Exploring the dissociative subtype of PTSD: The role of early-life trauma, cortisol, and inflammatory profiles

IF 3.4 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Psychoneuroendocrinology Pub Date : 2025-02-17 DOI:10.1016/j.psyneuen.2025.107406

Dana A. Jarkas , Rebecca Robillard , Claude-Richard Malenfant , Carley Richards , Malika Lanthier , Cecile Beaurepaire , Andrew A. Nicholson , Natalia Jaworska , Clifford M. Cassidy , Jakov Shlik , Zachary Kaminsky , Robyn J. McQuaid

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引用次数: 0

Abstract

Post-traumatic stress disorder (PTSD) is a heterogeneous mental health condition, characterized by diverse symptom profiles and biological underpinnings. A dissociative subtype of PTSD has been identified, though the potential risk factors and underlying neurobiology are yet to be understood. The current study comprised Canadian Armed Forces (CAF) members and Veterans with a history of deployment, and with diagnoses of non-dissociative (n = 31) and dissociative subtypes of PTSD (n = 19), in addition to non-deployed healthy controls (n = 14). Participants completed questionnaires assessing clinical symptoms and experiences of trauma, and provided saliva and blood samples for cortisol and inflammatory marker assessments. Individuals with dissociative PTSD displayed elevated PTSD and depression symptom severity, and greater reports of specific forms of childhood trauma compared to individuals with non-dissociative PTSD and controls. Morning cortisol was elevated in both PTSD groups compared to controls, however the PTSD groups did not differ from one another. Evening cortisol concentrations were elevated in both PTSD groups compared to controls, and in the dissociative PTSD subtype compared to the non-dissociative PTSD subtype when controlling for depression symptoms. PTSD diagnostic group moderated the relationship between awakening cortisol levels and PTSD symptom severity, such that the non-dissociative PTSD group displayed a negative correlation between awakening cortisol levels and PTSD symptom severity, while no significant relation was identified in the dissociative PTSD group. C-reactive protein (CRP) levels did not differ across diagnostic groups when accounting for body mass index (BMI). However, CRP positively correlated with depressive symptoms only among individuals with dissociative PTSD. Together, examining PTSD subtypes may help inform more effective and personalized treatment strategies in the future.

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探索创伤后应激障碍的分离亚型：早期生活创伤，皮质醇和炎症谱的作用

创伤后应激障碍（PTSD）是一种异质性的精神健康状况，具有多种症状特征和生物学基础。虽然潜在的危险因素和潜在的神经生物学尚不清楚，但已经确定了创伤后应激障碍的分离亚型。目前的研究包括加拿大武装部队（CAF）成员和有部署史的退伍军人，诊断为非解离性PTSD （n = 31）和解离性PTSD亚型（n = 19），以及非部署健康对照（n = 14）。参与者完成评估临床症状和创伤经历的问卷调查，并提供唾液和血液样本用于皮质醇和炎症标志物评估。与非分离性PTSD和对照组相比，分离性PTSD患者表现出更高的PTSD和抑郁症状的严重程度，并且有更多的特定形式的童年创伤的报告。与对照组相比，两个创伤后应激障碍组的早晨皮质醇水平都有所升高，但创伤后应激障碍组之间并无差异。在控制抑郁症状的情况下，两组PTSD患者的夜间皮质醇浓度均高于对照组，分离性PTSD亚型患者的夜间皮质醇浓度也高于非分离性PTSD亚型患者。PTSD诊断组调节唤醒皮质醇水平与PTSD症状严重程度的关系，非解离性PTSD组唤醒皮质醇水平与PTSD症状严重程度呈负相关，而解离性PTSD组未发现显著相关。当考虑到身体质量指数（BMI）时，c反应蛋白（CRP）水平在诊断组之间没有差异。然而，CRP与抑郁症状仅在分离性PTSD个体中呈正相关。总之，研究PTSD亚型可能有助于在未来提供更有效和个性化的治疗策略。

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来源期刊

Psychoneuroendocrinology 医学-精神病学

CiteScore

7.40

自引率

8.10%

发文量

268

审稿时长

66 days

期刊介绍： Psychoneuroendocrinology publishes papers dealing with the interrelated disciplines of psychology, neurobiology, endocrinology, immunology, neurology, and psychiatry, with an emphasis on multidisciplinary studies aiming at integrating these disciplines in terms of either basic research or clinical implications. One of the main goals is to understand how a variety of psychobiological factors interact in the expression of the stress response as it relates to the development and/or maintenance of neuropsychiatric illnesses.