Brain tissue yields clues to causes of increased PTS in women

Prefrontal Cortex

Women are more susceptible to post-traumatic stress (PTS) than men.  The National Alliance on Mental Illness indicates that 50% of women experience a traumatic event in their lifetime. A study published today in the journal Nature Neuroscience may offer some insights into the reason for the increased susceptibility.

Symptoms of post-traumatic stress have been documented since the time of the U.S. Civil War.  Most often associated with military service, the experience has been referred to by many names, such as battle fatigue or shell shock.  PTS symptoms—such as reliving traumatic events, avoiding other people, poor sleep, changes in mood or behavior, and agitation when exposed to events reminiscent of the original trauma—have remained the same over time.  However, what has changed is how we refer to post-traumatic injuries.

The word “disorder” is often, and appropriately, not used when referring to the symptoms because of the stigma attached to the term, making those who are most vulnerable uncomfortable or unwilling to seek help.  President George W. Bush said, “We’re getting rid of the D. PTS is an injury; it’s not a disorder.”

A study supported by a U.S. Veterans Affairs-based tissue bank that collects, processes, and shares research specimens for research recently uncovered something interesting.  A port-mortem analysis of gene expression patterns in brain tissue located the prefrontal cortex, which is the area of the brain associated with cognitive function and decision making, revealed distinct differences between people who had PTS and those who did not.

The types of cells in the prefrontal cortex that were most impacted by PTS experiences were the same in men or women.  However, there were distinct differences between genders in exactly where within the prefrontal cortex the genes impacting those cells were expressed. These differences might help explain why women are more than twice as likely to develop PTS symptoms and other anxiety disorders than men—and why they are more likely to experience more severe symptoms.

PTS is more common that you might imagine, with nearly 8% of the general population having been diagnosed.  In populations who experience severe psychological stress, such as combat veterans, refugees, and victims of assault, the incidence of PTS is as high as 35%.  Approximately half of all PTS patients are also diagnosed with some form of depression.

Researchers suggest this study represents a “new beginning” for the field of PTS.  A new generation of PTS treatments is needed, including the evidence-based practice of transcendental meditation, which has been highly successful, and novel pharmaceuticals. People, including those who are facing a new generation of trauma from the toxic stress of the pandemic and racial unrest, are in grave need.