neuroscience associated with PTSD

The Hippocampus Region of the Brain and PTSD Prevention
Abstract
This paper examines the relationship between neuroscience and PTSD. In particular it looks at recent findings in neuroscience regarding PTSD onset and prevention. The latest research shows that brain volume is impacted by PTSD and that individuals afflicted with PTSD literally see a diminishment of brain volume in both hemispheres of the brain. Other findings show that individuals who are most susceptible to PTSD have a deficiency in their hippocampal region of the brain, where associative learning has been linked. The conclusion is that the hippocampus is not stimulated enough to develop and thus this region of the brain is smaller than it normally is in most people. This could also explain why the majority of people who experience trauma are not afflicted with PTSD: they have adequately developed their hippocampus through associative learning and are able to process trauma by linking the traumatic event with ideas that are caused by and thus are not haunted by the event continuously but rather are able to move forward because they have understood the impact that it has had on themselves. This paper shows that to help prevent PTSD it may be necessary to improve associative learning in children and to increase their ability to persevere and face challenges with grit and determination so that they can apply critical thinking skills to develop that part of the brain that needs to be developed to combat PTSD.
Keywords: ptsd associative learning, ptsd hippocampus, ptsd neuroscience
Introduction
Increased attention has been brought to the issue of post-traumatic stress disorder (PTSD), particularly since veterans returning from the wars in the Middle East have necessitated that increase in attention as a result of their own mental health issues (Vogt et al., 2017). Currently, there are more than 1 million veterans of these wars who are at risk for suicide as a result of untreated PTSD (Kang et al., 2015). Soldiers are but one population afflicted with PTSD, however. Police officers also are at high risk for exposure to trauma and hence to the effects of PTSD (Chopko & Schwartz, 2012). How to identify the signs of PTSD and how effectively to treat it are issues debated primarily because the neuroscience of PTSD is still under review. Some debate over whether individuals are experiencing PTSD or rather traumatic brain injury (TBI) also goes on (Klimova, Korgaonkar, Whitford & Bryant, 2019). Nonetheless, what the neuroscience associated with PTSD has so far been able to show is that there are specific regions of the brain that do become smaller in people afflicted with PTSD (Tan et al., 2013). This paper will discuss the neuroscience associated with PTSD and show how brain imaging has been able to help researchers construct a new narrative about what happens with individuals who experience chronic PTSD.
What is PTSD?
According to DSM-5, PTSD is characterized by exposure to a significant stressor, such as death, the threat of death, or serious injury or violence; intrusive symptoms such as nightmares or flashbacks that cause the person to unwilling relive the traumatic experience; avoidance of all stimuli that could trigger these unwanted memories or thoughts; negative changes in the person’s thoughts and feelings, such as self-isolation or excessively negative thoughts; risky behavior, hypervigilance, aggression, functional impairment, depersonalization and derealization are other symptoms (Carmassi et al., 2013). PTSD can be caused by any experience that is traumatic, even if the traumatic event is only indirectly experienced. However, PTSD is different from post-traumatic distress, which is commonly experienced by people who directly or indirectly are involved with a traumatic incident. PTSD is longer-lasting and increasingly destabilizing, whereas post-traumatic distress goes away (Giordano et al., 2016). Something about PTSD in people prevents the distress from resolving. One of the clues for why this happens may be found in the field of neuroscience.
Neuroscience and PTSD
One of the interesting pieces of information that is consistent across PTSD literature is that individuals afflicted with PTSD lose interest in the things that used to interest them (Feeny, Zoellner, Fitzgibbons & Foa, 2000; Nader, Pynoos, Fairbanks, Al?Ajeel & Al?Asfour, 1993). There is a neurological impact of not stimulating the same areas of the brain that the body is used to stimulating. When a person is dealing with PTSD, those parts of the brain become inactive and atrophy, which causes a downward spiral leading to more areas of the brain not being engaged. A shrinking left superior parietal lobule has been associated with PTSD to prove this point (Tan et al., 2013). Tan et al. (2013) found in their examination of mine disaster survivors that PTSD caused parts of the brain on both hemispheres to shrink in size and lose volume. This finding is supported by the research of Lambert and McLaughlin (2019) who show that “smaller hippocampal volume is associated with increased risk for PTSD following trauma” (p. 729). However, the problem here is that the hippocampal function is uncertain. The researchers suggest that individuals with a propensity for PTSD also have “broad impairment in hippocampus-dependent associative learning” (Lambert & McLaughlin, 2019, p. 729). In other words, not everyone is hard-wired the same way so as to be afflicted with PTSD: some people are more vulnerable than others based on their hippocampus development. People who lack associative learning are more likely to display PTSD symptoms. The question that emerges from this study is whether PTSD is really a collection or basket of symptoms that come about as a result of co-morbidities that go unaddressed.
