Witnessing trauma may cause PTSD in a different way

Post-traumatic stress disorder (PTSD) often brings to mind soldiers who have seen action in war, or survivors of accidents. But what happens to those who witness others going through traumatic experiences?

Military veterans, first responders, and even bystanders make up 10 percent of PTSD cases. New research from Virginia Tech, published in the journal PLOS ONE, sheds light on this often-overlooked group.

The study found that observing trauma causes unique changes in the brain. These differ from changes seen in people who directly experience trauma. This discovery may lead to improved and more specific treatments for PTSD in those who are indirectly affected.

“Currently, patients with directly acquired PTSD and bystander PTSD are treated the same way – with a combination of therapy and medication,” said Timothy Jarome, the project’s principal investigator and associate professor of neurobiology in the College of Agriculture and Life Sciences.

“Our research suggests that indirect trauma and direct trauma create different biological responses, which could mean they require different treatment strategies that target distinct brain pathways.”

Observation can also harm the brain

Professor Jarome has long studied memory-related disorders such as PTSD and dementia. His interest in bystander PTSD began after the 2021 Miami condominium collapse. He noticed that even people who saw the tragedy from afar showed symptoms like insomnia and anxiety.

“People who saw it from across the street reported that they were suffering from nightmares, insomnia, and anxiety,” he related.

“They were showing symptoms of PTSD, but didn’t go through it or have any connection to the people in the building. We sought out to understand the brain mechanisms behind how that occurred.”

To explore this, Jarome’s team focused on three main brain regions that are linked to fear memory: the amygdala, anterior cingulate cortex, and retrosplenial cortex. They examined how trauma changed proteins in these areas.

Their findings confirmed that indirect trauma triggers different patterns in protein degradation in these three brain areas than direct trauma does.

PTSD from trauma differs by gender

The study also discovered gender-based differences in how brains process indirect trauma. Past work by Jarome’s lab had linked the K-63 ubiquitin protein to PTSD in women. This new research builds on that and confirms that female and male brains don’t respond to observed trauma in the same way.

“Our findings highlight significant biological differences in how male and female brains respond to witnessing trauma,” said the paper’s lead author, Shaghayegh Navabpour, a former Ph.D. student in translational biology, medicine, and health who is now a postdoctoral researcher at Stanford University.

“These differences may help explain why women are twice as likely as men to develop PTSD, leading to more targeted treatments that consider these sex-specific factors.”

The study opens a door to designing treatment plans based on the type of trauma experienced and the gender of the patient. Jarome’s next step involves studying the role of empathy in humans.

Empathy is rooted in a brain area called the anterior insular cortex and could explain why witnessing trauma affects people so deeply.

Contributions to PTSD trauma research

This research was made possible by a $420,000 grant from the National Institute of Mental Health. It funded materials and supported student researchers.

“At academic institutions, students – undergraduate, graduate, and postdocs – are the driving force for research,” Jarome said.

“While faculty members might secure the funding to do the projects, the reality is that the work is done by these students as they’re going through their training. Without graduate students, especially, but also undergraduates and postdocs, science doesn’t advance.”

Navabpour completed her Ph.D. at Virginia Tech in 2023. She now works at Stanford University on drug development for Alzheimer’s disease.

“My time in Dr. Jarome’s lab was hugely valuable in shaping my career and preparing me for my current role as a postdoc and my goal of becoming a faculty member,” she said.

“I learned how to think scientifically – how to ask the right questions and approach problems critically – and gained hands-on experience with key methods and techniques that continue to inform my research.”

This study changes how we view PTSD and its link to trauma. It reminds us that you don’t need to be in harm’s way to be deeply affected. With better understanding, future treatments may become more personal and precise.

The study is published in the journal PLOS One.

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