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Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by a particularly frightening, stressful, or distressing event.

Symptoms include intrusive memories, reliving the traumatic event, negative emotions about one's self, difficulty maintaining relationships, and overwhelming feelings of guilt.

Now, Stanford University School of Medicine in California discovers intriguing differences between male and female brains following traumatic stress. Among boys in the study, a brain area called the anterior circular sulcus was larger among those who had symptoms of a trauma, compared with a control group of boys who did not have any trauma symptoms. But among girls in the study, this brain region was smaller among those who had trauma symptoms. The region is associated with emotional awareness and empathy, the researchers said. Anterior circular sulcus plays a role in certain higher functions that operate only in humans.

The research team conducted MRI scans of the brains of 59 study participants ages 9-17. Thirty of them — 14 girls and 16 boys — had trauma symptoms, and 29 others — the control group of 15 girls and 14 boys — did not. The traumatized and non-traumatized participants had similar ages and IQs. Of the traumatized participants, five had experienced one episode of trauma, while the remaining 25 had experienced two or more episodes or had been exposed to chronic trauma.

“It is important that people who work with traumatized youth consider the sex differences,” said Megan Klabunde, PhD, the study’s lead author and an instructor of psychiatry and behavioral sciences. “Our findings suggest it is possible that boys and girls could exhibit different trauma symptoms and that they might benefit from different approaches to treatment.”

The insula normally changes during childhood and adolescence, with smaller insula volume typically seen as children and teenagers grow older. Thus, the findings imply that traumatic stress could contribute to accelerate cortical aging of the insula in girls who develop PTSD, Klabunde said. “There are some studies suggesting that high levels of stress could contribute to early puberty in girls,” she said.

Although the study garnered significant results and demonstrated clear differences, the researchers want to expand their research. They hope to design longitudinal studies where traumatized individuals can be followed over a longer period of time to understand the changes in more detail.

Once a clearer picture has been established, gender-specific treatments can eventually be designed to improve the outlook for individuals of both sexes with PTSD.

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