Grandma-Herc brought up an interesting topic in a prior post about indecision and anxiety.
One of the perks of working for higher education is free access to the research journals.
There are very concrete reasons why PTSD affects decision-making. In survival terms, if you step into a street with an on-rushing car, you don't have time to weigh decisions. Your body reacts in flight panic.
Once a body has been subjected to the fight/flight adrenalin overload for too long, there are physical changes that occur to make it easier on the body. One of those changes appears to turn down the decision-making capability. After all, if you ruminated about that on-rushing car and how heavy it was and how fast it was going and whether it was going to turn and BAM!!! it hits you.
The hypothalmus, which is the seat of memory, shrinks. The amygdala, which is the source of the fight/flight response, increases. Over time, with reduced stress, these changes may shift back to a normal size --but they also might not. The fight/flight stress response shuts down the cognitive sections of your brain so that you can handle reflex actions without that pesky thinking getting in the way.
That doesn't mean that you can't make decisions. Or that your decisions are bad. It just means that sometimes a decision can enter a feedback loop of ...uh, I can't decide....WAIT, NO, ACK! I have to pick SOMETHING....(and the panic immediately shuts down the cognitive side of your brain)...Uh, I CAN'T Decide!....WAIT, NO!!!.....
ya see?
There have been moments where I completely lose all ability to decide anything for myself. Just tell me to do it and I'm fine. Make me work at a decision, and, well, I'm lost. (This becomes a lot worse when I'm tired.) I've mentioned in another post on the board that I've actually gone to bed hungry with a full refrigerator of food simply because I couldn't decide what to cook. Actually, if my loving husband didn't feed me once a day, I'd probably get really really skinny. (Hmmmm, maybe a weight-loss technique? ;-) ) Really, it's rather scary that rather than face a decision on what to make to feed myself I'll just go hungry. From an evolutionary standpoint, that's probably right up there with platform shoes.
There's a lot more interest being given to PTSD and the physical changes in the brain and how they affect a person. Lemme source a couple, for those individuals that can get access to articles (sorry for the less-than-perfect attributions. No style guide, so I'm doing the source etiquette from memory instead of from...um...I forget...that book we used in college when working on our papers):
----------
Attentional biases in PTSD: More evidence for interference. Pineles, S., Shipherd, J., et al; Behavior Research and Therapy, Vol 47(12), Dec, 2009. pp. 1050-1057.
- Abstract basically boils down to took high PTSD and low PTSD participants and made them search for something and then make a lexical decision (probably a multiple choice question, though I didn't read the full experiment write-up). High PTSD participants had a much harder time making that decision when a trauma-related word was thrown in. Indicates that intrusive thoughts are shutting down the cognitive functions.
------------
Altered reward processing in the nucleus accumbens and mesial prefrontal cortex of patients with posttraumatic stress disorder. Sailer, U., Robinson, S., et al; Neuropsychologia, Vol 46(11), Sep, 2008. pp. 2836-2844.
- The abstract here describes a win-lose game that was designed with a set of controls and PTSD patients. The controls learned faster than the PTSD patients. The interesting part of the study came when both sets were hooked up to brain monitoring. Both sets had equivalent reactions to a loss. ("the agony of defeat..") But when the participant *won*, the reactions differed. The controls had the elation/reward response, but the PTSD patients had a much lowered elation/reward response. There's a description in the beginning about the lowered prefrontal brain functions in PTSD on working memory and attention.
------------
Traces of fear in the neural web — magnetoencephalographic responding to arousing pictorial stimuli. Rockstroh, B. and Elbert, T. International Journal of Psychophysiology, Feb 11, 2010.
- Abstract excerpt: "Consequently, the fear network undergoes neuroplastic modifications, for instance, incremental enlargements with repeated exposure to threat and danger. This will in turn modify future processing of sensory stimuli and ultimately lead to an altered architecture of the brain's processing machinery and information processing modes." ..."As a result, the brain's architecture is changed from a careful analyzer of the environment to a rapid threat detector with a low threshold to engage in costly defense."
