A Prospective Investigation of the Associations Between Mild Traumatic Brain Injury, Gonadal Steroid Hormones, and Posttraumatic Stress Disorder Open Access

Reddi, Preethi (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/q237ht22q?locale=en


Posttraumatic stress disorder (PTSD) is a debilitating condition that may develop after experiencing a traumatic event. Mild traumatic brain injury (mTBI) has previously shown to be a risk factor for PTSD. In order to develop better prognostic tools and treatment methods for PTSD, it is important to understand the mechanisms behind the relationship between PTSD and mTBI. Sex differences are prevalent in both PTSD and mTBI, with women more likely to experience worse outcomes from PTSD and mTBI while men are more likely to acquire PTSD and mTBI. Gonadal steroid hormones, such as estradiol, testosterone, and progesterone, may play a role in this relationship. This study aims to (i) further understand the relationship between PTSD and mTBI, (ii) examine the relationship between PTSD symptom clusters and mTBI, and (ii) explore the role of estradiol, testosterone, and progesterone in the relationship between PTSD and mTBI. This study includes 504 participants who presented to the Emergency Department (ED) of Grady Memorial Hospital following a traumatic event. PTSD diagnosis and symptoms were assessed at 1, 3, 6, and 12 months following trauma. Chi-square and Mann Whitney U tests were used to examine the relationship between PTSD and mTBI. Linear regression models were used to understand the use of mTBI, hormones, the interaction between mTBI and hormones, and gender in predicting PTSD symptoms. This study found that those with mTBI showed increased PTSD symptom reporting compared to those without mTBI at 3, 6, and 12 months. Those with mTBI reported increased avoidance symptoms at 3 and 6 months compared to those without mTBI. At 3, 6, and 12 months, those with mTBI reported increased intrusive symptoms compared to those without mTBI. At 3 months, those with mTBI reported increased hyperarousal symptoms compared to those without mTBI. Women reported higher PTSD scores compared to men at all time points. At 6 months, there was a negative association between testosterone levels and PSS scores for those with mTBI and those without mTBI. Our findings have potential to create more efficient prognostic and treatment tools for PTSD.

Table of Contents

Introduction (1)

Materials and Methods (7)

Procedure (7)

Participants (8)

Table 1 (9)

Statistical Analysis (10)

Results (11)

Figure 1 (12)

Figure 2 (13)

Figure 3 (14)

Figure 4 (14)

Figure 5 (15)

Table 2 (16)

Table 3 (17)

Table 4 (18)

Figure 6 (18)

Table 5 (19)

Discussion (20)

References (25)

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