Publications by authors named "Timothy D Ely"

Background: Moral injury (MI) is a condition that may emerge following a violation of an individual's moral code. MI leads to significant functional impairment in many trauma-exposed civilians with rumination proposed as a mechanism of action. Little is known about the neuropathophysiology of different MI dimensions, including MI related to transgressions caused by the self or others.

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Traumatic brain injuries (TBIs) account for over 2.5 million emergency department (ED) visits each year in the United States. The bulk of TBI research in acute care settings has focused exclusively on individuals who receive computed tomography (CT) scanning.

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Amygdala hyperreactivity early-post trauma has been a demonstrable neurobiological correlate of future posttraumautic stress disorder (PTSD). The basolateral amygdala (BLA) particularly is vital for fear memory and threat processing, but BLA functional dynamics following a traumatic event are unexplored. BLA reactivity to threat may be a trait that can predict PTSD and persist over time.

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Background: Childhood adversity is associated with susceptibility to posttraumatic stress disorder (PTSD) in adulthood. Both PTSD and adverse experiences in childhood are linked to disrupted white matter microstructure, yet the role of white matter as a potential neural mechanism connecting childhood adversity to PTSD remains unclear. The present study investigated the potential moderating role of previous childhood adversity on longitudinal changes in white matter microstructures and posttraumatic stress symptoms following a recent traumatic event in adulthood.

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Background: Residential segregation is associated with differential exposure to air pollution. Hippocampus structure and function are highly susceptible to pollutants and associated with posttraumatic stress disorder (PTSD) development. Therefore, we investigated associations between residential segregation, air pollutants, hippocampal neurobiology, and PTSD in recent trauma survivors.

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Background: Racial discrimination (RD) disrupts regulatory systems in minoritized individuals, particularly systems that govern attention, including attention to visceral signals (interoception). RD frequency is linked to physiological shutdown responses, characterized clinically by dissociation. We examined associations between RD frequency and functional connectivity of attention and interoceptive networks in a sample of trauma-exposed Black women, investigating potential links between connectivity and dissociation severity.

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  • This study investigates how early social support after trauma affects PTSD symptoms over time and explores specific brain regions involved in this process, such as the amygdala and ventromedial prefrontal cortex.
  • Using data from 315 participants in the AURORA study, researchers measured PTSD symptoms and perceived emotional support at multiple time points, while also conducting neuroimaging two weeks post-trauma.
  • The results show that early emotional support is linked to changes in white matter connectivity between key brain areas, but it also highlighted unexpected increased threat reactivity in the default mode network, suggesting complex neural pathways in response to social threats.
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  • Children who experience early life adversity, similar to adults with PTSD, show biased memory for negative emotional events, but the underlying mechanisms are unclear.
  • A study with 56 children (ages 8-14) involved fMRI scans while they viewed different emotional images and later tested their recall.
  • Findings indicate that children with less trauma had stronger emotional memory effects linked to higher brain activity in regions like the amygdala, while highly trauma-exposed children may rely on different neural pathways to process and remember positive emotional experiences.
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Although there is an established link between smaller hippocampal volume and anxiety, the longitudinal relations between hippocampus structure and anxiety in diverse youth are not well understood. The present longitudinal study investigated hippocampal volumes related to anxiety symptoms in a sample of Black 8-14-year-old youth (N = 64), a population historically underrepresented in neuroimaging research. Smaller hippocampal volumes were associated with greater anxiety symptoms independent of age, sex, intracranial volume and trauma exposure.

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  • Trauma can increase the risk of unhealthy alcohol use, and this study investigates how brain reward systems change after trauma exposure in humans.
  • The research involved 286 participants who were assessed for changes in alcohol use and brain activity through fMRI shortly after experiencing trauma.
  • Findings suggest that heightened brain activity in specific regions (like the VTA) and altered connections between brain areas may lead to increased alcohol consumption following traumatic events, indicating potential targets for early intervention.
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Importance: Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD).

Objective: To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward.

Design, Setting, And Participants: As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US.

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  • Structural neuroimaging studies reveal both common and disorder-specific gray matter deficits across various psychiatric conditions.
  • Large-scale data pooling helps identify potential neuroanatomical factors linked to mental illness vulnerability, although data-sharing faces significant challenges.
  • Using a federated analysis across eight research sites, the study found overlapping gray matter patterns in schizophrenia, major depressive disorder, and autism spectrum disorder, suggesting shared cortical and subcortical vulnerabilities.
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The neurocardiac circuit is integral to physiological regulation of threat and trauma-related responses. However, few direct investigations of brain-behavior associations with replicable physiological markers of PTSD have been conducted. The current study probed the neurocardiac circuit by examining associations among its core regions in the brain (e.

