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| Research News Project Overview: This proposal is for a project that expands the scope of disaster research to include physiological monitoring in disaster research methodologies. The project will 1) review the trauma literature for current strengths and weaknesses of monitoring, 2) examine current state-of-the art monitoring equipment and software, 3) increase understanding of how to adapt existing monitoring equipment to disaster field work by attending relevant workshops and conferences and 4) use the expertise of a mentor to help increase understanding of autonomic and sensorimotor responses to traumatic stress and methodologies for assessing those responses using physiological monitoring. Statement of the Problem: Although studies on natural disaster trauma typically report treatment outcomes in terms of both physical and psychological symptoms, mental health interventions seldom explicitly target physical symptoms and the regulation of autonomic nervous system responses to threat, nor have disaster researchers gone beyond paper and pencil assessments of physical symptoms. Trauma studies show that not only does untreated traumatic stress result in so-called "mental health" problems, but it also leads to a variety of serious somatic symptoms: loss of bowel and bladder control (Lehman, 1985; Solomon, Laor & McFarlane, 1996); shaking, trembling, and increased heart rate (Bernat, Ronfeldt & Calhoun, 1998; Resnik, 1997; Shalev et al.,1998); lightheadedness and dizziness (Litchfield, 2005); myofascial pain (Scaer, 2006); diabetes (Golden, Williams & Ford, 2004); heart disease (Musselman & Nemeroff, 2000), and a continuum of stress-related diseases (Green, Grace & Glesser,1985; Scaer). Traumatic symptoms represen t patterns of dysregulation throughout the body, which increase the risk of such physical and psychological illnesses as immune-system disorders, depression, anxiety, and cognitive impairment (Gunnar & Vazquez, 2001; McEwen, 1998; Sapolsky, 1994). During my month-long time in southern Thailand in February, 2005 providing treatment to tsunami survivors and collecting data, our team found that many so-called physical complaints (stomach ache, dizziness, limb weakness, pain) were reduced, and in many cases eliminated, when survivors were treated with an integrative, "bottom-up" approach (Somatic Experiencing) that worked directly with the body's dysregulation. We found that these survivors were less likely to present at the medical tent and were, therefore, less likely to be given medication. It was clear to our team that many physical symptoms are trauma responses which do not require medical intervention. It would have been extremely useful to have had monitoring equipment to compare physiological responses to survivors' verbal reports of symptoms. Researchers are increasingly using physiological monitoring to examine autonomic nervous system responses to traumatic events (Bryant, Harvey, Guthrie & Moulds, 2000; Griffin, Resick & Mechanic, 1997). The Griffin et.al. study found that when highly dissociative rape victims were verbally describing their rapes, there was a significant suppression of autonomic reactivity. In a study of assault victims, Bryant et.al. found that elevated sympathetic nervous system activation was associated with later development of PTSD. I was unable to locate any studies of survivors of natural disasters that used physiological monitoring, nor any physiological monitoring study that studied trauma treatment effectiveness. The non-disaster physiological studies, however, highlight the importance of trauma intervention approaches that assess and attend to the cascade of physiological and psychological responses that can follow traumatic events. Incorporating physiological monitoring into disaster research, particularly disaster research that is associated with treatment delivery, can:
Mentor: Dr. Bob Whitehouse, EdD, has agreed to be mentor for this project. He is a licensed psychologist, certified by BCIA as a senior biofeedback fellow, and emeritus psychology professor. Dr. Whitehouse has been involved with physiological monitoring since 1974 and is a known leader in the biofeedback and psychophysiology field. He has over 10,000 hours monitoring heart rate and other autonomic measures including ETCO2 measures of the chemistry of breathing. He teaches workshops on the use of these measures, their application to trauma and resiliency, and has developed special software for use in documenting traumatic and resilient responses. Proposed Activities and Costs:
TOTAL BUDGET= $14,950
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