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Published Online: 1 June 2010

How the Neurocircuitry and Genetics of Fear Inhibition May Inform Our Understanding of PTSD

Abstract

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.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 648 - 662
PubMed: 20231322

History

Received: 30 July 2009
Accepted: 5 November 2009
Published online: 1 June 2010
Published in print: June 2010

Authors

Details

Tanja Jovanovic, Ph.D.
Kerry J. Ressler, M.D., Ph.D.

Notes

Received July 30, 2009; revision received Oct. 6, 2009; accepted Nov. 5, 2009. From the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Howard Hughes Medical Institute, Chevy Chase, Md.; the Yerkes Primate Research Center, Atlanta; and the Center for Behavioral Neuroscience, Atlanta. Address correspondence and reprint requests to Dr. Jovanovic, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322; [email protected] (e-mail).

Competing Interests

Dr. Ressler has received awards and/or funding support from the Burroughs Wellcome Foundation, NARSAD, NIMH, the National Institute on Drug Abuse, and Lundbeck, was a co-founder of SyneuRX/Therapade, and has a patent pending with Extinction Pharmaceuticals for D-cycloserine-based therapeutics. Dr. Jovanovic reports no financial relationships with commercial interests.

Funding Information

Supported in part by NIMH grant MH071537, the Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources grant M01 RR00039, and the Burroughs Wellcome Fund.

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