Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave. #8448, New Orleans, LA, 70112, USA.
J Abnorm Child Psychol. 2018 Oct;46(7):1535-1545. doi: 10.1007/s10802-017-0396-0.
Previous studies have examined the concurrent relationship between posttraumatic stress disorder (PTSD) and a range of psychophysiological variables, including respiratory sinus arrhythmia (RSA). However, there is a lack of research examining the prospective development of trauma symptomatology, and the directionality of the association between RSA level and PTSD has yet to be determined. The current study is the first prospective study to examine whether RSA level and RSA reactivity are risk factors for PTSD symptoms in children. Assessments were conducted both prior to (Time 1) and following (Time 2) a natural disaster (i.e., Hurricane Katrina). Participants were 36 children who were 3-6 years-old during the Time 1 assessment. Structured diagnostic interviews were used to assess PTSD symptoms at both Time 1 and Time 2. RSA level during a neutral stimulus, RSA reactivity to emotional video stimuli (distress, joy, and trauma videos) and RSA reactivity to memory stimuli (remote happy memory, trauma memory, mother's recall of the trauma memory) were also collected at both time points. Time 1 RSA level during a neutral stimulus was a significant predictor of Time 2 PTSD symptoms (controlling for age, Time 1 PTSD symptoms, Time 2 neutral RSA level), such that lower RSA during a neutral condition was related to higher PTSD symptoms. Also, Time 1 RSA reactivity in response to memory (but not video) stimuli, in the form of relatively less vagal withdrawal, was a significant predictor of more Time 2 PTSD symptoms (controlling for age, Time 1 PTSD symptoms, Time 2 RSA reactivity). This unique prospective study provides evidence for level of RSA and RSA reactivity as pre-existing clinical markers of stress sensitivity that predict psychopathology following a trauma.
先前的研究已经考察了创伤后应激障碍（PTSD）与一系列心理生理变量之间的并发关系，包括呼吸窦性心律失常（RSA）。然而，目前缺乏研究来检验创伤症状学的前瞻性发展，以及 RSA 水平与 PTSD 之间的关联方向。本研究是第一个前瞻性研究，旨在检验 RSA 水平和 RSA 反应性是否是儿童 PTSD 症状的危险因素。评估分别在（时间 1）和（时间 2）自然灾害（即卡特里娜飓风）之后进行。参与者是 36 名在时间 1 评估时年龄在 3-6 岁的儿童。使用结构化诊断访谈在时间 1 和时间 2 评估 PTSD 症状。在中性刺激时的 RSA 水平、对情绪视频刺激（痛苦、喜悦和创伤视频）的 RSA 反应性以及对记忆刺激（遥远的快乐记忆、创伤记忆、母亲对创伤记忆的回忆）的 RSA 反应性也在两个时间点收集。中性刺激时的时间 1 RSA 水平是时间 2 PTSD 症状的显著预测指标（控制年龄、时间 1 PTSD 症状、时间 2 中性 RSA 水平），即中性条件下较低的 RSA 与较高的 PTSD 症状相关。此外，时间 1 对记忆（而不是视频）刺激的 RSA 反应性，表现为相对较少的迷走神经撤出，是时间 2 PTSD 症状的显著预测指标（控制年龄、时间 1 PTSD 症状、时间 2 RSA 反应性）。这项独特的前瞻性研究为 RSA 水平和 RSA 反应性作为预测创伤后精神病理学的应激敏感性的现有临床标志物提供了证据。