One of the perks of working for higher education is free access to the research journals.
There are very concrete reasons why PTSD affects decision-making. In survival terms, if you step into a street with an on-rushing car, you don't have time to weigh decisions. Your body reacts in flight panic.
Once a body has been subjected to the fight/flight adrenalin overload for too long, there are physical changes that occur to make it easier on the body. One of those changes appears to turn down the decision-making capability. After all, if you ruminated about that on-rushing car and how heavy it was and how fast it was going and whether it was going to turn and BAM!!! it hits you.
The hypothalmus, which is the seat of memory, shrinks. The amygdala, which is the source of the fight/flight response, increases. Over time, with reduced stress, these changes may shift back to a normal size --but they also might not. The fight/flight stress response shuts down the cognitive sections of your brain so that you can handle reflex actions without that pesky thinking getting in the way.
That doesn't mean that you can't make decisions. Or that your decisions are bad. It just means that sometimes a decision can enter a feedback loop of ...uh, I can't decide....WAIT, NO, ACK! I have to pick SOMETHING....(and the panic immediately shuts down the cognitive side of your brain)...Uh, I CAN'T Decide!....WAIT, NO!!!.....
ya see?
There have been moments where I completely lose all ability to decide anything for myself. Just tell me to do it and I'm fine. Make me work at a decision, and, well, I'm lost. (This becomes a lot worse when I'm tired.) I've mentioned in another post on the board that I've actually gone to bed hungry with a full refrigerator of food simply because I couldn't decide what to cook. Actually, if my loving husband didn't feed me once a day, I'd probably get really really skinny. (Hmmmm, maybe a weight-loss technique? ;-) ) Really, it's rather scary that rather than face a decision on what to make to feed myself I'll just go hungry. From an evolutionary standpoint, that's probably right up there with platform shoes.
There's a lot more interest being given to PTSD and the physical changes in the brain and how they affect a person. Lemme source a couple, for those individuals that can get access to articles (sorry for the less-than-perfect attributions. No style guide, so I'm doing the source etiquette from memory instead of from...um...I forget...that book we used in college when working on our papers):
----------
Attentional biases in PTSD: More evidence for interference. Pineles, S., Shipherd, J., et al; Behavior Research and Therapy, Vol 47(12), Dec, 2009. pp. 1050-1057.
- Abstract basically boils down to took high PTSD and low PTSD participants and made them search for something and then make a lexical decision (probably a multiple choice question, though I didn't read the full experiment write-up). High PTSD participants had a much harder time making that decision when a trauma-related word was thrown in. Indicates that intrusive thoughts are shutting down the cognitive functions.
------------
Altered reward processing in the nucleus accumbens and mesial prefrontal cortex of patients with posttraumatic stress disorder. Sailer, U., Robinson, S., et al; Neuropsychologia, Vol 46(11), Sep, 2008. pp. 2836-2844.
- The abstract here describes a win-lose game that was designed with a set of controls and PTSD patients. The controls learned faster than the PTSD patients. The interesting part of the study came when both sets were hooked up to brain monitoring. Both sets had equivalent reactions to a loss. ("the agony of defeat..") But when the participant *won*, the reactions differed. The controls had the elation/reward response, but the PTSD patients had a much lowered elation/reward response. There's a description in the beginning about the lowered prefrontal brain functions in PTSD on working memory and attention.
------------
Traces of fear in the neural web — magnetoencephalographic responding to arousing pictorial stimuli. Rockstroh, B. and Elbert, T. International Journal of Psychophysiology, Feb 11, 2010.
- Abstract excerpt: "Consequently, the fear network undergoes neuroplastic modifications, for instance, incremental enlargements with repeated exposure to threat and danger. This will in turn modify future processing of sensory stimuli and ultimately lead to an altered architecture of the brain's processing machinery and information processing modes." ..."As a result, the brain's architecture is changed from a careful analyzer of the environment to a rapid threat detector with a low threshold to engage in costly defense."