Abstract
Background: Increasing evidence indicates that survivors to traumatic events may show disruption of sleep pattern, eating and sexual behaviors, and somatic symptoms suggestive of alterations of biorhythmicity and vegetative functions. Therefore, the aim of this study was to investigate these possible alterations in a sample of survivors in the aftermath of earthquake exposure, with particular attention to gender differences and impact of post-traumatic stress disorder (PTSD).Methods: High school senior students, who had been exposed to the 2009 L'Aquila earthquake, were enrolled 21 months after the traumatic event and evaluated by the Trauma and Loss Spectrum Self-Report to investigate PTSD rates and by a domain of the Mood Spectrum Self-Report–Lifetime Version (MOODS-SR), to explore alterations in circadian/seasonal rhythms and vegetative functions.Results: The rates of endorsement of MOODS-SR rhythmicity and vegetative functions domain and subdomain scores were significantly higher in survivors with PTSD with respect to those without it. Among all earthquake survivors, women reported higher scores than men on the rhythmicity and vegetative functions domain and subdomain scores, except for the rhythmicity and sexual functions ones. Female survivors without PTSD showed significantly higher scores than men in the rhythmicity and vegetative functions total scores and the sleep and weight and appetite subdomains. Potentially traumatic events burden predicted rhythmicity and vegetative functions impairment, with a moderation effect of re-experiencing symptoms.Conclusions: We report impairments in rhythmicity, sleep, eating, and sexual and somatic health in survivors to a massive earthquake, particularly among subjects with PTSD and higher re-experiencing symptoms, with specific gender-related differences. Evaluating symptoms of impaired rhythmicity and vegetative functions seems essential for a more accurate assessment and clinical management of survivors to a mass trauma.
Highlights
Post-traumatic stress disorder (PTSD) is a complex syndrome that may occur after exposure to traumatic events, characterized by severe and often chronic psychological, physiological, and cognitive symptoms
Most of the research focused on sleep organization, studies on endocrine rhythmicity revealed that some abnormalities of both cortisol and sympathetic nervous system activity are frequently, albeit not constantly, observed in PTSD patients [2, 3]
All the MOODS-SR rhythmicity and vegetative functions subdomain scores were significantly higher in survivors with PTSD than in those without it (Table 1)
Summary
Post-traumatic stress disorder (PTSD) is a complex syndrome that may occur after exposure to traumatic events, characterized by severe and often chronic psychological, physiological, and cognitive symptoms. Neurobiological dysfunctions and hormonal alterations have been reported to contribute to the manifestations of the disorder, to the impairment in emotional regulation, memory, and learning. These symptoms have been explored through the investigation of endocrine rhythmicity and temporal synchrony in brain activity [1]. Increasing evidence indicates that survivors to traumatic events may show disruption of sleep pattern, eating and sexual behaviors, and somatic symptoms suggestive of alterations of biorhythmicity and vegetative functions. The aim of this study was to investigate these possible alterations in a sample of survivors in the aftermath of earthquake exposure, with particular attention to gender differences and impact of post-traumatic stress disorder (PTSD)
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