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HIPPOCAMPAL MORPOHLOGY AND CHILDHOOD TRAUMA
were tested (see supplementary material S3.2) and showed that the smaller hippocampal volume in PTSD-DID as compared with HC is a robust finding. However, the shape analyses did not survive multiple comparison correction, which is likely due to insufficient statistical power for conducting multiple tests across the hippocampal surface. Nevertheless, permutation testing can be considered too conservative in this context, as all the tests are treated independently, when in fact many of the surface points are highly related.
In conclusion, we provide novel evidence that smaller hippocampal global and subfield volumes and contractions of hippocampal surface in PTSD patients, with or without DID, are related to the severity of childhood traumatizing events and dissociative symptoms. Our findings are in line with the clinical observation that DID is related to chronic childhood abuse and neglect. These findings can help to understand the neurobiological mechanisms involved in PTSD and DID.
Acknowledgements
S. Chalavi is supported by a David Caul graduate research grant from the International Society for the Study of Trauma and Dissociation (ISSTD) (http:// www.isst-d.org/about/awards.htm). A.A.T.S. Reinders received support from the Netherlands Organization for Scientific Research (www.nwo.nl), NWO- VENI grant no. 451-07-009. This work was supported by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. P. Dazzan’s research is supported partially by a King’s College London Translational Research Grant and the Psychiatry Research Trust and NARSAD. AW Toga acknowledges grant P41EB015922.
The authors would like to thank all the participants and their therapists. We also would like to thank J.A. den Boer, R. Renken, A. Nederveen, A.J. Sibeijn- Kuiper, J. Streurman and R. van Luijk-Snoeks, S. van den Berg-Faay for their assistance with data acquisition, M. Jongsma and J. Reisel for their assistance with patient inclusion and H. Hofstetter for her help with the initial phases of the project.
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