Geänderte Inhalte

Lehre in der Abteilung für Arbeits- und Organisationspsychologie

Benedikt Graf, Leiter der Arbeits- und Organisationspsychologie Abteilung des Georg-Elias-Müller-Instituts

Steroid hormone dysregulations have frequently been implicated in posttraumatic stress disorder (PTSD) pathogenesis. However, the translation into naturalistic clinical settings as markers of symptomatology and treatment success remains complex. Particularly, there is little longitudinal data on steroid secretion over the course of interventions. This study examined the potential of long-term steroid hormone secretion assessed in hair as diagnostic and intervention-related biomarkers among medicated, multimorbid inpatients with PTSD. As part of a secondary analysis of a randomized controlled trial, 54 female inpatients with a primary diagnosis of PTSD receiving standardised treatment provided hair samples at pre-treatment, post-treatment, and 3-months follow-up. Cortisol, cortisone, and dehydroepiandrosterone (DHEA) were determined, alongside clinical assessments. Cross-sectional results showed a negative association of pre-treatment DHEA with anxiety symptoms and a trend-level association with lifetime trauma exposure. While inpatients improved in PTSD symptomatology during treatment, neither pre-treatment steroids, nor treatment-induced steroid changes predicted PTSD symptoms at post-treatment or follow-up. The study highlights the challenges of establishing biomarkers in naturalistic clinical populations. While the association of attenuated DHEA with anxiety symptoms warrants further exploration, our data points towards the potential necessity of patient sub-sample selection to understand, and in the long run clinically target, the endocrine mechanisms in PTSD.

Background: While available posttraumatic stress disorder (PTSD) treatments are generally successful, 30–40% of patients show limited improvement. The endocannabinoid system may play a role in the aftermath of trauma, in PTSD, and in extinction processes. Therefore, this secondary analysis of a randomized-controlled trial including PTSD inpatients over the course of trauma-focused treatment investigated whether a dysregulated endocannabinoid system is associated with symptom severity and treatment response. Methods: Fifty-four female PTSD inpatients provided hair samples and completed psychometric questionnaires at admission, discharge, and 3-month follow-up. Endocannabinoid (EC: AEA, 1AG/2AG) and N-acylethanolamine (NAE: SEA, OEA, PEA) concentrations were measured in scalp-near 3-cm hair segments. Results: At admission, higher hair AEA correlated with lower depressive and anxiety and higher PTSD symptoms (when controlling for depressive symptoms). Hair NAEs associated with more traumatic experiences. PTSD symptoms improved across treatment, remaining stable at follow-up, but were predicted neither by pre-treatment hair ECs/NAEs nor their changes. Subgroup analyses with those who received exposure treatment tentatively indicated a trend linking higher hair PEA and OEA to lower PTSD symptoms at discharge. Conclusions: Taken together, hair ECs/NAEs may relate differentially to trauma exposure and symptom severity, but not to PTSD inpatient treatment response. Larger-scale research is necessary to confirm this.