The Neurobiological Impact of Psychological Trauma The HPA Axis Anxiety and Depression

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16 Jul 2021

The Neurobiological Impact of Psychological Trauma The HPA Axis Anxiety and Depression SUBSCRIBE and click the BELL to get notified when new videos are uploaded Unlimited CEUs 59 based on these videos at a https 3A 2F 2Fallceus com a for social work counseling marriage and family therapy addiction counseling case management pastoral counseling and more Want to chat with me Join me at a https 3A 2F 2Fmembers docsnipes com 2F a For 10 month you get access to my tips for health and wellness and you can text chat with me privately neuropsychology PTSD Neuroscience Please click the link above to SUBSCRIBE and click the bell to be notified of new videos Sponsored by TherapyNotes com Manage your practice securely and efficiently Two free months of TherapyNotes with coupon code CEU CEUs are available for this presentation at a https 3A 2F 2Fwww allceus com 2Fmember 2Fcart 2Findex 2Fproduct 2Fid 2F1169 2Fc 2F a Want to listen to it as a podcast instead Subscribe to Counselor Toolbox Podcast a https 3A 2F 2Fpod link 2F1120947649 a Objectives Define and explain the HPA-Axis Identify the impact of trauma on the HPA Axis Identify the impact of chronic stress cumulative trauma on the HPA-Axis Identify symptoms of HPA-Axis dysfunction Identify interventions useful for this population Based on Post-traumatic stress disorder the neurobiological impact of psychological trauma Dialogues Clin Neurosci What is the HPA Axis Hypothalamic-Pituitary-Adrenal Axis Controls reactions to stress and regulates digestion the immune system mood and emotions sexuality and energy storage and expenditure The signs and symptoms of HPA-Axis dysfunction reflect a persistent abnormal adaptation of neurobiological systems to trauma or chronic stress Hypothyroid 4 6 IBS symptoms such as constipation and diarrhea Reduced tolerance to physical and mental stresses including pain Emotional Valence The NEVER Negative Emotional Valence Enhances Recapitulation model of emotional valence asserts that the greater the number of stimuli related to the unpleasant event that are remembered the greater the likelihood that the person will encounter reminders of the event leading to increased recapituation Recapitulation initially leads to repeated HPA-Axis activation but over time the continued stress prolongs the inflammatory response via continued activation of the HPA-Axis leading to glucocorticoid resistance causing cells to become less sensitive to cortisol to protect them from the persistent secretion Glucocorticoids Low cortisol levels glucocorticoid resistance at the time of exposure to psychological trauma may predict the development of PTSD Physiological Changes Due to Hypocortisolism Sustained HPA-Axis activation causes persistently high levels of CRH which eventually causes a blunting of the ACTH response to CRH stimulation Disinhibition of corticotropin releasing hormone CRH and norepinephrine which lead to an exaggerated response to acute stressors and corresponding increase in cortisol Exposure to additional stressors produces stronger trauma-related symptoms in part due to the exaggerated HPA-Axis response causing the stressor to have a stronger negative emotional valence Exaggerated elevation of cortisol during exposure to acute stressors increases the sensitivity of NMDA receptors which makes the brain generally more vulnerable to excitoxic effects of stress Physiological Changes Due to Hypocortisolism The volume of the hippocampus which controls not only the HPA-Axis and stress responses but also declarative memory is reduced due to the excitotoxic environment Amygdala activity increases and promotes hypervigilance and impairs threat discrimination Reduced prefrontal cortex volume impairs executive functioning and impulse control Reduced anterior cingulate volume impairs the extinction of fear responses Thyroid hormones become imbalanced leading to abnormal T3 T4 ratio and increases in anxiety Neurochemical Factors GABA inhibitory activity is decreased and glutamate excitatory activity is increased May indicate the usefulness of emotion regulation and distress tolerance skills due to potential emotional dysregulation We need to reduce excitotoxicity in order to reduce distress improve stress tolerance and enable the acquisition of new skills Physiological Changes Due to Hypocortisolism Increased dopamine and norepinephrine levels increase arousal startle response fear memory encoding and increased HPA-Axis activation in response to recapitulation Changes to the ratios of estrogen testosterone and progesterone occur which impact the body s ability to modulate cortisol levels Prolonged psychological stress suppresses estrogen causing amenorrhea which has profound effects on cardiac skeletal psychological and reproductive systems Serotonin levels are simultaneously decreased