Heber Ruth, Kellner Michael, Yehuda Rachel
Mount Sinai School of Medicine, USA.
J Clin Psychol. 2002 Dec;58(12):1521-30. doi: 10.1002/jclp.10102.
Trauma survivors with posttraumatic stress disorder (PTSD) have been shown to have lower basal cortisol levels in the urine, plasma, and saliva than in trauma survivors without PTSD, nontraumatized mentally ill, or healthy subjects. We report on a case study in which we measured pre- and post-Eye Movement Desensitization and Reprocessing (EMDR) treatment salivary cortisol levels and salivary cortisol response to 0.50 mg of dexamethasone in a 41-year-old female with chronic PTSD symptoms. Our goal was to determine whether symptom improvement following trauma-focused treatment (EMDR) is associated with changes in basal salivary cortisol or in the cortisol response to dexamethasone administration. Our findings show moderate symptom improvement, an increase in basal cortisol levels, and a more attenuated cortisol hypersuppression in response to the dexamethasone suppression test following EMDR treatment. These results suggest the potential utility of including neuroendocrine measures in the assessment of treatment outcome in PTSD.
创伤后应激障碍（PTSD）的创伤幸存者在尿液、血浆和唾液中的基础皮质醇水平，已被证明低于无PTSD的创伤幸存者、未受创伤的精神疾病患者或健康受试者。我们报告了一项案例研究，在该研究中，我们测量了一名患有慢性PTSD症状的41岁女性在眼动脱敏再处理（EMDR）治疗前后的唾液皮质醇水平，以及唾液皮质醇对0.50毫克地塞米松的反应。我们的目标是确定以创伤为重点的治疗（EMDR）后症状的改善是否与基础唾液皮质醇的变化或皮质醇对地塞米松给药的反应有关。我们的研究结果显示，症状有中度改善，基础皮质醇水平升高，并且在EMDR治疗后，对地塞米松抑制试验的皮质醇超抑制反应有所减弱。这些结果表明，在评估PTSD的治疗效果时纳入神经内分泌指标具有潜在的实用价值。
