Sex Differences in Re-experiencing Symptoms Between Husbands and Wives Who Lost Their Only Child in China: A Resting-State Functional Connectivity Study of Hippocampal Subfields.

Yifeng Luo,Xiaojie Zhang,Li Zhang,Hairong Shan,Zhao Qing,Lingjiang Li,Guangming Lu,Yifei Weng,Rongfeng Qi,Yu Liu,Zhihong Cao

doi:10.3389/fnhum.2021.655044

Abstract

Background: Losing one’s only child may lead to post-traumatic stress disorder (PTSD), of which re-experiencing is the core symptom. However, neuroimaging studies of sex differences in re-experiencing in the context of the trauma of losing one’s only child and PTSD are scarce; comparisons of the functional networks from the hippocampal subfields to the thalamus might clarify the neural basis.Methods: Thirty couples without any psychiatric disorder who lost their only child (non-PTSD group), 55 patients with PTSD, and 50 normal controls underwent resting-state functional magnetic resonance imaging. The functional connectivity (FC) from the hippocampal subregions to the thalamus and the correlations of FC with re-experiencing symptoms were analyzed within and between the sexes.Results: Compared with husbands without PTSD, wives without PTSD had higher re-experiencing symptoms and weaker FC between the right hippocampal cornu ammonis 3 (RCA3) and the right thalamus (RT; RCA3-RT). Moreover, only the correlation between the RCA3-RT FC and re-experiencing in wives without PTSD was significant. Among the three groups, only the RCA3-RT FC in female subjects was markedly different. Additionally, the RCA3-RT FC in wives without PTSD was remarkably lower relative to female patients with PTSD.Conclusion: Wives without PTSD who lost their only child had worse re-experiencing symptoms relative to their husbands, which was associated with the FC alteration between the hippocampal subregions and the thalamus. Importantly, the low level of the RCA3-RT FC may play a potentially protective role against the development of PTSD in wives who have lost their only child.

Highlights

In China, the one-child policy, legislated in the 1970s, led to millions of single-child families (Hesketh et al, 2005)
Between the wives/women and husbands/men in every group, there were no significant differences in age, educational level, duration of trauma, and scores on the Social Support Rating Scale (SSRS), SCSQ, Mini-Mental State Examination (MMSE), and total Clinician-Administered PTSD Scale (CAPS) (p > 0.05)
Among the normal controls (NCs), non-post-traumatic stress disorder (PTSD), and PTSD groups, no significant differences were found in age, educational level, and MMSE scores in male or female participants

Summary

Introduction

In China, the one-child policy, legislated in the 1970s, led to millions of single-child families (Hesketh et al, 2005) While this was an effort to curb the growing population, an unintended consequence was that the death of the only child placed parents at a high risk of post-traumatic stress disorder (PTSD) (Li and Wu, 2013; Yin et al, 2018); this included three symptom clusters: reexperiencing, avoidance, and hyperarousal (Association, 2013). Neuroimaging studies of sex differences in re-experiencing in the context of the trauma of losing one’s only child and PTSD are scarce; comparisons of the functional networks from the hippocampal subfields to the thalamus might clarify the neural basis

Methods

Results

Discussion

Conclusion