Skip to main content

Advertisement

SpringerLink
Log in

The effect of nicotine and trauma context on acoustic startle in smokers with and without posttraumatic stress disorder

  • Original Investigation
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

Rationale

Exaggerated startle response is a prominent feature of posttraumatic stress disorder (PTSD) although results examining differences in the acoustic startle response (ASR) between those with and without PTSD are mixed. One variable that may affect ASR among persons with PTSD is smoking. Individuals with PTSD are more likely to smoke and have greater difficulty quitting smoking. While smokers with PTSD report that smoking provides significant relief of negative affect and PTSD symptoms, the effects of smoking or nicotine deprivation on startle reactivity among smokers with PTSD are unknown.

Objectives

The purposes of the current study were to (1) examine baseline acoustic startle response (ASR) in smokers with and without PTSD under conditions of overnight abstinence, (2) evaluate the effect of smoking on ASR, and (3) evaluate the contextual effects of trauma versus neutral script presentations.

Methods

ASR was measured among 48 smokers with and without PTSD in the context of a 2 (group: PTSD vs. non-PTSD) × 2 (context: trauma vs. neutral) × 3 (smoking condition: usual brand cigarette vs. denicotinized cigarette vs. no smoking) design.

Results

Effects of modest size indicated that (1) PTSD participants demonstrated higher ASR (2) compared to non-PTSD participants, PTSD participants reported greater negative affect following a trauma-related script, and (3) following a trauma-related script and smoking a usual brand cigarette, PTSD participants demonstrated higher ASR.

Conclusions

Although many smokers with PTSD report that smoking reduces PTSD symptoms, results suggest that smoking may actually potentiate or maintain an exaggerated startle response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Beckham JC (1999) Smoking and anxiety in combat veterans with chronic posttraumatic stress disorder: a review. J Psychoactive Drugs 31:103–110

    PubMed  CAS  Google Scholar 

  • Beckham JC, Dennis MF, McClernon FJ, Mozley SL, Collie CF, Vrana SR (2007) The effects of cigarette smoking on script-driven imagery in smokers with and without posttraumatic stress disorder. Addict Behav 32:2900–2915

    Article  PubMed  Google Scholar 

  • Beckham JC, Feldman ME, Vrana SR, Mozley SL, Erkanli A, Clancy CP, Rose JE (2005) Immediate antecedents of cigarette smoking in smokers with and without posttraumatic stress disorder: a preliminary study. Exp Clin Psychopharmacol 13:218–228

    Google Scholar 

  • Beckham JC, Gehrman PR, McClernon FJ, Collie CF, Feldman ME (2004) Cigarette smoking, ambulatory cardiovascular monitoring and mood in Vietnam veterans with and without chronic posttraumatic stress disorder. Addict Behav 29:1579–1593

    Article  PubMed  Google Scholar 

  • Beckham JC, Wiley MT, Miller SC, Dennis MF, Wilson SM, McClernon FJ, Calhoun PS (2008) Ad lib smoking in posttraumatic stress disorder: an electronic diary study. Nicotine Tob Res 10:1149–1157

    Article  PubMed  Google Scholar 

  • Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM (1995) The development of a clinician-administered posttraumatic stress disorder scale. J Trauma Stress 8:75–80

    Article  PubMed  CAS  Google Scholar 

  • Cinciripini PM, Robinson JD, Carter BL, Lam C, Wu X, de Moor CA, Baile WF, Wetter DW (2006) The effects of smoking deprivation and nicotine administration on emotional reactivity. Nicotine Tob Res 8:379–392

    Article  PubMed  CAS  Google Scholar 

  • Cook I, EW, Davis TL, Hawk LW, Spence EW, Gautier CH (1992) Fearfulness and startle potentiation during aversive visual stimuli. Psychophysiology 29:633–645

    Article  PubMed  Google Scholar 

  • Cuthbert BN, Bradley MM, Lang PJ (1996) Probing picture perception: activation and emotion. Psychophysiology 33:103–111

    Article  PubMed  CAS  Google Scholar 

  • Davidson JRT, Book SW, Colket JT, Tupler LA, Roth S, David D, Hertzberg MA, Mellman T, Beckham JC, Smith RD, Davidson RM, Katz R, Feldman ME (1997) Assessment of a new self-rating scale for posttraumatic stress disorder: the davidson trauma scale. Psychol Med 27:153–160

    Article  PubMed  CAS  Google Scholar 

  • Feldner MT, Babson KA, Zvolensky MJ, Monson CM, Bonn-Miller MO, Gibson LE (2008) An examination of anxiety sensitivity as a moderator of the relationship between smoking level and posttraumatic stress symptoms among trauma-exposed adults. Cogn Ther Res 32:116–132

