title: A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities.
abstract: Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder.
authors.affiliation: Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Boston, MA, USA. radmon@mclean.harvard.edu
authors.forename: Roee
authors.initials: R
authors.lastname: Admon
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Milad
authors.forename: Talma
authors.initials: T
authors.lastname: Hendler
mesh_terms: D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D004777:Environment; D006801:Humans; D008954:Models, Biological; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics / Q000473:pathology