Annotated Bibliography

Bremner, J. D. (2006). Traumatic stress: effects on the brain. Dialogues in Clinical

Neuroscience, 8(4), 445461. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/

This study gives a comprehensive overview of PTSD within the brain. It gives detailed glimpses
in neurobiology, cognitive functioning, brain structure, and neural circuits as related to PTSD.
Instead of just focusing on brain structures, this article noted the importance of neurochemical
systems such as cortisol and norepinephrine in creating the prolonged stress that affects the brain.
The three main areas of the brain noted in this article that are affected by PTSD are the
hippocampus, prefrontal cortex, and amygdala.

Eckart, C., Stoppel, C., Kaufmann, J., Tempelmann, C., Hinrichs, H., Elbert, T., ...Kolassa, I.-T.

(2011). Structural alterations in lateral prefrontal, parietal and posterior midline regions

of men with chronic posttraumatic stress disorder. Journal of Psychiatry and

Neuroscience, 36(3), 176-186. Retrieved from http://go.galegroup.com/ps/i.do?p=GPS

&sw=w&u=henrico&v=2.1&it=r&id=GALE

%7CA254971319&asid=736e8cead29a1e544a5585b32c36d779

This study summarizes the previous studies findings on PTSD up until 2011 when this study
was conducted. The main disturbances from PTSD have been found in the functioning of the
neural network located in the medial prefrontal and medial temporal lobe structures. This region
would include structural alterations in the hippocampus, amygdala and anterior cingulate cortex
(ACC). All three structures have been found to be reduced and the prefrontal cortex as a whole,
thinner in war veterans. These findings cannot encompass the entirety of the complex symptoms
patterns, so this study takes a deep dive into the neuronal network in charge of the episodic
memory and emotional processing, looking more specifically at the structural changes in the
parietal, lateral prefrontal and posterior midline structures of this region. Using two techniques of
examination, patients with PTSD were found to have reduced brain volumes in several lateral
prefrontal regions, the right inferior parietal cortex, and the bilateral isthmus of the cingulate.
They believed to have a building block effect in which the volume loss correlated with extent
of traumatization. This addition to the emotional processing network suggests that these
structural changes might explain memory disturbances, or fragmentation of traumatic memories,
worse autobiographical memories, or high occurrence of recurrent, intrusive recollection of
traumatic memories. This study was helpful in defining the extent of the research on this topic so
far, and introducing a possible new finding that still needs to be validated by further studies.

Florida Institute for Neurologic Rehabilitation Atlas of Brain Injury & Anatomy. (n.d.).

Retrieved from http://www.finr.net/files/brain/index.htm

This interactive brain locates, defines, and determines the function of all major parts of the brain.
Provides basics needed to understand more complex processes of the brain, however still fails to
cover the complete anatomy of brain.

Koek, R. J., Langevin, J.-P., Krahl, S. E., Kosoyan, H. J., Schwartz, H. N., Chen, J. W.,

...Sultzer, D. (2014). Deep brain stimulation of the basolateral amygdala for treatment-

refractory combat post-traumatic stress disorder (PTSD): study protocol for a pilot

randomized controlled trial with blinded, staggered onset of stimulation. Trials, 15, 356.

Retrieved from http://go.galegroup.com/ps/i.do?p=GPS&sw=w&u=henrico&

v=2.1&it=r&id= GALE%7CA382566432&asid=ddcb81144933fbd15011e6fbd34bd4de

This article provided an in depth overview of everything related to PTSD prior to diving into the
potential procedure of the new treatment of deep brain stimulation of the amygdala. Gave up-to-
date statistics on what soldiers are specifically affected by PTSD- both the current percentage of
6.8 and the individual percentages from the past three major wars. Also provided the specific
symptoms of PTSD addressed by the DSM-IV clustered into four groups: Re-experiencing,
Avoidance and Numbing, Hyperarousal, and Negative Alterations in Cognition and Mood.
Finally, this new treatment has the potential to be an effective way to deactivate the amygdala,
drastically reducing symptoms.