The question is particularly important since exposure to trauma has been found to be widespread among all populations, from children to adults, with more than half of all children and three-fourths of adults experiencing trauma in their lives at some point (Kessler, 2000; McLaughlin, 2013). Since trauma experiences are so widespread, why is it that only a fraction of the population experiences PTSD? The answer may be found in the field of neuroscience and the study of brain volume particularly in the hippocampus (Lambert & McLaughlin, 2019).
Associative learning deficiencies could be one explanatory factor in this question. Individuals who lack the ability to link ideas and experiences may be at higher risk for PTSD because that region of the brain which is linked with associated learning has not be properly stimulated. In this sense associative learning could be viewed almost as a kind of antibody to PTSD, an immune system requirement to prevent trauma from negatively impacting the individual and creating a downward spiral of symptoms. The individual who is unable to cope with trauma because of an inability to like ideas with experiences and thereby process trauma in a healthy way is an individual who is at greater risk for PTSD (Lambert & McLaughlin, 2019). The lack of volume in the hippocampus is one indication that is could be the explanation needed for better understanding what is happening in people who have PTSD. It could also offer an explanation for how PTSD should be treated and approached.
Preventing PTSD could be a possible avenue to explore based on the neuroscience findings associated with PTSD onset, including the reduction in brain volume and the lack of brain development in the hippocampus region for those individuals most susceptible to PTSD. While PTSD is a common diagnosis for soldiers and police officers and individuals in high stress environments, there may be something worth exploring in more detail based on these findings, namely the idea of developing individuals’ associative learning skills.
Associative learning is something that teachers tend to use as a teaching technique but for some students it may be more difficult for them to grasp this teaching approach because of a lack of brain development (Li, Jiang, Shang & Chen, 2019). Without some stimulation these individuals may never get the developmental kickstart they need. Thus, assessing individuals while they are in a school could be the place to start in terms of preventative care. Once individuals are identified as possibly having a developmental issue with respect to associative learning, the individuals could then be assigned to one-on-one learning sessions with a teacher who will help the individual to focus on linking ideas with experiences and providing the stimulation required to develop the region of the brain.
Analysis
Since the brain is generally viewed as a muscle like any other in the body, it too requires working out. If an individual is not working out the parts of the brain that help the individual to ward off particular problems that could impair mental health, that person is like one who never comes into contact with germs and never gives his immune system the exposure it needs to build itself up. The solution here could be to engage young learners with more critical thinking exercises so that they are forced to link ideas with experiences and develop that part of the brain that has been neglected. One recent area of focus on this particular topic is the area of grit and the development of perseverance in school children. Perseverance has been linked with grittiness and the child’s ability to compel himself to think critically and to begin to link ideas with experience so that he can overcome obstacles (Perkins-Gough, 2013).
Academic work is challenging and the mind is a muscle that has to be exercised. It does not matter if you are not mentally gifted with a high IQ, just like it does not matter if you are not gifted with an athletic body: one can still work out the physical and mental muscles if one is determined and committed to doing so.
Honoring commitments is the way to do that, the way to get kids to build grit. Holding them to expectations and insisting that they stick with something. Kids who drop out do so because there is no one holding their feet to the fire. They are not going to be held accountable and they have not learned to hold themselves accountable, so they take the easy road out and disappear when challenges arise.
So it is a fine balance between protecting kids and nurturing and taking them out into the wild, so to speak, so they can learn to fend for themselves and grow on their own. The more challenges they face and learn to overcome the more driven and self-actualizing they will become. If they can self-actualize and become self-motivated learners, they will never fail in their academic journey. So developing grit is definitely something that teachers need to focus on. The question is: how do teachers help to develop grit in their students and what steps should they take to make sure learners are having the ability to persevere? The more focus that teachers can give on challenging students and empowering them to persevere and to want to overcome challenges, the more they may be doing to prevent the likelihood of that individual from succumbing to trauma, which the majority of people are exposed to but which the majority of people are able to process because they have developed that part of the brain linked with associative learning. The preventive factor here that could be exploited is the development of grit and determination in school children.
Conclusion
The neuroscience associated with PTSD has shown that brain volume is linked both with the affliction of PTSD and the vulnerability of being susceptible to PTSD. Because of the fact that most of the population experiences trauma at some point in their lives but does not become afflicted by it, there is reason to believe that the ability to process trauma may have something to do with the development of that part of the brain which allows for associative learning in the hippocampus. The failure of individuals to develop this part of the brain may put them at higher risk of PTSD, of failure to process trauma, to understand how ideas are linked to experience, and to put events behind them. Instead they are haunted by experiences of trauma because they do not understand how to process these events in a meaningful way. The more that educators do to help individuals develop this area of the brain the more they may be helping to prevent PTSD. The way for educators to do this may be to insist on the development of grit and toughness of character—the willingness of the learner to overcome challenges and apply critical thinking to link ideas with experiences and find solutions.
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