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The Neuropsychiatry of Post-traumatic Stress Disorder

Published online by Cambridge University Press:  02 January 2018

I. P. Burges Watson ,
L. Hoffman  and
G. V. Wilson
I. P. Burges Watson*
Affiliation:
Repatriation General Hospital, Hobart, Tasmania
L. Hoffman
Affiliation:
Repatriation General Hospital, Hobart
G. V. Wilson
Affiliation:
University of Tasmania, Hobart
*
∗Repatriation General Hospital, Hobart, Tasmania, Australia
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Abstract

The publication of DSM-III introduced the diagnosis Post-Traumatic Stress Disorder (PTSD), thus providing, for the first time, a framework for studying the consequences of extremely stressful events. Previously, traumatic neuroses had attracted a wide variety of labels – as wide as the experiences that produced them. Competing explanations in psychological and biological terms have characterised the approach to these disorders, and social and legal issues have added to the confusion. In recent years, psychosocial issues have tended to dominate the literature in relation to PTSD. While acknowledging the importance of such phenomenological and psychosocial approaches, this paper seeks to redress the balance by focusing on a biological perspective.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 152 , Issue 2 , February 1988 , pp. 164 - 173
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Alkon, D. L. & Farley, J. (1984) Primary Neural Substrates of Learning and Behavioural Change. Cambridge: Cambridge University Press.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorder (revised 3rd edn) (DSM-III-R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1980) Post traumatic stress disorder. In Comprehensive Textbook of Psychiatry III (eds Kaplan, H. I., Freedman, A. M. & Sadock, B. T.) vol. 3. Baltimore: Williams & Wilkins.Google Scholar
Asratyan, E. & Simonov, P. (1965) How Reliable is the Brain? Moscow: Mir Publishers.Google Scholar
Asratyan, E. & Simonov, P. (1983) The Learning Brain. Moscow: Mir Publishers.Google Scholar
Austin, F. H. (1969) A review of stress and fatigue monitoring of naval aviators during aircraft carrier combat operations: blood and urine biochemical studies. In The Psychology and Physiology of Stress (with Reference to Special Studies of the Vietnam War) (ed. Bourne, P. G.), pp. 197–218. New York: Academic Press.Google Scholar
Bartrop, R. W., Lazarus, L., Luckhurst, E., Kiloh, L. G. & Penny, R. (1977) Depressed lymphocyte function after bereavement. The Lancet, 834–836.Google Scholar
Bergland, R. (1985) The Fabric of Mind. Ringwood, Victoria: Penguin Books Australia.Google Scholar
Blanchard, E. B., Kolb, L. C., Pallmeyer, T. P. & Gerardi, R. J. (1982) The development of a psychophysiological assessment procedure for post-traumatic stress disorder in Vietnam veterans. Psychiatric Quarterly, 54, 220–229.Google Scholar
Blaszczynski, A. P. & Winter, S. W. (1984) Endorphins and psychiatry. Australian and New Zealand Journal of Psychiatry, 18, 111–112.Google Scholar
Bleich, A., Garb, R. & Kottler, M. (1986a) Treatment of prolonged combat reaction. British Journal of Psychiatry, 148, 493–496.Google Scholar
Bleich, A., Siegel, B., Garb, R. & Lehrer, B. (1986b) Post-traumatic stress disorder following combat exposure: clinical features and psychopharmacological treatment. British Journal of Psychiatry, 149, 365–369.Google Scholar
Bloom, F. E. & McGinty, J. F. (1981) Cellular distribution and function of endorphins. In Endogenous Peptides and Learning and Memory Processes (eds Martinez, J. L., Jenson, R. A., Messing, R. B., Richter, H. and McGaugh, J. L.). New York: Academic Press.Google Scholar
