Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder.

Abstract

Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p = .015; adjusted-p [padj] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p = .010-.034; padj = .032-.053); worse self-monitoring (p = .018; padj = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

• Authors: Erika J Wolf, Sage E Hawn, Danielle R Sullivan, Mark W Miller, Victoria Sanborn, Emma Brown, Zoe Neale, Dana Fein-Schaffer, Xiang Zhao, Mark W Logue, Catherine B Fortier, Regina E McGlinchey, William P Milberg
• Journal: Journal of psychopathology and clinical science (J Psychopathol Clin Sci) Vol. 132 Issue 4 Pg. 409-427 (May 2023) ISSN: 2769-755X [Electronic] United States
• PMID: 37023279 (Publication Type: Journal Article)

Topics

• Humans
• Male
• Stress Disorders, Post-Traumatic (genetics, diagnosis)
• Multivariate Analysis
• Gyrus Cinguli (diagnostic imaging)
• Dissociative Disorders (genetics, diagnosis)
• Hippocampus (diagnostic imaging)