PTSD, but not childhood maltreatment, modifies responses to unpleasant odors Ilona Croy a,b, ⁎, Julia Schellong a , Peter Joraschky a , Thomas Hummel b a Department of Psychosomatic Medicine, University of Dresden Medical School, Fetscherstr. 74, D-01307 Dresden, Germany b Smell and Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Fetscherstr. 74, D-01307 Dresden, Germany abstract article info Article history: Received 25 June 2009 Received in revised form 30 December 2009 Accepted 7 January 2010 Available online 15 January 2010 Keywords: Smell Olfaction Child maltreatment Child abuse PTSD Childhood maltreatment (CM) as well as posttraumatic stress disorder (PTSD) is said to result in functional changes to amygdalae and orbitofrontal cortex. Thus, it might be expected to change olfactory function in adults with a CM-history and current PTSD symptomatology as amygdalae and orbitofrontal cortex are of major importance for olfactory information processing. To explore this we investigated olfactory function in 31 women with current psychopathology and a history of CM, 28 without CM, and 27 healthy women. We used the “Sniffin' Sticks” threshold and identification test and analyzed chemosensory event-related potentials. Participants were also asked to complete a questionnaire to access current symptoms of posttraumatic stress disorder (PTSD). We found no significant difference between the CM-Group and the two control groups, but PTSD severity correlated significantly with odor identification scores and with parameters of event-related potentials in response to unpleasant stimuli. The results indicate preferential processing of unpleasant stimuli in PTSD patients irrespective of the childhood history. © 2010 Elsevier B.V. All rights reserved. 1. Introduction The aim of this study was to investigate relations between emotional information processing and the sense of smell by exploring olfactory function in groups of individuals that are characterized by psychopathology involving emotion regulation deficits. This was based on the idea that some studies indicate functional and structural changes in amygdalae and orbitofrontal cortex following psychoso- matic and psychiatric disorders involving emotion regulation deficits. Both regions are highly important for olfactory information proces- sing. For this exploratory study, we focused on patients with psychosomatic disorders and with a history of childhood maltreat- ment (CM), as well as on adults suffering from posttraumatic stress disorder (PTSD) symptomatology. In contrast to other patients with psychopathology, patients with CM are often seen as a special group, requiring special treatment. This is due to a conspicuous emotion regulation deficit in these patients, involving hyperarousal and depression (Herman, 1992; Sack, 2004). CM constitutes a major social issue. For example, approximately 10% of German students report severe physical abuse by their parents (Pfeiffer et al., 1999). Similar estimates exist for the USA. In a retrospective study with over 17,000 participants, 12% of USAmerican adults report severe maltreatment in their childhood (Anda et al., 2006). Maltreated children not only perform worse in tests of language and cognitive function (Hoffman-Plotkin and Twentyman, 1984; Beers and Bellis, 2002; Prasad et al., 2005), they also suffer to adulthood from their childhood experiences. Adults with a history of CM are more likely to develop psychiatric diseases, like depression, anxiety or substance abuse (Anda et al., 2006). In contrast to the biographical experience of CM, PTSD is a psychosomatic disorder. It is described by the criteria of hyperarousal, intrusion and avoidance following an extreme traumatic experience (American-Psychiatric-Association, 2000). Lifetime prevalence of PTSD is estimated at about 8% (Kessler et al., 1995). The prevalence of trauma survivors developing PTSD is estimated at about 25% (Yehuda, 2002). It is important to note, that although adults with a history of CM have an enhanced risk to develop psychiatric diseases (Anda et al., 2006), not all of them get PTSD. On the other side, not all PTSD patients have traumatic childhood experiences, but might develop PTSD after traumatic adulthood experiences. Neurostructural changes have been described in the context of CM and PTSD. Some authors suggest a reduced brain volume in CM patients (DeBellis et al., 1999; DeBellis and Keshavan, 2003). More specifically, volume reduction is reported in parts of the limbic system, including amygdalae (Driessen et al., 2000; Teicher et al., 2003; Vermetten et al., 2006), hippocampus (Bremner et al., 1997) and anterior cingulate cortex (Kitayama et al., 2006). In all of these studies, the participants also suffered from psychopathology, mostly PTSD. Thus, one could argue that the smaller volumes of these structures are not the result of traumatic experiences, but that smaller volumes in these brain regions enhance the risk to develop psychopathology, especially PTSD in participants with CM. International Journal of Psychophysiology 75 (2010) 326–331 ⁎ Corresponding author. Smell and Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Fetscherstr. 74, 01307 Dresden, Germany. Tel.: +49 351 4584663; fax: +49 351 4584326. E-mail address: Ilona.Croy@mailbox.tu-dresden.de (I. Croy). 0167-8760/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.ijpsycho.2010.01.003 Contents lists available at ScienceDirect International Journal of Psychophysiology journal homepage: www.elsevier.com/locate/ijpsycho