Prospective examination of pre-trauma anhedonia as a risk factor for post-traumatic stress symptoms.
Prospective examination of pre-trauma anhedonia as a risk factor for post-traumatic stress symptoms.
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DOI：
10.1080/20008198.2021.2015949
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发表时间：
2022
影响因子：
5
通讯作者：
Baker DG
中科院分区：
文献类型：
--
作者：
Acheson DT;Vinograd M;Nievergelt CM;Yurgil KA;Moore TM;Risbrough VB;Baker DG
快感缺乏，即快乐和寻求奖励行为的减少，是一种具有良好描述的神经回路介质的转诊断症状。虽然通常在疾病状态下观察到，现存的假设表明，快感缺失也可能是精神病理学发展的早期风险因素。了解快感缺失对创伤反应轨迹的贡献可能有助于推断有助于创伤前风险与创伤相关症状表达的生物学机制，了解这些机制有助于有针对性的干预措施。采用前瞻性纵向设计，在创伤性疾病的风险人群中，我们测试了这一假设，即快感缺失可能是创伤后应激障碍（PTSD）症状的创伤前危险因素。在三个时间点（部署前、部署后3个月和6个月）对来自海洋复原力研究的成年男性参与者（N = 2，593）进行了评估。从创伤前的自我报告工具中提取快感缺失因子，并测试其与部署后PTSD再体验症状发展的关系。当控制创伤前PTSD和抑郁症状时，较高的部署前快感缺失预测部署后3个月和6个月PTSD侵入性再体验症状增加。抑郁症状不是随后PTSD侵入性再体验症状的显著预测因子。3个月时的快感缺失也有力地预测了6个月时间点PTSD侵入性再体验症状的维持。部署前快感缺失可能是创伤后应激障碍的创伤前风险因素，而不仅仅是创伤暴露和创伤后应激障碍症状表达的状态依赖性影响。快感缺失可能导致PTSD症状出现后再次经历症状的持续性和/或慢性化。美国海军陆战队的快感缺乏症在战斗部署后显著增加。快感缺乏与横断面上再次出现症状有关。快感缺乏与前瞻性地重新经历症状相关。与抑郁症相比，快感缺失与再体验的相关性更强。
Anhedonia, the reduction of pleasure and reward-seeking behaviour, is a transdiagnostic symptom with well-described neural circuit mediators. Although typically observed during disease state, extant hypotheses suggest that anhedonia may also be an early risk factor for development of psychopathology. Understanding the contribution of anhedonia to the trauma-response trajectory may bolster inferences about biological mechanisms contributing to pre-trauma risk versus trauma-related symptom expression, knowledge of which could aid in targeted interventions. Using a prospective, longitudinal design in a population at risk for trauma disorders, we tested the hypothesis that anhedonia may be a pre-trauma risk factor for post-traumatic stress disorder (PTSD) symptoms. Adult male participants from the Marine Resilience Study (N = 2,593) were assessed across three time-points (pre-deployment, 3-month and 6-month post-deployment). An anhedonia factor was extracted from self-report instruments pre-trauma and tested for its relationship with development of PTSD re-experiencing symptoms after deployment. Higher pre-deployment anhedonia predicted increased PTSD intrusive re-experiencing symptoms at 3- and 6-months post-deployment when controlling for pre-trauma PTSD and depression symptoms. Depression symptoms were not significant predictors of subsequent PTSD intrusive re-experiencing symptoms. Anhedonia at 3 mo also robustly predicted maintenance of PTSD intrusive re-experiencing symptoms at the 6 mo time point. Pre-deployment anhedonia may be a pre-trauma risk factor for PTSD, not simply a state-dependent effect of trauma exposure and PTSD symptom expression. Anhedonia may contribute to persistence and/or chronicity of re-experiencing symptoms after the emergence of PTSD symptoms. Anhedonia in US Marines significantly increased following combat deployment. Anhedonia was associated with re-experiencing symptoms cross-sectionally. Anhedonia was associated with re-experiencing symptoms prospectively. Anhedonia was associated more strongly with re-experiencing compared to depression.
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