Abstract
Traumatic events can lead to lifelong, inflexible adaptations in threat perception and behavior, which characterize posttraumatic stress disorder (PTSD). This process involves associations between sensory cues and internal states of threat and then generalization of the threat responses to previously neutral cues. However, most formulations neglect adaptations to threat that are not specific to those associations. To incorporate nonassociative responses to threat, we propose a computational theory of PTSD based on adaptation to the frequency of traumatic events by using a reinforcement learning momentum model. Recent threat prediction errors generate momentum that influences subsequent threat perception in novel contexts. This model fits primary data acquired from a mouse model of PTSD, in which unpredictable footshocks in one context accelerate threat learning in a novel context. The theory is consistent with epidemiological data that show that PTSD incidence increases with the number of traumatic events, as well as the disproportionate impact of early life trauma. Because the theory proposes that PTSD relates to the average of recent threat prediction errors rather than the strength of a specific association, it makes novel predictions for the treatment of PTSD.
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No conflicts of interest are relevant to the current study. Dr. Kaye receives or has received research funding from Transcend Therapeutics and Freedom Biosciences. Dr. Krystal has received consulting fees from Aptinyx, Inc., Atai Life Sciences, AstraZeneca Pharmaceuticals, Biogen, Idec, MA, Biomedisyn Corporation, Bionomics, Limited (Australia), Boehringer Ingelheim International, Cadent Therapeutics, Inc., Clexio Bioscience, Ltd., COMPASS Pathways, Limited, United Kingdom, Concert Pharmaceuticals, Inc., Epiodyne, Inc., EpiVario, Inc., Greenwich Biosciences, Inc., Heptares Therapeutics, Limited (UK), Janssen Research & Development, Jazz Pharmaceuticals, Inc., Otsuka America Pharmaceutical, Inc., Perception Neuroscience Holdings, Inc., Spring Care, Inc., Sunovion Pharmaceuticals, Inc., Takeda Industries, Taisho Pharmaceutical Co., Ltd, is on the board of directors at Freedom Biosciences, Inc.; he is a member of the scientific advisory board at Biohaven Pharmaceuticals, BioXcel Therapeutics, Inc. (Clinical Advisory Board), Cadent Therapeutics, Inc. (Clinical Advisory Board), Cerevel Therapeutics, LLC, Delix Therapeutics, Inc., EpiVario, Inc., Eisai, Inc., Jazz Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation, PsychoGenics, Inc., RBNC Therapeutics, Inc., Tempero Bio, Inc., Terran Biosciences, Inc.; he owns stock at Biohaven Pharmaceuticals, Sage Pharmaceuticals, and Spring Care, Inc. and owns stock options at Biohaven Pharmaceuticals Medical Sciences, EpiVario, Inc., Neumora Therapeutics, Inc., Terran Biosciences, and Inc., Tempero Bio, Inc. Dr. Krystal has also received free drug for research studies from Astra Zeneca (Saracatinib), Novartis (Mavoglurant), and Cerevel (CVL-751). Dr. Kwan is on the advisory board of Transcend Therapeutics, Freedom Biosciences, and Empyrean Neuroscience. Dr. Ressler has served on advisory boards or as a consultant for Bioxcel, Janssen, Takeda, and Verily, and he has received sponsored research support from Alkermes, Alto Neuroscience, BrainsWay, and Takeda.
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Kaye, A.P., Rao, M.G., Kwan, A.C. et al. A computational model for learning from repeated traumatic experiences under uncertainty. Cogn Affect Behav Neurosci 23, 894–904 (2023). https://doi.org/10.3758/s13415-023-01085-5
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DOI: https://doi.org/10.3758/s13415-023-01085-5