How the Neurocircuitry and Genetics of Fear Inhibition May Inform Our Understanding of PTSD
- 1 June 2010
- journal article
- review article
- Published by American Psychiatric Association Publishing in American Journal of Psychiatry
- Vol. 167 (6), 648-662
- https://doi.org/10.1176/appi.ajp.2009.09071074
Abstract
Exposure to traumatic events that produce extreme fear and horror is all too common in both military and civilian populations, but not all individuals develop posttraumatic stress disorder (PTSD) as a result of the exposure. What mediates risk and resilience in the development of PTSD and other stress-related psychopathology is of paramount importance to our further understanding of trauma-related psychopathology as well as the development of new treatment approaches. Biological factors, such as genotype and neurobiology, interact with environmental factors, such as childhood background and trauma load, to affect vulnerability and resilience in the aftermath of trauma exposure. One of the core symptoms of PTSD is the inability to control fear, which has led some investigators and clinicians to conceptualize PTSD as a disorder of fear or, more importantly, its inhibition. This review focuses on translational methods that have been used to examine fear conditioning and inhibition of fear in PTSD and summarizes genetic and neurobiological factors related to fear inhibition. The authors also discuss different pharmacological approaches that enhance fear inhibition and may improve treatment outcomes for patients with PTSD.Keywords
This publication has 99 references indexed in Scilit:
- Microstimulation reveals opposing influences of prelimbic and infralimbic cortex on the expression of conditioned fearLearning & Memory, 2006
- Amygdala BDNF signaling is required for consolidation but not encoding of extinctionNature Neuroscience, 2006
- Alterations in cortisol negative feedback inhibition as examined using the ACTH response to cortisol administration in PTSDPsychoneuroendocrinology, 2006
- Brain derived neurotrophic factor (BDNF) gene variants and Alzheimer's disease, affective disorders, posttraumatic stress disorder, schizophrenia, and substance dependenceNeuropsychiatric Genetics, Part B of the American Journal of Medical Genetics (AJMG), 2006
- Different mechanisms of fear extinction dependent on length of time since fear acquisitionLearning & Memory, 2006
- Polymorphisms in FKBP5 are associated with peritraumatic dissociation in medically injured childrenMolecular Psychiatry, 2005
- Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey ReplicationArchives of General Psychiatry, 2005
- A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims.Journal of Consulting and Clinical Psychology, 1999
- Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling.Journal of Consulting and Clinical Psychology, 1991
- Emotional processing of fear: Exposure to corrective information.Psychological Bulletin, 1986