A new study is opening up avenues to detect more symptoms of post-traumatic stress disorder (PTSD) in patients. It is a pioneering study in understanding the role of the spindle and kinetochore-associated complex subunit 2 (SKA2) gene in the development of PTSD.
The details of the study, which were orchestrated by researchers at Boston University School of Medicine (BUSM), the National Center for PTSD and the Translational Research Center for TBI and Stress Disorders at VA Boston Healthcare System, appear in the online version of the journal Molecular Psychiatry.
PTSD is common among war veterans. Among the veterans who served in Operations Enduring Freedom and Iraqi Freedom, 11 to 20 percent have experienced PTSD in a given year. Studies suggest that compared to the general population there is a heightened risk of suicide and other mental health aberrations in veterans who have sustained warzone trauma, PTSD symptoms and other post-deployment mental health problems.
As part of the study, the team analyzed MRI brain-scans and blood samples from 200 veterans who had recently returned from conflicts in Iraq and Afghanistan. The aim of the study was to determine whether the blood chemical change in the function of the SKA2 gene could be used to predict the thickness of brain cortex and psychological symptoms, especially PTSD and depression.
The researchers found that an increase in the blood chemical changes associated with the SKA2 gene is linked with decreased cortical thickness in the prefrontal cortex. The team theorizes that this may play a role in the development of PTSD. It also explains why the gene in question predicts risk for mental health problems, like PTSD events and suicide.
According to lead and corresponding author Naomi Samimi Sadeh, Ph.D., who is also assistant professor of psychiatry at BUSM and a psychologist in the National Center for PTSD at VA Boston, the findings indicate that in the future it will be possible to identify military personnel who are at a risk of developing PTSD with the help of a genetic blood test.
PTSD causes: Role of other genes and brain areas
Genes – While the role of the defective SKA2 gene in PTSD has been established by the above study, scientists are also focusing on the role of other genes to see if they create fear memories. For example, PTSD researchers have honed in on:
- 1. Genes that make stathmin. Stathmin is a protein needed to form fear memories.
- 2. Genes that make GRP (gastrin-releasing peptide). GRP is a signaling chemical in the brain released during emotional events.
- 3. A version of the 5-HTTLPR gene. It controls levels of serotonin — a brain chemical related to mood – that appears to fuel the fear response.
Brain areas – Many parts of the brain are involved in dealing with fear and stress. These brain areas play a role in the development of PTSD. Some of these brain areas are:
- 1. The amygdala – This structure in the brain is known for its role in emotion, learning, and memory. The amygdala appears to be active in fear acquisition or learning to fear an event.
- 2. Prefrontal cortex – This area is responsible for storing extinction memories and dampening the original fear response. This area is also involved in tasks such as decision-making, problem-solving and judgment.
- 3. Medial prefrontal cortex – Controls the stress response.
- 4. Ventromedial prefrontal cortex – Helps sustain long-term extinction of fearful memories.
In addition to the genes and brain areas, other factors, such as a history of mental illness, childhood trauma or a head injury, may be causative factors.
Who is at risk of post-traumatic stress disorder?
People of all ages and both sexes can have post-traumatic stress disorder. However, some factors that increase the risk of developing PTSD after a traumatic event are:
- Exposure to intense or long-lasting trauma
- History of trauma earlier in life, including childhood abuse or neglect, physical attack, being threatened with a weapon
- Occupations that have a high risk of being exposed to trauma
- Having other mental health problems, such as anxiety or depression
- People who do not have a good support system of family and friends
- People who come from families with mental health problems, including depression or PTSD
- PTSD in women is common after a sexual assault or rape
Symptoms of post-traumatic stress disorder
In most cases the signs and symptoms of PTSD may start within three months of a traumatic event, but there are cases where symptoms have not appeared until years after the PTSD event.
PTSD symptoms are generally grouped into:
- Unwanted distressing memories of the traumatic event, occurring repeatedly
- Flashbacks of traumatic events
- Distressing nightmares about traumatic events
- Trying to avoid thinking or talking about the traumatic event
- Keeping away from activities, people or places that remind you of a trauma
Negative changes in thinking and mood
- Negative feelings about other people and even yourself
- Incapable of experiencing positive emotions
- Not feeling emotionally active
- A dip in interest in activities you once enjoyed
- Hopelessness about the future
- An inability to maintain close relationships
Changes in emotional reactions
- Irritability, angry outbursts or aggressive behavior
- Always being on guard for danger
- Overwhelming guilt or shame
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble concentrating
- Being easily startled or frightened
How to treat post-traumatic stress disorder
The primary method of treatment is psychotherapy, often combined with medication. Several types of psychotherapy, also called talk therapy, can be used, including:
- Cognitive therapy – This type of talk therapy helps a patient move away from the negative or inaccurate ways of perceiving normal situations.
- Exposure therapy – This behavioral therapy exposes a patient to fearful situations to make them learn to cope with it effectively.
- Eye movement desensitization and reprocessing (EMDR) – EMDR combines exposure therapy with a series of eye movements that help people process traumatic memories and change how they react to traumatic memories.
- Healthy diet – A healthy diet of fresh, whole foods can help calm the nervous system and boost a patient’s immunity. There are also a number of calming, restorative herbs to supplement the diet. Holy basil is a good example. This common herb supports the adrenal glands, protecting them from the stress of surviving a violent, traumatic event.
- Homeopathy – Many people with PTSD seem to benefit from this form of holistic medicine that treats an individual rather than a symptom. The results are very positive.
Coping with post-traumatic stress disorder
Post-traumatic stress disorder symptoms take a serious toll on your health, leading to faster aging and even early death. Don’t let the disorder linger untreated. Take back control with these natural approaches to feeling like yourself again. And while you are at it, it pays to remember these simple rules to help you cope with the condition.
- Don’t self-medicate – Turning to alcohol or drugs to numb your feelings won’t help and can lead to more problems down the road and can also prevent real healing.
- Break the cycle – Be mindful about your symptoms. When you feel anxious, distract yourself and re-focus by taking a brisk walk or working on a hobby.
- Talk to someone – Stay connected with supportive and caring people. You don’t have to talk about what happened; just spending time with loved ones can offer healing and comfort.
- Consider a support group – Ask your healthcare professional for help finding a support group, or contact your community’s social services system. The stronger your support network, the better.
The team of researchers involved in the above mentioned study hope their efforts will ultimately enhance our ability to identify individuals who are at risk for developing PTSD.
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