Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma

Jennifer S. Stevens, Nathaniel G. Harnett, Lauren A.M. Lebois, Sanne J.H. Van Rooij, Timothy D. Ely, Alyssa Roeckner, Nico Vincent, Francesca L. Beaudoin, Xinming An, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Scott L. Rauch, Christopher Lewandowski, Alan B. Storrow, Phyllis L. Hendry, Sophia Sheikh, Paul I. MuseyJohn P. Haran, Christopher W. Jones, Brittany E. Punches, Michael S. Lyons, Michael C. Kurz, Meghan E. McGrath, Jose L. Pascual, Elizabeth M. Datner, Anna M. Chang, Claire Pearson, David A. Peak, Robert M. Domeier, Brian J. O'Neil, Niels K. Rathlev, Leon D. Sanchez, Robert H. Pietrzak, Jutta Joormann, Deanna M. Barch, Diego A. Pizzagalli, John F. Sheridan, Beatriz Luna, Steven E. Harte, James M. Elliott, Vishnu P. Murty, Tanja Jovanovic, Steven E. Bruce, Stacey L. House, Ronald C. Kessler, Karestan C. Koenen, Samuel A. McLean, Kerry J. Ressler

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objective: Major negative life events, such as trauma exposure, can play a key role in igniting or exacerbating psychopathology. However, few disorders are diagnosed with respect to precipitating events, and the role of these events in the unfolding of new psychopathology is not well understood. The authors conducted a multisite transdiagnostic longitudinal study of trauma exposure and related mental health outcomes to identify neurobiological predictors of risk, resilience, and different symptompresentations. Methods: A total of 146 participants (discovery cohort: N569; internal replication cohort: N577) were recruited from emergency departments within 72 hours of a trauma and followed for the next 6 months with a survey, MRI, and physiological assessments. Results: Task-based functional MRI 2 weeks after a motor vehicle collision identified four clusters of individuals based on profiles of neural activity reflecting threat reactivity, reward reactivity, and inhibitory engagement. Three clusters were replicated in an independent sample with a variety of trauma types. The clusters showed different longitudinal patterns of posttrauma symptoms. Conclusions: These findings provide a novel characterization of heterogeneous stress responses shortly after trauma exposure, identifying potential neuroimagingbased biotypes of trauma resilience and psychopathology.

Original languageEnglish
Pages (from-to)1037-1049
Number of pages13
JournalAmerican Journal of Psychiatry
Issue number11
StatePublished - Nov 2021


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