Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in motor vehicle accident victims
Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in motor vehicle accident victims
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DOI：
10.1016/s0887-6185(02)00185-8
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发表时间：
2003-01-01
影响因子：
10.3
通讯作者：
Cullado, M
中科院分区：
文献类型：
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作者：
Delahanty, DL;Raimonde, AJ;Cullado, M
本研究探讨了机动车事故（MVA）和创伤后应激障碍（PTSD）评估后1个月的创伤事件，生命威胁和损伤严重程度的历史之间的关系。此外，最初的尿皮质醇水平事故后进行了检查，作为一个可能的调解人的这种关系。15小时尿皮质醇样本收集MVA受害者入院后的创伤单位。在医院，主观的生命威胁进行了测量和客观的伤害严重程度评分（ISS）进行了计算。事故发生一个月后，研究人员对参与者的创伤经历史、急性创伤后应激障碍的存在以及侵入性和回避性思想和行为的水平进行了评估。符合PTSD诊断标准的受害者报告了更多的先前创伤事件，并且尽管比没有发展PTSD的受害者接受了显着较低的ISS，但生命威胁显着更大。皮质醇水平介导了ISS与PTSD症状、既往创伤史与PTSD症状之间的关系。结果表明，皮质醇水平在急性创伤事件后可能作为一种机制，通过各种因素可能会增加PTSD的风险。(C)2002年爱思唯尔科学公司All rights reserved.
This study examined the relationship between prior history of traumatic events, life threat, and injury severity experienced during a motor vehicle accident (MVA), and posttraumatic stress disorder (PTSD) assessed 1 month after the accident. In addition, initial urinary cortisol levels after the accident were examined as a possible mediator of this relationship. Fifteen-hour urinary cortisol samples were collected from MVA victims upon admission to the trauma unit. In the hospital, subjective life threat was measured and objective Injury Severity Scores (ISSs) were computed. One month after the accident, participants were assessed for prior history of traumatic experiences, presence of acute PTSD, and levels of intrusive and avoidant thoughts and behaviors. Victims, who met PTSD diagnostic criteria, reported more prior traumatic events, and significantly greater life threat despite receiving significantly lower ISSs than victims who did not develop PTSD. The relationships between ISSs and PTSD symptoms and prior trauma history and PTSD symptoms were mediated by cortisol levels. Results suggest that cortisol levels in the acute aftermath of a traumatic event may serve as a mechanism through which various factors may increase risk for PTSD. (C) 2002 Elsevier Science Inc. All rights reserved.