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دانلود رایکان مقاله انگلیسی ISI با موضوع قرار گرفتن در معرض تروما مربوط به استرس شدید،مورفولوژی آمیگدال تغییریافته

عنوان فارسی مقاله:

قرار گرفتن در معرض تروما مربوط به استرس شدید، مورفولوژی آمیگدال تغییریافته و یادگیری انسداد ناکافی: ملاحظات روان پزشکی

عنوان انگلیسی مقاله:

Trauma exposure relates to heightened stress, altered amygdala morphology and deficient extinction learning: implications for psychopathology

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2. Material and Methods

2.1 Study participants

Eighteen healthy persons with previous trauma experience without diagnosis of PTSD or depression (TR group, 8 female), and 18 non-exposed healthy matched controls (HC group, 8 female) took part in the study. The two groups did not significantly differ in age, sex or years of education. Sample characteristics are reported in Table 1. The participants were recruited in schools for rescue ambulance workers located in Baden-Württemberg and Rheinland-Pfalz, Germany, and were part of a larger sample monitored within the context of a longitudinal study on the consequences of stress exposure. Previous studies have documented that rescue workers are at higher risk for a later onset of stress-related mental disorders, due to the frequent traumatic situations they experience on a regular basis (McFarlane et al., 2009). Trauma exposure was evaluated using the Post-traumatic Stress Diagnostic Scale (Foa et al., 1997) and the Clinician-Administered PTSD scale (Blake et al., 1995), assessing: a) the presence of a traumatic event in the life of the person; b) the nature of the traumatic exposure; c) the severity of the trauma and d) the timing of the traumatic exposure. Exclusion criteria were gross brain structural abnormality and the presence of mental disorders such as major depressive disorder, chronic or acute substance abuse, schizophrenia, or borderline personality disorder, as assessed with the German version of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV (Wittchen et al., 1997). Subjects were assigned to the TR group when they had experienced a traumatic event in their life, according to the diagnostic criteria for trauma experience provided by DSM-IV-TR (American Psychiatric Association, 2000). In the TR group, all participants experienced a single traumatic exposure (type 1 trauma), which occurred on average 7.41 (standard deviation = 5.55) years before the experiment. Of the traumas, 41.2% referred to a severe vehicle accident, 29.4% to traumatic loss of a loved one, 23.5% to domestic violence, and 5.9% to childhood abuse. All subjects provided written informed consent to participate in the study. The study protocol was approved by the Ethics Committee of the Medical Faculty Mannheim of the University of Heidelberg, and conformed to the Code of Ethics of the World Medical Association (Declaration of Helsinki, sixth revision, 2008).