Neuropsychologische Testleistungen, Hippocampus-Volumina und Stressverarbeitungsstrategien bei traumatisierten Probanden in Abhängigkeit vom Vorliegen einer Posttraumatischen Belastungsstörung

Abstract

In recent studies, subjects with post traumatic stress disorders (PTSD) have been found with more cognitive deficits and smaller hippocampal volumes in comparison to traumatized subjects without PTSD and healthy control subjects. It was also reported, that subjects with PTSD used different coping strategies than traumatized subjects without PTSD. Most of the recent studies concentrated on Vietnam veterans and were confounded by methodological problems (e.g. high psychiatric comorbidities).This study examined the cognitive functioning and hippocampal volumes of 15 subjects with PTSD after a severe burn injury, 15 similarly traumatized subjects without PTSD and 15 healthy control subjects. The trauma specific coping strategies of the subjects with and without PTSD were compared.In comparison to the healthy control subjects, the traumatized subjects with and without PTSD showed deficits in intellectual functioning, in delayed verbal recall and smaller hippocampal volumes. The subjects with PTSD showed deficits in visual memory. Stronger burn injuries were associated with smaller left hippocampal volumes. The analgosedative treatment with the NMDA antagonist ketamine was related to larger right hippocampal volumes and to stronger PTSD symptoms. The subjects with PTSD showed an increased use of dysfunctional trauma-specific coping strategies when compared with traumatized subjects without PTSD. The trauma-specific coping strategies were associated with the psychopathology, not with the general coping strategies.