When the body is confronted with a threat to its integrity, there are physiological reactions that comprise the stress response. The amygdala, the brain region that first senses danger, is responsible for alerting the endocrine system, which releases hormones such as noradrenaline and adrenaline. This results in an acceleration of breathing and heart rate (e.g., “the fight-or-flight response”). This also leads to an increase in the release of energy to muscles, which then allows us to escape a stressful situation or mobilize a response to the stressor.
Once the immediate danger has passed, other hormones, particularly cortisol, are released to slow down the prior stressor-activated reaction. It follows that the more stress one encounters, the more cortisol is needed to contain the stress response.
Research conducted by the Traumatic Stress Studies Division (TSSD) on Holocaust survivors, Holocaust offspring, and combat veterans, has resulted in findings, which include:
In Holocaust survivors and offspring:
- Identifying important differences in memory and concentration in Holocaust survivors
- Identifying important differences in hormone levels and metabolism in Holocaust survivors, which include changes in metabolism that may be related to the development of hypertension and diabetes
- Demonstrating that survivors with PTSD have higher levels of noradrenaline and lower levels of cortisol, which implies that people who suf
- fer from PTSD are not sufficiently recovering from their body’s stress response
- Showing that PTSD as a result of trauma exposure in parents is a predictor of vulnerability to develop PTSD in their children
- Showing that adult children of Holocaust survivors have similar hormonal changes as do Holocaust survivors
In combat veterans with PTSD:
- Identifying important differences in memory and brain function in combat veterans with PTSD
- Identifying important changes in cortisol and cortisol metabolism, as well as other important genetic and molecular markers of PTSD
- Showing that combat veterans with PTSD may have different responses to psychotherapy compared to “civilian” trauma survivors
In 9/11 victims:
- Identifying biological predictors of treatment response
Many of our studies take place in the context of providing treatment, and our programs include a comprehensive evaluation by a trained trauma specialist. We provide medical consultations, treatment planning and medication management by a team of trained clinicians. We offer psychotherapy, psychoeducation and assistance with services such as disability and benefits.
Through our research, we continuously are learning about the effects of trauma and development of more effective treatments. We tailor our treatments to the unique reactions of an individual trauma survivor and utilize tested therapeutic modalities. Our treatments are informed substantially by our research findings and we offer opportunities for educating trauma survivors about the results of our research.
People with PTSD frequently try to avoid trauma reminders, including thoughts, feelings, situations (like crowds, subways, and going to the movies) and people. Prolonged exposure (PE) therapy is a type of treatment that helps you to manage the upsetting emotions that you have about your trauma by helping you to gradually approach the things that remind you about the trauma. Repeated exposure to the memory, or to activities that remind you of trauma, can help you learn to tolerate the distress associated with the memory or activity, and/or to experience less fear in relation to it. A therapist guides you through repeated contact with these thoughts, feelings, and situations, which helps to reduce the power they have to cause distress.
Unfortunately, PE does not help all people. We believe that certain biological factors may explain why many veterans with PTSD get better with PE treatment, while some do not. We have several treatment studies that are designed to understand who will benefit most from PE treatment.
Rachel Yehuda, PhD
Tel: 718-741-4000 x6677