TY  - JOUR
PY  - 2022//
TI  - Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure
JO  - American journal of psychiatry
A1  - Lebois, Lauren A. M.
A1  - Harnett, Nathaniel G.
A1  - van Rooij, Sanne J. H.
A1  - Ely, Timothy D.
A1  - Jovanovic, Tanja
A1  - Bruce, Steven E.
A1  - House, Stacey L.
A1  - Ravichandran, Caitlin
A1  - Dumornay, Nathalie M.
A1  - Finegold, Katherine E.
A1  - Hill, Sarah B.
A1  - Merker, Julia B.
A1  - Phillips, Karlye A.
A1  - Beaudoin, Francesca L.
A1  - An, Xinming
A1  - Neylan, Thomas C.
A1  - Clifford, Gari D.
A1  - Linnstaedt, Sarah D.
A1  - Germine, Laura T.
A1  - Rauch, Scott L.
A1  - Haran, John P.
A1  - Storrow, Alan B.
A1  - Lewandowski, Christopher
A1  - Musey, Paul I. Jr
A1  - Hendry, Phyllis L.
A1  - Sheikh, Sophia
A1  - Jones, Christopher W.
A1  - Punches, Brittany E.
A1  - Swor, Robert A.
A1  - McGrath, Meghan E.
A1  - Hudak, Lauren A.
A1  - Pascual, Jose L.
A1  - Seamon, Mark J.
A1  - Datner, Elizabeth M.
A1  - Chang, Anna M.
A1  - Pearson, Claire
A1  - Domeier, Robert M.
A1  - Rathlev, Niels K.
A1  - O'Neil, Brian J.
A1  - Sergot, Paulina
A1  - Sanchez, Leon D.
A1  - Miller, Mark W.
A1  - Pietrzak, Robert H.
A1  - Joormann, Jutta
A1  - Barch, Deanna M.
A1  - Pizzagalli, Diego A.
A1  - Sheridan, John F.
A1  - Smoller, Jordan W.
A1  - Luna, Beatriz
A1  - Harte, Steven E.
A1  - Elliott, James M.
A1  - Kessler, Ronald C.
A1  - Koenen, Karestan C.
A1  - McLean, Samuel A.
A1  - Stevens, Jennifer S.
A1  - Ressler, Kerry J.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: Dissociation, a disruption or discontinuity in psychological functioning, is often linked with worse psychiatric symptoms; however, the prognostic value of dissociation after trauma is inconsistent. Determining whether trauma-related dissociation is uniquely predictive of later outcomes would enable early identification of at-risk trauma populations. The authors conducted the largest prospective longitudinal biomarker study of persistent dissociation to date to determine its predictive capacity for adverse psychiatric outcomes following acute trauma. <br><br>METHODS: All data were part of the Freeze 2 data release from the Advancing Understanding of Recovery After Trauma (AURORA) study. Study participants provided self-report data about persistent derealization (N=1,464), a severe type of dissociation, and completed a functional MRI emotion reactivity task and resting-state scan 2 weeks posttrauma (N=145). Three-month follow-up reports were collected of posttraumatic stress, depression, pain, anxiety symptoms, and functional impairment. <br><br>RESULTS: Derealization was associated with increased ventromedial prefrontal cortex (vmPFC) activation in the emotion reactivity task and decreased resting-state vmPFC connectivity with the cerebellum and orbitofrontal cortex. In separate analyses, brain-based and self-report measures of persistent derealization at 2 weeks predicted worse 3-month posttraumatic stress symptoms, distinct from the effects of childhood maltreatment history and current posttraumatic stress symptoms. <br><br>CONCLUSIONS: The findings suggest that persistent derealization is both an early psychological and biological marker of worse later psychiatric outcomes. The neural correlates of trauma-related dissociation may serve as potential targets for treatment engagement to prevent posttraumatic stress disorder. These results underscore dissociation assessment as crucial following trauma exposure to identify at-risk individuals, and they highlight an unmet clinical need for tailored early interventions.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-953X
UR  - http://dx.doi.org/10.1176/appi.ajp.21090911
ID  - ref1
ER  -