Boman, B. (1985) Post-traumatic stress disorder (traumatic war neurosis) and concurrent psychiatric illness among Australian Vietnam veterans: a controlled study. Journal of the Royal Army Medical Corps, 131, 128–131.Google Scholar
Bourne, P. G. (1970) Military psychiatry and the Vietnam experience. American Journal of Psychiatry, 127, 123–130.Google Scholar
Brende, J. O. (1982) Electrodermal responses in post-traumatic syndromes: a pilot study of cerebral hemisphere functioning in Vietnam veterans. Journal of Nervous and Mental Diseases, 170, 353–361.Google Scholar
Brende, J. O. (1984) The psychophysiologic manifestations of dissociation. Electrodermal responses in a multiple personality patient. Psychiatric Clinics of North America, 7, 41–50.Google Scholar
Brett, E. A. & Ostroff, R. (1985) Imagery and posttraumatic stress disorder: an overview. American Journal of Psychiatry, 142, 417–424.Google Scholar
Brinsmead, M., Smith, R., Singh, B., Lewin, T. & Owens, P. (1985) Peripartum concentrations of beta-endorphin and Cortisol and maternal mood states. Australian and New Zealand Journal of Obstetrics and Gynaecology, 25, 194–197.Google Scholar
Buchsbaum, M. S., Davis, G. C. & Bunney, W. E. Jr (1977) Naloxone alters pain perception and somatosensory evoked potential in normal subjects. Nature (London), 270, 620–622.Google Scholar
Burges Watson, I. P. (1987) Post-traumatic stress disorder in Australia and New Zealand. The consequences of inescapable horror. The Medical Journal of Australia (in press).CrossRefGoogle Scholar
Clement-Jones, V., McLoughlin, L., Tomlin, S., Besser, G. M. et al (1980) Increased beta-endorphin but not metenkephalin levels in human CSF after acupunture for recurrent pain. The Lancet, ii, 946–948.Google Scholar
Cohen, M. R., Pickar, D., Dubois, M. & Bunney, W. E. (1982) Stress-induced plasma beta-endorphin immunoreactivity may predict post-operative morphine usage. Psychiatry Research, 6, 7–12.CrossRefGoogle Scholar
Copolov, D. (1985) Opioid biology: the next set of questions. Australian and New Zealand Journal of Medicine, 15, 98–106.Google Scholar
Cuello, A. C. (1983) Central distribution of opioid peptides. British Medical Bulletin, 39, 11–16.Google Scholar
Daly, R. J. (1983) Samuel Pepys and post-traumatic stress disorder. British Journal of Psychiatry, 143, 64–68.Google Scholar
Daly, R. J., Duggan, P. F., Bracken, P. J., Doonan, H. J. & Kelleher, N. J. (1987) Plasma levels of beta-endorphin in depressed patients with and without pain. British Journal of Psychiatry, 150, 224–227.CrossRefGoogle ScholarPubMed
Davidson, J., Walker, J. I. & Kilts, C. (1987) A pilot study of phenelzine in the treatment of post-traumatic stress disorder. British Journal of Psychiatry, 150, 252–255.Google Scholar
Dimond, S. J., Farrington, L. & Johnson, P. (1976) Differing emotional response from right and left hemispheres. Nature (London), 261, 690–692.CrossRefGoogle ScholarPubMed
Elmadjian, F. (1955) Adrenocortical function of combat infantrymen in Korea. Endocrinology, 8, 627–655.Google Scholar
Elton, F., Stanley, G. & Burrows, G. (1983) Physiological Control of Pain. Sydney: Grune & Stratton.Google Scholar
Eth, S. & Pynoos, R. (1985) Post-Traumatic Stress Disorder in Children. Washington: American Psychiatric Press Inc.Google Scholar
Eysenck, H.J. (1968) A theory of the incubation of anxiety/fear responses. Behaviour Research and Therapy, 6, 309–321.Google Scholar
Eysenck, H.J. (1983) Psychophysiology and personality: introversion, neuroticism and psychoticism. In Physiological Correlates of Human Behaviour, vol. III: Individual Differences and Psychopathology (eds Gale, A. & Edwards, J. A.). London: Academic Press.Google Scholar
