Mri Assessment Of Brain Abnormalities In Ptsd And Trauma Spectrum Disorders
Findings of smaller hippocampal volume appear to be associated with a range of trauma related psychiatric disorders, as long as there is the presence of psychological trauma. We have used MRI to show smaller hippocampal volume in PTSD,,,, depression, depression with early abuse, borderline personality disorder with early abuse, and Dissociative Identity Disorder with early abuse. The greatest magnitude of difference was seen in the DID patients, who had unusually severe early childhood sexual abuse histories. We did not find changes in hippocampal volume in patients with panic disorder without a history of abuse . We found smaller amygdala volume in BPD with early abuse and increased amygdala volume in depression., Patients with depression had smaller orbitofrontal cortex volume with no changes in anterior cingulate or medial prefrontal cortex . More recently, we found smaller anterior cingulate volume in women with abuse and PTSD relative to controls.
How Trauma Changes The Brain
After experiencing trauma, both the brain and the body react and change. Dr. Arkadiy Stolyar, Assistant Professor of Psychiatry, Harvard Medical School and Principal Investigator in Psychiatry at Boston Clinical Trials shares with us an article on how physical changes in the brain lead to symptoms of PTSD:
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What Are The Effects Of Ptsd
There are many. They may include disturbing flashbacks, trouble sleeping, emotional numbness, angry outbursts, and feelings of guilt. You might also avoid things that remind you of the event, and lose interest in things that you enjoy.
Symptoms usually start within 3 months of a trauma. But they might not show up until years afterward. They last for at least a month. Without treatment, you can have PTSD for years or even the rest of your life. You can feel better or worse over time. For example, a news report about an assault on television may trigger overwhelming memories of your own assault.
PTSD interferes with your life. It makes it harder for you to trust, communicate, and solve problems. This can lead to problems in your relationships with friends, family, and coworkers. It also affects your physical health. In fact, studies show that it raises your risk of heart disease and digestive disorders.
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The Symptoms Of Trauma
PTSD stems from psychological trauma after witnessing a distressing or life-threating event. You may experience fear or helplessness, resulting in permanent psychological damage. This can lead to cognitive, behavioral and emotional changes, making you not feel like yourself.
Psychological trauma is classified into three groups of symptoms:
- Re-experience You may relive moments of the traumatic event through flashbacks, nightmares and intrusive thoughts.
- Hyper-arousal You may feel frequently on edge, experiencing insomnia, agitation, impulsivity, irritability and anger.
- Avoidance You may avoid social interactions and experience numbing, confusion, dissociation and depression.
Why Ptsd Affects Memory
There are several theories surrounding why PTSD is associated with memory deficits, Samuelson says. The first is that people with PTSD use so much of their energy in looking for threats and being hyper-attentive that they dont have enough left over for thinking about the past. Essentially, there is a cognitive burden of PTSD symptoms that taxes cognitive resources, pulling them away from memory and attention processes.
The second theory is that the issues come from PTSDs damaging effects on the brain. When somebody with PTSD is triggered, Samuelson says, the amygdala becomes over-activated and releases neurotransmitters that disrupt other brain areas, like the hippocampus and prefrontal cortex.
The third theory is that these deficits might not be a consequence of PTSD at all, but a potential risk. A number of research studies have found that poorer cognitive functioning assessed prior to trauma served as a risk factor for the development of PTSD, Samuelson says. The flip side of that means that having strong memory abilities can play a role in protecting a person against developing PTSD.
The reality, Samuelson says, is that all three are probably true. There are preexisting deficits, there is a toxic effect of PTSD on memory, and finally, PTSD symptoms tax cognitive resources which in turn hinders a personÃ¢â¬â¢s ability to attend to, store, and recall information.
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Overview Of Psychological Trauma Post
Although the biological, psychological, and social ramifications of PTSD have been under scientific scrutiny for some time now, and treatment has improved dramatically, much remains unknown about this condition and controversy persists in both the neuroscientific as well as the clinical/treatment literature. In this text, we review the neurobiological impact of psychological trauma from the perspective that genetic, developmental, and experiential factors predispose certain individuals to the development of PTSD. More specifically, we review the current database as pertains to biological markers of PTSD and the possibility that some biological markers may not be acquired but, rather, may in fact predate trauma until functionally unmasked by stress. Where relevant, we also make note of similarities between PTSD and TBI, which extend beyond wellknown signs and symptoms to include abnormalities in the same neurobiological systems. Lastly, the article includes a short section on basic considerations for future direction. Ideas put forth in this communication are done so in the interest of developing a consistent model for conceptual purposes. It is recognized at the outset that numerous inconsistencies can be found in the literature that highlight the multifactorial and complex nature of this field.
Emotional Trauma And The Hippocampus
The hippocampus is part of the limbic system in the brain. It is mostly responsible for storing and retrieving memories, while also differentiating between past and present experiences.
When affected by trauma, the hippocampus may be physically affected studies have shown that in people suffering from PTSD, the volume of their hippocampus may be smaller than others.
