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Posttraumatic Stress Disorder

Neuroscience in the 21st Century

Abstract

Posttraumatic stress disorder (PTSD) is a psychiatric condition that emerges in some people after experiencing a serious traumatic event like sexual assault, natural disaster, accidents, or combat. Symptoms may include recurrent memories or bad dreams about the event, avoidance of any reminders of the event, negative changes to mood and thinking, and hyperarousal including increased startle, difficulty concentrating, and trouble sleeping. Descriptions of PTSD have existed for centuries and across different cultures, but PTSD was often viewed with skepticism. Largely through the efforts of neuroscientists over the past few decades, objective biological evidence for PTSD began to emerge and the reality of PTSD is no longer in doubt. This chapter reviews some of that biological evidence. Theoretical understanding of PTSD and its treatment is largely based in rodent models of Pavlovian fear conditioning, and studies of individuals with PTSD have shown increased conditioned fear, decreased extinction of that learned fear, and decreased ability to recall safety learning. These abnormalities are reflected in the neurocircuitry of PTSD. Individuals with PTSD exhibit functional abnormalities in emotion and memory-related structures such as the dorsal and rostral anterior cingulate cortex, amygdala, hippocampus, and insula. In general, structures involved in the expression of fear and defensive behaviors are hyper-responsive in PTSD while structures that inhibit fear are hypo-responsive. Interestingly, some functional brain abnormalities are actually vulnerability factors that pre-date the triggering traumatic event, as opposed to acquired characteristics of PTSD diagnosis. Inherited genetics may contribute to PTSD vulnerability as well, but one of the most profound PTSD vulnerability factors is a prior history of trauma. The chapter ends with a brief description of epigenetic mechanisms that may explain how environmental experience could confer long-lasting biological effects such as changes in the sensitivity to the stress hormone cortisol.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Division of Psychiatric Neuroscience, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Michael B. VanElzakker

  2. Department of Psychology, Tufts University, Medford, MA, USA

    Michael B. VanElzakker

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  1. Michael B. VanElzakker
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Correspondence to Michael B. VanElzakker .

Editor information

Editors and Affiliations

  1. Rockefeller University Lab. Neurobiology & Behaviour, New York, New York, USA

    Donald W. Pfaff

  2. National Institutes of Health (NIH), National Institute of Drug Abuse (NIDA), Rockville, Maryland, USA

    Nora D. Volkow

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VanElzakker, M.B. (2015). Posttraumatic Stress Disorder. In: Pfaff, D., Volkow, N. (eds) Neuroscience in the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6434-1_161-1

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  • DOI: https://doi.org/10.1007/978-1-4614-6434-1_161-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-6434-1

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Chapter history

  1. Latest

    Posttraumatic Stress Disorder
    Published:
    12 October 2016

    DOI: https://doi.org/10.1007/978-1-4614-6434-1_161-2

  2. Original

    Posttraumatic Stress Disorder
    Published:
    11 March 2016

    DOI: https://doi.org/10.1007/978-1-4614-6434-1_161-1

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