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  • Racial discrimination may negatively impact brain health by affecting emotion processing networks and altering deep brain regions' connectivity, which could lead to increased health risks.
  • The study aimed to explore the relationship between racial discrimination and brainstem/midbrain functional connectivity, along with DNA methylation age acceleration, specifically in a sample of Black women in the US.
  • Conducted from 2012 to 2015, the research utilized various scales to measure racial discrimination and PTSD, while analyzing brain connectivity related to specific regions and assessing their epigenetic aging through a detailed assay.
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Background: Females are more likely to develop posttraumatic stress disorder (PTSD) than males. Impaired inhibition has been identified as a mechanism for PTSD development, but studies on potential sex differences in this neurobiological mechanism and how it relates to PTSD severity and progression are relatively rare. Here, we examined sex differences in neural activation during response inhibition and PTSD following recent trauma.

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  • Exposure to traumatic events is linked to mental health issues like PTSD, depression, and anxiety, as well as physical conditions such as asthma, particularly among women.
  • A study with 508 women found that those with asthma experienced higher levels of PTSD and depression; another smaller group underwent fMRI scans to examine brain responses to social threats.
  • Results suggest a connection between asthma and increased severity of trauma-related symptoms, highlighting the relationship between stress, brain activity, and mental health.
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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 ( = 2178) were recruited following acute trauma exposure (primarily motor vehicle collision).

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Importance: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.

Objective: To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.

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Background: Moral injury references emotional and spiritual/existential suffering that may emerge following psychological trauma. Despite being linked to adverse mental health outcomes, little is known about the neurophysiological mechanisms of this phenomenon. In this study, we examined neural correlates of moral injury exposure and distress using the Moral Injury Exposure and Symptom Scale for Civilians.

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Background: Dissociative symptoms can emerge after trauma and interfere with attentional control and interoception; disruptions to these processes are barriers to mind-body interventions such as breath-focused mindfulness (BFM). To overcome these barriers, we tested the use of an exteroceptive augmentation to BFM, using vibrations equivalent to the amplitude of the auditory waveform of the actual breath, delivered via a wearable subwoofer in real time (VBFM). We tested whether this device enhanced interoceptive processes, attentional control and autonomic regulation in trauma-exposed women with dissociative symptoms.

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Childhood trauma is a known risk factor for trauma and stress-related disorders in adulthood. However, limited research has investigated the impact of childhood trauma on brain structure linked to later posttraumatic dysfunction. We investigated the effect of childhood trauma on white matter microstructure after recent trauma and its relationship with future posttraumatic dysfunction among trauma-exposed adult participants (n = 202) recruited from emergency departments as part of the AURORA Study.

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Article Synopsis
  • There are differences in how different racial and ethnic groups experience stress and resources that can affect their brains, especially the amygdala, which helps process fear and trauma.
  • A study with 283 participants looked at how their brains reacted to scary and neutral faces after trauma, finding that Black and Hispanic people had different brain connections compared to White people.
  • The results suggest that these differences in brain activity and responses to stress may influence how likely someone is to develop PTSD after experiencing traumatic events.
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  • Trauma memories can vividly affect survivors, particularly in the context of PTSD, impacting normal functioning.
  • Most neuroscience research on trauma focuses on threat-processing, neglecting the role of visual circuitry, which is crucial for understanding PTSD symptoms.
  • A study of 278 participants found that structural changes in the ventral visual stream post-trauma are linked to PTSD symptoms like nightmares and cognitive issues, suggesting that this visual network might worsen trauma memory reactivation.
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Hippo campal impairments are reliably associated with post-traumatic stress disorder (PTSD); however, little research has characterized how increased threat sensitivity may interact with arousal responses to alter hippocampal reactivity, and further how these interactions relate to the sequelae of trauma-related symptoms. In a sample of individuals recently exposed to trauma ( = 116, 76 female), we found that PTSD symptoms at 2 weeks were associated with decreased hippocampal responses to threat as assessed with fMRI. Further, the relationship between hippocampal threat sensitivity and PTSD symptomology only emerged in individuals who showed transient, high threat-related arousal, as assayed by an independently collected measure of fear potentiated startle.

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Article Synopsis
  • The study explores the link between dissociation, specifically derealization, and adverse psychiatric outcomes following trauma, aiming to understand if it can help identify at-risk individuals.
  • It uses self-reported data and brain imaging from participants two weeks post-trauma to assess the predictive power of derealization on later symptoms like PTSD, depression, and anxiety.
  • The results indicate that persistent derealization is a significant early marker, both psychologically and biologically, for predicting worse mental health outcomes, highlighting the need for assessing dissociation after trauma.
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