Fairbank, J. A., Langley, K., Jarvie, J. G. & Keane, T. M. (1981) A selected bibliography on post traumatic stress disorder in Vietnam veterans. Professional Psychology, 12, 578–586.Google Scholar
Fenton, G. W. (1985) Temporal lobe epilepsy, laterality and psychosis: A reply to Pierre Flor-Henry's commentary. Psychiatric Developments, 3, 307–315.Google Scholar
Flor-Henry, P. (1979) On certain aspects of the localization of the cerebral systems regulating and determining emotion. Biological Psychiatry, 14, 677–698.Google ScholarPubMed
Gantt, W. H. (1953) Principles of nervous breakdown – schizokinesis and autokinesis. Annals of the New York Academy of Sciences, 56, 143–163.CrossRefGoogle ScholarPubMed
Gantt, W. H. (1976) Neo-Pavlovianism. In Behaviour Control and Modification of Physiological Activity (ed. Mostofsky, D. I.). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Geschwind, N. & Galaburda, A. M. (1986) Cerebral lateralisation biological mechanisms, association and pathology: A hypothesis and a programme for research. Archives of Neurology, 42, I: 428–459, II: 521–552, III: 553–654.Google Scholar
Goodwin, J. (1985) Post-traumatic symptoms in incest victims. In Post-Traumatic Stress Disorder in Children (eds Eth, S. & Pynoos, R. S.). Washington: American Psychiatric Press.Google Scholar
Gray, J. A. (1964) Pavlov's Typology. Oxford: Pergamon Press.Google Scholar
Gray, J. A. (1979) Pavlov. Glasgow: Fontana Paperbacks.Google Scholar
Green, B. L., Lindy, J. D. & Grace, M. C. (1985) P.T.S.D. Towards DSM-4. Journal of Nervous and Mental Diseases, 174, 406–411.Google Scholar
Grossmann, A. (1983) Brain opiates and neuroendocrine function. Clinics in Endocrinology and Metabolism, 12, 725–746.CrossRefGoogle Scholar
Horowitz, M. (1986a) Stress-response syndromes: A review of post-traumatic and adjustment disorders. Hospital and Community Psychiatry, 37, 241–249.Google Scholar
Horowitz, M. (1986b) States of Mind. New York: Plenum.Google Scholar
Howard, J. M., Olney, J. M., Frawley, J. P., Peterson, R. E. et al (1985) Studies of adrenal function in combat and wounded soldiers. A study in Korean theatre. Annals of Surgery, 141, 314–320.Google Scholar
Hughes, J., Smith, T. W., Kosterlitz, H. W., Fothergill, L. A. et al (1975) Identification of two related pentapeptides from the brain with potent opiate agonist activity. Nature (London), 258, 577–579.Google Scholar
Jones, G. H. & Lovett, J. W. T. (1987) Delayed psychiatric sequelae among Falklands War veterans. Journal of the Royal College of General Practitioners, 37, 34–35.Google Scholar
Kaplan, H. I. & Sadock, B. J. (1980) Neurophysiology of behaviour. In Comprehensive Textbook of Psychiatry (3rd edn) (eds Kaplan, H. I., Freedman, A. M. & Sadock, B. J.), ch. 2.5. Baltimore: Williams & Wilkins.Google Scholar
Kardiner, A. (1941) The traumatic neuroses of war. In American Handbook of Psychiatry (ed. Arieti, S.) vol. 1. New York: Basic Books.Google Scholar
Kardiner, A. & Spiegel, H. (1947) War Stress and Neurotic Illness (2nd edn, completely rewritten from original The Traumatic Neuroses of War ). New York: Paul B. Hoeber Inc.Google Scholar
Katz, E. R., Sharp, B., Lellerman, J. et al (1982) Beta-endorphin immunoreactivity and acute behavioural distress in children with leukemia. Journal of Nervous and Mental Disease, 170, 72–77.Google Scholar
Kiloh, L. G. & Smith, J. S. (1978) The neural basis of aggression and its treatment by psychosurgery. Australian and New Zealand Journal of Psychiatry, 12, 21–28.Google Scholar
van der Kolk, B. A. (1987) Psychological Trauma. Washington, DC: American Psychiatric Press.Google Scholar
