Schmalbach Ileana, Steudte-Schmiedgen Susann, Renner Vanessa, Drees Philipp, Petrowski Katja
Department of Medical Psychology and Medical Sociology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Transl Psychiatry. 2025 Mar 19;15(1):88. doi: 10.1038/s41398-025-03295-6.
Previous research highlights inconsistent associations between premorbid hair cortisol concentrations (HCC) and posttraumatic stress disorder (PTSD) symptoms, often neglecting the critical role of childhood trauma (CT) in civilian populations. To address this gap, our study investigates the predictive value of HCC for PTSD symptoms following a motor vehicle crash (MVC), extending our prior findings by assessing CT as a moderator within a sample that includes participants with and without CT. We hypothesize that pre-MVC HCC is positively associated with PTSD risk and that this relationship is moderated by early adversity. We examined N = 272 participants with a traumatic brain injury aged 18-65 years who experienced a MVC between 2010 and 2020. Cortisol concentrations were determined in 3 cm scalp-near segments of hair samples that were obtained at the emergency room shortly after the MVC (t1). Participants completed measuring instruments capturing symptoms of posttraumatic stress (Posttraumatic Diagnostic Scale [PDS]; Impact of Event Scale-Revised [IES-R]) and Childhood Trauma Questionnaire (CTQ). PDS and IES-R were re-collected three months post-MVC (t2). Elevated pre-MVC HCC predicted PTSD symptoms (p < 0.05), emphasizing the role of chronic stress and HPA axis dysregulation in PTSD. Contrary to our hypothesis, CT did not moderate this relationship, suggesting that HCC's impact on PTSD is independent of early adverse experiences. In this context, CT emerged as an independent predictor of PTSD at the 3-month follow-up, underscoring its lasting influence on psychological trauma vulnerability, particular in the face of recent adversity. Our study confirmed that elevated pre-MVC HCC levels predict PTSD symptoms. Although childhood trauma did not moderate this relationship, it independently predicted PTSD at follow-up. These findings underscore the lasting impact of early adversity on mental health, highlighting the importance of considering both HPA axis regulation and trauma history to develop targeted interventions for adults exposed to new stressors.
先前的研究强调了病前头发皮质醇浓度（HCC）与创伤后应激障碍（PTSD）症状之间的关联并不一致，且常常忽视童年创伤（CT）在平民群体中的关键作用。为了填补这一空白，我们的研究调查了机动车碰撞事故（MVC）后HCC对PTSD症状的预测价值，通过在一个包含有和没有童年创伤的参与者的样本中评估CT作为调节因素，扩展了我们先前的研究结果。我们假设MVC前的HCC与PTSD风险呈正相关，并且这种关系受早期逆境的调节。我们研究了272名年龄在18 - 65岁之间、患有创伤性脑损伤且在2010年至2020年间经历过MVC的参与者。在MVC后不久于急诊室采集的头发样本的3厘米头皮附近段中测定皮质醇浓度（t1）。参与者完成了用于测量创伤后应激症状的量表（创伤后诊断量表[PDS]；事件影响量表修订版[IES - R]）和儿童创伤问卷（CTQ）。在MVC后三个月（t2）再次收集PDS和IES - R。MVC前HCC升高可预测PTSD症状（p < 0.05），强调了慢性应激和下丘脑 - 垂体 - 肾上腺（HPA）轴失调在PTSD中的作用。与我们的假设相反，CT并未调节这种关系，这表明HCC对PTSD的影响独立于早期不良经历。在此背景下，CT在3个月随访时成为PTSD的独立预测因素，强调了其对心理创伤易感性的持久影响，尤其是在面对近期逆境时。我们的研究证实，MVC前HCC水平升高可预测PTSD症状。虽然童年创伤并未调节这种关系，但它在随访时独立预测了PTSD。这些发现强调了早期逆境对心理健康的持久影响，突出了考虑HPA轴调节和创伤史以制定针对暴露于新应激源的成年人的针对性干预措施的重要性。
