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Post-traumatic Stress Disorder01:27

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Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
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Stress Reactivity After Pediatric Traumatic Brain Injury: Relation With Behavioral Adjustment.

Linda Ewing-Cobbs1, Christina V Danna1, Tammy D Tolar2

  • 1Children's Learning Institute and Department of Pediatrics, McGovern School of Medicine, University of Texas Health Science Center, Houston, Texas, USA.

Journal of Neurotrauma
|November 25, 2022
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Summary
This summary is machine-generated.

Children with traumatic brain injury show altered autonomic nervous system responses, specifically salivary alpha-amylase (sAA) reactivity, linked to poorer emotion regulation and psychological adjustment. Cortisol reactivity remained unchanged, suggesting sAA as a key indicator of vulnerability.

Keywords:
cortisolemotion regulationexternalizinginternalizingsalivary alpha amylasetraumatic brain injury

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Area of Science:

  • Neuroscience
  • Psychology
  • Pediatrics

Background:

  • Traumatic injuries, including traumatic brain injury (TBI) and extracranial injury (EI), are increasingly linked to lasting psychological health issues and altered stress response systems.
  • Investigating the reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) provides insight into the biological mechanisms underlying these changes.

Purpose of the Study:

  • To compare the stress reactivity of the HPA axis (cortisol) and ANS (salivary alpha-amylase, sAA) in children with TBI or EI versus healthy controls.
  • To examine the relationship between stress reactivity (cortisol and sAA) and psychological health outcomes (emotion regulation, internalizing, and externalizing problems) 7 months post-injury.

Main Methods:

  • A prospective cohort study involving children aged 8-15 years hospitalized for TBI (n=74), EI (n=35), or healthy controls (n=51).
  • Salivary cortisol and sAA levels were measured before and after a psychosocial stress procedure to assess reactivity (Area Under the Curve increase - AUCinc).
  • Multivariable general linear models analyzed the association between demographic factors, family functioning, injury group, cortisol/sAA AUCinc, and psychological outcomes.

Main Results:

  • While cortisol and sAA reactivity (AUCinc) did not differ significantly across the TBI, EI, and control groups, their association with psychological outcomes varied.
  • Greater sAA reactivity was linked to increased emotion dysregulation in the TBI group, unlike in controls.
  • The association between sAA reactivity and internalizing/anxiety symptoms was attenuated in both TBI and EI groups compared to controls, suggesting ANS dysregulation.
  • sAA reactivity interacted with sex, indicating greater psychological dysregulation in girls than boys across groups.

Conclusions:

  • Altered salivary alpha-amylase (sAA) reactivity, not cortisol reactivity, appears to be a significant indicator of biological vulnerability following traumatic brain injury (TBI).
  • The findings suggest a potential mechanism of autonomic nervous system dysregulation contributing to poorer psychological adjustment and emotion regulation difficulties after TBI and, to a lesser extent, EI.
  • Sex differences in the relationship between sAA reactivity and psychological outcomes highlight the need for sex-specific considerations in understanding and addressing post-injury adjustment.