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创伤事件与心理健康:创伤前系统性炎症的放大效应。

Traumatic events and mental health: The amplifying effects of pre-trauma systemic inflammation.

机构信息

Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.

Department of Anthropology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA.

出版信息

Brain Behav Immun. 2021 Nov;98:173-184. doi: 10.1016/j.bbi.2021.08.208. Epub 2021 Aug 12.

Abstract

BACKGROUND

Traumatic experiences are strongly predictive of adverse mental health outcomes. Experimental studies have demonstrated that systemic inflammation can increase reactivity to threatening stimuli. It is not known whether naturally occurring inflammation amplifies the impact of traumatic experiences on mental health. Here we test whether incident traumatic events are more predictive of adverse mental health outcomes for individuals with greater pre-trauma systemic inflammation in a racially and ethnically diverse cohort study of youth assigned male at birth who identify as sexual or gender minorities (ages 16-29, n = 518), a group at high risk for trauma exposure.

METHODS

Measures of inflammation, depression symptom severity, and perceived stress were measured at baseline. One year later, depression symptom severity and perceived stress were measured again, and participants reported the traumatic events they had experienced in the intervening year.

RESULTS

In a model adjusted for baseline depression symptom severity and other key covariates, we found that higher baseline levels of interleukin-1β amplified the effect of incident trauma exposure on depression symptom severity at follow-up (β = 0.234, SE = 0.080, P = 0.004). In a model adjusted for baseline perceived stress and other key covariates, we found that higher baseline scores on a multi-marker inflammatory index amplified the effect of incident trauma exposure on perceived stress at follow-up (β = 0.243, SE = 0.083, P = 0.003).

CONCLUSIONS

These findings suggest that greater pre-trauma inflammation may predict poorer mental health following trauma exposure. Understanding how inflammation interacts with trauma to shape mental health may generate novel insights for preventing and treating the debilitating psychological consequences of trauma.

摘要

背景

创伤经历强烈预示着不良心理健康结果。实验研究表明,系统性炎症会增加对威胁性刺激的反应性。目前尚不清楚自然发生的炎症是否会放大创伤经历对心理健康的影响。在这里,我们测试了在一个种族和民族多样化的青年队列研究中,对于预先存在系统性炎症的个体,是否有更多的创伤性事件预示着不良心理健康结果,该研究中的个体被分配为男性出生,且自我认同为性少数群体或性别少数群体(年龄 16-29 岁,n=518),他们是创伤暴露的高风险群体。

方法

在基线时测量炎症、抑郁症状严重程度和感知压力。一年后,再次测量抑郁症状严重程度和感知压力,参与者报告了在这一年中经历的创伤性事件。

结果

在调整基线抑郁症状严重程度和其他关键协变量的模型中,我们发现,较高的基线白细胞介素-1β水平放大了创伤性暴露对随访时抑郁症状严重程度的影响(β=0.234,SE=0.080,P=0.004)。在调整基线感知压力和其他关键协变量的模型中,我们发现,较高的基线多标志物炎症指数得分放大了创伤性暴露对随访时感知压力的影响(β=0.243,SE=0.083,P=0.003)。

结论

这些发现表明,创伤前的炎症程度可能预示着创伤后心理健康状况较差。了解炎症如何与创伤相互作用来塑造心理健康,可能为预防和治疗创伤带来的衰弱性心理后果提供新的见解。

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