At some point in time, up to half the population could be exposed to a traumatic event such as a car accident, a natural disaster, military exposure or an assault. For some it will result in post-traumatic stress disorder, or PTSD, according to Ananda Amstadter, Ph.D., assistant professor of psychiatry at the Virginia Commonwealth University School of Medicine and the Virginia Institute for Psychiatric and Behavioral Genetics.
October includes Mental Health Awareness Week – a campaign supported by the National Alliance on Mental Illness to raise awareness and change attitudes toward mental illness, including depression, schizophrenia, bipolar disorder and anxiety or mood disorders such as PTSD.
Although there is a stigma attached to mental illness, there is a growing knowledge of the neurobiological and genetic bases of behavior that has put mental illness on par with physical illness. Additionally, research is opening doors to explore novel and effective treatments for mental disorders.
Ananda Amstadter is an active researcher in the area of traumatic stress – specifically in determining genetic predictors of traumatic stress-related conditions and gene-by-environment interactions. She said the anxiety disorder is relatively common and can affect anybody in the population, from young children to older adults. Individuals who experience PTSD generally have a cluster of symptoms including re-experiencing the event, avoiding anything or anyone that is related or reminds them of the event, feeling emotionally numb following a traumatic event and hyper-vigilance, or being extra alert to any signs of threat.
“PTSD affects approximately 8 percent of the population, but varies depending on the type of trauma a person experiences. For example, events such as physical assault or sexual assault tend to be linked to a higher rate of PTSD than the rates for a motor vehicle accident or a natural disaster,” explained Amstadter.
The treatment of PTSD can involve a variety of psychosocial treatments, including cognitive behavioral therapy, or CBT. This form of therapy does not involve the use of medications. Generally during a CBT counseling session, a therapist will work with an individual to approach the traumatic or feared event and talk about what happened. The therapist can lead the individual to re-experience the traumatic episode in a way that will help them move past the fear to which they have become accustomed.
“One of the hallmark symptoms of PTSD is avoidance. Often times, affected individuals will avoid thinking and talking about the event. They may also likely avoid anything that reminds them of the event,” said Amstadter.
“Unfortunately, this continued avoidance actually doesn’t lead to a natural habituation or a natural getting used to or accepting what happened,” said Amstadter.
Through her research, Amstadter is examining the environmental factors, as well as the biologic and genetic factors, to help understand the post-trauma trajectory of symptoms. For example, her research hopes to help better predict the factors that differentiate individuals who either do not develop symptoms or who experience a naturalistic recovery, from those who develop long-lasting symptoms of a mental health disorder, such as PTSD.
“On the biologic end, we know that about 33 percent of the risk for PTSD is due to genetic factors. We don’t know specifically which genes put people at risk for PTSD and that is what our research is trying to uncover,” said Amstadter.
“If we can determine which genes are involved and understand the effects of a particular variant we may be able to identify people that may need help in the aftermath of a traumatic event,” she said.
Through support from a National Institutes of Health grant, Amstadter and her team are examining the effects of combat history and PTSD status on stress reactivity and subsequent drinking behavior in emerging adults, as well as the role of genetic variants that may play a role in stress-related drinking. Through another NIH grant she is examining the genetic substrates of PTSD in a large epidemiologic study of disaster-exposed youths.
Through her work, she hopes to help to develop an upfront treatment that may prevent PTSD and associated disorders or reduce the suffering of those who encounter it.
In other work, Amstadter is a co-investigator on a research project to develop and determine the effectiveness of a web-based intervention for children and families affected by a disaster.
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