Psychophysiological characteristics of pediatric posttraumatic stress disorder during script-driven traumatic imagery

Figures & data

Fig. 1 Flowchart of the study.

Table 1 Sample description of children and adolescents with trauma history and PTSD and a traumatized control group without PTSD (TC)

Variable M (SD) or n (%)	PTSD (n=16)	TC (n=18)	Statistic	p
Female	11 (68.8)	10 (55.6)	χ ^2 =0.624	0.497
Age (years)	12.71 (3.3)	12.67 (2.5)	t=−0.045	0.964
In foster care	7 (43.8)	5 (27.8)	χ ^2 =0.946	0.475
Parents of foreign origin	6 (37.5)	5 (27.8)	χ ^2 =0.366	0.717
Special education school	4 (25.0)	4 (22.2)	χ ^2 =0.361	1.000
CAPS-CA total score	55.44 (15.7)	13.44 (5.9)	t=−10.083	<0.001***
Reexperiencing	20.94 (5.0)	5.17 (2.9)	t=−11.088	<0.001***
Avoidance/numbing	17.00 (7.0)	4.72 (3.6)	t=−6.525	<0.001***
Hyperarousal	17.44 (9.1)	3.67 (2.9)	t=−5.791	<0.001***
Index trauma n	Physical V. 6 Sexual abuse 4 Domestic V. 2 Accident 1 Death 2, other 1	Physical V. 1 Sexual abuse 2 Domestic V. 6 Accident 2 Death 4, other 3	χ ^2 =9.152	0.242
Time since trauma (years)	2.36 (1.4)	1.97 (1.6)	t=−0.720	0.477
Interpersonal	13 (81.2)	12 (66.7)	χ ^2 =0.962	0.448
Sequential	9 (56.2)	10 (55.6)	χ ^2 =0.002	1.000
Victim (instead of witness)	9 (56.2)	5 (27.8)	χ ^2 =2.835	0.163
Multiple trauma types	8 (50.0)	5 (27.8)	χ ^2 =1.771	0.291

***Significant at α<0.001; CAPS-CA: Clinician Administered PTSD Scale for Children and Adolescents; V.: violence.

Table 2 Baseline levels of self-reported anxiety and psychophysiological variables in children and adolescents with trauma history and PTSD and a traumatized control group without PTSD (TC)

Variable	PTSD n=16 M (SD)	TC n=18 M (SD)	F (1, 36) or χ ^2 (1, 38)	p	Δ	Δ 95% CIs	d
Anxiety	2.25 (3.17)	0.28 (0.96)	χ ^2 =6.292	0.012*	−1.97	(−3.57, −0.38)	0.89
EMG (mV)	3.95 (2.18)	3.64 (1.84)	0.700	0.409	−0.31	(−1.72, 1.09)	0.16
NSF (1/min)	1.39 (1.94)	3.00 (3.46)	2.810	0.104	1.60	(−0.30, 3.51)	0.58
SCL (µS)	3.39 (1.94)	4.09 (2.66)	0.731	0.399	0.69	(−0.96, 2.36)	0.31
RSA (ms^2)	8.21 (1.16)	8.54 (0.85)	1.790	0.191	0.33	(−0.38, 1.03)	0.34
HR (bpm)	76.62 (8.97)	75.72 (9.79)	0.279	0.601	−0.90	(−7.49, 5.69)	0.10

*Significant at α<0.05; Δ=M of TC minus M of PTSD; CI=confidence interval; EMG=electromyographic activity of the corrugator supercilii muscle; HR=heart rate; NSF=non-specific fluctuation rate of skin conductance; RSA=respiratory sinus arrhythmia; SCL=skin conductance level.

Table 3 Reactivity and script contrast of self-reported anxiety and psychophysiological variables in children and adolescents with trauma history and PTSD and a traumatized control group without PTSD (TC)

