Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma

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The American journal of psychiatry


OBJECTIVE: Major negative life events, such as trauma exposure, can play a key role in igniting or exacerbating psychopathology. However, few disorders are diagnosed with respect to precipitating events, and the role of these events in the unfolding of new psychopathology is not well understood. The authors conducted a multisite transdiagnostic longitudinal study of trauma exposure and related mental health outcomes to identify neurobiological predictors of risk, resilience, and different symptom presentations.

METHODS: A total of 146 participants (discovery cohort: N=69; internal replication cohort: N=77) were recruited from emergency departments within 72 hours of a trauma and followed for the next 6 months with a survey, MRI, and physiological assessments.

RESULTS: Task-based functional MRI 2 weeks after a motor vehicle collision identified four clusters of individuals based on profiles of neural activity reflecting threat reactivity, reward reactivity, and inhibitory engagement. Three clusters were replicated in an independent sample with a variety of trauma types. The clusters showed different longitudinal patterns of posttrauma symptoms.

CONCLUSIONS: These findings provide a novel characterization of heterogeneous stress responses shortly after trauma exposure, identifying potential neuroimaging-based biotypes of trauma resilience and psychopathology.

Medical Subject Headings

Biological Variation, Individual; Disease Susceptibility; Emergency Service, Hospital; Female; Functional Neuroimaging; Humans; Life Change Events; Magnetic Resonance Imaging; Male; Mental Disorders; Middle Aged; Precipitating Factors; Psychiatric Status Rating Scales; Psychopathology; Psychophysiology; Trauma Severity Indices; United States; Wounds and Injuries

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ePub ahead of print





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