PTSD, also known as Post Traumatic Stress Disorder, is a disorder in which individuals who suffer from it are having difficulty recovering from a trauma. Traumas can include things like being in the war, being a rape victim, witnessing or being involved in a violent crime, and so much more. It is estimated that 10-20% of people who experience trauma will develop PTSD. Symptoms of it include fear and avoidance associated with the event, flashbacks, nightmares, anxiety, depression, and much more. PTSD has a high comorbidity with other anxiety disorders and substance abuse, is resistant to therapy and an increased propensity of the new phobia. There are a few treatments for PTSD right now, but the future of treatment for it is still very unknown. On October 22nd, Dr. Michael Fanselow came to speak to us about his article, “Neurobehavioral perspectives on the distinction between fear and anxiety”, which presented the idea that fear should be seen in a non-associative rather than associative like it is now. The associative fear conditioning is known as Pavlovian fear conditioning (PFC), and it believes that cues that are present at the time of trauma provoke fear memories and responses. It is treatable by exposure therapy and is currently the focus of biobehavioral research. Dr. Fanselow’s research focuses on the idea of non-associative fear conditioning called stress-enhanced fear conditioning (SEFL). SEFL is not bound by cues specifically associated with traumatic situations and is not dependent on associative memory.
In an article by Bret Stetka titled, “Can Fear Be Erased?” he explores the study of a researcher named Monika Eckstein who used Pavlovian fear conditioning and fear extinction in combination with oxytocin as a way to treat PTSD. When oxytocin is used as a treatment for anxiety disorders and activity in the amygdala (which is the main fear center of the brain) decreases. In her experiment, she used neutral stimuli like pictures of houses combined with electrical shocks to induce fear. She then gave one group a dose of oxytocin and the other group a placebo. After the dosing, participants were placed into a functional MRI and went through fear extinction therapy, in which participants were shown the same images this time without electrical shocks. The results showed that the participants who had received a dose of oxytocin had their amygdala decrease its responsiveness to the images and have increased activity in the prefrontal cortex where the brain gets fear under control. This shows that oxytocin may enhance extinction-based therapies for fear and anxiety conditions.
This relates to Dr. Fanselow’s talk about fear and anxiety because it uses the associative methods that he mentioned. It may not have as much to do with SEFL, but it shows that PFC can still be effective. While PTSD is commonly more resistant to exposure therapy, I do not think it should be ruled out as a treatment option. If it is effective, even just for one, it is still an effective treatment. I think that SEFL and PFC should be used in combination as a treatment for PTSD. In Dr. Fanselow’s article, “Induction and Expression of Fear Sensitization Caused by Acute Traumatic Stress”, he presents the idea that corticosteroid is permissive to trauma-induced changes in the basolateral amygdala. When someone experiences trauma, there is a stress response sent to increase corticosteroid levels, which then bind to glucocorticoid receptors in the basolateral amygdala, which works to increase the amount of memories made and increase stress response. Treatment is still unknown in SEFL but maybe because oxytocin acts within the amygdala, it can be used in combination to create a more effective treatment for PTSD than PFC currently is.
Works Cited:
Perusini, J.N., Meyer, E.M., Long, V.A., Rau, V., Nocera N., Avershal, J., Maksymetz, J., Spigelman, I., & Fanselow, M.S. (2016) “Induction and Expression of Fear Sensitization Caused by Acute Traumatic Stress.” Neuropsychopharmacology, 41, 45-57. PMC4677128
Perusini, J.N., & Fanselow, M.S. (2015) “Neurobehavioral perspectives on the distinction between fear and anxiety”. Learning and Memory, 22, 417-425. PMC4561408
Stetka, Bret. (2014) “Can Fear Be Erased?” Scientific American, Scientific American, www.scientificamerican.com/article/can-fear-be-erased/.
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