Olfactory identification dysfunction, aggression and impulsivity in war veterans with post-traumatic stress disorder

• Published in: Psychological medicine Vol. 38; no. 4; pp. 523 - 531
• Main Authors: Dileo, J. F., Brewer, W. J., Hopwood, M., Anderson, V., Creamer, M.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.04.2008
• Subjects: Adult and adolescent clinical studies; Aggression; Aggression - physiology; Aggression - psychology; Alcoholism - diagnosis; Alcoholism - physiopathology; Alcoholism - psychology; Anxiety - diagnosis; Anxiety - physiopathology; Anxiety - psychology; Anxiety disorders. Neuroses; Anxiety-Depression; Arousal - physiology; Behavior; Biological and medical sciences; Combat Disorders - diagnosis; Combat Disorders - physiopathology; Combat Disorders - psychology; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Depression - diagnosis; Depression - physiopathology; Depression - psychology; Humans; Identification; Impulsive Behavior - diagnosis; Impulsive Behavior - physiopathology; Impulsive Behavior - psychology; Impulsivity; Male; Medical imaging; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Neuropsychological Tests; Neurosciences; Odors; Olfaction Disorders - diagnosis; Olfaction Disorders - physiopathology; Olfaction Disorders - psychology; olfactory identification; Personality disorders; Post-traumatic stress disorder; Posttraumatic stress disorder; Prefrontal Cortex - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Research methodology; Statistical analysis; Studies; Temporal Lobe - physiopathology; Veterans; Veterans - psychology; impulsivity; olfactory identification; post-traumatic stress disorder; Aggression; Nervous system diseases; Impulsivity; Posttraumatic syndrome; Anxiety disorder; Posttraumatic stress disorder; Identification; Olfactory disorder; Neurological disorder; Veteran; Stress
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291707001456

Due to neuropsychological conceptualizations of orbitoprefrontal cortex (OFC) dysfunction underpinning impulsive aggression and the incidence of such behaviour in post-traumatic stress disorder (PTSD), this study aimed to explore olfactory identification (OI) ability in war veterans with PTSD as a probe of putative OFC dysfunction; and to explore the utility of OI ability in predicting aggressive and impulsive behavior in this clinical population. Participants comprised 31 out-patient male war veterans with PTSD (mean=58.23 years, s.d.=2.56) recruited from a Melbourne Veterans Psychiatry Unit, and 31 healthy age- and gender-matched controls (mean=56.84 years, s.d.=7.24). All participants were assessed on clinical measures of PTSD, depression, anxiety, and alcohol misuse; olfactory identification; neurocognitive measures of dorsolateral prefrontal, lateral prefrontal and mesial temporal functioning; and self-report measures of aggression and impulsivity. War veterans with PTSD exhibited significant OI deficits (OIDs) compared to controls, despite uncompromised performance on cognitive measures. OIDs remained after covaring for IQ, anxiety, depression and alcohol misuse, and were significant predictors of aggression and impulsivity. This research contributes to emerging evidence of orbitoprefrontal dysfunction in the pathophysiology underlying PTSD. This is the first study to report OIDs as a predictor of aggression and impulsivity in this clinical population. It prompts further exploration of the potential diagnostic utility of OIDs in the assessment of PTSD. Such measures may help delineate the clinical complexity of PTSD, and support more targeted interventions for individuals with a greater susceptibility to aggressive and impulsive behaviors.