Mainly, the hippocampus will affect the ability to recall some memories for trauma survivors.
Other memories may be extremely vivid and constantly on the mind of survivors. Environments that remind the survivor of their trauma in even small ways can cause fear, stress, and panic.
This is because the victim cannot differentiate their past trauma and the present situation. The fight-or-flight response is then activated due to the brains perception of a threat.
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After The Threat Has Passed
When the threat has passed, you are left with a strong, negative emotional memory of the experience, but you lack clear recollection of the context of the event. In other words, you may learn to associate individual sights, smells, and sounds from the event with danger, but be unable to recall the sequence of events clearly.
Later on, if you encounter things that remind you of the traumatic event, like a smell that was present when it happened, your amygdala will retrieve that memory and respond strongly signaling that you are in danger and automatically activating your fight-or-flight system. This is why during a flashback, you start sweating, your heart races, and you breath heavily your amygdala has set off a chain reaction to prepare your body to respond against a threat.
Normally when your amygdala senses a possible threat, your hippocampus will then kick in to bring in context from past memories to determine whether or not you are really in danger. But because the hippocampus wasnt functioning properly during the traumatic experience, the context of the memory wasnt stored, and theres no feedback system to tell your amygdala this situation is different and youre not in danger. Also, since the memory is retrieved without context like where or when the experience happened, you might even feel like the traumatic experience is happening again.
The Benefits Of Early Treatment For Post
These physical and psychological symptoms can mean long-term dangerous effects, especially the longer it takes for a person to get treatment for PTSD. The risks of developing or worsening co-occurring mental health disorders also increase when necessary treatment is delayed. If you have a loved one who is suffering from post-traumatic stress disorder, its very important to recognize that they need compassionate clinical care. This is the only way for them to safely overcome the difficult obstacles to processing their trauma and to mitigate the possible risks to their brain and body health.
Whereas life with post-traumatic stress disorder can feel volatile and out of control, treatment for PTSD can feel safe and supportive for someone who has been haunted by their trauma for a long time. Long-term treatment gives clients a chance to develop strong, trusting relationships with their therapists, who can help them to truly reshape the active relationship to stress and trauma. Only in the context of a treatment center, under the close assessment of clinicians, can a clients particular treatment needs be determined. PTSD treatment options are diverse, and individualized plans respond to each persons recovery needs. Healing begins here.
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The Science Behind Ptsd Symptoms: How Trauma Changes The Brain
By Michele Rosenthal
After any type of trauma , the brain and body change. Every cell records memories and every embedded, trauma-related neuropathway has the opportunity to repeatedly reactivate.
Sometimes the alterations these imprints create are transitory, the small glitch of disruptive dreams and moods that subside in a few weeks. In other situations the changes evolve into readily apparent symptoms that impair function and present in ways that interfere with jobs, friendships and relationships.
One of the most difficult aspects for survivors in the aftermath of trauma is understanding the changes that occur, plus integrating what they mean, how they affect a life and what can be done to ameliorate them. Launching the recovery process begins with normalizing post-trauma symptoms by investigating how trauma affects that brain and what symptoms these effects create.
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What Happens If Post Traumatic Stress Disorder Goes Untreated
While post traumatic stress has become more visible and discussed in recent years, especially in the aftermath of the Iraq War, thousands of people still struggle with undiagnosed and untreated post-traumatic stress disorder.
The consequences of untreated post traumatic stress disorder can be severe and can impact an individuals mental, emotional, behavioral, and physical health. The risks of untreated post-traumatic stress disorder include:
Ongoing stress and anxiety
- Individuals with untreated post-traumatic stress disorder may suffer from chronic episodes of traumatic stress, anxiety, or flashbacks, often triggered by sights, sounds, or sensations associated with the traumatic event. Over time, this stress response can lead to a deterioration of physical health, as well.
Difficulty managing personal and professional relationships
- Post-traumatic stress disorder can often lead individuals to isolate themselves away from family, friends, and colleagues as a way of coping with intrusive thoughts and feelings. When left untreated over a long period of time, the disorder can cause rifts within families and lead to lost jobs, missed school, and other complications.
- Post-traumatic stress disorder has been linked to other health issues, including difficulty sleeping, long-term pain, challenges with blood flow or the heart, and muscular or skeletal injuries. Psychologically, PTSD sufferers are more likely to struggle with anxiety and panic disorders.
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How Does Ptsd Affect The Brain
PTSD is a disordered relationship to stress originally triggered by an overwhelmingly stressful event in the past. And stress is a physical and chemical response that happens automatically in the face of certain triggers. In an original biological sense, our heightened state under stress is a positive coping mechanism when we are in danger and need to protect ourselves. When personal protection is on the line, surges in the hormones cortisol and norepinephrine can give us a survival edge. But were not meant to have the stress-related regions of our brain firing overtime on a regular, daily basis. This can lead to serious neurochemical and biological dysregulation.
