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创伤后应激障碍和儿童虐待后 ICD-11 创伤后应激障碍及复杂创伤后应激障碍青少年和年轻成人情绪线索的差异化处理。

Differentiated processing of emotional cues in adolescents and young adults with ICD-11 PTSD and complex PTSD after child abuse.

机构信息

Department of Psychology, Bielefeld University, Bielefeld, Germany.

Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany.

出版信息

Brain Behav. 2023 Mar;13(3):e2904. doi: 10.1002/brb3.2904. Epub 2023 Feb 7.

Abstract

BACKGROUND

The recent update of the International Classification of Diseases 11th revision (ICD-11) introduced the diagnosis of complex posttraumatic stress disorder (CPTSD) as a distinct entity from posttraumatic stress disorder (PTSD). Because psychophysiological alterations are a core diagnostic feature of PTSD and CPTSD, the aim of the current study was to examine potential distinctive patterns in cortical and cardiac responses to emotional words in adolescent and young adult patients with PTSD and CPTSD.

METHOD

Event-related potentials and heart rate responses were studied in 81 adolescent and young adult participants, of which 17 individuals were diagnosed with ICD-11 PTSD and 32 individuals with CPTSD, each after childhood sexual and/or physical abuse. Thirty-two individuals served as healthy controls. The paradigm consisted of a passive reading task with neutral, positive, physically threatening, and socially threatening words.

RESULTS

Differentiated early processing of emotional words was indicated by differences on P1 and left EPN components. Additionally, PTSD and CPTSD patients presented with specific patterns of heart rate responses to emotional words. In CPTSD patients, heart rate reactions to emotional words were more variable than in PTSD patients.

CONCLUSIONS

These findings provide early evidence of differentiated cortical and cardiac response patterns in adolescent and young adult patients with CPTSD and PTSD, supporting a nosological distinction between PTSD and complex PTSD. However, due to small and unequal sample sizes, findings presented in the current study are preliminary and require future research.

摘要

背景

最近发布的《国际疾病分类》第 11 版(ICD-11)将复杂创伤后应激障碍(CPTSD)作为一种与创伤后应激障碍(PTSD)不同的疾病诊断引入。由于心理生理改变是 PTSD 和 CPTSD 的核心诊断特征,因此本研究旨在探讨 PTSD 和 CPTSD 青少年和年轻患者对情绪词的皮质和心脏反应是否存在潜在的差异模式。

方法

研究了 81 名青少年和年轻参与者的事件相关电位和心率反应,其中 17 名被诊断为 ICD-11 PTSD,32 名被诊断为 CPTSD,他们均在童年时期遭受过性和/或身体虐待。32 名参与者作为健康对照组。该范式包括一个带有中性、积极、身体威胁和社会威胁词的被动阅读任务。

结果

情绪词的早期加工差异表明 P1 和左 EPN 成分存在差异。此外,PTSD 和 CPTSD 患者对情绪词的心率反应呈现出特定的模式。在 CPTSD 患者中,情绪词引起的心率反应比 PTSD 患者更不稳定。

结论

这些发现为 CPTSD 和 PTSD 青少年和年轻患者的皮质和心脏反应模式存在差异提供了早期证据,支持 PTSD 和复杂 PTSD 之间的分类学区别。然而,由于样本量小且不均衡,本研究中的发现是初步的,需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26e5/10013947/8dc8612ec265/BRB3-13-e2904-g004.jpg

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