Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Psychiatry Clin Neurosci. 2024 Oct;78(10):612-619. doi: 10.1111/pcn.13718. Epub 2024 Aug 7.
This study aimed to explore the relationships between serum cortisol levels, personality traits, and the development of Post-Traumatic Stress Disorder (PTSD) over 2 years among individuals with physical injuries.
Participants were consecutively recruited from a trauma center and followed prospectively for 2 years. At baseline, serum cortisol levels were measured, and personality traits were categorized into five dimensions (Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness), using the Big Five Inventory-10. The diagnosis of PTSD during follow-up (at 3, 6, 12, and 24 months post-injury) was determined using the Clinician-Administered PTSD Scale for DSM-5. Binary and multinomial logistic regression analyses were conducted to examine the interactions between cortisol levels, personality traits, and PTSD development.
Among 923 patients analyzed, 112 (12.1%) were diagnosed with PTSD at some point during the study period, with prevalence rates decreasing from 8.8% at 3 months to 3.7% at 24 months post-injury. Direct associations between cortisol levels or personality traits and PTSD were not observed. However, a significant interaction between lower cortisol levels and higher Neuroticism in relation to PTSD risk was identified, especially during the early follow-up periods (3 to 6 months), but this association waned from the 12-month follow-up onward.
Our findings reveal Neuroticism-dependent associations between serum cortisol levels and PTSD development, exhibiting temporal variations. These results suggest that PTSD development may be influenced by a complex, time-sensitive interplay of biological and psychosocial factors, underscoring the importance of considering individual differences in stress reactivity and personality in PTSD research and treatment.
本研究旨在探讨躯体损伤患者 2 年内血清皮质醇水平、人格特质与创伤后应激障碍（PTSD）发展之间的关系。
研究对象连续纳入一家创伤中心，前瞻性随访 2 年。基线时测量血清皮质醇水平，采用大五人格量表（Big Five Inventory-10）将人格特质分为五个维度（外向性、宜人性、尽责性、神经质和开放性）。采用 DSM-5 临床医师管理 PTSD 量表在随访期间（损伤后 3、6、12 和 24 个月）确定 PTSD 诊断。采用二元和多项逻辑回归分析检验皮质醇水平、人格特质与 PTSD 发展之间的交互作用。
在分析的 923 例患者中，112 例（12.1%）在研究期间的某个时间点被诊断为 PTSD，患病率从损伤后 3 个月的 8.8%降至 24 个月的 3.7%。未观察到皮质醇水平或人格特质与 PTSD 之间存在直接关联。然而，发现皮质醇水平较低和神经质较高与 PTSD 风险之间存在显著的交互作用，特别是在早期随访期间（3 至 6 个月），但这种关联从 12 个月随访开始减弱。
我们的研究结果揭示了血清皮质醇水平与 PTSD 发展之间存在神经质依赖的关联，表现出时间变化。这些结果表明，PTSD 的发展可能受到生物和心理社会因素之间复杂的、时间敏感的相互作用的影响，这强调了在 PTSD 研究和治疗中考虑应激反应和人格个体差异的重要性。
