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自主神经系统和下丘脑-垂体-肾上腺(HPA)轴基础活动及对急性应激反应性的改变:创伤青少年与健康对照的比较

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls.

作者信息

Schuurmans Angela A T, Nijhof Karin S, Cima Maaike, Scholte Ron, Popma Arne, Otten Roy

机构信息

Department of Research and Development, Pluryn, Nijmegen, The Netherlands.

Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.

出版信息

Stress. 2021 Nov;24(6):876-887. doi: 10.1080/10253890.2021.1900108. Epub 2021 Apr 16.

Abstract

Alterations in neurobiological stress systems such as the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis contribute to the development and maintenance of psychological and behavioral problems after traumatic experiences. Investigating neurobiological parameters and how these relate to each other may provide insight into the complex mechanisms at play. Whereas the preponderance of studies focuses on either the ANS or the HPA axis separately, the current study is the first to evaluate relations between posttraumatic stress and both basal activity during rest and stress reactivity of the ANS as well as the HPA axis in a sample of traumatized adolescents and healthy controls. The traumatized sample ( = 77), based on clinical levels of posttraumatic stress, was a convenience sample that was recruited within residential institutions, was compared to a healthy control sample ( = 48) recruited within the general community. For the ANS, we expected increased SNS and decreased PNS activity during rest and increased SNS and decreased PNS reactivity to social stress among traumatized adolescents compared to healthy controls. Regarding the HPA axis, we expected increased basal cortisol levels and decreased cortisol reactivity to stress in the traumatized sample. Compared to healthy controls, traumatized adolescents exhibited significantly higher sympathetic and lower parasympathetic activation during rest and increased sympathetic reactivity to acute stress (ANS parameters). Outcomes on the HPA axis (i.e. cortisol) indicated that traumatized adolescents showed increased cortisol levels during rest and blunted cortisol reactivity to acute stress. Implications for clinical relevance and trauma-focused treatment purposes are discussed.

摘要

神经生物学应激系统的改变,如自主神经系统(ANS)和下丘脑 - 垂体 - 肾上腺(HPA)轴,会导致创伤经历后心理和行为问题的发展与维持。研究神经生物学参数及其相互关系,可能有助于深入了解其中复杂的作用机制。尽管大多数研究分别聚焦于ANS或HPA轴,但本研究首次评估了创伤后应激与受创伤青少年及健康对照样本在静息状态下的基础活动以及ANS和HPA轴的应激反应性之间的关系。基于创伤后应激的临床水平,受创伤样本(n = 77)是在寄宿机构招募的便利样本,与在普通社区招募的健康对照样本(n = 48)进行比较。对于ANS,我们预计受创伤青少年在静息状态下交感神经系统(SNS)活动增加、副交感神经系统(PNS)活动减少,且对社会应激的SNS反应增加、PNS反应减少,与健康对照相比。关于HPA轴,我们预计受创伤样本的基础皮质醇水平升高,且对应激的皮质醇反应性降低。与健康对照相比,受创伤青少年在静息状态下表现出显著更高的交感神经激活和更低的副交感神经激活,以及对急性应激的交感神经反应性增加(ANS参数)。HPA轴的结果(即皮质醇)表明,受创伤青少年在静息状态下皮质醇水平升高,且对急性应激的皮质醇反应迟钝。本文还讨论了其临床相关性及以创伤为重点的治疗目的的意义。

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