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At one point or another, millions of individuals – in the United States alone – experience a traumatic event during their lifetime. However, approximately only 2.6–6.8% of Americans will develop symptoms reflective of post-traumatic stress disorder; PTSD (Wang et al., 2016). Over the last several decades, there have been many research studies conducted to further investigate the causes, effects, and potential treatments in patients with PTSD. Such research has revealed a correlation between trauma-exposed survivors and altered brain functionality, as well as its structures (Li et al., 2017). Specifically, neurological images of participants with PTSD showed reduced development in the prefrontal limbic systems, involved in emotional regulation, resulting in greater grey matter density (Carrion, Wong & Kletter, 2012). Images from the PTSD groups also found the amygdala to be hyperresponsive, which is associated with exaggerated fear responses as well as emotional arousal; both of which are common symptoms in PTSD patients (Carrion, Wong & Kletter, 2012). Vass amounts of research support the hypothesis that brain functionality is hindered resulting from the experience of a traumatic event(s).
Researchers used functional magnetic resonance imaging (fMRI) to capture images of various participants brain structures. The results were then analyzed to measure change in brain activity and grey matter density. The same method was used on maltreatment-related pediatric participants, revealing under-developed brain structures, including the dorsal medial prefrontal cortex (dmPFC) and ventral medial prefrontal cortex (vmPFC) (Carrion, Wong & Kletter, 2012). Another method employed was the use of neuropsychological assessments, such as the PTSD Checklist-Stressor Specific Version (Wang et al., 2016). Participants were separated into probable PTSD or non-PTSD groups according to the criterion established by the DSM-IV; the Diagnostic and Statistical Manual of Mental Disorders (Wang et al. 2016).
Participants in pediatric studies with PTSD were found to have increased grey matter density in their prefrontal cortex (PFC) (Carrion, Wong & Kletter, 2012). In other words, their brains were underdeveloped. These same subjects performed worse on measures of attention, reasoning, mental-flexibility, problem-solving, and memory (Carrion, Wong & Kletter, 2012). They also exhibited less control over their inhibitions and slower, less-effective learning in comparison to controls. Carrion and colleagues posit a parent’s role in their children’s lives are crucial in that they influence how the child determines their own worth, feelings of safety, and ability to appropriately express their emotions in a given situation (2012). Psychologists have indicated early intervention in pediatric PTSD yields a greater likelihood of recovery, however initial expression of such symptoms are difficult to catch.
Neurological images from 42 young adults were studied; 21 of which were identified as having PTSD. All were roughly the same age, varying in ethnic backgrounds and gender, and all were victims of the Wenchuan Earthquake (Li et al., 2017). Their MRI’s were examined to determine the extent of which a traumatic occurrence alters the brains structures. The PFC of these participants consistently showed greater grey matter density, similar to the subjects in the pediatric study (Li et al., 2017). Not only were certain regions underdeveloped, but images also showed strengthened functional connectivity between the amygdala and the hippocampus compared to controls, whereas those diagnosed with PTSD showed less gray matter volume in the parietal cortex compared to healthy controls (Li et al., 2017). This connection is associated with greater recollection of memories, though there appeared to be a bias in favor of memories involving negative emotions. These prefrontal limbic systems also play an important role in the regulation of emotions (Li et al., 2017).
Furthermore, individuals who were recruited after a motor vehicle collision (MVC) were assessed, and those who were said to be a probable PTSD patient were asked to participate in further research involving changes in emotional processing after being exposed to a trauma. The control group in this study were people who were also a part of an MVC, but whose assessments suggested they would not develop symptoms indicative of post-traumatic stress disorder. In this 2016 study, participants MRI’s showed very few differences between the control group and the PTSD group when initially observed, and no significant differences at all when surveyed three months after the MVC (Wang et al.). Researchers experienced some issues with this study, however, resulting in only forty-two of the initial seventy-two subject’s data remaining viable for analysis. This was due to several factors, including changes in condition and self-withdrawal (Wang et al., 2016). These confounding variables are possibly responsible for the lack of congruity between the results generated here in comparison to the findings of previous studies with similar objectives.
Neurological changes associated with post-traumatic stress disorder include, but are not limited to, greater grey matter density, lowered inhibition, and a resting state of heightened arousal. This hypothesis was confirmed in both the 2012 and 2017 studies. When participants involved in the 2016 motor vehicle study, however, were tested again after three months, researchers yielded results incongruent with data from initial assessments retrieved after only two weeks, finding no significant differences in activity of the dmPFC.
Early symptoms of PTSD remain difficult to diagnose; therefore, people often do not know or receive aid until after a major episode occurs, usually in response to some kind of ‘trigger’. In the aforementioned case studies, research has revealed a correlation between survivors of traumatizing events and heightened emotional arousal, exaggerated fear response, poorer performance on measures of memory, attention, and emotional regulation (Carrion, Wong, & Kletter, 2012). In order to better assist individuals at risk for developing PTSD, greater attention must be showed when symptoms indicative of the disorder first arise. Intervention and therapy has been proven to decrease the severity of this anxiety disorder, giving patients a higher quality of life.
- Carrion, V. G., Wong, S. S., & Kletter, H. (2012). Update on Neuroimaging and Cognitive Functioning in Maltreatment-Related Pediatric PTSD: Treatment Implications. Journal of Family Violence, 28(1), 53-61. doi:10.1007/s10896-012-9489-2
- Li, Y., Hou, X., Wei, D., Du, X., Zhang, Q., Liu, G., & Qiu, J. (2017). Long-Term Effects of Acute Stress on the Prefrontal-Limbic System in the Healthy Adult. PLoS ONE, 12(1). doi:10.1371/journal.pone.0168315
- Wang X, Xie H, Cotton AS, Duval ER, Tamburrino MB, Brickman KR, et al. (2016) Preliminary Study of Acute Changes in Emotion Processing in Trauma Survivors with PTSD Symptoms. PLoS ONE 11(7): e0159065. https://doi.org/10.1371/journal.pone.0159065
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