Can we predict who will develop PTSD after a trauma?

Understanding of psychology, trauma, PTSD and C-PTSD is evolving – and at quite a pace. At PTSD UK we feel it’s vital that we can bring you information and news about new research, treatment programmes and other breakthroughs from scientific studies to help provide up-to-date insights on causes and treatments, and ways to address symptoms of PTSD and C-PTSD

That said, much of the research available is very scientific, in-depth, and not particularly ‘accessible’ for people who simply want more information, so we’re starting a new series of articles looking to break these studies and research projects into more easily digestible formats.

The first in this series is a study which looked at whether PTSD could be ‘predicted’ based on changes shown in a particular brain structure (in this case, the hippocampus). The study is from 2018 and is called  “The role of the hippocampus in predicting future PTSD symptoms in recently traumatized civilians.”

Why the study was done

Two people who experience a similar or even identical traumatic situation can go on to display very different recovery speeds and success rates. Why is that? Is it possible to predict who will get PTSD or C-PTSD, and who will recover from trauma the quickest?

Knowing this would make it easier to intervene swiftly and decisively, delivering help to the people most at risk from PTSD or C-PTSD.

It can seem like a difficult task, to make predictions about human reactions and emotions. However, this study looked at whether the answer lies in the brain’s structure, chemistry and processes.

The role of the hippocampus

Central to this study is a part of the brain most associated with trauma response – the hippocampus.

The hippocampus is part of the limbic system (situated at the base of the brain). This limbic system is involved in how we experience key emotions including fear and anger. The hippocampus also plays a role in how we store and retrieve memories.

The theory is that substantial stress damages the hippocampus in some people. It becomes less active, and therefore less able to sort memories according to logical principles.

This makes it difficult for the person to untangle memories and instinctive emotions. Emotions such as fear can become inappropriate and out of proportion, as they are attached to a memory that the person struggles to ‘store’ in a desensitised way.

In other words, they get PTSD or C-PTSD symptoms.

Who was involved in this research?

The study was carried out by medical scientists at the Department of Psychiatry and Behavioural Sciences, Emory University School of Medicine, Atlanta, USA.

They recruited study participants from hospital Emergency Departments (EDs) within 24 hours of them experiencing a traumatic situation.

The symptoms of PTSD were evaluated while they were in the ED, and then one, three and six months later.

The evaluation included the use of a ‘3T’ MRI scanner, that provided a strong, clear image of the brain. The medical scientists also looked at demographic and clinical information – like the person’s age, race and the type of trauma they had experienced.

What can affect levels of response to trauma?

In looking at the different participants and their trauma responses, the medical scientists uncovered a series of significant variations. One was the different levels of hippocampus activity.

Other factors in whether someone had substantial and long-lasting PTSD were charted too, including their relative experience during their time in ED. For example, the race of the individual and the degree of pain they experienced, appeared to play a role.

What can be learnt from this?

The most significant finding was, according to the study authors, “Decreased inhibition-related hippocampal activation soon after trauma prospectively predicted greater future PTSD symptom severity”

and “Greater hippocampal activation was related to post-trauma resilience and lower PTSD symptoms three months post-trauma.”

What does that all mean?

When someone’s hippocampus fails to do its job sufficiently well, it is likely that the person will have PTSD symptoms. When the hippocampus is active and effective, they are more resilient and can recover quicker.

This gives hope that we are on the way to “early identification of at-risk individuals”. This will make it far more possible to concentrate resources on potential targets for intervention or symptom prevention in the aftermath of trauma as studies continue and evolve. 

You can read the full article here.

ARTICLE INFORMATION: van Rooij SJH, Stevens JS, Ely TD, Hinrichs R, Michopoulos V, Winters SJ, Ogbonmwan YE, Shin J, Nugent NR, Hudak LA, Rothbaum BO, Ressler KJ, Jovanovic T. The Role of the Hippocampus in Predicting Future Posttraumatic Stress Disorder Symptoms in Recently Traumatized Civilians. Biol Psychiatry. 2018 Jul 15;84(2):106-115. doi: 10.1016/j.biopsych.2017.09.005. Epub 2017 Sep 20. PMID: 29110899; PMCID: PMC5860925.

You can read more about the science and biology of PTSD here, and for a super simple explanation of PTSD, you can read our article here which uses Pixar’s film Inside Out as a tool for explanation.