ABSTRACT

Background: Posttraumatic stress disorder (PTSD) is associated with dysregulated neural, cortisol, and cardiac stress reactivity and recovery. This understanding is predominantly based on studies in adults applying emotional-cognitive and trauma-related stimuli inducing negative emotions or perceived threat. Despite large numbers of adolescents with PTSD, few studies are available on neurobiological stress reactivity in this population. Moreover, no previous studies investigated neural reactivity to social-evaluative stress.

Objective: To investigate functional brain connectivity, cortisol and cardiac reactivity to acute social-evaluative stress, and additional cortisol measures in trauma-exposed adolescents with and without high PTSD symptoms.

Method: A speech preparation task to induce acute social-evaluative stress elicited by anticipatory threat, was used in a subsample of the Amsterdam Born Child and their Development (ABCD) birth cohort, consisting of trauma-exposed adolescents with (n = 20) and without (n = 29) high PTSD symptoms. Psychophysiological interaction analyses were performed to assess group differences in functional connectivity of the hippocampus, mPFC and amygdala during social-evaluative stress and recovery, measured by fMRI. Additionally, perceived stress, heart rate and cortisol stress reactivity and recovery, cortisol awakening response and day curve were compared.

Results: The stressor evoked significant changes in heart rate and perceived stress, but not cortisol. The PTSD symptom and control groups differed in functional connectivity between the hippocampus and cerebellum, middle and inferior frontal gyrus, and the mPFC and inferior frontal gyrus during social-evaluative stress versus baseline. Mostly, the same patterns were found during recovery versus baseline. We observed no significant group differences in amygdala connectivity, and cortisol and cardiac measures.

Conclusions: Our findings suggest threat processing in response to social-evaluative stress is disrupted in adolescents with PTSD symptoms. Our findings are mainly but not entirely in line with findings in adults with PTSD, which denotes the importance to investigate adolescents with PTSD as a separate population.

摘要

背景：创伤后应激障碍 (PTSD) 与失调的神经、皮质醇和心脏应激反应和恢复有关。这种理解主要基于对成年人应用情绪认知和创伤相关刺激诱发负面情绪或感知威胁的研究。尽管有大量青少年患有 PTSD，但很少有关于该人群神经生物学应激反应的研究。此外，之前没有研究调查对社会评价压力的神经反应。

目的：研究具有和不具有高 PTSD 症状的创伤暴露青少年的功能性脑连接、皮质醇和心脏对急性社会评价压力的反应性，以及额外的皮质醇测量。

方法：在阿姆斯特丹出生儿童及其发育 (ABCD) 出生队列的一个子样本中使用了一项演讲准备任务，以诱导由预期威胁引起的急性社会评价压力，该队列由暴露于创伤的青少年组成 ( n = 20 )和没有 ( n = 29) 高 PTSD 症状。进行了心理生理学相互作用分析，以评估通过 fMRI 测量的社会评价压力和恢复期间海马体、mPFC 和杏仁核功能连接的组别差异。此外，还比较了感知压力、心率和皮质醇压力反应性和恢复、皮质醇觉醒反应和日曲线。

结果：压力源会引起心率和感知压力的显着变化，但皮质醇不会。PTSD 症状组和对照组在社会评价压力与基线期间海马体和小脑、额中回和额下回以及 mPFC 和额下回之间的功能连接不同。大多数情况下，在恢复与基线期间发现了相同的模式。我们观察到杏仁核连通性、皮质醇和心脏指标没有显着的组别差异。

结论：我们的研究结果表明，在有 PTSD 症状的青少年中，对社会评价压力的威胁处理被破坏了。我们的研究结果主要但不完全符合成人 PTSD 的研究结果，这表明将患有 PTSD 的青少年作为一个单独的人群进行调查的重要性。