Project Summary:
Over 80% of Americans will be exposed to at least one traumatic event in their lifetime. Each year, over 30 million people are treated for traumatic injuries in hospital emergency departments (EDs) in the United States. After experiencing a traumatic injury, risk for poor mental health such as posttraumatic stress disorder (PTSD), depression, and anxiety increases. However, studies estimate only 10-20% of injury survivors go on to develop PTSD, suggesting a vast majority of survivors exhibit resilience after injury.
Though most survivors exhibit resiliency after injury, less is known about how the specific resilience factors facilitate recovery, as most research focuses on risk factors. Understanding the pathway to resilience is fundamental to reduce the significant individual and societal impact of poor recovery (e.g., disability, PTSD) and foster positive outcomes. Social support is one resilience factor that may mitigate risk for poor mental health outcomes after traumatic injury.
Social support broadly describes several factors relating to one’s social connectedness and networks through structural (i.e., living arrangements, marital status) and functional (e.g., emotional, mental) support. Though social connectedness promotes overall health, it is specifically a prominent and transdiagnostic determinant of mental health. Social support can abate symptoms of depression and anxiety over time, whereas social isolation and loneliness increase risk for developing depression and anxiety. There are several theories of the underlying mechanism of the benefit of social support on mental health, including the etiological model of PTSD that suggests social support provides a context that facilitates adaptive appraising of the traumatic event and coping. It is also posited that social support can act as a stress-buffer which reduces likelihood of dysregulation of biological stress response systems and reduces likelihood of maladaptive coping in response to stress. However, this theory of the mechanism of social support after injury has yet to be explored in a sample of recently injured patients.
Examining social support after injury would improve understanding of early recovery and how this pathway might predict resilience or pathology. This could then augment intervention and prevention efforts by leveraging patient social support needs.
At the neurobiological level, the effects of social support are facilitated through release of the neuropeptide oxytocin (OXT). OXT plays peripheral and central roles best documented in breastfeeding, childbirth, and maternal bonding; however, OXT underlies several other prosocial behaviors. In both preclinical and human studies, OXT release facilitates courtship, pair bonding, memory, and recognition of social stimuli, among other social behaviors. OXT is synthesized primarily in a region of the brain called the hypothalamus. OXT is released directly into the bloodstream via activation of the posterior pituitary gland in the brain, and OXT receptors are distributed widely in the brain indicating potential widespread effects of OXT upon release. Release of OXT in the brain is also strongly associated with activation of reward regions and dampening of stress and fear response neurocircuitry.
By examining OXT within the context of trauma-exposed individuals, this project aims to discern differences between those who are exposed yet resilient to psychopathology in relation to those who go on to experience poor mental health. This study also has the capacity to inform the understanding of the mechanisms of resilience early after trauma exposure to better elucidate the role that oxytocin may play in prevention of PTSD development through increased social support. This, in turn, can pave the way for targeted interventions post-trauma via novel pharmacological and psychological interventions for injury survivors. This is particularly vital as most interventions treat already-developed PTSD, rather than prevention of PTSD. Further, examination of the relationship of OXT with structural volume and functional connectivity of the reward neurocircuitry in this population is innovative and novel. This work will provide critical pilot data for an NIH submission in 2026 to evaluate interventions of OXT and social support at trauma centers.
Overall, this project seeks to expand the researchers’ understanding of the underlying mechanisms that foster a vital protective factor such as social support and, in turn, improved mental health after injury. This study will provide novel insight into the role of OXT as a potential resilience mechanism after injury that could mitigate risk for poor psychological outcomes. Ultimately, this work has the potential to not only advance scientific knowledge in an understudied area but also directly impact clinical practice, potentially revolutionizing how providers approach care for trauma patients by leveraging the interplay between social support, oxytocin, and mental health.