Shih Chia-Hao, Thalla Palguna R, Elhai Jon D, Mathews Jeremy, Brickman Kristopher R, Redfern Roberta E, Xie Hong, Wang Xin
Department of Psychiatry, University of Toledo, Toledo, OH, USA.
Department of Psychology, University of Toledo, Toledo, OH, USA.
Eur J Psychotraumatol. 2020 Sep 29;11(1):1815279. doi: 10.1080/20008198.2020.1815279.
: The presence of mild traumatic brain injury (mTBI) increases post-traumatic stress disorder (PTSD) symptoms in the months following injury. However, factors that link mTBI and PTSD development are still unclear. Acute stress responses after trauma have been associated with PTSD development. mTBI may impair cognitive functions and increase anxiety immediately after trauma. : This research aimed to test the possibility that mTBI increases acute stress symptoms rapidly, which in turn results in PTSD development in the subsequent months. : Fifty-nine patients were recruited from the emergency rooms of local hospitals. Post-mTBI, acute stress, and PTSD symptom severity were measured using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Acute Stress Disorder Scale (ASDS), and PTSD Checklist for DSM-5 (PCL-5), respectively. : Moderated mediation analysis indicated that ASDS, at 2 weeks post-trauma, mediated the relationship between RPQ scores at 2 weeks and PCL-5 scores at 3 months post-trauma, only for patients who met mTBI diagnostic criteria. : These findings present preliminary evidence suggesting that acute stress disorder symptoms may be one of the mechanisms involved in the development of PTSD among trauma survivors who have experienced mTBI, which provides a theoretical basis for early intervention of PTSD prevention after mTBI.
轻度创伤性脑损伤(mTBI)的存在会在损伤后的数月内增加创伤后应激障碍(PTSD)症状。然而,将mTBI与PTSD发展联系起来的因素仍不清楚。创伤后的急性应激反应与PTSD的发展有关。mTBI可能会损害认知功能,并在创伤后立即增加焦虑。本研究旨在测试mTBI是否会迅速增加急性应激症状,进而导致随后数月内PTSD的发展。从当地医院的急诊室招募了59名患者。分别使用Rivermead脑震荡后症状问卷(RPQ)、急性应激障碍量表(ASDS)和DSM-5创伤后应激障碍检查表(PCL-5)测量mTBI后、急性应激和PTSD症状的严重程度。调节中介分析表明,仅对于符合mTBI诊断标准的患者,创伤后2周时的ASDS介导了创伤后2周时的RPQ评分与创伤后3个月时的PCL-5评分之间的关系。这些发现提供了初步证据,表明急性应激障碍症状可能是经历mTBI的创伤幸存者中PTSD发展所涉及的机制之一,这为mTBI后PTSD预防的早期干预提供了理论依据。