| Part One:The relationship between coping styles and post-traumatic stress disorder in parents who lost their child :the mediating role of functional changes in brain regionsObjectiveTo investigate the effect of amplitude of low frequency fluctuation(ALFF)on the effects of coping style on the clinical symptoms of PTSD in patients with or without PTSD.MethodsSixty cases of parents who lost their only child with PTSD(44 cases with positive coping styles and 16 cases with negative coping styles)and 60 cases without PTSD(46cases with positive coping styles and 14 cases with negative coping styles)were scanned using 3.0T MRI.Using SPM12 software based on Matlab,gender,age,time from trauma occurrence,and fame-wise displacement parameter were applied as covariables.Multiple regression analysis was used to explore the positive/negative coping style main effect,diagnosis main effect and the interaction effect of positive/negative coping style and diagnosis on the brain ALFF of parents who lost their only child.In addition,the mediation effect model was used to explore the role of ALFF changes in the middle brain region in the influence of coping styles on the clinical symptoms of PTSD,and the Bootstrap program was used to test the mediation effect.ResultsIn the positive group,the positive coping style main effect mainly affected the right posterior central gyrus,right angular gyrus,right inferior parietal angular gyrus and right middle occipital gyrus.The diagnostic main effect mainly affected the right precuneus,right middle temporal gyrus,right fusiform gyrus,right inferior temporal gyrus,right superior temporal gyrus,right hippocampus and left inferior parietal angular gyrus.The interaction effect of positive coping style and diagnosis on brain ALFF was not significant.In the negative group,the diagnostic main effect was mainly on the right middle occipital gyrus,right suproccipital gyrus,right cuneus,right lingual gyrus,and right peritaloid fissure cortex.The interaction between negative coping style and diagnosis mainly affected the right fusiform gyrus,right inferior temporal gyrus,left fusiform gyrus,left inferior temporal gyrus and left middle temporal gyrus.The negative coping style main effect on ALFF was not significant.In the group with PTSD,positive coping style score was positively correlated with the ALFF value of the right posterior central gyrus(r=0.397,P=0.011),and positive coping style score and ALFF value of the right posterior central gyrus were negatively correlated with CAPS-C score(r=-0.344,P=0.03;r=-0.356,P=0.024).The mediating effect results showed that in the positive group with PTSD,the positive coping style had an impact on avoidance symptoms through ALFF changes in the right posterior central gyrus,while no significant mediating effect was found in the positive group without PTSD and the negative group without PTSD.ConclusionPositive coping style has a significant effect on ALFF changes in the right posterior central gyrus of PTSD patients who lost their only child,and less positive coping style may aggravate avoidance symptoms by affecting related brain regions that process sensory and perceptual information.Part Two:The relationship between coping styles and post-traumatic stress disorder in parents who lost their child:the mediating role of structural changes in brain regionsObjectiveTo explore the role of gray matter volume change in coping style on the clinical symptoms of PTSD in patients with or without PTSD.MethodsA 3.0T MRI scan was performed on 68 patients who lost their only child with PTSD(50 patients with positive coping style and 18 patients with negative coping style)and 67 patients without PTSD(46 patients with positive coping style and 21 patients with negative coping style).Gender,age,distance from trauma occurrence and Total intracranial volume(TIV)were used as covariables using SPM12 software based on Matlab.The main effect of positive/negative coping style,diagnostic main effect and the interaction effect of extreme/negative coping style and diagnosis on the brain regions with significant influence on the volume of gray matter were explored.In addition,the mediation effect model was used in this study to explore the effect of coping styles on the clinical symptoms of PTSD on the change of gray matter volume in the middle brain region,and the Bootstrap program was used to test the mediation effect.ResultsIn the positive group,positive coping style main effect was mainly on left inferior temporal gyrus and left medial temporal gyrus.The diagnostic main effect was mainly on the right lingual gyrus and the cortex surrounding the right taloid fissure.The interaction between positive coping style and diagnosis was mainly distributed in left lingual gyrus,left middle frontal gyrus and left trigonal-inferior frontal gyrus.In negatie group who lost their only child,the main effect of negative coping style,main effect of diagnosis,negative coping style and interaction effect of diagnosis had no significant influence on the brain gray matter volume.In the group who lost their only child without PTSD,positive coping style score was negatively correlated with gray matter volume of left inferior temporal gyrus and CAPS-C5 score(r=-0.605,P=0.001;r=-0.315,P=0.042),gray matter volume of left inferior temporal gyrus was positively correlated with CAPSC5 score(r=0.411,P=0.007).The mediating effect results showed that in the positive group without PTSD,the positive coping style had an effect on avoidance-related symptoms through the gray matter volume of the left inferior temporal gyrus,while no significant mediating effect was found in the positive group with PTSD and the negative group without PTSD.ConclusionActive coping style has a significant effect on the change of gray matter volume in the left inferior temporal gyrus of parents who lost their only child without PTSD,and less active coping style may aggravate the avoidance-related symptoms by affecting the brain regions related to visual information processing. |
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