War can quickly become a “catch as catch can” situation for anyone to be in. The extreme nature of combat situations can leave a lasting, detrimental effect on the mind — impacting both mental and physical health. According to the National Council for Behavioral Health, 30 percent of U.S. soldiers returning from Iraq and Afghanistan have a mental health condition that requires treatment: around 730,000 men and women who experience post-traumatic stress disorder (PTSD), major depression, or another serious condition. There is no question that combat situations cause both psychological and physiological stress.
According to the most recent report published by the U.S. Department of Veterans Affairs, which looked at the records of 55 million veterans from 1979 to 2014, an average of 20 veterans a day die from suicide. With suicide rates among soldiers at an all-time high since the U.S. military started keeping records in 1979, the psychological health of soldiers is of paramount concern — and finding new ways to identify at-risk soldiers is more crucial than ever.
Among other methods, researchers are using functional magnetic resonance imaging (fMRI) to shed light on what happens to the brain during PTSD. After exposure to a traumatic event, PTSD can develop, where those with PTSD experience frightening and intrusive thoughts and memories of the event, sleep problems, feelings of detachment or numbness, and can be easily startled. While nearly half of all U.S. adults experience a traumatic event in their lifetime, the majority of them do not develop PTSD.
Researchers are trying to determine why some people can develop and suffer greatly from PTSD, by looking for fMRI “biomarkers” that can identity those people most at risk to develop severe PTSD symptoms. In a study published in Nature Neuroscience, researchers at Yale University and the Icahn School of Medicine found that combat veterans with severe PTSD symptoms have distinct neurological patterns involved in “associative learning” — which help to determine the difference between safe and harmful stimuli in the environment. For those with severe PTSD symptoms, two areas of the brain — the amygdala and striatum — were less able to track changes in the environmental “threat level” as compared to those without severe PTSD.
Dr. Ifat Levy, associate professor of comparative medicine and neuroscience at Yale and study co-author, says, “The findings of this study provide new and innovative understandings of the neurobiology of PTSD and a better understanding of learning processes in this population that might be useful in the future to refine treatment for the disorder.” These findings could help explain why PTSD can be severe for some people but not have the same impact in others.
“What these results tell us is that PTSD symptom severity is reflected in how combat veterans respond to negative surprises in the environment — when predicted outcomes are not as expected — and the way in which the brain is attuned to these stimuli is different,” says Dr. Daniela Schiller, and associate professor of psychiatry and neuroscience at the Icahn School of Medicine at Mount Sinai and co-author of the study. “This gives us a more fine-grained understanding of how learning processes may go awry in the aftermath of combat trauma and provides more specific targets for treatment.”
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