Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 Apr;4(4):381-389. doi: 10.1016/j.bpsc.2018.12.010. Epub 2019 Jan 4.
Pathological peritraumatic encoding is proposed as a proximal risk factor for the development of posttraumatic stress disorder (PTSD), with trauma-analog studies linking increased neural processing of trauma films to intrusive trauma recollections, a core symptom of PTSD. Cumulative lifetime adversity is proposed as a more distal risk factor, with research indicating a tipping point at about five events with regard to PTSD development following re-exposure to trauma. Thus, within a diathesis × stress framework, increased peritraumatic neural processing may constitute a specific risk factor for PTSD, particularly in individuals with several lifetime adversities.
Fifty-three healthy women watched highly aversive films depicting severe interpersonal violence versus neutral films during functional magnetic resonance imaging, and they reported involuntary recollections during subsequent days. Moderation analyses tested the interactive relationship between peritraumatic neural processing and lifetime adversity in predicting intrusion load, i.e., the total number of intrusions weighted for their average distress.
Increased processing of aversive versus neutral films in the amygdala, anterior insula, dorsal and rostral anterior cingulate cortices, and hippocampus predicted increased intrusion load only in participants reporting above five lifetime adversities; for participants reporting few to none, no such relationship was found. This interactive relationship explained ≤59% of variance. Conditioned stimuli preceding film viewing mirrored this pattern.
Peritraumatic neural processing in multiple salience network regions and cumulative lifetime adversity interactively predicted PTSD-like symptomatology, representing a diathesis × stress framework that might guide identification of at-risk individuals and potential targets for symptom prevention after traumatic incidents.
病理性创伤后编码被认为是创伤后应激障碍（PTSD）发展的近端风险因素，创伤模拟研究将创伤影片的神经处理增加与 PTSD 的核心症状——侵入性创伤回忆联系起来。累积的终生逆境被认为是一个更遥远的风险因素，研究表明，在再次暴露于创伤后，大约有五个事件会导致 PTSD 的发展。因此，在素质-应激框架内，创伤后神经处理的增加可能构成 PTSD 的一个特定风险因素，特别是在有多个终生逆境的个体中。
53 名健康女性在功能磁共振成像期间观看了描绘严重人际暴力的高度厌恶影片与中性影片，并在随后的几天内报告了无意识的回忆。调节分析测试了创伤后神经处理与终生逆境在预测侵入性负荷（即加权平均痛苦的侵入总数）方面的交互关系。
杏仁核、前岛叶、背侧和前扣带皮质以及海马体中对厌恶影片与中性影片的处理增加仅在报告有五个以上终生逆境的参与者中预测了侵入性负荷的增加；对于报告有很少或没有逆境的参与者，没有发现这种关系。这种交互关系解释了≤59%的方差。在观看影片之前的条件刺激中也反映出了这种模式。
多个显著性网络区域的创伤后神经处理与累积的终生逆境交互预测了类似 PTSD 的症状，代表了一种素质-应激框架，可能有助于识别高危个体，并在创伤事件后预防症状。
