Page 57 - PIECES OF THE PUZZLE Eline Vissia

HIPPOCAMPAL MORPOHLOGY AND CHILDHOOD TRAUMA
Figure 3.3 Scatter plots of the bilateral global hippocampal volumes from PTSD-DID and PTSD-only groups in relation to total childhood traumatization (as assessed using CTQ)
Abbreviations:
PTSD-only = patients with only posttraumatic stress disorder; PTSD-DID= patients with PTSD and dissociative identity disorder; CTQ: Childhood Trauma Questionnaire.
DISCUSSION
This study is the first to investigate clinical correlates of global and regional morphological abnormalities of the hippocampus in DID and PTSD patients. As hypothesized, we found that in all patients with PTSD and patients with DID, relative to healthy controls, global hippocampal volume is smaller and regional volumetric abnormalities are localized in the subfields CA2-3, CA4- DG and subiculum. Furthermore, these findings are supported by evidence of hippocampal surface contractions in the subfields CA1, CA2-3 and subiculum. Another important finding is that within our patient sample, the severity of childhood traumatizing events, in particular emotional neglect and sexual abuse, was negatively correlated with global and subfield hippocampal volumes. However, severity of dissociative symptoms (psychoform or somatoform) was negatively associated with the volumes of the left presubiculum and subiculum only. These findings support a link between hippocampal morphological abnormalities and childhood traumatization in both DID and PTSD patients.
The subgroup with DID, who all had co-morbid PTSD (PTSD-DID), had significantly smaller global volumes as compared with HC (left: 10.19%; right:
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