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近期创伤与既往创伤对情绪、社会支持、暴饮、情绪化进食和体重指数的不同影响,以及对急性应激的神经反应。

Differential effects of recent versus past traumas on mood, social support, binge drinking, emotional eating and BMI, and on neural responses to acute stress.

作者信息

Hermes Gretchen, Fogelman Nia, Seo Dongju, Sinha Rajita

机构信息

Department of Psychiatry, Yale Stress Center, Yale University, New Haven, CT, USA.

出版信息

Stress. 2021 Nov;24(6):686-695. doi: 10.1080/10253890.2021.1877271. Epub 2021 Feb 17.

Abstract

Traumatic stress is associated with risk of psychiatric and physical illnesses. However, the differential and separable effects of past versus recent traumas on maladaptive coping and neural responses are not known. We conducted two studies to assess separate and combined effects of cumulative recent and past trauma on health outcomes (study 1) and on neural responses to acute stress exposure in a subsample of individuals (study 2). Study 1 assessed a large cohort of 677 community adults cross-sectionally, and findings indicated that both high recent (within the last 12 months) and past trauma (prior to the last twelve months) were associated with more physical and psychological symptoms, including increased depression (all 's < .05). However, recent trauma alone was associated with higher problematic alcohol use, a greater maximum number of alcohol drinks consumed, greater emotional eating scores, higher state and trait anxiety scores, and poorer lifestyle habits (all 's < .05). Past trauma alone was associated with higher BMI, decreased social support, and a lower average cortisol relative to ACTH ratio (all 's < .02). Study 2 involving a functional brain scan on a subsample ( = 75) indicated greater recent trauma was associated with a hyperactive response in the ventromedial prefrontal cortex (VmPFC) to neutral-relaxed exposure, but blunted VmPFC response to acute stress exposure ( < .05: whole brain corrected-WBC). By contrast, high past trauma was associated with a hyper-sensitized neural response to stress in the cortico-limbic-striatal regions ( < .05, WBC) critical for reward and emotion processing. Together, these findings suggest differential neurobehavioral and health effects of cumulative past versus recent trauma exposure.

摘要

创伤应激与精神疾病和身体疾病的风险相关。然而,过去创伤与近期创伤对适应不良应对和神经反应的差异及可分离效应尚不清楚。我们进行了两项研究,以评估近期和过去累积创伤对健康结果(研究1)以及对部分个体急性应激暴露的神经反应(研究2)的单独和综合影响。研究1对677名社区成年人的大型队列进行了横断面评估,结果表明,近期(过去12个月内)和过去创伤(过去十二个月之前)均与更多的身体和心理症状相关,包括抑郁增加(所有p值<0.05)。然而,仅近期创伤与更高的问题饮酒、更大的饮酒量、更高的情绪化进食得分、更高的状态和特质焦虑得分以及更差的生活习惯相关(所有p值<0.05)。仅过去创伤与更高的体重指数、社会支持减少以及相对于促肾上腺皮质激素的较低平均皮质醇比值相关(所有p值<0.02)。研究2对一个子样本(n = 75)进行了功能性脑扫描,结果表明,更多的近期创伤与腹内侧前额叶皮层(VmPFC)对中性放松暴露的反应过度活跃有关,但VmPFC对急性应激暴露的反应减弱(p < 0.05:全脑校正-WBC)。相比之下,高过去创伤与对奖励和情绪处理至关重要的皮质-边缘-纹状体区域对压力的神经反应超敏有关(p < 0.05,WBC)。总之,这些发现表明过去累积创伤与近期创伤暴露对神经行为和健康有不同的影响。

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