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Elevated Resting Heart Rate as a Predictor of Posttraumatic Stress Disorder After Severe Traumatic Brain Injury

From the School of Psychology, University of New South Wales, New South Wales, Australia; and the Department of Rehabilitation Medicine, Westmead Hospital, Sydney, Australia.

Address correspondence and reprint requests to Richard A. Bryant, PhD, School of Psychology, University of New South Wales, NSW, 2052, Australia. E-mail: r.bryant{at}unsw.edu.au

OBJECTIVE: This study indexed the relationship between resting heart rates (HRs) after injury and subsequent posttraumatic stress disorder (PTSD) in patients who sustained severe traumatic brain injury (TBI).

METHODS: Patients who sustained a severe TBI (N = 68) had their resting HR assessed 1 week and 1 month after injury, and they were assessed for PTSD 6 months after injury with the PTSD Interview, a structured clinical interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised.

RESULTS: PTSD was diagnosed in 23% of patients. PTSD participants had higher HRs at 1 week but not at 1 month after trauma than non-PTSD participants. This difference remained significant when the effect of posttraumatic amnesia was controlled, but it was not significant when the effect of Glasgow Coma Scale was controlled.

CONCLUSION: These findings accord with the proposal that fear conditioning can occur outside the level of awareness and contribute to PTSD development.

Key Words: posttraumatic stress disorder, • traumatic brain injury, • heart rate, • fear conditioning.

Abbreviations: PTSD = posttraumatic stress disorder;; HR = heart rate;; TBI = traumatic brain injury;; PTA = posttraumatic amnesia;; GCS = Glasgow Coma Scale;; PTSD-I = Posttraumatic Stress Disorder Interview;; SD = standard deviation.

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