Stress Disorder, Resilience and Cortical Thickness Neuroimaging in Rehabilitation Patients after Traumatic Injury
|School||Third Military Medical University|
|Keywords||stress disorder, post-traumatic rehabilitation psychology, clinical resilience mental health|
Objective: As of April 2006 the total number of persons with disabilities has reached 8.296 million, which accounted for a considerable trauma disability percentage. The purpose of this study on rehabilitation patients after traumatic injury is to study their stress disorder, resilience and structural characteristics of the brains. It is also to provide a theoretical basis for developing targeted mental treatments for those patients, further explore the relationship between stress disorder, resilience and the volume of the cerebral cortex, understand the psychological characteristics, and provide future intervention ideas at a neurobiological level in those patients.Methods: One hundred and seventy-nine rehabilitation patients after traumatic injury admitted in 3 high-grade hospitals from December 2008 to March 2010 were tested with PTSD Checklist-Civilian Version (PCL-C), Resilience Scale for Adult (RSA), Self-report Symptom Checklist 90 (SCL-90), Eysenck Personality Questionnaire (EPQ), and Copying Style Questionnaire. From the 179 patients, 30 people were selected with good health and without hand dysfunction (including 15 people from PTSD positive group, 15 from negative group) as well as 15 normal persons. Then we studied the volume of the cerebral cortex of those people.Results: The average RSA total score of this cohort was 75.85±15.31. The average PTSD score of this cohort was 34.72±11.89. Significant difference was found in each factor and the total score of RSA between PTSD positive and negative groups (t=-4.744,p=0.000). Compared with the norms, evaluative indexes scores of SCL-90 including somatization, depression, anxiety, fear, crankiness and psychosis were higher (p<0.05). The scores on self-cognition and planning in RSA, nervousness in personality, self-blame, delusion, withdrawal and rationalization in copying style were significantly different between SCL-90 positive and negative groups (p<0.05 or p<0.01). Correlation analysis showed resilience was positively correlated with extraversion, settling problems and seeking for help. The volume of orbitofrontal cortex in the left brain of the PTSD positive group was significantly smaller than the negative group(p= 0.018). Correlation analysis showed several factor scores of RSA were correlated with different volume of the cortex separately.Conclusion: The mental health and resilience level of rehabilitation patients after traumatic injury were low. When the resilience of patients is lower, PTSD is higher. Low resilience and mental health might be the main predictors for PTSD. Factors such as extraversion, settling problems and seeking for help can be of good prognostication ability. This suggests that patients can interfere with the character and improve the level of mental health patients to improve resilience and reduce the incidence of PTSD. In addition, it was shown that the PTSD positive group had a lower volume of orbitofrontal cortex in the left brain.