On top of the general levels of pain and suffering that happen under so much stress, a person with post-traumatic stress disorder may also experience other psychological disturbances, including:
Flashbacks Show The Extent Of Ptsd’s Effects On The Mind
The long-term effects of PTSD are one thing, but what happens in the brain of somebody when they’re experiencing a traumatic flashback â an episode where they seem to relive the traumatic event, with all of the accompanying sensations and emotions? Flashbacks are still mysterious for neurologists, because they aren’t like a regular memory the mind acts as if the trauma is happening all over again. “During a flashback,” says Clouston, “the brain acts much like it would when individuals are actually experiencing a severely traumatic event, often the most stressful and frightening event of a person’s life. Their brain turns on both brain and body pathways and activates stress response systems.” The body takes cues from those signals and enters high alert, even if there’s no threat whatsoever.
Studies have revealed that when it’s experiencing flashbacks, a person with post-traumatic stress doesn’t just seem to relive what’s happened their body actively goes through all its reactions to the event again. A study in 2016 published in Psychological Medicine, says Dr. Jain, looked at images of neural activity while patients were having flashbacks, and found that the visual cortex and the areas that control spatial and temporal awareness both showed a lot of activity.
Sean Clouston Ph.D., assistant professor, Stony Brook Medicine
Dr. Shaili Jain M.D.
Professor Israel Liberzon M.D., department head, Texas A& M College of Medicine’s Department of Psychiatry
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The Effects Of Trauma On The Brain
People often talk about how the effects of childhood trauma can carry over into adulthood, and it is true.
Traumatic events and experiences can have a lasting impact on people. For some people, effects will include the development of post-traumatic stress disorder symptoms that can vary in severity and sometimes hinder their lives, especially if they never receive formal PTSD treatment. For others, trauma can lead to more subtle changes in their behavior, actions, or thinking. Either way, trauma can impact people in more ways than they may realize.
Risk And Resilience For Developing Ptsd
Individuals exposed to an event that either threatens serious injury/death, or is perceived as such, respond in different ways. Most will experience minimal to brief to short-term abnormalities while a smaller number will suffer from significant psychopathology over longer-term and chronic time frames. In short, not all individuals who face potentially catastrophic trauma go on to develop PTSD. Why some individuals will develop PTSD following trauma, whereas others do not, is of paramount importance. Because the majority of trauma survivors do not go on to develop PTSD, it is crucial going forward to understand vulnerability and resiliency factors. In this section, the role of genetic factors, gender differences, and early developmental stress experiences in moderating risk for developing PTSD in response to psychological trauma are discussed as is the increased risk for developing PTSD in the context of co-occurring physical traumas .
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What Brain Areas Are Implicated In Ptsd
PTSD symptoms develop due to dysfunction in two key regions:
This is a small almond-shaped structure located deep in the middle of the temporal lobe. The amygdala is designed to:
- Detect threats in the environment and activate the fight or flight response
- Activate the sympathetic nervous system to help you deal with the threat
- Help you store new emotional or threat-related memories
The Prefrontal Cortex
The Prefrontal Cortex is located in the frontal lobe just behind your forehead. The PFC is designed to:
- Regulate attention and awareness
- Determine the meaning and emotional significance of events
- Regulate emotions
- Inhibit or correct dysfunctional reactions
When your brain detects a threat, the amygdala initiates a quick, automatic defensive response involving the release of adrenaline, norepinephrine, and glucose to rev up your brain and body. Should the threat continue, the amygdala communicates with the hypothalamus and pituitary gland to release cortisol. Meanwhile, the medial part of the prefrontal cortex consciously assesses the threat and either accentuates or calms down the fight or flight response.
Studies of response to threat in people with PTSD show:
- A hyper reactive amygdala
- A less activated medial PFC
In other words, the amygdala reacts too strongly to a potential threat while the medial PFC is impaired in its ability to regulate the threat response.
Does Ptsd Alter The Brain
Preclinical studies show that stress affects these brain areas. Studies in patients with PTSD show alterations in brain areas implicated in animal studies, including the amygdala, hippocampus, and prefrontal cortex, as well as in neurochemical stress response systems, including Cortisol and norepinephrine.
Similarly one may ask, what does PTSD do to the brain?
Your body continues to send out stress signals, which lead to PTSD symptoms. Studies show that the part of the brain that handles fear and emotion is more active in people with PTSD. Over time, PTSD changes your brain. The area that controls your memory becomes smaller.
Secondly, what areas of the brain are affected by PTSD? Brain imaging studies of posttraumatic stress disorder have identified a few key brain regions whose function appears to be altered in PTSD, most notably the amygdala, the ventromedial prefrontal cortex and the hippocampus.
Similarly, you may ask, can PTSD cause permanent brain damage?
Anyone suffering from emotional trauma or PTSD may exhibit emotional scars for months, years, or even for the rest of their life. The three areas of the brain that are impacted the most are the amygdala, hippocampus, and prefrontal cortex.
Does PTSD change your personality?
In conclusion, posttraumatic stress disorder after the intense stress is a risk of development enduring personality changes with serious individual and social consequences.
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