Meinhausen Corinne, Sanchez Gabriel J, Edmondson Donald, Kronish Ian M, Schwartz Joseph E, Hinrichs Rebecca, Jovanovic Tanja, Sumner Jennifer A
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA.
Depress Anxiety. 2023;2023. doi: 10.1155/2023/6671337. Epub 2023 Jul 15.
Posttraumatic stress disorder (PTSD) symptoms can develop following acute, life-threatening medical events. This study explores a potential biomarker of PTSD risk that is novel to a medical trauma population: a noninvasive, mobile skin conductance (SC) measurement.
Participants (=64) were enrolled in-hospital following a stroke or transient ischemic attack (TIA). Mobile measurement of SC reactivity to recalling the stroke/TIA traumatic event was conducted at hospital bedside in the days following the stroke/TIA. PTSD symptoms that developed in response to the stroke/TIA were measured at 1-month follow-up. We tested the association between SC reactivity and total 1-month PTSD symptoms, as well as PTSD symptom dimensions of fear and dysphoria.
In unadjusted analyses, there were significant positive associations between in-hospital SC reactivity to recalling the stroke/TIA traumatic event and higher-order fear-related symptoms (=.30, =.016), as well as lower-order fear-related symptoms of anxious arousal (=.27, =.035) and avoidance (=.25, =.043) at 1 month. Associations between SC reactivity and the fear, anxious arousal, and avoidance symptom dimensions remained significant in multivariable regression models that adjusted for relevant covariates including age, gender, stroke severity, medical comorbidity, and psychosocial factors. Although there was a positive association observed between SC reactivity to recalling the stroke/TIA event and total PTSD symptom severity at 1-month follow-up, it did not reach the level of statistical significance (=.23, =.070). Further, no significant association was detected for dysphoria-related symptoms (=.11, =.393).
This is the first study to test the prospective association of SC reactivity with PTSD symptom development following a medical trauma. The findings indicate that mobile measures of SC reactivity may be useful for in-hospital identification of individuals at risk for fear-related PTSD symptom development following a medical event and highlight the potential mechanisms involved in the development of these symptoms following a medical event.
创伤后应激障碍(PTSD)症状可在急性、危及生命的医疗事件后出现。本研究探索了一种PTSD风险的潜在生物标志物,这对于医疗创伤人群来说是新颖的:一种非侵入性的、可移动的皮肤电导(SC)测量方法。
参与者(n = 64)在中风或短暂性脑缺血发作(TIA)后入院。在中风/TIA后的几天内,于医院床边对回忆中风/TIA创伤事件时的SC反应性进行移动测量。在1个月随访时测量因中风/TIA而出现的PTSD症状。我们测试了SC反应性与1个月时PTSD总症状以及恐惧和烦躁不安的PTSD症状维度之间的关联。
在未调整的分析中,住院期间回忆中风/TIA创伤事件时的SC反应性与1个月时高阶恐惧相关症状(r =.30,p =.016)以及低阶恐惧相关症状焦虑唤醒(r =.27,p =.035)和回避(r =.25,p =.043)之间存在显著正相关。在调整了包括年龄、性别、中风严重程度、医疗合并症和社会心理因素等相关协变量的多变量回归模型中,SC反应性与恐惧、焦虑唤醒和回避症状维度之间的关联仍然显著。尽管在1个月随访时观察到回忆中风/TIA事件时的SC反应性与PTSD总症状严重程度之间存在正相关,但未达到统计学显著性水平(r =.23,p =.070)。此外,未检测到与烦躁不安相关症状的显著关联(r =.11,p =.393)。
这是第一项测试SC反应性与医疗创伤后PTSD症状发展的前瞻性关联的研究。研究结果表明,SC反应性的移动测量可能有助于在医院内识别医疗事件后有发生与恐惧相关的PTSD症状风险的个体,并突出了医疗事件后这些症状发展所涉及的潜在机制。