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洛桑婴儿啼哭应激范式:对产后早期应激范式在分娩相关创伤后应激障碍低风险与高风险女性中的验证

The Lausanne Infant Crying Stress Paradigm: Validation of an Early Postpartum Stress Paradigm with Women at Low vs. High Risk of Childbirth-Related Posttraumatic Stress Disorder.

作者信息

Sandoz Vania, Stuijfzand Suzannah, Lacroix Alain, Deforges Camille, Quillet Diop Magali, Ehlert Ulrike, Rubo Marius, Messerli-Bürgy Nadine, Horsch Antje

机构信息

Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland.

Department of Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zurich, Switzerland.

出版信息

J Pers Med. 2021 May 26;11(6):472. doi: 10.3390/jpm11060472.

DOI:10.3390/jpm11060472
PMID:34073240
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8228424/
Abstract

Stress reactivity is typically investigated in laboratory settings, which is inadequate for mothers in maternity settings. This study aimed at validating the Lausanne Infant Crying Stress Paradigm (LICSP) as a new psychosocial stress paradigm eliciting psychophysiological stress reactivity in early postpartum mothers ( = 52) and to compare stress reactivity in women at low ( = 28) vs. high risk ( = 24) of childbirth-related posttraumatic stress disorder (CB-PTSD). Stress reactivity was assessed at pre-, peri-, and post-stress levels through salivary cortisol, heart rate variability (high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio), and perceived stress via a visual analog scale. Significant time effects were observed for all stress reactivity outcomes in the total sample (all < 0.01). When adjusting for perceived life threat for the infant during childbirth, high-risk mothers reported higher perceived stress ( < 0.001, = 0.91) and had lower salivary cortisol release ( = 0.023, = 0.53), lower LF/HF ratio ( < 0.001, = 0.93), and marginally higher HF power ( = 0.07, = 0.53) than low-risk women. In conclusion, the LICSP induces subjective stress and autonomic nervous system (ANS) reactivity in maternity settings. High-risk mothers showed higher perceived stress and altered ANS and hypothalamic-pituitary-adrenal reactivity when adjusting for infant life threat. Ultimately, the LICSP could stimulate (CB-)PTSD research.

摘要

应激反应通常在实验室环境中进行研究,这对于处于孕产环境中的母亲来说并不适用。本研究旨在验证洛桑婴儿啼哭应激范式(LICSP)作为一种新的社会心理应激范式,可引发产后早期母亲(n = 52)的心理生理应激反应,并比较分娩相关创伤后应激障碍(CB - PTSD)低风险(n = 28)与高风险(n = 24)女性的应激反应。通过唾液皮质醇、心率变异性(高频(HF)功率、低频(LF)功率和LF/HF比值)以及视觉模拟量表评估的感知应激,在应激前、应激期间和应激后水平对应激反应进行评估。在总样本中,所有应激反应结果均观察到显著的时间效应(所有p < 0.01)。在调整分娩期间对婴儿的感知生命威胁后,高风险母亲报告的感知应激更高(p < 0.001,r = 0.91),唾液皮质醇释放更低(p = 0.023,r = 0.53),LF/HF比值更低(p < 0.001,r = 0.93),且高频功率略高于低风险女性(p = 0.07,r = 0.53)。总之,LICSP在孕产环境中诱发主观应激和自主神经系统(ANS)反应。在调整婴儿生命威胁后

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb2/8228424/d4ab71f8ae62/jpm-11-00472-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb2/8228424/d4ab71f8ae62/jpm-11-00472-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb2/8228424/d4ab71f8ae62/jpm-11-00472-g001.jpg

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Childbirth-related PTSD: is it a unique post-traumatic disorder?分娩相关的创伤后应激障碍:它是一种独特的创伤后应激障碍吗?
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