At no point was I taught about the state of the art in the pathoaetiology of stress-related disorders. I was however taught about the now defunct monoamine hypothesis. Let's assume you suffered the same fate and talk about the neuroscience of PTSD.
The fear conditioning model of PTSD suggests that:
- Fear conditioning plasticity would have an evolutionary advantage in facilitating the rapid recognition of danger
- Malfunction in this could lead to overconditioning wherein a patient might experience too great a response to the stimulus OR develop too vague a pattern recognition system for that event
- This may be caused by elevated cortisol at the time OR elevated catecholamines
Amstadter et al discuss the three main neurobiological systems that are implicated in this model:
- The Locus Coeruleus (and noradrenargic system)
- The HPA Axis
- The Limbofrontal neurocircuitry of fear
They then discuss the genetics of PTSD - making this a really fun and varied read (as long as you just accept that there will be a lot of acronyms, because hey, this is genetics). Unsurprisingly there is a lot of difficulty in separating genetic risk factors from environmental ones but there is some solid evidence relating to serotonin receptor- and transport-related alleles, alleles relating to BDNF, Dopamine receptor modulation of traumatic memories, Corticotrophin-releasing hormone related alleles and much more.
Also they flag up lots of research that should be done. No mention of epigenetics which I positively GUARANTEE will be involved somehow, but ho hum.
Good Learning and happy new academic year.
Marblecake
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