	Reactivity							Script contrast
Variable	PTSD n=16 M (SD)	TC n=18 M (SD)	F(1, 36) or χ ^2 (1, 38)	p	Δ	Δ 95% CIs	d	PTSD n=16 M (SD)	TC n=18 M (SD)	F(1, 36) or χ^2 (1, 38)	p	Δ	Δ 95% CIs	d
Anxiety	3.75 (4.65)	1.78 (2.90)	χ ^2 =5.322	0.021*	−1.97	(−4.65, −0.70)	0.59	4.88 (4.77)	1.72 (2.74)	χ ^2 =10.391	0.001***	−3.15	(−5.83, −0.47)	0.85
EMG (mV)	1.76 (3.38)	0.56 (1.86)	1.37	0.251	−1.19	(−3.07, 0.69)	0.46	1.83 (2.98)	−0.01 (1.75)	4.55	0.041*	−1.85	(−3.53, −0.16)	0.79
NSF (1/min)	5.10 (4.59)	2.63 (4.64)	2.63	0.115	−2.47	(−5.70, 0.76)	0.55	3.16 (4.76)	3.02 (3.51)	0.04	0.843	−0.14	(−3.04, 2.76)	0.03
SCL (µS)	1.53 (1.24)	0.95 (0.83)	2.51	0.123	−0.58	(−1.32, 0.17)	0.57	0.88 (0.91)	0.49 (0.61)	2.12	0.155	−0.39	(−0.94, 0.16)	0.53
RSA (ms^2)	−0.13 (0.79)	−0.01 (0.51)	0.34	0.563	0.13	(−0.33, 0.58)	0.19	0.05 (0.87)	−0.04 (0.54)	0.13	0.718	−0.09	(−0.59, 0.41)	0.13
HR (bpm)	1.60 (6.58)	−0.01 (4.09)	0.81	0.376	−1.59	(−5.38, 2.18)	0.31	2.48 (6.38)	0.44 (3.69)	1.07	0.310	−2.05	(−5.63, 1.55)	0.41

***Significant at α=0.001; *significant at α=0.05; Δ=M of TC minus M of PTSD; CI=confidence interval; reactivity=difference between trauma script and baseline; script contrast=difference between trauma and neutral script; EMG=electromyographic activity of the corrugator supercilii muscle; HR=heart rate; NSF=non-specific fluctuation rate of skin conductance; RSA=respiratory sinus arrhythmia; SCL=skin conductance level.

Table 4 Reactivity and script contrast of psychophysiological variables in all participants (n=34)

	Reactivity							Script contrast
Variable	Baseline M (SD)	Trauma script M (SD)	F(1, 34)	p	Δ	Δ 95% CIs	d	Neutral script M (SD)	F(1, 34)	p	Δ	Δ 95% CIs	d
EMG (mV)	3.67 (1.89)	4.85 (3.37)	6.24	0.018*	1.19	(2.19, 2.16)	0.16	3.95 (1.93)	4.04	0.053	0.90	(−0.01, 1.81)	0.11
NSF (1/min)	2.23 (2.85)	5.98 (3.73)	20.23	0.001***	3.74	(2.05, 5.44)	0.39	2.97 (3.39)	17.60	0.001***	3.01	(1.55, 4.47)	0.36
SCL (µS)	3.75 (2.33)	4.98 (2.34)	43.72	0.001***	1.23	(0.85, 1.61)	0.58	4.30 (2.29)	24.78	0.001***	0.68	(0.40, 0.96)	0.44
RSA (ms^2)	8.44 (0.97)	8.38 (0.99)	0.30	0.586	−0.06	(−0.30, 0.17)	0.01	8.38 (0.99)	0.01	0.983	0.01	(−0.25, 0.26)	0.01
HR (bpm)	75.75 (9.13)	76.45 (8.82)	0.58	0.453	0.72	(−1.21, 2.66)	0.02	74.95 (9.51)	2.84	0.102	1.52	(−0.32, 3.36)	0.08

***Significant at α=0.001; *significant at α=0.05; Δ=M of trauma script minus M of baseline respectively M of trauma script minus M of neutral script; CI=confidence interval; reactivity=difference between trauma script and baseline; script contrast=difference between trauma and neutral script; EMG=electromyographic activity of the corrugator supercilii muscle; HR=heart rate; NSF=non-specific fluctuation rate of skin conductance; RSA=respiratory sinus arrhythmia; SCL=skin conductance level.

Table 5 Correlations between psychophysiological and psychological self-reported variables

Measure	1	2	3	4	5	6	7
Thoughts about traumatic event	–	0.15	−0.03	−0.39**	−0.29*	0.13	−0.15
Anxiety	0.15	–	−0.14	−0.06	0.11	0.01	0.01
EMG (mV)	−0.03	−0.14	–	−0.02	0.18	−0.08	−0.01
NSF (1/min)	−0.39**	−0.06	−0.02	–	0.28*	0.05	0.14
SCL (µS)	−0.29*	0.11	0.18	0.28*	–	−0.09	0.18
RSA (ms^2)	0.13	0.01	−0.08	0.05	−0.09	–	−0.22
HR (bpm)	−0.15	0.01	−0.01	0.14	0.18	−0.22	–

*Significant at α<0.05; **significant at α<0.01; EMG=electromyographic activity of the corrugator supercilii muscle; HR=heart rate; NSF=non-specific fluctuation rate of skin conductance; RSA=respiratory sinus arrhythmia; SCL=skin conductance level.