Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study

• Type of Material: Article
• Authors: Grace E. Rowland, McLean Hospital; Alyssa Roeckner, Emory University; Timothy D. Ely, Emory University; Lauren A.M. Lebois, Harvard University; Sanne van Rooij, Emory University; Steven E. Bruce, Uniersity of Missouri, St. Louis; Tanja Jovanovic, Wayne State University; Stacey L. House, Washington University, St. Louis; Francesca L. Beaudoin, Brown University; Xinming An, University of North Carolina at Chapel Hill; Thomas C. Neylan, University of California, San Francisco; Gari D. Clifford, Emory University; Sarah D. Linnstaedt, University of North Carolina at Chapel Hill; Laura T. Germine, Harvard University; Scott L. Rauch, Harvard University; John P. Haran, University of Massachusetts, Worcester; Alan B. Storrow, Vanderbilt University; Christopher Lewandowski, Henry Ford Health System; Paul I. Musey Jr., Indiana University; Phyllis L. Hendry, University of Florida, Jacksonville; Sophia Sheikh, University of Florida, Jacksonville; Christopher W. Jones, Rowan University; Brittany E. Punches, Ohio State University; Michael C. Kurz, University of Alabama, Birmingham; Nina T. Gentile, Temple University; Lauren A. Hudak, Emory University; Jose L. Pascual, University of Pennsylvania; Mark J. Seamon, University of Pennsylvania; Erica Harris, Einstein Medical Center; Claire Pearson, Wayne State University; Roland C. Merchant, Brigham and Women's Hospital; Robert M. Domeier, Saint Joseph Mercy Hospital; Niels K. Rathlev, University of Massachusetts, Springfield; Paulina Sergot, University of Texas, Houston; Leon D. Sanchez, Harvard University; mark W. Miller, Boston University; Robert H. Pietrzak, Yale University; Jutta Joormann, Yale University; Diego A. Pizzagalli, Harvard University; John F. Sheridan, Ohio State University; Jordan W. Smoller, Massachusetts General Hospital; Steven E. Harte, University of Michigan, Ann Arbor; James M. Elliott, University of Sydney; Ronald C. Kessler, Harvard University; Karestan C. Koenen, Harvard University; Samuel A. McLean, University of North Carolina at Chapel Hill; Kerry J. Ressler, Harvard University; Jennifer Stevens, Emory University; Nathaniel G. Harnett, Harvard University
• Language: English
• Date: 2023-02-16
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.bpsgos.2023.02.004
• Title of Journal or Parent Work: Biological Psychiatry global Open Science
• Volume: 3
• Issue: 4
• Start Page: 705
• End Page: 715
• Grant/Funding Information: This project was supported by the National Institute of Mental Health (NIMH) (Grant Nos. K00MH119603 and U01MH110925), the U.S. Army MRMC, One Mind, and The Mayday Fund.
• Keywords: Sexual trauma; Longitudinal study; Neuroimaging; Posttraumatic stress disorder
• Research Categories: Health Sciences, General

Abstract

Background Prior sexual trauma (ST) is associated with greater risk for posttraumatic stress disorder after a subsequent traumatic event; however, the underlying neurobiological mechanisms remain opaque. We investigated longitudinal posttraumatic dysfunction and amygdala functional dynamics following admission to an emergency department for new primarily nonsexual trauma in participants with and without previous ST. Methods Participants (N = 2178) were recruited following acute trauma exposure (primarily motor vehicle collision). A subset (n = 242) completed magnetic resonance imaging that included a fearful faces task and a resting-state scan 2 weeks after the trauma. We investigated associations between prior ST and several dimensions of posttraumatic symptoms over 6 months. We further assessed amygdala activation and connectivity differences between groups with or without prior ST. Results Prior ST was associated with greater posttraumatic depression (F1,1120 = 28.35, p = 1.22 × 10−7, ηp2 = 0.06), anxiety (F1,1113 = 17.43, p = 3.21 × 10−5, ηp2 = 0.05), and posttraumatic stress disorder (F1,1027 = 11.34, p = 7.85 × 10−4, ηp2 = 0.04) severity and more maladaptive beliefs about pain (F1,1113 = 8.51, p = .004, ηp2 = 0.02) but was not related to amygdala reactivity to fearful versus neutral faces (all ps > .05). A secondary analysis revealed an interaction between ST and lifetime trauma load on the left amygdala to visual cortex connectivity (peak Z value: −4.41, corrected p < .02). Conclusions Findings suggest that prior ST is associated with heightened posttraumatic dysfunction following a new trauma exposure but not increased amygdala activity. In addition, ST may interact with lifetime trauma load to alter neural circuitry in visual processing regions following acute trauma exposure. Further research should probe the relationship between trauma type and visual circuitry in the acute aftermath of trauma.