Neurobiological Correlates of Coping Strategies in PTSD: The Role of IGF-1, CASP-9, nNOS, and IL-10 Based on Brief-COPE Assessment

创伤后应激障碍应对策略的神经生物学相关性:基于简式应对方式评估的IGF-1、CASP-9、nNOS和IL-10的作用

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Abstract

Post-traumatic stress disorder (PTSD) is associated with long-term disturbances in stress regulation, neuroinflammation, and oxidative stress and reduced psychological coping capacity. The aim of the study was to assess the relationship between selected neurobiological biomarkers (Insulin-like Growth Factor 1-IGF-1; Caspase-9-CASP-9; Neuronal Nitric Oxide Synthase-nNOS; and Interleukin-10-IL-10) and coping styles evaluated using the Brief Coping Orientation to Problems Experienced (Brief-COPE) questionnaire in men with trauma experience. Particular emphasis was placed on analyzing the effect of PTSD chronicity (≤5 years vs. >5 years) on these relationships. The study included 92 adult men with a history of life-threatening situations. Participants were divided into three groups: PTSD within the past ≤5 years (n = 33), PTSD within the past >5 years (n = 31), and a No PTSD group (n = 28). Biomarkers were measured in blood serum. Coping strategies were assessed using the Brief-COPE questionnaire, which includes four subscales: task-oriented, emotion-oriented, avoidant, and general coping. Due to the lack of normal distribution, the Kruskal-Wallis test and Dunn's post hoc test were used. Correlations between biomarkers and Brief-COPE subscales were calculated using Spearman's Rank Correlation Coefficient (Rho). Significant differences between groups were found in all four biomarkers (p < 0.001). IGF-1 and IL-10 reached the highest values in the No PTSD group and the lowest in the PTSD ≤ 5 years group, indicating neuroprotective and anti-inflammatory deficits in PTSD. Conversely, CASP-9 and nNOS levels (markers of apoptosis and oxidative stress) were highest in PTSD ≤ 5 years, with partial normalization in the PTSD > 5 years group. In terms of coping strategies, the No PTSD group displayed a highly adaptive profile (task-oriented: 30/32; emotion-oriented: 43/48; and avoidant: 12/32). Individuals with PTSD ≤ 5 years presented a maladaptive pattern (task-oriented: 13/32; avoidant: 26/32; and emotion-oriented: 27/48), while in PTSD > 5 years, a further decline in emotion-oriented (21/48) and general coping (59/112) was observed, suggesting progressive depletion of psychological resources. The strongest correlations between biomarkers and coping strategies occurred in PTSD groups. Low IGF-1 levels in PTSD ≤ 5 years correlated negatively with emotion-oriented coping (Rho = -0.39) and general coping (Rho = -0.35). High CASP-9 levels were associated with reduced task-oriented coping in PTSD > 5 years (Rho = -0.29). Similar trends were observed for nNOS and IL-10, indicating a disturbance in neurobiological balance that favors persistence of PTSD symptoms. PTSD, both in its acute and chronic phases, is associated with an abnormal profile of neuroprotective, apoptotic, and inflammatory biomarkers, which correlates with impaired adaptive coping capacity. Although partial normalization of biological parameters is observed in chronic PTSD, deficits in emotion-oriented and task-oriented coping persist. The Brief-COPE questionnaire, combined with biomarker analysis, may serve as a useful clinical tool for assessing psychophysiological balance and designing early interventions. These results highlight the potential of IGF-1, CASP-9, nNOS, and IL-10 as biomarkers of stress adaptation and therapeutic targets in PTSD.

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