2 - The neural circuitry of PTSD—An RDOC approach

Abstract

Posttraumatic stress disorder (PTSD) is a severe psychiatric condition that affects a significant portion of the population, particularly groups exposed to intense psychological trauma, such as combat veterans, refugees, and assault victims. Core symptoms include distressing intrusive thoughts, heightened reactivity, mood disturbances, cognitive challenges, and an aversion to trauma-related triggers. Current knowledge highlights the amygdala, the prefrontal cortex, and the hippocampus as key pathophysiological players. Research has shown that PTSD can be perceived as a dysregulation of standard fear processes. This perspective aligns with our understanding of the neural circuitry associated with fear- and threat-related behaviors in mammals, particularly the interplay between the amygdala, hippocampus, and medial prefrontal cortex. The National Institute of Mental Health introduced the Research Domain Criteria (RDoC) framework to shift from a diagnosis-centric research approach to one that spans across traditional diagnostic systems. By aligning core discoveries from PTSD research with the RDoC's domains and units of analysis, we can gain a deeper understanding of psychiatric disorders as pathobiological entities manifested by the maladaptive interweaving of specific neural circuits that influence behavior, cognition, and emotions. These domains, given their relevance across various psychiatric disorders, could provide a more holistic approach to not just PTSD but psychiatric research in general.