PTSD & Brain Function

Brain Imaging Shows Kids' PTSD Symptoms Linked to Poor Hippocampus Function

ScienceDaily (Dec. 17, 2009) — Psychological trauma leaves a trail of
damage in a child's brain, say scientists at the Stanford University School of
Medicine and Lucile Packard Children's Hospital. Their new study gives the
first direct evidence that children with symptoms of post-traumatic stress
suffer poor function of the hippocampus, a brain structure that stores and
retrieves memories. The research helps explain why traumatized children behave as
they do and could improve treatments for these kids.

"The brain doesn't divide between biology and psychology," said Packard
Children's child psychiatrist Victor Carrion, MD, the primary author of the new
research. "We can use the knowledge we get from understanding brain
function to improve the psychology of the individual and vice versa."

Extreme stressors can
make children isolate themselves from family and friends, feel disconnected
from reality, experience intrusive thoughts about the trauma and struggle in
school. "Post-traumatic stress is not only about the traumatic memories; it
really affects daily living," said Carrion, who is an associate professor of
child and adolescent psychiatry at the School of Medicine and director of
Stanford's early life stress research program. The research will be published
online Dec. 8 in the Journal of Pediatric Psychology.

The findings could be an important step toward better monitoring of PTSD
treatments, which include psychotherapy techniques such as teaching relaxation
exercises, helping children to construct a cohesive story about the
traumatic event and helping them learn to cope with reminders of the trauma. Right
now, psychologists assess such treatments by looking for improvements in
symptoms, but that's a problem because the symptoms can fluctuate from day to
day. "That method has the disadvantage that we don't know what's happening at
the neural level," Carrion said.

To observe how kids' brains work after trauma, Carrion's team used
functional magnetic resonance imaging to compare 16 young people who had PTSD
symptoms with a control group of 11 normal youths. The scientists scanned the
brains of the 10- to 17-year-old subjects during a simple test of verbal memory.
Subjects read a list of words, then saw a similar list with new words
added, and were asked which terms were present on the original list.

The hippocampus worked equally well in stressed and control subjects when
the word list was first introduced. However, subjects with PTSD symptoms made
more errors on the recall part of the test and showed less hippocampus
activity than control subjects doing the same task.

Subjects with the worst hippocampus function were also most likely to
experience a specific set of PTSD symptoms: Such impairment of the hippocampus
was strongly correlated with "avoidance and numbing" symptoms of PTSD,
including difficulty remembering the trauma, feeling cut off from others and lack
of emotion.

Parents and other caregivers may find the new discoveries useful as they
tend to traumatized children, Carrion said, particularly when children respond
to trauma by withdrawing from people who are trying to help. Parents may
sometimes misinterpret this behavior as a child's attempt to retaliate, when
it actually represents an overload of the brain's normal mechanism for
handling fear. "When parents understand that PTSD is real, they don't take it as
personally," he said. "They become more available to their kids. That's good
because the kids need them."

In the future, physicians and scientists may be able to use fMRI scans of
the hippocampus to identify children who are at high risk of PTSD after mass
catastrophes, added Carrion, who has consulted on response teams for natural
disasters such as Hurricane Katrina and the February 2009 wildfires in
southeastern Australia. However, larger studies of brain activity in pediatric
PTSD are still needed to give a more detailed understanding of the disorder.

It's already clear that untreated PTSD can interfere with a child's normal
brain development and increase the risk of other psychiatric conditions such
as depression and substance abuse, Carrion concluded. "Early intervention
is critical for children with post-traumatic stress," he said.

* I had a really hard time last night at a family gathering and then got up this morning and read this listed on a "Conciously Parenting" sight. I'm feeling so guilty. But coping better than I would have a few years ago.
I wish I would have read this article and quote yesterday. Maybe it would have helped.

"I found that many of his rages and misbehaviors were triggered by expectations he was not capable of fulfilling."

This statement resonates with me big time. I wonder how many of our difficulties are the result of this.