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经条件化的生理反应与 PTSD 症状在月经周期中的变化:焦虑敏感作为一个调节变量。

Conditioned physiological reactivity and PTSD symptoms across the menstrual cycle: Anxiety sensitivity as a moderator.

机构信息

Women's Health Sciences Division.

Veterans Affairs (VA) Boston Healthcare System.

出版信息

Psychol Trauma. 2022 Mar;14(3):453-461. doi: 10.1037/tra0001129. Epub 2021 Oct 4.

DOI:10.1037/tra0001129
PMID:35175083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8857506/
Abstract

OBJECTIVE

Posttraumatic stress disorder (PTSD) is often associated with heightened physiological reactivity during fear conditioning procedures, but results vary across studies. This study examined whether anxiety sensitivity (AS), or the fear of arousal-related sensations, strengthens the relationship between PTSD symptoms and skin conductance responses (SCR) during fear conditioning and extinction. Because gonadal hormones implicated in fear learning fluctuate across the menstrual cycle, the stability of these relationships in women was examined in 2 distinct menstrual cycle phases.

METHOD

Thirty-two trauma-exposed women, half of whom had PTSD, completed the Clinician-Administered PTSD Scale, Anxiety Sensitivity Inventory, and a fear conditioning and extinction paradigm during the midluteal (mLP) and early-follicular (eFP) menstrual cycle phases.

RESULTS

In the mLP, stronger SCR to stimuli paired with shock (CS +) during fear acquisition significantly predicted greater PTSD symptoms only when AS was high and after removing an outlier. This appeared driven by effects on Numbing and Hyperarousal symptom clusters. Other hypothesized interactions between AS and CS responses were not significant. However, in the eFP, differential SCR between the CS + and CS- during extinction predicted significantly greater PTSD symptoms, and there was a trend for this effect being stronger as AS increased.

CONCLUSIONS

Results offer preliminary evidence that high AS contributes to a stronger relationship between SCR during fear acquisition and PTSD symptoms, at least among women in the mLP. Further research investigating the impact of individual differences in traits such as AS on the relationship between conditioned fear responses and PTSD symptoms is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

创伤后应激障碍(PTSD)常与恐惧条件反射过程中的生理反应增强有关,但研究结果存在差异。本研究旨在探讨焦虑敏感(AS),即对唤醒相关感觉的恐惧,是否会增强 PTSD 症状与恐惧条件反射和消退过程中的皮肤电反应(SCR)之间的关系。因为与恐惧学习有关的性腺激素在月经周期中波动,所以在两个不同的月经周期阶段检查了这些关系在女性中的稳定性。

方法

32 名创伤后暴露的女性,其中一半患有 PTSD,在月经中期(mLP)和早期卵泡期(eFP)完成了临床医生管理的 PTSD 量表、焦虑敏感量表和恐惧条件反射和消退范式。

结果

在 mLP 中,恐惧获得过程中与电击配对的刺激(CS +)的 SCR 越强,仅当 AS 较高且去除异常值后,与 PTSD 症状的相关性越强。这似乎是由麻木和过度唤醒症状群的影响驱动的。AS 和 CS 反应之间其他假设的相互作用并不显著。然而,在 eFP 中,在消退过程中 CS +和 CS-之间的 SCR 差异显著预测 PTSD 症状更大,并且随着 AS 的增加,这种效应有增强的趋势。

结论

结果初步表明,在 mLP 中的女性中,高 AS 导致恐惧获得过程中的 SCR 与 PTSD 症状之间的关系更强。进一步研究个体差异(如 AS)对条件性恐惧反应与 PTSD 症状之间关系的影响是有必要的。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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