Vol. 6, No. 3, 2000 Page 5 
|
Vol. 6, No. 3, 2000 Page 5 |
Since its creation as a psychi-atric diagnosis in 1980, posttraumatic stress disorder (PTSD) has played a role in numerous legal cases involving murders and other crimes committed by war veterans, battered wives, or abused children. (In the most recent hi igh-profile case, a group of combat journalists fought unsuccessfully to prevent the State of California from executing Vietnam veteran Manny Babbitt for a robbery that resulted in a fatality, arguing that Babbitt was suffering from PTSD at the time of th he crime.)
While PTSD is becoming a common defense in the courtroom, however, it remains a medical mystery: why do some people develop severe psychiatric symptoms following traumatic experiences, while others weather them well? New research hints that many PTSD suf fferers may be inherently vulnerable, well before suffering trauma or abuse.
Tamara Gurvits and colleagues studied 21 adult women who were sexually abused as children, and 38 veterans of the Vietnam War. Each group contained subjects with and without symptoms of PTSD. When the researchers performed neuro-logical and psychological tests on their subjects, they found that "subjects with PTSD reported more neurodevelopmental problems and more childhood attention deficit hyperactivity disorder symptoms and had lower IQs, all of which were significantly correlated with neurologic soft signs." These results remained true after the researchers accounted for alcoholism or head injury.
Gurvits and colleagues conclude, "Neurologic compromise is evident from subject history and findings from physical examination in both women and men with chronic PTSD who had experienced different kinds of traumatic events in childhood and adulthood."
The researchers say their find-ings do not negate the validity of post-traumatic stress disorder as a diagnostic entity, noting that "in the veterans, the correlation of combat exposure with PTSD symptoms was high." They theorize, rather, that "a diminish hed ability to cope with a traumatic event and its consequences owing to lower intelligence may increase the likelihood of the PTSD outcome." They note, too, that neurologic soft signs are associated with a variety of psychiatric disorders, ranging from s schizophrenia to obsessive-compulsive disorder.
Gurvits et al. are not the first researchers whose findings reveal pre-trauma vulnerability in sufferers of PTSD. A large-scale study by Paula Schnurr and colleagues in 1993 found that high precombat levels of paranoia, depression, psychopathy, and other psychiatric problems indicative of neurological dysfunction predicted either the development or severity of PTSD symptoms.
"Neurologic soft signs in chronic posttraumatic stress disorder," T. V. Gurvits, M. W. Gilbertson, N. B. Lasko, A. S. Tarhan, D. Simeon, M. L. Macklin, S. P. Orr, and R. K. Pitman, Archives of General Psychiatry, Vol. 57, No. 2, February 2000, pp. 181-186. Address: T. V. Gurvits, Veterans Affairs Medical Center, 718 Smyth Road, Manchester, NH 03104.
"Premilitary MMPI scores as predictors of combat related PTSD symptoms," Paula Schnurr, Matthew Friedman, and Stanley Rosenberg, American Journal of Psychiatry, Vol. 150, No. 3, March 1993. Address: Paula Schnurr, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, White River Junction, VT 05009.