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The 2D:4D (Second to Fourth Digit Ratio) Provides Mixed Evidence in Two Samples

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The 2D:4D (Second to Fourth Digit Ratio) Provides Mixed Evidence in Two Samples UNIVERSITY OF STIRLING Why laterality matters in trauma: sinister aspects of memory and emotion CAROLYN J CHOUDHARY A thesis submitted in partial fulfilment for the degree of Doctor of Philosophy in the Department of Psychology July 2008 To Alexander & Jade my left handed twins i Abstract This thesis presents an eclectic mix of studies which consider laterality in the context of previous findings of increased prevalence of Posttraumatic Stress Disorder (PTSD) in male combat veterans with non-consistent right hand preference. Two studies extend these findings not just to civilian populations and women, but to left handers and find that left, rather than mixed, handedness is associated with increased prevalence of PTSD in both general population and clinical samples, and to severity of symptoms in the former. To examine issues relevant to the fear response in healthy populations, a movie excerpt is shown to be theoretically likely to target the emotion of fear and to generate subjective and physiological (skin conductance) responses of fear. The film is used as a laboratory analogue of fear to examine possible differences in left and right handers in memory (for events of the film) and in an emotional Stroop paradigm known to produce a robust and large effect specifically in PTSD. According to predictions based on lateralisation of functions in the brain relevant to the fear response, left handers show a pattern of enhanced memory for visual items and poorer memory for verbal material compared to right handers. Immediately after viewing the film, left handers show an interference effect on the Stroop paradigm to general threat and film words and increased response latency compared to right handers, approaching performance of previously reported clinical samples with PTSD. A novel non-word Stroop task fails to show these effects, consistent both with accounts of interference as language processing effects and compromised verbal processing in PTSD. Unexpected inferior performance of females in memory for the film, contrary to previous literature, may also be amenable to explanations invoking compromised left hemisphere language functions in fear situations. In testing one theory of left handedness as due to increased levels of in utero testosterone, the 2D:4D (second to fourth digit ratio) provides mixed evidence in two samples. A possible association of more female-like digit ratios in males with PTSD is a tentative finding possibly relevant to sex differences in prevalence of PTSD. A critique of existing and inadequate theoretical accounts of handedness concludes the thesis and proposes a modification of the birth stress hypothesis to one specifically considering peri-natal trauma to account for the above findings. This hypothesis remains to be empirically tested. PAPERS ii Papers The following is a list of papers that have resulted from this thesis Choudhary, C. J. & O'Carroll, R. E. (2007). Left hand preference is related to Posttraumatic Stress Disorder. Journal of Traumatic Stress, 20, 365-369. [Included at Appendix 24] Choudhary, C. J., Alexander, D.A.A., Forbes, D., Creamer, M., Huntley, Z., Fuchkan, N., Brewin, C.R., Durham, R.C., O'Carroll, R. E. (2008) (submitted). Left hand preference is related to Posttraumatic Stress Disorder, but not to other anxiety disorders. Psychological Medicine. Choudhary, C. J., & O'Carroll, R. E. (in preparation). Left handers differ from right handers in memory for events of a fearful film in ways similar to deficits in memory found in PTSD. Learning & Memory. Choudhary, C. J., & O'Carroll, R. E. (in preparation). Unexpected sex differences in memory for events of a fearful film: females perform worse than males, but not on a standard test of verbal memory. Learning & Memory. Choudhary, C. J., & O'Carroll, R. E. (in preparation). Left handers show Stroop interference after viewing a fearful film to general threat and film- related words. Journal of Experimental Psychology: General. Choudhary, C. J., & O'Carroll, R. E. (in preparation). Mixed evidence for theories implicating in utero testosterone in left handedness, but do males with PTSD show a more female-like digit ratio? Evolution and Human Behavior. Choudhary, C. J., & O'Carroll, R. E. (in preparation). Historical considerations of PTSD in the context of DSM-V. Psychological Medicine. PAPERS iii Choudhary, C. J., McIntyre, A., Hancock, P.J.B., O'Carroll, R. E. (in preparation). It’s not what you study, but when you recruit: results depend on whether students want to participate. The Psychologist. CONTENTS iv Table of Contents ABSTRACT................................................................................................................................................ I PAPERS.....................................................................................................................................................II TABLE OF CONTENTS ........................................................................................................................IV LIST OF FIGURES............................................................................................................................. VIII LIST OF TABLES.................................................................................................................................... X ACKNOWLEDGEMENTS ....................................................................................................................XI DECLARATION ................................................................................................................................. XIII CHAPTER 1 INTRODUCTION..............................................................................................................1 1.1 INTRODUCTORY REMARKS.........................................................................................................1 1.2 POSTTRAUMATIC STRESS DISORDER (PTSD): A NEW DISORDER? .............................................4 1.3 PTSD AS A DISORDER: OF EMOTION, DISSOCIATION AND MEMORY..........................................22 1.3.1 Lateralisation in emotion...................................................................................................30 1.3.2 The fear response...............................................................................................................32 1.3.3 Fear conditioning and the amygdala .................................................................................41 1.3.4 Extinction and the PFC: fear memories may be forever (LeDoux, 1999)..........................45 1.3.5 A fear conditioning model of PTSD ...................................................................................46 1.3.6 Is PTSD an anxiety disorder?: fear is not equivalent to anxiety or stress .........................48 1.3.7 The nature of traumatic memories .....................................................................................51 1.3.8 PTSD as a dissociative disorder ........................................................................................56 1.3.9 PTSD as a disorder of memory: memory functions are also lateralised............................61 1.3.10 Summary: back to a behavioural account.....................................................................67 1.4 SEX DIFFERENCES IN PTSD .....................................................................................................69 1.5 STUDIES OF LATERAL PREFERENCE IN PTSD: A NEW RISK FACTOR?........................................72 1.6 HANDEDNESS AND LATERALITY ..............................................................................................77 1.7 STRUCTURE OF THE FOLLOWING CHAPTERS.............................................................................81 CHAPTER 2 METHODOLOGICAL ISSUES .....................................................................................85 2.1 POSTTRAUMATIC DIAGNOSTIC SCALE (PDS) ..........................................................................85 2.2 MEASUREMENT OF HANDEDNESS ............................................................................................88 2.3 2D:4D .....................................................................................................................................94 2.4 A MEASURE OF PERCEIVED STRESS: THE PSS10 ......................................................................96 2.5 THE USE OF FILMS....................................................................................................................97 CHAPTER 3 LEFT HANDEDNESS AND POSTTRAUMATIC STRESS DISORDER IN NON- CLINICAL POPULATIONS................................................................................................................104 3.1 PTSD IS RELATED TO LEFT HANDEDNESS IN A GENERAL POPULATION SAMPLE .....................105 3.1.1 Introduction .....................................................................................................................105 3.1.2 Methods............................................................................................................................106 3.1.3 Results..............................................................................................................................108 3.1.4 Discussion........................................................................................................................113 3.2 A REPLICATION USING PARTICIPANTS FROM THE EXPERIMENTAL STUDIES: DIFFERENCES IN REPORTING OF TYPES OF TRAUMA........................................................................................................114
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