For many people, a traumatic incident can leave an indelible scar on the psyche in the form of post-traumatic stress disorder (PTSD). PTSD is a common behavioral health problem, which affects eight percent of the population in the United States. Majority of refugees, victims of domestic violence and up to 30 percent of war-exposed veterans suffer from PTSD.
The traumatic events can include incidents such as accidents, situation of war or natural disasters, demise of loved ones, prolonged illness, domestic violence, sexual assault, any childhood trauma, separation of parents during childhood.
In short, situations that are threatening to the integrity of a person can cause trauma. Even when a person witness any life-threatening incident happening to others can suffer from trauma. In case of trauma the brain transits to a “survival mode,” and it’s adapts proactively to an avoidance tendency to prevent from getting another experience of trauma.
The person becomes hyper-vigilant, anxious and continuously looks for any danger lurking around. The afflicted person experiences flashbacks and nightmares about the particular incident. Trauma compels a person to avoid a place, situation or people that would remind them of the unpleasant incident. PTSD is very often accompanied by anxiety and depression.
How fMRI can detect changes in brain structure after trauma
In psychiatry, clinical practices, brain scans are used to screen any visible brain lesions that may be causing mental health symptoms.
Brain scan method such as MRI (magnetic resonance imaging) is used to find out any changes in the brain structure volume and integrating pathways that connects the brain.
While functional MRI (fMRI) is designed to look into the blood flow in different areas of the brain as a counter measure of dynamic function of the brain. fMRI is used in imaging the brain that has undergone a trauma or viewing trauma-related images.
According to a new study published in the American Journal of Psychiatry on October 14, 2021, functional MRI (fMRI) shows the difference in how traumatic event affects people’s brain. These differences or variations may prognosticate negative long-term mental health outcomes.
The study was conducted at the University in Atlanta, and the survey was designed by Laura Stevens, Ph.D., of Emory University in Atlanta. The research was focused on finding how activity profile in brain imaged by fMRI can be used as a better diagnostic tool to identify PTSD and can contribute in patients’ care.
According to the U.S. National Institute of Mental Health (NIMH), health care providers can deliver effective interventions for people enduring traumatic experience by establishing predictive profile for stress response. This can greatly improve clinical care.
Each person reacts differently to stress and traumatic events. Some people may portray intense and strong initial reaction but it fades away with time. While others may experience prolonged symptoms of stress and the mind may get stuck in the cynical thought of that very incident, which, in turn, can result in PTSD. Post traumatic stress disorder can create an obstacle in leading a healthy life and perform daily activities.
The research included 3,000 participants who were tracked for 12 months after the traumatic incident. The study specifically included 68 participants who have undergone a car accident and was treated in an emergency department.
Each participant’s brain activity was scanned by fMRI two weeks after the unpleasant incident had occurred. A chain of computer-based tasks that brought about responses to reward cues, social threat cues and circumstances that tested their impulsivity were completed. Digital survey was maintained for the participants for over six months and symptoms for depression, anxiety, impulsivity, disassociation or PTSD were closely monitored.
The brain profiles were divided into four categories:
Inhibited: Exhibited very little threat with some amount of inhibition, and extremely low reward activity
Reactive/disinhibited: It included a strong threat and reward-related activity with weak response inhibition activity
High reward: Included strong reward activity while triggered weak response inhibition, and absolutely no threat activity
Low reward/high threat: Included strong threat-related activity while relatively low reward-related activity
PTSD was reflected in patients having reactive/disinhibited brain profiles. Additionally, these patients experienced anxiety for about six months. No connection was established between brain profiles and other mental illness such as depression, anxiety, impulsivity or disassociation.
The study showed that reactive/disinhibited profile with high reward activity contributes greater risk towards long term mental health problems. Research suggests that more attention is required towards reward activity to determine the potential link between mental health issue and fMRI imaging in context to stress-related symptoms following trauma.
What is the current treatment for PTSD and how to seek help
The current treatment for PTSD remains to be a combination of medication and psychotherapy such as talk therapy, cognitive behavioral therapy, family counseling, recreational activities, family therapy and group therapy.
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