Psychophysiological assessment: clinical applications for PTSD

Descriptions of anxiety disorders clearly recognize the physiological features of anxiety, yet in most clinical practice and research there is little actual use of physiological measurement. This is unfortunate because a potentially important source of information is thereby unavailable and is likely to result in judgements about emotional experience that are less accurate, complete, and reliable than those that include physiological information. The neglect of physiological measures may result from a variety of concerns regarding test attributes such as reliability, validity, utility, and complexity. Promising results from studies of posttraumatic stress disorder (PTSD) demonstrate that physiological assessment can provide valuable clinical and theoretical insight. Numerous studies have now shown that heightened physiological reactivity to trauma-related cues is highly indicative of a diagnosis of PTSD. Physiological tests have achieved some success in predicting the development and persistence of PTSD, and in predicting and assessing treatment response. Studies of the startle response, aversive conditioning, and brain potentials during cognitive processing have identified several potentially important differences between PTSD patients and controls. This paper provides an overview of psychophysiological findings in PTSD and considers potential clinical applications of psychophysiological assessment for this disorder.