کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4934363 1433961 2017 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Pre-treatment cortisol awakening response predicts symptom reduction in posttraumatic stress disorder after treatment
ترجمه فارسی عنوان
پیش از درمان، بیداری کورتیزول، کاهش علائم اختلال استرس پس از سانحه پس از درمان را پیش بینی می کند
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی علوم غدد
چکیده انگلیسی


- HPA-axis reactivity was measured in veterans with PTSD.
- Veterans with PTSD received trauma focused psychotherapy for 6-8 months.
- CARi before and after treatment was compared.
- CARi accounted for 10% of the treatment effect.
- CARi can be used to predict symptom reduction in PTSD.

Dysfunction of the HPA-axis has frequently been found in the aftermath of trauma exposure with or without PTSD. Decreasing HPA-axis reactivity to different stress cues has been reported during PTSD treatment. The cortisol awakening response (CARi) is a well-validated, standardized measure of HPA-axis reactivity which can be easily acquired in the clinical setting. Whether CARi changes over time in traumatized individuals are specific to PTSD treatment is unknown. Furthermore, a possible role for the baseline CARi in predicting symptom reduction after treatment in PTSD has not been examined before. To answer these questions, a cohort study was conducted in which the awakening cortisol was measured in both PTSD (N = 41) and non-PTSD (N = 25) combat-exposed male subjects. Measurements took place at inclusion and 6-8 months after inclusion for both the PTSD and the non-PTSD group. During the 6-8 months interval, PTSD patients received trauma-focused focused psychotherapy, whereas non-PTSD patients received no treatment. We found a decrease in the CARi over time in both groups, suggesting it was not specific to PTSD or the effect of treatment. Therefore, caution is warranted when attributing diminished HPA-axis reactivity over time to effects of PTSD treatment. Second, CARi prior to treatment predicted PTSD symptom reduction (CAPS score change) after treatment, and accounted for 10% of the variance, even when adjusted for changes in depressive symptoms and medication use during the study period. A putative role emerges for CARi as a predictive biomarker of symptom reduction in male individuals with combat-related PTSD.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Psychoneuroendocrinology - Volume 82, August 2017, Pages 1-8
نویسندگان
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