Correlates of Skin Conductance Reactivity to Stroke-Related Trauma Reminders During Hospitalization for Stroke

Abstract

Objective Although several risk factors for stroke-induced posttraumatic stress disorder (PTSD) have been identified, objective risk measures that can be detected in the acute aftermath of these events are needed. This study is the first to collect an objective measure of psychophysiological arousal—skin conductance (SC) reactivity to a trauma interview—in patients after stroke or transient ischemic attack (TIA) and investigate correlates of SC reactivity. Methods Mobile SC measurement during a resting baseline and standardized trauma interview was performed in-hospital in 98 individuals following stroke/TIA. We examined associations between several stroke-induced PTSD risk factors (sociodemographic, psychosocial, and medical characteristics) and SC reactivity to a trauma interview involving a free-response recalling of the stroke/TIA event. Results Of the sociodemographic, psychosocial, medical characteristics examined as correlates to SC reactivity to recalling the stroke/TIA event, 2 factors reflecting aspects of prior and in-hospital experience were significantly associated with this indicator of sympathetic nervous system activation. A greater cumulative trauma burden was significantly associated with greater SC reactivity ( r = .23, P = .04). Additionally, individuals administered benzodiazepines in-hospital had significantly greater SC reactivity to recalling the stroke/TIA event ( M = 1.51, SD = 1.52) than those who were not ( M = 0.76, SD = 1.16; P = .01). Greater cumulative trauma burden remained significantly associated with greater SC reactivity when adjusting for age and in-hospital benzodiazepine administration ( β=0.22, P = .04). Conclusion This study demonstrated that SC reactivity was related to both behavioral and psychological risk factors for PTSD after a stroke/TIA event. Additionally, we demonstrated the feasibility of a low-cost, mobile measurement of SC that can be conducted in-hospital in a novel patient population: individuals with a medical trauma. With this measure, we were able to identify those individuals with the greatest trauma-related sympathetic nervous system reactivity in the days following a medical trauma. Future research is needed to determine whether SC reactivity may be leveraged in the development of brief, noninvasive screening measures for enhancing PTSD risk prediction.

Skin Conductance Reactivity as a Predictor of Stroke-Induced Posttraumatic Stress Disorder Symptoms: A Dimensional Approach

“…An inhospital study that used mobile assessments of SC reactivity measured during the acute aftermath of nonmedical trauma exposure found that heightened SC reactivity during a standardized trauma interview predicted subsequent development of PTSD symptoms and more chronic PTSD symptom manifestations [11]. Another recent study found that poststroke heightened SC was associated with several medically induced PTSD risk factors, including greater cumulative trauma burden and inhospital benzodiazepine administration [12]. Although SC measurement has traditionally been conducted in a research setting among individuals exposed to external (nonmedical) trauma, recently developed mobile SC assessments are a low-cost, noninvasive alternative, offering naturalistic measurement while patients are under the care of medical professionals following a serious medical event [11].…”