Steroid hormone levels in posttraumatic stress disorder: Examination of long-term endocrine alterations in a cross-sectional and a therapy evaluation design

创伤后应激障碍中的类固醇激素水平：横截面和治疗评估设计中长期内分泌变化的检查

• 批准号: 237755525
• 负责人: Dr. Tobias Stalder
• 金额: --
• 依托单位: Professur für Klinische Psychologie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2013
• 资助国家: 德国
• 起止时间: 2012-12-31 至 2015-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/237755525?language=en
• 关键词: Steroid; hormone; levels; posttraumatic; stress

Over the past decade, evidence has increasingly emerged suggesting links between altered activity of the hypothalamic-pituitary-adrenal axis and the pathophysiology and treatment-response of posttraumatic stress disorder (PTSD). While most of this research has suggested a general hypocortisolism in PTSD patients with a long time interval since traumatisation, specific findings of this research have been characterised by some inconsistency. Amongst other things, this may be due to limitations in the measurement of long-term cortisol secretion using previous methods. The assessment of cortisol levels in hair for the first time provides a valid index of cumulative hormone secretion over time periods of several months and thus opens up important new perspectives for research into the neuroendocrine correlates of PTSD. The current research project aims to provide a detailed investigation of long-term endocrine correlates and therapy-induced changes of PTSD. For this, the novel method of hair cortisol analysis is applied within a longitudinal therapy evaluation study with a nested cross-sectional element. At baseline, detailed endocrine assessments of PTSD patients are compared with respective data of both (i) healthy, non-traumatised controls as well as (ii) healthy, traumatised controls without psychiatric morbidity. In addition, a pre-post control group design is used to examine intraindividual changes in cumulative hair steroid levels over the course of a cognitive behavioural therapy treatment. Results of this research are believed to significantly extend current fundamental knowledge regarding the psychoendocrinology of traumatisation and PTSD as well as to inform future research into innovative treatment approaches.

在过去的十年中，越来越多的证据表明，下丘脑-垂体-肾上腺轴的活动改变与创伤后应激障碍（PTSD）的病理生理学和治疗反应之间存在联系。虽然大多数研究表明，创伤后应激障碍患者在创伤后很长一段时间内都会出现皮质醇减少症，但这项研究的具体结果存在一些不一致。除其他外，这可能是由于使用以前的方法测量长期皮质醇分泌的限制。头发中皮质醇水平的评估首次提供了一个有效的指标，累积激素分泌超过几个月的时间段，从而开辟了重要的新的角度研究创伤后应激障碍的神经内分泌相关。目前的研究项目旨在提供一个长期的内分泌相关性和治疗引起的PTSD的变化的详细调查。为此，毛发皮质醇分析的新方法应用于具有嵌套横截面元素的纵向治疗评价研究中。在基线时，将PTSD患者的详细内分泌评估与（i）健康的、未受创伤的对照以及（ii）健康的、受创伤的、没有精神病发病率的对照的相应数据进行比较。此外，使用前后对照组设计来检查在认知行为疗法治疗过程中累积毛发类固醇水平的个体内变化。这项研究的结果被认为显着扩展了目前关于创伤和PTSD的精神内分泌学的基础知识，并为未来的创新治疗方法研究提供了信息。

项目成果

Hair cortisol concentrations and cortisol stress reactivity in generalized anxiety disorder, major depression and their comorbidity.

• DOI: 10.1016/j.jpsychires.2016.09.024
• 发表时间: 2017
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: S. Steudte-Schmiedgen;Susann Wichmann;T. Stalder;K. Hilbert;Markus Muehlhan;U. Lueken;K. Beesdo-Baum

An integrative model linking traumatization, cortisol dysregulation and posttraumatic stress disorder: Insight from recent hair cortisol findings

• DOI: 10.1016/j.neubiorev.2016.07.015
• 发表时间: 2016-10
• 期刊: Neuroscience & Biobehavioral Reviews
• 影响因子: 8.2
• 作者: S. Steudte-Schmiedgen;C. Kirschbaum;N. Alexander;T. Stalder

Trauma exposure is associated with increased context-dependent adjustments of cognitive control in patients with posttraumatic stress disorder and healthy controls

• DOI: 10.3758/s13415-014-0299-2
• 发表时间: 2014-06
• 期刊: Cognitive, Affective, & Behavioral Neuroscience
• 作者: S. Steudte-Schmiedgen;T. Stalder;C. Kirschbaum;Fanny Weber;J. Hoyer;F. Plessow