Linking plasma cortisol levels to phenotypic heterogeneity of posttraumatic stress symptomatology.
Linking plasma cortisol levels to phenotypic heterogeneity of posttraumatic stress symptomatology.
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DOI：
10.1016/j.psyneuen.2013.10.003
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发表时间：
2014-01
影响因子：
3.7
通讯作者：
Neumeister, Alexander
中科院分区：
文献类型：
--
作者：
Horn, Charlotte A. C.;Pietrzak, Robert H.;Corsi-Travali, Stefani;Neumeister, Alexander
最近对创伤后应激障碍（PTSD）维度结构的验证性因素分析研究表明，这种障碍可能最好地表征为五个症状维度——重新体验、逃避、麻木、烦躁唤醒和焦虑唤醒。PTSD患者的下丘脑-垂体-肾上腺（HPA）轴失调与糖皮质激素反应性增强有关。然而，hpa -轴功能的改变与当代PTSD表型模型的关系尚不清楚。我们比较了无药物的创伤后应激障碍平民成人（N=29）与创伤暴露（TC， N=12）和非创伤暴露健康对照（HC， N=23）的晨间血浆皮质醇水平。然后，我们检查了皮质醇水平与当代PTSD患者PTSD症状的5因素“不安唤醒”模型之间的关系。在调整白人种族/民族、教育、终生酒精使用障碍和当前吸烟状况后，PTSD （Cohen’s d=1.1）和TC （Cohen’s d=1.3）组的皮质醇水平显著低于HC组；皮质醇水平在TC组和PTSD组之间没有差异。除了年龄（r=−）。46)，其他人口统计学、创伤相关或临床变量（包括终生情绪/焦虑障碍和当前抑郁和焦虑症状的严重程度）均与皮质醇水平无关。在逐步线性回归分析中，年龄(β=−。44)和情绪麻木症状的严重程度(β= -。35)与PTSD组皮质醇水平独立相关；其他创伤后应激障碍症状群或抑郁症状都不显著。事后分析显示，情感范围受限（即无法拥有爱的感觉）的情感麻木症状的严重程度与皮质醇水平独立相关（β= - 0.35）。这些结果表明，与健康的、没有创伤暴露的成年人相比，创伤暴露的平民成年人有或没有创伤后应激障碍的皮质醇水平显著降低。他们进一步指出，成年PTSD患者的低皮质醇水平可能与PTSD特有的情绪麻木症状有关，而这种症状与抑郁症状无关。
Recent confirmatory factor analytic studies of the dimensional structure of posttraumatic stress disorder (PTSD) suggest that this disorder may be best characterized by five symptom dimensions—re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal. Hypothalamic-pituitary-adrenal (HPA) axis dysregulation in PTSD and has been attributed to enhanced glucocorticoid responsiveness. However, little is known about how altered HPA-axis function is related to this contemporary phenotypic model of PTSD. We compared morning plasma cortisol levels of drug-free civilian adults with PTSD (N=29) to trauma-exposed (TC; N=12) and non trauma-exposed healthy controls (HC; N=23). We then examined the relation between cortisol levels and a contemporary 5-factor ‘dysphoric arousal’ model of PTSD symptoms among individuals with PTSD. After adjustment for white race/ethnicity, education, lifetime alcohol use disorder, and current smoking status, the PTSD (Cohen’s d=1.1) and TC (Cohen’s d=1.3) groups had significantly lower cortisol levels than the HC group; cortisol levels did not differ between the TC and PTSD groups. Except for age (r=−.46), none of the other demographic, trauma-related, or clinical variables, including lifetime mood/anxiety disorder and severity of current depressive and anxiety symptoms, were associated with cortisol levels. In a stepwise linear regression analysis, age (β= −.44) and severity of emotional numbing symptoms (β= −.35) were independently associated with cortisol levels in the PTSD group; none of the other PTSD symptom clusters or depression symptoms were significant. Post-hoc analyses revealed that severity of the emotional numbing symptom of restricted range of affect (i.e., unable to have loving feelings) was independently related to cortisol levels (β= −.35). These results suggest that trauma-exposed civilian adults with and without PTSD have significantly lower cortisol levels compared to healthy, non-trauma-exposed adults. They further suggest that low cortisol levels among adults with PTSD may be specifically linked to emotional numbing symptomatology that is unique to the PTSD phenotype and unrelated to depressive symptoms.
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DOI：
10.1111/j.1749-6632.2009.04979.x
发表时间：
2009-01-01
期刊：
GLUCOCORTICOIDS AND MOOD CLINICAL MANIFESTATIONS, RISK FACTORS, AND MOLECULAR MECHANISMS
影响因子：
--
作者：
Yehuda, Rachel
通讯作者：
Yehuda, Rachel
DOI：
10.1016/j.ecl.2013.05.004
发表时间：
2013-09-01
影响因子：
4.5
作者：
Daskalakis, Nikolaos P.;Lehrner, Amy;Yehuda, Rachel
通讯作者：
Yehuda, Rachel
影响因子：
3.6
作者：
Kubany, ES;Haynes, SN;Burns, K
通讯作者：
Burns, K
影响因子：
10.6
作者：
Steudte, Susann;Kirschbaum, Clemens;Stalder, Tobias
通讯作者：
Stalder, Tobias
影响因子：
11
作者：
Neumeister, A.;Normandin, M. D.;Pietrzak, R. H.;Piomelli, D.;Zheng, M. Q.;Gujarro-Anton, A.;Potenza, M. N.;Bailey, C. R.;Lin, S. F.;Najafzadeh, S.;Ropchan, J.;Henry, S.;Corsi-Travali, S.;Carson, R. E.;Huang, Y.
通讯作者：
Huang, Y.