Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype.
Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype.
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DOI：
10.1176/appi.ajp.2009.09081168
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发表时间：
2010-06
期刊：
影响因子：
--
通讯作者：
Spiegel D
中科院分区：
文献类型：
--
作者：
Lanius RA;Vermetten E;Loewenstein RJ;Brand B;Schmahl C;Bremner JD;Spiegel D
在这篇文章中，作者提出了关于分离型PTSD亚型的证据，其临床和神经生物学特征可以与非分离型PTSD区分开来。分离亚型的特征是情感的过度调节，而更常见的调节不足型则涉及重新体验和过度唤醒症状的优势。这篇文章的重点是在创伤后应激障碍的解离亚型的神经表现，并比较它的基础上的再体验/hyperaroused亚型。一个模型，包括这两种类型的情绪失调的PTSD描述。在这个模型中，再体验/过度唤醒反应被视为一种情绪失调的形式，涉及情绪调节不足，由边缘系统区域的前额叶抑制失败介导。相比之下，PTSD的分离亚型被描述为一种情绪失调的形式，涉及由相同边缘系统区域的中线前额叶抑制介导的情绪过度调节。这两种类型的调制都涉及到一个动态的相互作用，并导致交替的PTSD症状概况。这些发现对创伤后应激障碍的治疗具有重要意义，包括需要评估创伤后应激障碍患者的分离症状，并将分离症状的治疗纳入阶段性创伤治疗。
In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.
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影响因子：
6.9
作者：
Felmingham, K.;Kemp, A. H.;Bryant, R.
通讯作者：
Bryant, R.
影响因子：
--
作者：
Geuze, Elbert;Westenberg, Herman G. M.;Schmahl, Christian
通讯作者：
Schmahl, Christian
影响因子：
5.9
作者：
Jaycox, LH;Foa, EB;Morral, AR
通讯作者：
Morral, AR
DOI：
10.1196/annals.1364.010
发表时间：
2006-01-01
期刊：
PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS
影响因子：
--
作者：
Frewen, Paul A.;Lanius, Ruth A.
通讯作者：
Lanius, Ruth A.
影响因子：
3.3
作者：
Hopper, James W.;Frewen, Paul A.;Lanius, Ruth A.
通讯作者：
Lanius, Ruth A.