask the participant to think about and imagine the traumatic event. Record SC and HR continuously for 60 seconds. Mark the end of the 1-minute period or stop and save the data as "Trauma imagery."

DATA SCORING:

Calculate average SC for 5-minute Baseline, Trauma interview, and Trauma imagery. Calculate the difference between Trauma interview and Baseline, and Trauma imagery and Baseline. Calculate average SC for first minute and last minute of each phase. Note duration of Trauma interview. Calculate change score from first to last minute within each phase (correct Trauma interview by duration). Repeat with HR data.

There will be a total of 9 variables for each measure:

1. Baseline average

2. Trauma interview average

3. Trauma imagery average

4. Difference between Baseline and Trauma interview averages

5. Difference between Baseline and Trauma imagery averages

6. Change from first to last minute of Baseline

7. Change from first to last minute of Trauma interview

8. Change from first to last minute of Trauma imagery

Change from first to last minute of Trauma interview divided by interview duration

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population and to respond appropriately to emotional distress that can be elicited by trauma interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Research technicians must be trained in the proper administration and placement of the skin conductance and heart-rate monitors.

Equipment Needs

Skin conductance (SC): Any device that records continuously at a rate of 5 samples per second or higher that can export data for analysis. Add isotonic paste to metal part of electrodes, and attach them to fingers.

Heart rate (HR): Any device that records continuously at a rate of 20 samples per second or higher that can export data for analysis. Attach to finger (devices such as pulse oximeters) or wrist (for watch devices).

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Physical Measurement

Life Stage:

Adult

Participants:

Adults, ages 18 and older

Specific Instructions:

This protocol combines the Standardized Trauma Interview (STI) developed by Foa & Rothbaum (1998) with the procedure for recording skin conductance and heart rate during trauma script imagery developed by Pitman et al. (1987). The procedure included in Pitman et al. (1987) utilizes participant-specific scripts that were developed during a prior interview and then read during the trauma challenge. This process for developing the trauma-script is not standardized and does not meet the PhenX criteria for low burden protocols. Both of these issues are resolved by instead using the STI for trauma script imagery.

Selection Rationale

The Baseline and Trauma Challenge Psychophysiological Recordings protocol is a widely used, valid, and reliable objective measure of emotion-related biological arousal.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Trauma interview psychophysiological test Score 4588716 CDE Browser
Derived Variables

None

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford Press.

Pitman, R. K., Orr, S. P., Forgue, D. F., de Jong, J. B., & Claiborn, J. M. (1987). Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. Archives of General Psychiatry, 44(11), 970-975.

General References

Blechert, J., Michael, T., Grossman, P., Lajtman, M., & Wilhelm, F. H. (2007). Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder. Psychosomatic Medicine, 69(9), 935-943.

Bryant, R. A. (2006). Longitudinal psychophysiological studies of heart rate: Mediating effects and implications for treatment. Annals of the New York Academy of Sciences, 1071, 19-26.

Buckley, T. C., & Kaloupek, D. G. (2001). A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosomatic Medicine, 63(4), 585-594.

Keane, T. M., Kolb, L. C., Kaloupek, D. G., Orr, S. P., Blanchard, E. B., Thomas, R. G., Hsieh, F. Y., & Lavori, P. W. (1998). Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: Results from a Department of Veterans Affairs Cooperative Study. Journal of Consulting and Clinical Psychology 66(6), 914-923.

Jovanovic, T., Norrholm, S. D., Sakoman, A. J., Esterajher, S., & Kozarić-Kovacić, D. (2009). Altered resting psychophysiology and startle response in Croatian combat veterans with PTSD. International Journal of Psychophysiology, 71(3), 264-268.

McTeague, L. M., Lang, P. J., Laplante, M. C., Cuthbert, B. N., Shumen, J. R., & Bradley, M. M. (2010). Aversive imagery in posttraumatic stress disorder: Trauma recurrence, comorbidity, and physiological reactivity. Biological Psychiatry, 67(4), 346-356.

Orr, S. P., Meyerhoff, J. L., Edwards, J. V., & Pitman, R. K. (1998). Heart rate and blood pressure resting levels and responses to generic stressors in Vietnam veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 155-164.

Pineles, S. L., Mostoufi, S. M., Ready, C. B., Street, A. E., Griffin, M. G., & Resick, P. A. (2011). Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship? Journal of Abnormal Psychology, 120(1), 240-246.

Pineles, S. L., Suvak, M. K., Liverant, G. I., Gregor, K., Wisco, B. E., Pitman, R. K., & Orr, S. P. (2013). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychiatry, 122(3), 635-644.

