PTSD is a heterogenous disorder with symptom and prognostic variability. Researchers have attempted to group PTSD into clusters or “biotypes,” but how useful are these groupings clinically?

Post-traumatic stress disorder (PTSD) can develop in people who have experienced a shocking or dangerous event. There has been a lot of study into why some people develop PTSD and others do not. In addition, PTSD can present very differently amongst sufferers. Because PTSD is such a heterogenous disorder, researchers have attempted to cluster PTSD into various subgroups. Many researchers have proposed groupings or “biotypes” have been based on functional MRI studies. Patients in the same cluster were seen to have similar neuroimaging findings on functional MRI scans. Researchers then posited that these clusters would behave similarly in terms of psychopathology, and, hopefully, treatment response.

A recent American Journal of Psychiatry article reported on a study evaluating the subgrouping hypothesis. In the study, a total of 130 people who met criteria had images at one month, six months, and fourteen months after a traumatic event. The researchers aggregated the data from these images into four clusters, and attempted to map them onto various scales assessing for worsening PTSD symptoms. Despite their ability to group people into clusters, as had been done before in prior studies, the researchers found that the clusters did not show statistical significance when it came to assessing for worsening PTSD and anxiety symptoms. In other words, no clear conclusions could be made based on the imaging clusters. This recent work does not mean an association doesn’t exist between the biotypes and PTSD symptoms. But it does strongly suggest additional work needs to be done for developing PTSD biotypes for treatment recommendations.

PTSD can develop after many traumas. It is important to reach out for help if you or a loved one begins to experiences nightmares or persistent hypervigilance after a traumatic event. Our psychiatrists at CalPsychiatry are well-trained to screen for and treat PTSD. Call today for an initial evaluation and start your journey to mental wellness. Call today or book an initial evaluation and start your journey to mental wellness.


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