C-Reactive Protein as a Potential Risk Factor for Post-Traumatic Stress Disorder Symptoms and Diagnosis: A Prospective Study Open Access

Bartel, Katarina Bajic (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/z316q2403?locale=en
Published

Abstract

Background: Post-traumatic stress disorder (PTSD) is a debilitating psychological disorder with potentially severe psychological, physiological, and community-wide impacts. Physiological co-morbidities with PTSD have led to research showing that heightened inflammation is associated with PTSD symptoms and diagnosis. While it has previously been demonstrated that PTSD can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis and lead to heightened inflammation, more recent findings show that heightened baseline inflammation, specifically heightened levels of the pro-inflammatory marker C-reactive protein (CRP), may also contribute to PTSD symptom development.

Methods: Participants were recruited from the Marcus Trauma Center at Grady Memorial Hospital in Atlanta, GA. During enrollment, blood samples were taken from participants for blood plasma CRP concentration determination. As well, participants underwent various psychological evaluations. All participants were invited to follow-up assessments every three months for the year following enrollment. Psychological assessments were repeated during follow-up appointments to track PTSD symptom progression.

Results: No significant effect of CRP level (high vs. low) was found for any measure of PTSD outcome (total symptoms, symptom clusters, diagnosis, and trajectory).

Conclusion: The present study undertakes one of the first prospective explorations of inflammation and PTSD in a civilian population. Compared to a similar prospective study examining the relationship between CRP levels and PTSD outcomes, the current sample is extremely limited by extensive demographic variation. Moreover, the present study is limited by a small enrollment sample size and low retention rate throughout the year post enrollment. Further investigation within the ongoing project should re-examine the effect of CRP levels on PTSD outcomes. With larger sample sizes, future analysis will be better able to account for population variability and will yield a more generalizable result.

Table of Contents

Introduction ..........................................................................................................................1

Post-Traumatic Stress Disorder ...............................................................................1

PTSD Risk, Prevalence, and Co-Morbidity .............................................................2

Stress Sensitization and the Psychophysiology of PTSD ........................................5

Stress sensitization.......................................................................................5

Fear potentiated startle (FPS) and transfer of fear inhibition ......................6

Hypothalamic-pituitary-adrenal (HPA) axis and PTSD ..............................8

Glucocorticoids and memory formation ......................................................9

The immune system, C-reactive protein (CRP), and PTSD ......................10

Methods..............................................................................................................................13

Participants.............................................................................................................13

Procedures & Measures .........................................................................................13

CRP Assays and Concentrations............................................................................14

Statistical Analysis.................................................................................................15

Results ................................................................................................................................17

Demographic Characteristics .................................................................................17

CRP Level and PTSD Outcomes ...........................................................................17

Discussion ..........................................................................................................................19

Limitations .............................................................................................................19

Future Directions ...................................................................................................23

References ..........................................................................................................................28

Tables and Figures .............................................................................................................36

About this Honors Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Degree
Submission
Language
  • English
Research field
Keyword
Committee Chair / Thesis Advisor
Committee Members
Last modified

Primary PDF

Supplemental Files