Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity

Abstract

Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.

Understanding the relationship between disaster-related prenatal maternal stress and child motor development: The QF2011 Queensland Flood Study

“…Maternal cortisol during pregnancy can predict infant cortisol response (O'Connor et al, 2013;Perroud et al, 2014;Yehuda et al, 2005), and infant cortisol can predict later cognitive development (Bergman et al, 2010;Huizink et al, 2002b). Disengagement coping is associated with higher cortisol levels and strategies like problem-solving are associated with lower cortisol levels (Morris & Rao, 2013). This suggests that coping may influence the physiological reactions to stressors, and by extension may influence the effect of prenatal maternal stress on child development.…”

“…For example, avoidance and denial are associated with prolonged neuroendocrine reactions to stress, while active and problem-focused strategies are associated with a reduced neuroendocrine response (Olff, Langeland, & Gersons, 2005a). In particular, active coping strategies can reduce the risk of trauma-related psychopathology by reducing fear-conditioned associations, which are a critical part of PTSD onset and maintenance (LeDoux & Gorman, 2001;Morris & Rao, 2013;Southwick et al, 2005). Theories like that of Lazarus and Folkman (1984) explain that coping can modify the effects of stress on wellbeing;…”

“…Coping is an ideal candidate for intervention with pregnant mothers because of its effectiveness in reducing the associated outcomes of stress, its amenability to change (Kessler et al, 1985;McColl et al, 1995), and its association with cortisol levels, which are a primary focus for the transmission of the effects of prenatal stress (Morris & Rao, 2013;O'Connor et al, 2014). However, few prenatal stress studies have incorporated maternal coping.…”

“…Coping strategies predict short-term psychological and physiological stress reactions, indirectly influencing the relationship between the stressor and long-term health and wellbeing (Kendall & Terry, 2009;Lazarus & Folkman, 1984). This process is highly individualised, explaining why different individuals can have different reactions to, and consequences from, the same stressor (Honey et al, 2003;Kendall & Terry, 2009;Lazarus & Folkman, 1984;Morris & Rao, 2013).…”

“…Under the Lazarus and Folkman (1984) model (Figure 4.2), when a potentially stressful situation occurs, the individual appraises the level of threat and activates their coping strategies. This process mediates the effects of the situation on the individual's short-term health and wellbeing, with flow-on effects to long-term health and wellbeing (Honey, Bennett, & Morgan, 2003;Kendall & Terry, 2009;Lazarus & Folkman, 1984;Morris & Rao, 2013). In other words, an event is not stressful until the person decides that it is, and this decision is influenced by the individual's assessment of the level of threat (primary appraisal) and the sufficiency of the individual's perceived ability to deal with the threat (secondary appraisal) (Kendall & Terry, 2009;Lazarus & Folkman, 1984).…”