Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
Dev Psychobiol. 2023 May;65(4):e22385. doi: 10.1002/dev.22385.
Fear-potentiated startle (FPS) can be used to measure fear and safety learning-behaviors affected by trauma that may map onto posttraumatic stress disorder (PTSD). Therefore, FPS could be a candidate biomarker of trauma-related psychopathology and a potential identifier of trauma-exposed youth in need of focused treatment. We enrolled n = 71 (35 females, M = 12.7 years) Syrian youth exposed to civilian war trauma. Eyeblink electromyogram (EMG) data from a differential conditioning FPS paradigm were obtained 2.5 years after resettlement. Youth provided self-report of trauma exposure (Harvard Trauma Questionnaire) and PTSD symptoms (UCLA PTSD Reaction Index). While FPS during conditioning was not associated with symptoms, associations with psychopathology emerged in fear extinction. Probable PTSD was associated with FPS in the last block of extinction, such that FPS to threat cue was significantly greater in the PTSD+ group compared to the PTSD- group at the end of extinction (F = 6.25, p = .015). As with adults, we observed a deficit in extinction learning but not fear conditioning in youth with PTSD. These results support the use of trauma-informed cognitive behavioral therapy based on the learning principles of extinction in youth with PTSD.
恐惧增强的惊跳反应（FPS）可用于测量创伤后可能映射到创伤后应激障碍（PTSD）的恐惧和安全学习行为。因此，FPS 可能是创伤相关精神病理学的候选生物标志物，也是需要集中治疗的创伤暴露青年的潜在识别标志。我们招募了 n = 71 名（35 名女性，M = 12.7 岁）经历过平民战争创伤的叙利亚青年。在重新安置 2.5 年后，从差异条件反射 FPS 范式中获得了眨眼肌电图（EMG）数据。青年提供了创伤暴露的自我报告（哈佛创伤问卷）和 PTSD 症状（UCLA PTSD 反应指数）。虽然在条件反射期间的 FPS 与症状无关，但在恐惧消退中出现了与精神病理学的关联。可能的 PTSD 与消退过程中的最后一个阶段的 FPS 相关，因此在消退结束时，PTSD+组的威胁线索的 FPS 明显高于 PTSD-组（F = 6.25，p = 0.015）。与成年人一样，我们观察到 PTSD 青年在消退学习中存在缺陷，但在恐惧条件反射中没有缺陷。这些结果支持在 PTSD 青年中使用基于消退学习原理的创伤知情认知行为疗法。
