Abstract

BackgroundAlthough there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers.ObjectiveThis article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications.MethodLiterature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed.ResultsBiologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers.ConclusionsPotential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

Highlights

  • There are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD

  • It is tempting to think that the application of biological information to clinical and employment-related decisionmaking will be a straightforward good, and there are clearly many potentially beneficial applications of putative biomarkers of PTSD

  • Biological markers with sufficient specificity may assist in validating PTSD diagnosis, assessing risk for PTSD, and documenting trauma exposure

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Summary

Background

There are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers. Objective: This article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers. As the field moves closer to identifying biomarkers based on established criteria, it is important to anticipate how such markers would be used (Yehuda, Neylan, Flory, & McFarlane, 2013) These questions are relevant for the military (prevention) and the Veteran’s Administration (treatment), which represent institutions in a position to take leadership in this arena.

Amy Lehrner and Rachel Yehuda
Applications of PTSD biomarkers
Conclusions
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