The role of emotion dysregulation in PTSD symptomology

描述（由申请人提供）：创伤后应激障碍（PTSD）是一种使人衰弱的精神障碍，在暴露于创伤事件的人群中发展。在低收入的市中心人群中，终生PTSD的发生率显著增加， 遭受多重创伤事件和童年创伤的人数远远高于一般人口。在这种类型的高危样本中研究PTSD病理学提供了一个独特的机会，可以更好地了解PTSD症状发展和维持的潜在机制。 一个可能决定PTSD症状发展风险更大的心理因素是情绪失调。情绪失调反映了对情绪的认识和接受以及管理强烈负面情绪状态的调节策略的缺陷。研究已经表明，情绪失调可以被视为一个transdiagnosis过程，有助于许多类型的成人精神病理学，包括创伤后应激障碍。情绪调节的困难经常在暴露于创伤事件的个体中发现，有证据表明这些问题可以在早期发展并持续到成年。因此，情绪失调在创伤相关精神病理学中的作用可能在一生中面临多重创伤风险的人群中特别突出。这些发现都表明，情绪失调可能是理解创伤、PTSD和其他精神病理学之间复杂关系的关键因素。 虽然有越来越多的证据表明情绪失调在创伤后应激障碍病理学中的重要性，但大多数关于情绪失调的研究都集中在一维自我报告措施上，并没有建立情绪失调与创伤后应激障碍客观识别的生物标志物之间的关系。此外，由于创伤后应激障碍症状的不同表现，研究超越对分类障碍的关注，而是评估对侵入、回避、麻木和过度觉醒症状群的持续表现的不同影响是至关重要的。这种方法与NIMH RDoC倡议高度相关，因为它将包括生物学以及心理学指标，并检查跨越DSM定义的疾病的结构。具体来说，本研究将使用主观和行为措施的情绪失调，并评估这些差异如何与创伤后应激障碍症状群以及创伤后应激障碍的行为和生理生物标志物在一个高度创伤的城市少数民族人口的目标是了解创伤暴露和创伤后应激障碍症状之间的途径。

DESCRIPTION (provided by applicant): Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder that develops in a subset of people exposed to traumatic events. The rate of lifetime PTSD in low income, inner-city populations where there is significantly increased risk for exposure to multiple traumatic events and childhood trauma is much higher than the general population. Studying PTSD symptomatology in this type of at-risk sample provides a unique opportunity to better understand underlying mechanisms in the development and maintenance of PTSD symptoms. One psychological factor that may determine greater risk in the development of PTSD symptoms is emotion dysregulation. Emotion dysregulation reflects deficits in awareness and acceptance of emotions as well as in regulation strategies to manage intense negative emotional states. Research has already shown that emotion dysregulation can be viewed as a transdiagnostic process that contributes to many types of adult psychopathology, including PTSD. Difficulties with emotion regulation are often found in individuals exposed to traumatic events and evidence suggests that these problems can develop early on and persist into adulthood. Therefore, the role of emotion dysregulation in trauma-related psychopathology may be particularly salient in populations at risk for exposure to multiple traumas across the lifespan. These findings all suggest that emotion dysregulation may be a critical factor in understanding the complex relationship between trauma, PTSD, and other psychopathology. While there is growing evidence to suggest the importance of emotion dysregulation in PTSD symptomology, most research on emotion dysregulation has focused on unidimensional self-report measures and has not established how emotion dysregulation relates to objectively identified biomarkers of PTSD. Furthermore, because of the varied presentation of PTSD symptoms, it is critical that research move beyond a focus on the categorical disorder and instead [evaluate differential effects on the continuous presentation of symptoms across intrusion, avoidance, numbing and hyperarousal symptom clusters. This approach is highly relevant to the NIMH RDoC initiative in that it will include biological in addition to psychologica metrics and examine constructs that cut across DSM defined disorders.] Specifically, the present study will use subjective and behavioral measures of emotion dysregulation and evaluate how these differentially relate to the PTSD symptom clusters as well as behavioral and physiological biomarkers of PTSD in a highly traumatized urban minority population with the goal of understanding pathways between trauma exposure and PTSD symptoms.