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亲密伴侣暴力女性幸存者中,应激相关障碍的潜在原因是神经生物学反应迟钝以及对威胁的注意力偏差。

Blunted neurobiological reactivity and attentional bias to threat underlie stress-related disorders in women survivors of intimate partner violence.

作者信息

Goldberg X, Espelt C, Nadal R, Alon Y, Palao D, Bar-Haim Y, Armario A

机构信息

Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain.

ISGlobal, Barcelona, Spain.

出版信息

Psychol Med. 2023 Nov;53(15):7329-7340. doi: 10.1017/S0033291723000910. Epub 2023 May 17.

Abstract

BACKGROUND

Intimate partner violence (IPV) alters women's neurobiological stress response systems. We propose that individual differences early in the attentional processing of threats are associated with these neurobiological mechanisms and contribute to mental illness in this population.

METHODS

We assessed attentional bias in relation to threat (AB) in women survivors of IPV ( = 69) and controls ( = 36), and examined overall cortisol secretion using hair cortisol (HC), and stress responsiveness measuring salivary cortisol and -amylase (sAA) before (T0), and after (T1, T2) an acute psychosocial stress task (Trier Social Stress Test). We used repeated-measures ANCOVAs to explore the associations between Group (IPV, control) and AB with acute stress response, and regression models to examine the associations with mental health symptoms.

RESULTS

There were no between-group differences in HC levels. An interaction between Group and AB was found regarding cortisol reactivity ( < 0.05). IPV women with threat avoidance AB showed a blunted cortisol response compared to controls and to IPV participants with threat vigilance AB. The association between sAA reactivity and the interaction between Group, AB, and time approached significance ( = 0.07), with a trend to lower sAA levels particularly in IPV women with threat avoidance AB. Group and cortisol reactivity were associated with symptoms of depression, generalized anxiety, and post-traumatic stress disorder (8-20% explained variance).

CONCLUSIONS

Threat avoidance AB is associated with blunted acute cortisol response among women exposed to chronic stress (IPV). Experiencing IPV and acute cortisol response appear to be clearly implicated in long-term mental health problems.

摘要

背景

亲密伴侣暴力(IPV)会改变女性的神经生物学应激反应系统。我们提出,在威胁的注意力加工早期的个体差异与这些神经生物学机制相关,并导致该人群出现精神疾病。

方法

我们评估了IPV女性幸存者(n = 69)和对照组(n = 36)中与威胁相关的注意力偏差(AB),并使用毛发皮质醇(HC)检查总体皮质醇分泌,以及在急性心理社会应激任务(特里尔社会应激测试)之前(T0)和之后(T1、T2)测量唾液皮质醇和α-淀粉酶(sAA)的应激反应性。我们使用重复测量协方差分析来探讨组(IPV、对照组)和AB与急性应激反应之间的关联,并使用回归模型来检查与心理健康症状的关联。

结果

HC水平在组间没有差异。在皮质醇反应性方面发现组和AB之间存在交互作用(p < 0.05)。与对照组以及具有威胁警觉性AB的IPV参与者相比,具有威胁回避AB的IPV女性表现出皮质醇反应迟钝。sAA反应性与组、AB和时间之间的交互作用之间的关联接近显著(p = 0.07),特别是在具有威胁回避AB的IPV女性中sAA水平有降低的趋势。组和皮质醇反应性与抑郁、广泛性焦虑和创伤后应激障碍症状相关(解释方差为8 - 20%)。

结论

在遭受慢性应激(IPV)的女性中,威胁回避AB与急性皮质醇反应迟钝相关。经历IPV和急性皮质醇反应似乎明显与长期心理健康问题有关。

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