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Event-related potential studies of post-traumatic stress disorder: a critical review and synthesis
In: http://www.biolmoodanxietydisord.com/content/1/1/5
Abstract Despite the sparseness of the currently available data, there is accumulating evidence of information processing impairment in post-traumatic stress disorder (PTSD). Studies of event-related potentials (ERPs) are the main tool in real time examination of information processing. In this paper, we sought to critically review the ERP evidence of information processing abnormalities in patients with PTSD. We also examined the evidence supporting the existence of a relationship between ERP abnormalities and symptom profiles or severity in PTSD patients. An extensive Medline search was performed. Keywords included PTSD or post-traumatic stress disorder, electrophysiology or EEG, electrophysiology, P50, P100, N100, P2, P200, P3, P300, sensory gating, CNV (contingent negative variation) and MMN (mismatch negativity). We limited the review to ERP adult human studies with control groups which were reported in the English language. After applying our inclusion-exclusion review criteria, 36 studies were included. Subjects exposed to wide ranges of military and civilian traumas were studied in these reports. Presented stimuli were both auditory and visual. The most widely studied components included P300, P50 gating, N100 and P200. Most of the studies reported increased P300 response to trauma-related stimuli in PTSD patients. A smaller group of studies reported dampening of responses or no change in responses to trauma-related and/or unrelated stimuli. P50 studies were strongly suggestive of impaired gating in patients with PTSD. In conclusion, the majority of reports support evidence of information processing abnormalities in patients with PTSD diagnosis. The predominance of evidence suggests presence of mid-latency and late ERP components differences in PTSD patients in comparison to healthy controls. Heterogeneity of assessment methods used contributes to difficulties in reaching firm conclusions regarding the nature of these differences. We suggest that future ERP-PTSD studies utilize standardized assessment scales that provide detailed information regarding the symptom clusters and the degree of symptom severity. This would allow assessment of electrophysiological indices-clinical symptoms relationships. Based on the available data, we suggest that ERP abnormalities in PTSD are possibly affected by the level of illness severity. If supported by future research, ERP studies may be used for both initial assessment and treatment follow-up.
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Weighing up the risks, considering the benefits: public perceptions of smart grid technologies
Much has been written on the possible implications of the introduction of smart grids for the UK energy market on standards and technical issues, data handling, regulation and investment. Less consideration has been given to lay perceptions of smart grids; yet consumer engagement will likely influence the extent to which such technologies will help with managing energy demand more efficiently, reduce peak loads and household bills. Sharing data, compromising confidentiality and being subjected to unsolicited marketing calls were key, interlinked issues of great importance to participants when considering a future smart grid. Participants were usually comfortable with their data being used if anonymised for the smoother operation of the network and in return for cheaper prices. If data could be linked back to them personally, opinion was divided over whether this would be an invasion of privacy or simply knowledge of daily routines and household energy usage. Some wanted to see a more dynamic relationship whereby if consumers shared information, they would be kept informed as to how it was used, and thus also receive some benefit. Quantitative data collected supported these ideas, highlighting that participants did not perceive benefits to the consumer of a future smart grid to outweigh the related risks. We additionally found that perceived benefits to society and to energy companies were perceived as higher than those conferred to the consumer and significantly outweighed the relative perceived risks. Discussions highlighted that particip ants assumed that future changes to the energy system were likely to maximise profits and benefit supply and demand for energy companies alone. We note that current negative perceptions of the 'big six' energy companies also greatly influenced participants' attitudes to data sharing, and motivations to change their behaviour. Frequently emerging was the idea that energy supply was a basic need to be managed for the good of everyone rather than led by commercial pressures and share holders in the private sector. In relation to behavior change, participants envisaged being able to interact with new technologies and systems in order to use mainly renewable 'clean' energy, with the proviso that they could override systems where necessary. Yet there was also the view that such decisions should be taken out of consumers' hands as part of a government-led green strategy where only one sustainable option would be available. Developing and effectively communicating consumer and societal benefits would likely increase engagement with a future smart grid. It is argued that strong policy to address this along with decisive regulation would help to build trust and reduce risks. ; UKERC
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