Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Psychoneuroendocrinology. 2022 May;139:105686. doi: 10.1016/j.psyneuen.2022.105686. Epub 2022 Feb 11.
Understanding the neurobiological and cognitive processes underlying the development of posttraumatic stress disorder (PTSD) and its specific symptoms may facilitate preventive intervention development. Severe traumatic stress and resulting biological stress system activations can alter contextual memory processes. This may provide a neurobiological explanation for the occurrence of intrusive memories following trauma. Investigating the associations between temporal aspects and individual variation in peri- and post-traumatic hypothalamic pituitary adrenal (HPA) axis and sympathetic nervous system (SNS) stress reactivity and memory processing may increase our understanding of intrusive symptom development. The experimental trauma film paradigm is commonly used for this purpose but lacks robust SNS and HPA axis activation. Here, we performed an RCT to investigate the effect of an adjusted trauma film paradigm containing an added brief psychosocial stressor on HPA and SNS stress reactivity throughout the experiment and intrusive memory frequency in the following week in healthy males (N = 63, mean age = 22.3). Secondary, we investigated effects on film-related declarative memory accuracy and intrusion-related characteristics, and associations between acute HPA and SNS stress reactivity, film-related memory, glucocorticoid receptor functioning and intrusion frequency and characteristics. Participants were randomized to the socially-evaluated cold pressor test (seCPT n = 29) or control condition (warm water n = 34) immediately prior to a trauma film. Linear Mixed Models revealed increased acute SNS and cortisol reactivity, lower recognition memory accuracy and more intrusions that were more vivid and distressing during the following week in the seCPT compared to control condition. Linear regression models revealed initial associations between cortisol and alpha amylase reactivity during the experimental assessment and subsequent intrusions, but these effects did not survive multiple comparison corrections. Thus, with this adjustment, we increased the translational value of the trauma film paradigm as it appears to elicit a stronger stress response that is likely more comparable to real-life trauma. The adapted paradigm may be useful to investigate individual variation in biological and cognitive processes underlying early post-trauma PTSD symptoms and could advance potential preventive interventions.
了解创伤后应激障碍（PTSD）及其特定症状发展背后的神经生物学和认知过程，可能有助于预防性干预措施的开发。严重的创伤应激和由此产生的生物应激系统激活会改变情境记忆过程。这可能为创伤后出现侵入性记忆提供了神经生物学解释。研究创伤前后下丘脑-垂体-肾上腺（HPA）轴和交感神经系统（SNS）应激反应与记忆处理的时间方面和个体差异之间的关联，可能会增加我们对侵入性症状发展的理解。实验性创伤电影范式通常用于此目的，但缺乏强大的 SNS 和 HPA 轴激活。在这里，我们进行了一项 RCT，以调查包含附加短暂心理社会应激源的调整创伤电影范式对 HPA 和 SNS 应激反应的影响，以及在接下来的一周内健康男性（N=63，平均年龄=22.3）侵入性记忆频率。其次，我们调查了对电影相关陈述性记忆准确性和侵入性相关特征的影响，以及急性 HPA 和 SNS 应激反应、电影相关记忆、糖皮质激素受体功能与侵入性频率和特征之间的关联。参与者在观看创伤电影之前立即随机分配到社会评价冷水压迫测试（seCPT n=29）或对照条件（温水 n=34）。线性混合模型显示，在 seCPT 中，与对照条件相比，急性 SNS 和皮质醇反应增加，识别记忆准确性降低，并且在接下来的一周内，侵入性更生动、更痛苦。线性回归模型显示，在实验评估期间皮质醇和α淀粉酶反应与随后的侵入性之间存在初始关联，但这些影响在多次比较校正后并未持续存在。因此，通过这种调整，我们增加了创伤电影范式的转化价值，因为它似乎引发了更强的应激反应，更可能与现实生活中的创伤相媲美。适应后的范式可能有助于研究创伤后早期 PTSD 症状背后的生物和认知过程中的个体差异，并可能推进潜在的预防干预措施。
