Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Department of Psychology, University of Georgia, Athens, GA, USA.
J Psychiatr Res. 2023 Jun;162:193-199. doi: 10.1016/j.jpsychires.2023.05.028. Epub 2023 May 5.
Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to be related to diverging patterns of physiological response. To date, few studies have examined how specific dissociative symptoms, namely, depersonalization and derealization, relate to skin conductance response (SCR), a marker of autonomic function, within the context of PTSD symptoms. We examined associations among depersonalization, derealization, and SCR during two conditions - resting control and breath-focused mindfulness - in the context of current PTSD symptoms.
Sixty-eight trauma-exposed women (82.4% Black; M = 42.5, SD = 12.1) were recruited from the community for a breath-focused mindfulness study. SCR data were collected during alternating resting control and breath-focused mindfulness conditions. Moderation analyses were conducted to examine relations among dissociative symptoms, SCR, and PTSD for these different conditions.
Moderation analyses revealed that depersonalization was linked to lower SCR during resting control, B = 0.0005, SE = 0.0002, p = .006, in participants low-to-moderate PTSD symptoms; however, depersonalization was associated with higher SCR during breath-focused mindfulness, B = -0.0006, SE = 0.0003, p = .029, in individuals with similar levels of PTSD symptoms. No significant interaction between derealization and PTSD symptoms on SCR was observed.
Depersonalization symptoms may associate with physiological withdrawal during rest, but greater physiological arousal during effortful emotion regulation in individuals with low-to moderate levels of PTSD, which has significant implications for barriers to treatment engagement as well as treatment selection in this population.
分离性和创伤后应激障碍(PTSD)症状通常是对心理创伤的共同反应。然而,这两组症状似乎与不同的生理反应模式有关。迄今为止,很少有研究探讨特定的分离症状,即人格解体和现实解体,与 PTSD 症状背景下的皮肤电反应(SCR)之间的关系,SCR 是自主功能的标志物。我们在当前 PTSD 症状的背景下,检查了人格解体、现实解体和 SCR 之间在两种情况下(休息控制和呼吸焦点正念)的关联。
从社区招募了 68 名创伤后暴露的女性(82.4%为黑人;M=42.5,SD=12.1)参加呼吸焦点正念研究。在交替的休息控制和呼吸焦点正念条件下收集 SCR 数据。进行了调节分析,以检查这些不同条件下分离症状、SCR 和 PTSD 之间的关系。
调节分析显示,在 PTSD 症状低至中度的参与者中,人格解体与休息控制期间的 SCR 较低有关,B=0.0005,SE=0.0002,p=0.006;然而,在 PTSD 症状相似的个体中,人格解体与呼吸焦点正念期间的 SCR 较高有关,B=-0.0006,SE=0.0003,p=0.029。在 SCR 上,没有观察到现实解体与 PTSD 症状之间的显著交互作用。
人格解体症状可能与休息时的生理退缩有关,但在 PTSD 症状低至中度的个体中,在努力进行情绪调节时会出现更大的生理唤醒,这对治疗参与的障碍以及该人群的治疗选择具有重要意义。