van der Kolk, B. A., Greenberg, M., Boyd, H. & Krystal, J. (1985) Inescapable shock, neurotransmitters, and addiction to trauma: Toward a psychobiology of post traumatic stress. Biological Psychiatry, 20, 314–325.Google Scholar
Kreuz, L. E., Rose, R. M. & Jennings, J. R. (1972) Suppression of plasma testosterone levels and psychological stress. A longitudinal study of young men in officer candidate school. Archives of General Psychiatry, 26, 479–482.Google Scholar
Kruglikov, R. I. (1983) Some neurochemical correlates of learning and memory. In The Learning Brain (eds Asratyan, E. & Simonov, P.). Moscow: Mir Publishers.Google Scholar
Leedy, M. G. & Wilson, M. S. (1985) Testosterone and Cortisol levels and crewmen of U.S. air force fighter and cargo planes. Psychosomatic Medicine, 47, 333–338.Google Scholar
Levine, Jon D., Gordon, N. C. & Fields, H. L. (1978) The mechanisms of placebo analgesia. The Lancet, ii, 654–657.Google Scholar
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., Rao, K. & Price, T. R. (1983) Mood change following bilateral hemisphere injury. British Journal of Psychiatry, 143, 266–273.Google Scholar
Maier, S., Drugan, R., Grau, J., Hyson, R. et al (1983) Learned helplessness, pain inhibition, and the endogenous opiates. In Advances in Analysis of Behaviour. Vol. 3. Biological Factors in Learning (eds Zeiler, M. & Harzern, P.). Chichester: John Wiley & Sons.Google Scholar
Malloy, P. F., Fairbank, J. A. & Keane, T. M. (1983) Validation of a multimethod assessment of post-traumatic stress disorders in Vietnam veterans. Journal of Consulting and Clinical Psychology, 51, 488–494.Google Scholar
Mangan, G. L. (1982) The Biology of Human Conduct. Oxford: Pergamon Press.Google Scholar
Martinez, J. L., Jensen, R. A., Messing, R. B., Rigter, H. & McGaugh, J. L. (1981) Endogenous Peptides and Learning Memory Processes. New York: Academic Press.Google Scholar
Martinez, J. L., & Kessner, R. P. (1986) Learning and Memory. A Biological View. New York: Academic Press Inc.Google Scholar
Mason, J. W., Giller, E. L., Kosten, T. R., Ostroff, R. B. & Podd, L. (1986) Urinary free-cortisol levels in posttraumatic stress disorder patients. Journal of Nervous and Mental Disease, 174, 145–149.Google Scholar
Mason, S. T. (1984) Catecholamines and Behaviour. Cambridge: Cambridge University Press.Google Scholar
Mateyev, D. (1961) Excitation, inhibition, fatigue and recovery. Sechenov Physiological Journal of the USSR, 47, 1282–1289.Google Scholar
Mayer, D. J., Price, D. D. & Rafii, A. (1977) Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Research, 121, 368–372.Google Scholar
McFarlane, A. C. & Raphael, B. (1984) Ash Wednesday: The effects of a fire. Australian and New Zealand Journal of Psychiatry, 18, 341–351.Google Scholar
Mendelson, G. (1987) The concept of post-traumatic stress disorder. International Journal of Law and Psychiatry, 10, 45–62.Google Scholar
Moretti, C., Fabbri, A., Gnessi, L. et al (1983) Naloxone inhibits exercise-induced release of PRL and GH in athletes. Clinical Endocrinology, 18, 135–138.Google Scholar
Pallmeyer, T. P., Blanchard, E. B. & Kolb, L. C. (1986) The psycho-physiology of combat-induced post-traumatic stress disorder in Vietnam veterans. Behaviour Research and Therapy, 24, 645–652.Google Scholar
Poe, R. O., Rose, R. M. & Mason, J. W. (1970) Multiple determinants of 17-HCS excretion in recruits during basic training. Psychosomatic Medicine, 32, 369–378.Google Scholar
Price, H. H. (1984) The Falklands: rate of British psychiatric combat casualties compared to recent American Wars. Journal of the Royal Army Medical Corps, 130, 109–113.CrossRefGoogle ScholarPubMed