    Article  Google Scholar 

  • First MB, Spitzer RL, Gibbon M, Williams JBW (1994) Structured clinical interview for axis I DSM-IV disorders. Biometrics Research Department, New York

    Google Scholar 

  • Geier A, Mucha R, Pauli P (2000) Appetitive nature of drug cues confirmed with physiological measures in a model of using pictures of smoking. Psychopharmacol 150:283–291

    Article  CAS  Google Scholar 

  • Gilbert DG (1995) Smoking: individual differences, psychopathology and emotion. Taylor and Francis, Bristol

    Google Scholar 

  • Grillion C, Morgan CA, Davis M, Southwick SM (1998) Effects of experimental context and explicit threat cues on acoustic startle in Vietnam veterans with posttraumatic stress disorder. Biol Psychiatry 44:1027–1036

    Article  Google Scholar 

  • Grillon C, Baas J (2003) A review of the modulation of the startle reflex by affective states and its application in psychiatry. Clin Neurophysiol 114:1557–1579

    Article  PubMed  Google Scholar 

  • Hamm AO, Cuthbert BN, Globisch J, Vaitl D (1997) Fear and the startle reflex: blink modulation and autonomic response patterns in animal and mutilation fearful subjects. Psychophysiology 34:97–107

    Article  PubMed  CAS  Google Scholar 

  • Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO (1991) The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict 86:1119–1127

    Article  PubMed  CAS  Google Scholar 

  • Hogle JM, Curtain JJ (2006) Sex differences in negative affective response during nicotine withdrawal. Psychophysiology 43:1–14

    Article  Google Scholar 

  • Kardiner AK (1941) The traumatic neuroses of war. Paul B Hoeber, New York

    Book  Google Scholar 

  • Kassel JD, Stroud LR, Paronis CA (2003) Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psychol Bull 129:270–304

    Article  PubMed  Google Scholar 

  • Kassel JD, Unrod M (2000) Smoking, anxiety, and attention: support for the role of nicotine in attentionally mediated anxiolytics. J Abnorm Psychol 109:161–166

    Article  PubMed  CAS  Google Scholar 

  • Kubany ES, Haynes SN, Leisen MB, Owens JA, Kaplan AS, Watson SB, Burns K (2000) Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the traumatic life events questionnaire. Psychol Assess 12:210–224

    Article  PubMed  CAS  Google Scholar 

  • Kumari V, Cotter PA, Checkley SA, Gray JA (1997) Effect of acute subcutaneous nicotine on prepulse inhibition of the acoustic startle inhibition of the acoustic startle reflex in heathy male non-smokers. Psychopharmacol 132:389–395

    Article  CAS  Google Scholar 

  • Lang PJ, Bradley MM, Cuthbert BN (1990) Emotion, attention and startle reflex. Psychol Rev 97:377–395

    Article  PubMed  CAS  Google Scholar 

  • Lasser K, Boyd JW, Woolhander S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610

    Article  PubMed  CAS  Google Scholar 

  • McDonald SD, Beckham JC, Morey RA, Calhoun PS (2009) The validity and diagnostic efficiency of the Davidson Trauma Scale in military veterans who have served since September 11, 2001. J Anxiety Disord 23:247–255

    Article  PubMed  Google Scholar 

  • Metzger LJ, Orr SP, Berry NJ, Ahern CE, Lasko NB, Pitman RK (1999) Physiologic reactivity to startling tones in women with posttraumatic stress disorder. J Abnorm Psychol 108:347–352

    Article  PubMed  CAS  Google Scholar 

  • Mueller V, Mucha RF, Pauli (1998) Dependence on smoking and the acoustic startle response in healthy smokers. Pharmacol Biochem Behav 59:1031–1038

    Article  PubMed  CAS  Google Scholar 

  • Mulligan NW, Wiesen C (2003) Using the analysis of covariance to increase the power of priming experiments. Can J Exp Psychol 57:152–166

    PubMed  Google Scholar 

  • Orr SP, Claiborn JM, Altman B, Forgue DF, de Jong JB, Pitman RK, Herz LR (1990) Psychometric profile of posttraumatic stress disorder, anxious and healthy Vietnam veterans: correlations with psychophysiologic responses. J Consult Clin Psychol 58:329–335

    Article  PubMed  CAS  Google Scholar 

  • Orr SP, Metzger LJ, Lasko NB, Macklin ML, Hu FB, Shalev AY, Pitman RK, Investigators HVAP-tSDTS (2003) Physiologic responses to sudden loud tones in monozygotic twins discordant for combat exposure: association with posttraumatic stress disorder. Arch Gen Psychiatry 60:283–288

