SELF-REGULATORY CHANGES FOLLOWING PSYCHOLOGICAL TRAUMA AND THE EFFECTS OF SUCCESSFUL TREATMENT.

Bessel A van der Kolk, M.D.

Medical Director, the Trauma Center,

Professor of Psychiatry,

Boston University School of Medicine

Website: www.traumacenter.org

The human response to psychological trauma is one of the most important public health problems in the world. Traumatic events such as family and social violence, rapes and assaults, disasters, wars, accidents and predatory violence may temporarily or permanently alter the organism's response to its environment. The imprints of the traumatic experience consist of alterations in basic life regulatory mechanisms, disorganization of a host of psychosomatic functions, and of vague, over-general, fragmented, incomplete, and often disorganized personal narratives.

           Exposure to events that overwhelm the organism's coping mechanisms can damage the self-regulatory systems necessary to restore the organism to its previous state. This involves a variety of "filtering" systems in the CNS that help distinguish relevant from irrelevant stimuli. These involve the biological systems involved in arousal modulation and attention: the sympathetic and parasympathetic nervous systems, Heart Rate Variability, the Hypothalamic/pituitary /adrenal axis; various brain regions involved in information processing such as the amygdala, hippocampus, thalamus, anterior cingulate, medial frontal cortex, and dorsolateral prefrontal cortex, and alterations in the immune response.

       With the help of videotaped interviews and the presentation of research outcome data this lecture will present the current status of knowledge regarding these neurobiological alterations, and initial data on how effective therapies for PTSD seem to be able to reverse some of these changes.

Reference: van der Kolk BA: The psychobiology of Post Traumatic Stress. In: Textbook of Neurobiology. Edited by Jaak Panksepp. Baltimore, Wiley, 2003.