Abstract
Understanding post-traumatic biological adaptations is essential to elucidating the pathophysiology of complex trauma and dissociation, as well as identifying possible treatment targets. The identification of treatment targets is essential in moving the field toward precision medicine, or the individualized tailoring of treatment that is possible with comprehensive understanding of a condition. In this symposium, we will present two studies that examine the neurobiology of conditions that are highly related to complex trauma and dissociation: psychosis and suicidality. Specifically, the first presentation will focus on an investigation of relationships between progesterone metabolism and symptoms of posttraumatic stress disorder (PTSD), dissociation, and psychosis. Importantly, this study included participants with trauma-related disorders both with and without co-occurring psychotic spectrum disorders. Examining progesterone metabolism among these participant groups is critical, as individuals with dissociative disorders are frequently misdiagnosed with psychotic spectrum disorders, delaying effective intervention. This presentation will discuss the implications of overlapping and distinct hormonal profiles among clinical groups. The findings of this investigation shed light on biological mechanisms underlying trauma, dissociation, and psychosis which may guide us toward more effective treatments. With the second presentation, we will shift focus to a study aimed at developing a neural biomarker of suicidality in PTSD. Individuals with complex trauma and dissociation are at elevated risk for suicide. The lack of predictive neurobiological markers of suicide hinders both assessment and development of intervention targets. The second presentation will share findings of an investigation that aimed to develop a predictive neural biomarker of suicide in a group of adults with PTSD and varying levels of dissociative symptoms. This presentation will discuss patterns of brain connectivity across several networks that were important in suicide prediction and will highlight important differences between the present work and prior studies. Finally, the discussant will summarize the findings of both studies, placing them in the context of the neurobiological literature, and will highlight possible clinical applications. The symposium will include ample time for questions and discussion.