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

• Authors: Corinne Meinhausen, University of California, Los Angeles; Gabriel J Sanchez, Columbia University Irving Medical Center; Theodore F Robles, University of California, Los Angeles; Donald Edmondson, Columbia University Irving Medical Center; Ian M Kronish, Columbia University Irving Medical Center; Rebecca Hinrichs, Emory University; Tanja Jovanovic, Emory University; Jennifer A Sumner, University of California, Los Angeles
• Journal Title: Chronic Stress
• Volume: Volume 7
• Publisher: (publisher) | 2023-01-01, Pages 24705470231156571-24705470231156571
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1177/24705470231156571
• Subjects: Health Sciences, Medicine and Surgery; Biology, Neuroscience; Health Sciences, Mental Health; Psychology, Behavioral
• Keywords: PTSD screening; Posttraumatic stress disorder; benzodiazepine; medically induced PTSD; psychophysiology; skin conductance; stroke; transient ischemic attack

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.