Neurology and Trauma
Impact and Treatment
Implications
Damien Dowd & Jocelyn Proulx
HPA - Axis
Hypothalamus
Corticotropin-releasing hormone
Pituitary gland
Beta-endorphins – pain suppression
Adrenocorticotropic hormone
Adrenal gland
Cortisol
Effects of Beta Endorphins
Avoiding stimuli reminiscent of the event
Emotional numbing
Loss of interest in daily activities
Detachment from others
Effects of Cortisol
Dysregulation of cortisol levels
Low levels interfere with ability to process the event into long term memory leading to flashbacks and intrusive memories
High levels can lead to hypersensitivity to psychologically threatening stimuli
Hippocampus
Formation of
memories
Stress regulation
Medial Prefrontal Cortex
Decisions about
appropriate or required
cognitive, emotional or
behavioural responses
Suppresses or
modified emotional
responses generated
by the amygdala
Filtering of information
Genetic Markers
Family mental health
Cortical dysfunction
Smaller hippocampus
Larger cavum septum pellucidum
Serotonin and dopamine systems
Treatment Approaches
Drug Therapies
Serotonin re-uptake inhibitors
Drugs reducing corticotropin-releasing
hormone
Antidepressants
Cognitive Behaviour Therapies
Exposure therapy
Imagery rehearsal
Stress inoculation therapy
Narrative therapy
Emotion focused therapy
EMDR
Eye movement desensitization and
reprocessing
MBSR
Mindfulness based stress reduction
Meditation
Evidence and Recommendations
Eclectic approach
Therapeutic relationship
Need for evaluative research