Pole, N., Neylan, T. C., Otte, C., Metzler, T. J., Best, S. R., Henn-Haase, C., & Marmar, C. R. (2007). Associations between childhood trauma and emotion-modulated psychophysiological responses to startling sounds: A study of police cadets. Journal of Abnormal Psychology, 116(2), 352-361.

Shalev, A. Y., Peri, T., Brandes, D., Freedman, S., Orr, S. P., & Pitman, R. K. (2000). Auditory startle response in trauma survivors with posttraumatic stress disorder: A prospective study. American Journal of Psychiatry, 157(2), 255261.

Zatzick, D. F., Grossman, D. C., Russo, J., Pynoos, R., Berliner, L., Jurkovich, G., Sabin, J. A., Katon, W., Ghesquiere, A., McCauley, E., & Rivara, F. P. (2006). Predicting posttraumatic stress symptoms longitudinally in a representative sample of hospitalized injured adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 45(10), 1188-1195.

Protocol ID:

630901

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX630901_Average_HeartRate_Baseline PX630901100000 Average Heart Rate for 5-minute Baseline 4 N/A
PX630901_Average_HeartRate_TraumaImagery PX630901120000 average Heart Rate for Trauma imagery 4 N/A
PX630901_Average_HeartRate_TraumaInterview PX630901110000 Average Heart Rate for Trauma interview 4 N/A
PX630901_Average_SkinConductance_Baseline PX630901010000 Average Skin Conductance for 5-minute Baseline 4 N/A
PX630901_Average_SkinConductance_TraumaImagery PX630901030000 average Skin Conductance for Trauma imagery 4 N/A
PX630901_Average_SkinConductance_TraumaInterview PX630901020000 Average Skin Conductance for Trauma interview 4 N/A
PX630901_Change_HeartRate_Baseline_FirstToLast_Minute PX630901150000 Change of Heart Rate from first to last minute of Baseline 4 N/A
PX630901_Change_HeartRate_TraumaImagery_FirstToLast_Minute PX630901170000 Change of Heart Rate from first to last minute of Trauma imagery 4 N/A
PX630901_Change_HeartRate_TraumaInterview_FirstToLast_Minute PX630901160000 Change of Heart Rate from first to last minute of Trauma interview 4 N/A
PX630901_Change_HeartRate_TraumaInterview_Over_Duration PX630901180000 Change of Heart Rate from first to last minute of Trauma interview divided by interview duration 4 N/A
PX630901_Change_SkinConductance_Baseline_FirstToLast_Minute PX630901060000 Change of Skin Conductance from first to last minute of Baseline 4 N/A
PX630901_Change_SkinConductance_TraumaImagery_FirstToLast_Minute PX630901080000 Change of Skin Conductance from first to last minute of Trauma imagery 4 N/A
PX630901_Change_SkinConductance_TraumaInterview_FirstToLast_Minute PX630901070000 Change of Skin Conductance from first to last minute of Trauma interview 4 N/A
PX630901_Change_SkinConductance_TraumaInterview_Over_Duration PX630901090000 Change of Skin Conductance from first to last minute of Trauma interview divided by interview duration 4 N/A
PX630901_Difference_HeartRate_Baseline_TraumaImagery PX630901140000 Difference of Heart Rate between Baseline and Trauma imagery averages 4 N/A
PX630901_Difference_HeartRate_Baseline_TraumaInterview PX630901130000 Difference of Heart Rate between Baseline and Trauma interview averages 4 N/A
PX630901_Difference_SkinConductance_Baseline_TraumaImagery PX630901050000 Difference of Skin Conductance between Baseline and Trauma imagery averages 4 N/A
PX630901_Difference_SkinConductance_Baseline_TraumaInterview PX630901040000 Difference of Skin Conductance between Baseline and Trauma interview averages 4 N/A
Research Domain Information
Measure Name:

Baseline and Trauma Challenge Physiology

Release Date:

November 21, 2014

Definition

A psychophysiological test to measure changes in skin conductance and heart rate in response to a trauma interview and trauma imagery.

Purpose

Post-traumatic stress disorder (PTSD) is associated with excessive autonomic nervous system arousal and physiological reactivity to trauma-related cues long after the occurrence of the traumatic event. Quantification of this reactivity has potential relevance to individual differences in physical and mental health outcomes that include medical conditions and response to PTSD treatment.

Keywords

Trauma, Heart rate, Skin conductance, Trauma imagery, Physiological response, Reactivity, Post-traumatic stress disorder, PTSD