Putnam, F. (1984) The psychophysiologic investigation of multiple personality disorder. Psychiatric Clinics of North America, 7, 31–40.Google Scholar
Raphael, B. (1986) When Disaster Strikes. London: Hutchinson.Google Scholar
Reichlin, S. (1981) Neuroendocrinology. In Textbook of Endocrinology (ed. Williams, R. H.). Philadelphia: W. B. Saunders Co.Google Scholar
Reichlin, S. (1985) Neuroendocrinology. In William's Textbook of Endocrinology (eds Wilson, J. D. and Foster, D. W.). Philadelphia: W. B. Saunders Co.Google Scholar
Riccio, D. C. & Concannon, J. T. (1981) ACTH and the reminder phenomena. In Endogenous Peptides and Learning and Memory Processes (eds Martinez, J. L. et al). New York: Academic Press.Google Scholar
Rogers, D. (1987) Neuropsychiatry. British Journal of Psychiatry, 150, 425–427.Google Scholar
Rose, R. M. (1969) Androgen excretion in stress. In The Psychology and Physiology of Stress (with Reference to Special Studies of the Vietnam War) (ed. Bourne, P. G.). New York: Academic Press.Google Scholar
Rose, R. M. (1985) Psychoendocrinology. In Williams' Textbook of Endocrinology (eds Wilson, J. D. and Foster, D. W.). Philadelphia: W. B. Saunders Co.Google Scholar
Rose, R. M., Bourne, P. G., Poe, R. O., Mougey, E. H. et al (1969) Androgen responses to stress. Excretion of testosterone, epitestosterone, androsterone and etiocholanolone during basic combat training and under threat of attack. Psychosomatic Medicine, 31, 418–436.Google Scholar
Sargent, W. (1957) Battle for the Mind. London: Wm Heinemann Ltd.Google Scholar
Schuchter, S. R., Zisook, S., Kirkowicz, C. & Risch, C. (1986) The DST in acute grief. American Journal of Psychiatry, 143, 879–881.Google Scholar
Selye, H. (1976) The Stress of Life. New York: McGraw Hill.Google Scholar
Silver, S. M. (1982) Post traumatic stress disorders in Vietnam veterans: an addendum to Fairbanks et al. Professional Psychology, 13, 522–525.Google Scholar
Smith, G. C. & Copolov, D. (1985) Brain amines and peptides – their relevance to psychiatry. Australian and New Zealand Journal of Psychiatry, 13, 283–291.Google Scholar
Spiegel, D. (1984) Multiple personality as a post-traumatic stress disorder. Psychiatric Clinics of North America, 7, 101–110.Google Scholar
Spragg, G. S. (1972) Psychiatry in the Australian Military Forces. Medical Journal of Australia, 1, 745–751.Google Scholar
Streimer, J. H., Cosstick, J. & Tennant, C. (1985) The psychosocial adjustment of Australian Vietnam veterans. American Journal of Psychiatry, 142, 616–618.Google Scholar
Strelau, J. (1983) Temperament, Personality, Activity. London: Academic Press.Google Scholar
Taylor, A. J. W. & Frazer, A. G. (1982) The stress of post-disaster body handling and victim identification work. Journal of Human Stress, 4, 4–12.Google Scholar
Trimble, M. R. (1981a) Post-Traumatic Neurosis. Chichester, New York, Brisbane, Toronto: John Wiley & Sons.Google Scholar
Trimble, M. R. (1981b) Neuropsychiatry. Chichester: John Wiley & Sons.Google Scholar
Walton, J. (1985) Brain's Diseases of the Nervous System (9th edn). Oxford: Oxford University Press.Google Scholar
Wexler, B. (1986) Alterations in cerebral laterality during acute psychotic illness. British Journal of Psychiatry, 149, 202–209.Google Scholar
Willer, J. C., Denen, H. & Cambier, J. (1981) Stress induced analgesia in humans: endogenous opioids and naloxone-reversible depression of pain reflexes. Science, 212, 689–691.Google Scholar
Zeiler, M. D. & Harzem, P. (1983) Advances in Analysis of Behaviour, Vol. 3. Biological Factors in Learning. Chichester: John Wiley & Sons.Google Scholar
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