UMass Chan Medical School Faculty Publications


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

UMMS Affiliation

Department of Emergency Medicine; UMMS - Baystate Regional Campus

Publication Date


Document Type



Cognitive Neuroscience | Psychiatry | Psychiatry and Psychology | Trauma


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 symptom presentations.

METHODS: A total of 146 participants (discovery cohort: N=69; internal replication cohort: N=77) 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 neuroimaging-based biotypes of trauma resilience and psychopathology.


Biological Markers, Cognitive Neuroscience, Neuroimaging, Posttraumatic Stress Disorder (PTSD), Stress

DOI of Published Version



Stevens JS, Harnett NG, Lebois LAM, van Rooij SJH, Ely TD, Roeckner A, Vincent N, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Lewandowski C, Storrow AB, Hendry PL, Sheikh S, Musey PI Jr, Haran JP, Jones CW, Punches BE, Lyons MS, Kurz MC, McGrath ME, Pascual JL, Datner EM, Chang AM, Pearson C, Peak DA, Domeier RM, O'Neil BJ, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Luna B, Harte SE, Elliott JM, Murty VP, Jovanovic T, Bruce SE, House SL, Kessler RC, Koenen KC, McLean SA, Ressler KJ. Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma. Am J Psychiatry. 2021 Nov;178(11):1037-1049. doi: 10.1176/appi.ajp.2021.20101526. Epub 2021 Oct 14. PMID: 34645277. Link to article on publisher's site


Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

The American journal of psychiatry

PubMed ID