Page 45 - PIECES OF THE PUZZLE Eline Vissia

HIPPOCAMPAL MORPOHLOGY AND CHILDHOOD TRAUMA
The current study is the first to investigate hippocampal morphological correlates of childhood traumatization and dissociative symptoms in both DID and PTSD patients. To this end, we obtained structural MRI scans from HC and patients with DID and/or PTSD. All participants were carefully matched for age, sex, and education. We investigated global hippocampal volume, subfield volumes, as well as hippocampal regional shape deformations. In the patient samples, we examined the association between hippocampal volume and severity of self-reported early childhood traumatization, that is physical maltreatment, sexual and emotional abuse, and emotional neglect, and severity of dissociative symptoms. We tested three a priori hypotheses: 1) both DID and PTSD patients, as compared with HC, would have smaller global hippocampal volume, regional volumetric abnormalities, and shape deformations in various hippocampal subfields; 2) global hippocampal volume, as well as, regional volume in the CA4-DG, CA2-3 and subiculum subfields would be negatively associated with the severity of childhood traumatization; and 3) global hippocampal and regional volumes would be negatively associated with dissociative symptoms.
METHODS
Subjects
Sixty-five women (only female patients with DID volunteered to participate in this study) underwent magnetic resonance imaging (MRI): 17 with a diagnosis of DID, 16 with a diagnosis of PTSD and 32 HC. Four HC were excluded from the demographic and morphological analyses due to the presence of artifacts in the MRI scans. Participants were matched for sex, age, years of education (Table 3.1) and Western European ancestry. PTSD patients with a history of interpersonal traumatizing events and DID patients were recruited via mental healthcare institutions and internet advertisements.
The diagnosis of DID was confirmed by one of two DID experts (E.N. or N.D.) using the Structural Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) (Boon, Draijer 1993b, Steinberg 1993), during which PTSD co- morbidity was assessed as well. The evaluation revealed that all DID patients met criteria for either current co-morbid PTSD (82.35%) or PTSD in remission (17.65%). Therefore, we refer to this sample as “PTSD-DID”. The personal
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