    Article  PubMed  Google Scholar 

  • Orr SP, Pitman RK, Lasko NB, Herz LR (1993) Psychophysiological assessment of posttraumatic stress disorder imagery in World War II and Korean combat veterans. J Abnorm Psychol 102(1):152–159

    Article  PubMed  CAS  Google Scholar 

  • Orr SP, Roth WT (2000) Psychophysiological assessment: clinical applications for PTSD. J Affect Disord 61:225–240

    Article  PubMed  CAS  Google Scholar 

  • Piasecki TM, Shi FY, Fiore MC, Baker TB (2002) Affective consequences of smoking cues, smoking withdrawal, and smoking availability: a startle probe study. Paper presentation. Society for Research on Nicotine and Tobacco, Savannah

    Google Scholar 

  • Piper ME, Curtin JJ (2006) Tobacco withdrawal and negative affect: an analysis of initial emotional response intensity and voluntary emotion regulation. J Abnorm Psychol 151:96–102

    Article  Google Scholar 

  • Pitman RK, Orr SP, Forgue DF, Altman B, de Jong JB, Herz LR (1990) Psychophysiologic responses to combat imagery of Vietnam veterans with posttraumatic stress disorder versus other anxiety disorders. J Abnorm Psychol 99:49–54

    Article  PubMed  CAS  Google Scholar 

  • Pitman RK, Orr SP, Forgue DF, de Jong JB, Clairborn JM (1987) Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. Arch Gen Psychiatry 44:970–975

    PubMed  CAS  Google Scholar 

  • Pitman RK, Orr SP, Steketee GS (1989) Psychophysiological investigations of posttraumatic stress disorder imagery. Psychopharmacol Bull 25:426–431

    PubMed  CAS  Google Scholar 

  • Pole N (2007) The psychophysiology of posttraumatic stress disorder: a meta-analysis. Psychol Bull 133:725–746

    Article  PubMed  Google Scholar 

  • Rose JE, Ananda S, Jarvik ME (1983) Cigarette smoking during anxiety-provoking and monotonous tasks. Addict Behav 8:353–359

    Article  PubMed  CAS  Google Scholar 

  • Rose JE, Behm FM (2004) Extinguishing the rewarding value of smoke cues: pharmacologic and behavioral treatments. Nicotine Tob Res 6:523–532

    Article  PubMed  Google Scholar 

  • Shalev AY, Rogel-Fuchs Y (1993) Psychophysiology of the posttraumatic stress disorder: from sulfur fumes to behavioral genetics. Psychosom Med 55:413–423

    PubMed  CAS  Google Scholar 

  • Vrana SR, Spence EL, Lang PJ (1988) The startle probe response: a new measure of emotion? J Abnorm Psychol 97:487–491

    Article  PubMed  CAS  Google Scholar 

  • Watson D, Clark LA, Carey G (1988a) Positive and negative affectivity and their relation to anxiety and depressive disorder. J Abnorm Psychol 97:346–353

    Article  PubMed  CAS  Google Scholar 

  • Watson D, Clark LA, Tellegen A (1988b) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank the participants for their assistance in this research. This material is based upon work supported in part by R21DA019704, R21CA12896, 2K24DA016388, and the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research and Development, and Health Services Research and Development.

Conflict of interest

The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the National Institutes of Health, or the United States government. The authors have no competing interests.

Author information

Authors and Affiliations

  1. VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA

    Patrick S. Calhoun, H. Ryan Wagner, F. Joseph McClernon, Sherman Lee & Jean C. Beckham

  2. DurhamVeterans Affairs Medical Center, Durham, NC, USA

    Patrick S. Calhoun, H. Ryan Wagner, F. Joseph McClernon, Sherman Lee, Michelle F. Dennis, Carolina P. Clancy, Claire F. Collie, Yashika C. Johnson & Jean C. Beckham

  3. Duke University Medical Center, Durham, NC, USA

    Patrick S. Calhoun, F. Joseph McClernon, Michelle F. Dennis, Claire F. Collie & Jean C. Beckham

  4. VA Center for Health Services Research in Primary Care, Durham, NC, USA

    Patrick S. Calhoun

  5. Virginia Commonwealth University, Richmond, VA, USA

    Scott R. Vrana

Authors
  1. Patrick S. Calhoun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Ryan Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Joseph McClernon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sherman Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michelle F. Dennis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Scott R. Vrana
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carolina P. Clancy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Claire F. Collie
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yashika C. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jean C. Beckham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrick S. Calhoun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Calhoun, P.S., Wagner, H.R., McClernon, F.J. et al. The effect of nicotine and trauma context on acoustic startle in smokers with and without posttraumatic stress disorder. Psychopharmacology 215, 379–389 (2011). https://doi.org/10.1007/s00213-010-2144-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-010-2144-9

Keywords

Search

Navigation