An Inherited Bias for PTSD
The adult children of individuals with PTSD show a reduction in cortisol production similar to that of their parents. It was also noted that many of the individuals in this group of adult children of PTSD parents also suffered from Mood Disorders. An article in the Archives of General Psychiatry, 2007, September, 64:1040 by R. Yehuda, M.D. described a study to assess low cortisol levels as a vulnerability factor in adult children of parents with PTSD. The study noted changes in the activity level of the hypothalamic-pituitary-adrenal (HPA) axis of the adult children cohort and further identified the possibility that these individuals are more likely to develop PTSD if exposed to a traumatic event.
Individuals with a low probability of developing PTSD have been studied by M. Friedman and reported in Neuropsychiatry Review, January 2006. Dr. Friedman noted that resilient individuals were capable of mobilizing a substance identified as "Neuropeptide Y". These individuals had a lower likelihood of developing PTSD even though they were exposed to the same wartime experiences as individuals who developed PTSD. Individuals without this mobilizing ability were seen as less resilient and more likely to develop long term effects of exposure to trauma. Dr. Friedman, like Dr. Yehuda observed changes within specific regions of the brain. The changes in both studies were lasting and, in the Yehuda study were found to effect the children of individuals with PTSD.
Clearly, the human brain reacts to long term stress exposure through establishing changes which will effect the individual and, as we now have learned, will create a bias for their children to be predisposed to certain psychological problems. Currently the Department of Defense is increasing their assessment of returning troops to determine if they have PTSD, Mild Brain Injury and other problems related to combat acquired physical and psychological injuries. We need to mindful that the effects of the injury may expand beyond the person. Charles Figley, Ph.D. refers to the process of contagion and secondary victimization in PTSD.
Mike Mason, a journalist who wrote "Dead Men Walking" in a recent issue of Discover magazine, interviewed military medical personnel as well as injured soldiers at Balad Hospital . He has presented their story at several brain injury conferences and recently at the Professional Seminar Series here at Brookhaven Hospital. The interviews conducted by Mr. Mason with the trauma physicians, nurses and the patients are remarkably similar in the context of being able to hear in the voices of these individuals the impact of their exposure to enormous trauma at primary and secondary levels. We will wait for the future to determine which of those people will develop PTSD or another disorder or which will escape the lasting psychological problems. I hope that we don't make these people or potentially, their children and family, wait to receive the help they may need.