Kolassa, I. T., & Elbert, T. (2007). Structural and functional neuroplasticity in relation to

traumatic stress. Current Directions in Psychological Science, 16(6), 321-325. Retrieved

from http://journals.sagepub.com/doi/abs/10.1111/j.1467-8721.2007.00529.x

In depth explanation about the building block phenomenon, or the idea is that the more
traumatic experiences one has, the more risk one has of getting PTSD (28+ experiences has
100% rate of PTSD). The idea stems from the development of the neural fear network which is
strengthened and extended as more experiences occur. The building block also applies to the
severity of the disease, so this offers a new way to look at the progress of the disease over time.
It also confirms previous findings about the hippocampus and amygdala, while introducing the
anterior cingulate cortex which is responsible for the extinguishing of fear.

Mazza, M., Tempesta, D., Pino, M., Catalucci, A., Gallucci, M., & Ferrara, M. (2013). Regional

cerebral changes and functional connectivity during the observation of negative

emotional stimuli in subjects with post-traumatic stress disorder. European Archives Of

Psychiatry & Clinical Neuroscience, 263(7), 575. doi:10.1007/s00406-013-0394-3

This study was done to determine the neural circuits involved in emotional dysfunction and
inhibition as related to PTSD. Comparing a sample of individuals affected with PTSD to a
healthy sample, researchers determined the connections between activated areas of the brain
when viewing negative emotional valence (intrinsic averseness) images. They found that subjects
who developed PTSD had a higher reactivity in the limbic brain regions, more specifically the
insula and amygdala. This activation in the presence of negative stimuli could cause subjects to
enact protective coping strategies. There was also less response in the prefrontal and frontal
cortex. When you combine these two it suggests an immediate reaction to emotional stimuli
without more complex information processing. This research study directly defines certain
connections between the brain and behavior that are integral. This decreased activity in the
cortexes could possibly be the basis of avoidance and numbing symptoms that are commonly
found in subjects with PTSD.

Rigg, J. (2015, March 20). The effect of trauma on the brain and how it affects behaviors:

TedxAugusta [Video file]. Retrieved from https://www.youtube.com/watch?v=

m9Pg4K1ZKws

Being the director of traumatic brain injury at a Army fort in Augusta florida, John Rigg offers
anecdotes and examples from working with soldiers that create a picture of what trauma does to
the brain. This Tedx Talk does not reference PTSD specifically but instead generalizes the brains
response to any trauma experienced by soldiers in war. Many of the reactions that soldiers
experience upon returning home from deployment are the result of the primitive, subcortical
brain being constantly stimulated by stress. The hyperactive amygdala isnt going to comprehend
the geographical change back to the US; therefore, it stays in survival mode where aggressive
reactions are triggered by the subcortical brain before the cortical one can comprehend safety.
This talk is a good place to start in explaining the complex changes in the brain for basic
understanding.

Seahorn, J. (2016, March 14). Understanding PTSD's effects on brain, body, and emotions:
 TEDxCSU [Video file]. Retrieved from https://www.youtube.com/watch?v=BEHDQe

IRTgs

Seahorn first went through the basic reactions to stress in the brain as stated in other articles, and
then proceeded to connect the constant release of stress hormones to a sensory overload which
triggers the hypervigilance, insomnia, and flashbacks. As both an expert and a wife to a Vietnam
War veteran with PTSD, she received the brunt of the anxiety, irritability, and detachment
without understanding PTSD, and through personal stories gives an important glance into the
blatant misinterpretations that family members make about behaviors because this disorder is a
silent one that cannot be seen, heard or felt by anyone but the individual affected. This view from
the inside is key to understanding how PTSD behaviors and symptoms affect loved ones.

Taylor, S. (2006). Clinicians guide to PTSD: A cognitive-behavioral approach. New York: The

Guilford Press.

This chart represents the specific qualification for PTSD from the DSM-IV. Lists the main
categories of Avoidance and Numbing, Reexperiencing, and Hyperarousal. Also specifically lists
behaviors within these categories. Helpful to compare with other sources to connect the changes
in the brain with the specific symptoms or category of symptoms behind them.

Taylor, S. (2006). Clinicians guide to PTSD: A cognitive-behavioral approach. New York: The

Guilford Press.

The chapter within this book called Neurobiology of PTSD is an overview of the normal
neurological reactions in the brain to fear and stress, important studies on the brain that range
from neuroimaging to animal tests, and the current knowledge about brain structures and brain-
behavior links. Argues the importance of an understanding of neurobiology for anyone working
with patients who have PTSD.