Restoring resilience
after childhood trauma
  


As the newly appointed professor holding a faculty chair in ‘Stress and Resilience in Psychiatry’, Christiaan Vinkers envisions novel ways to repair the damage caused by traumatic events in childhood. “Stress is an integral part of normal healthy life, but everyone has a tipping point where stress has a negative impact.”




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“There’s something strange about our approach to stress,” says psychiatrist and Professor ‘Stress & Resilience’ at Amsterdam UMC, Christiaan Vinkers. “It’s a normal and integral part of our daily life. It keeps us aware of threats, big and small; it keeps us ‘sharp’. Without a healthy bit of stress, we literally wouldn’t be able to live. Yet, we only talk about it as if stress itself is our biggest threat.” While many of us want to believe there is something like ‘The Ten Best Tips against Stress’ – “sheer nonsense” – Vinkers prefers to talk about stress as if it were a valuable, delicately balanced orchestra. “Our autonomous nervous system, the immune system, emotions, experiences, nature and nurture… they’re all essential players in our ‘stress symphony’. They contribute to a normal and adaptive response to stress. But that doesn’t mean that the orchestra never plays out of tune.” 

“Without a healthy bit of stress, we literally wouldn’t be able to live.”

From abuse to neglect              

One of the most efficient ways to mess up the score of the stress orchestra is childhood trauma. “In approximately 25% of all depressed patients we see a history of childhood trauma,” says Vinkers. “This can be physical abuse, but emotional neglect in childhood is also a large cause of both psychiatric and somatic diseases later in life.” 

 

With an €800,000 VIDI grant from the Dutch Research Council (NWO), Vinkers wants to find out how childhood trauma affects the normal functioning of the stress system and, therefore, leads to depression and other psychological and physical damage. “First, with our research group, we want to find out which components of the stress system are affected by childhood trauma. Secondly, we need to look at childhood trauma-related depression in daily life. With a stress test in the laboratory, we will try to disentangle the stress dynamics of these patients and thus try to find out where and how the dynamic regulation of stress becomes out of tune.”

Christiaan Vinkers_138

Christiaan Vinkers, Psychiatrist and Professor Stress & Resilience in Psychiatry, Amsterdam UMC

Psychology and biology

Vinkers and his team also want to examine whether either a pharmacological treatment or psychological therapy may improve the performance of the normal ‘stress orchestra’: the so-called RESET (REStoring mood after Early life Trauma) trials, funded by the Hersenstichting and Stichting tot Steun VCVGZ. “Mifepristone is a medicine that blocks the glucocorticoid receptor in the brain. In preclinical settings this has proven to be a potentially valuable treatment to help repair the consequences of childhood trauma in adults. Now is the time to examine this drug in a robust clinical trial.” 

 

In another therapeutic approach, Vinkers and his team want to see if psychotherapy can reset the brain to a healthy way of dealing with childhood trauma. “Eye Movement Desensitization and Reprocessing, and Imaginary Rescripting have become very strong instruments in modern psychiatry for patients with mental issues caused by traumatic events. I firmly believe that the therapeutic value of literally rescripting your memory has been underestimated so far. In our RESET trials, we want to compare either this psychological approach or the biological approach through glucocorticoid receptor-blockers, with the regular approach of modern-day psychological care in childhood trauma.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

“The brain is one of the most intriguing organs [...] I never hear anybody talk that passionately about the kidney or any other organ for that matter.”

New chair

Apart from being awarded a prestigious VIDI grant, Vinkers has also been appointed as faculty chair ‘Stress and Resilience in Psychiatry’ at Amsterdam UMC as of September 1, 2021. “Rooted in the Departments of Psychiatry and of Anatomy & Neurosciences, this is an enormous honor,” Vinkers admits. “The brain is one of the most intriguing organs. Stress, mental health and the brain: it seems like everybody has an opinion about it. Nobody talks as passionately about the kidney or any other organ for that matter. We are fascinated by the brain. But stress and resilience are complex and dynamic phenomena and should not be oversimplified. As the British philosopher Alfred Whitehead said more than a century ago: ‘Seek simplicity and distrust it’. This applies to research in the brain like no other field of research. How we respond to stress is a surprisingly dynamic process. Stress initiates a cascade of behavioral, (neuro)biological and physiological changes. Even talking about the stress system like an orchestra doesn’t do it full justice. An integrated stress response is individual-specific, depending on biological and psychological factors, previous experiences, and the context of an individual’s life.” 

 

Transcending disciplines

Vinkers emphasizes that research into normal, as well as unhealthy, stress response requires collaboration across various disciplines. “Stress research needs a translational and interdisciplinary approach, which is the backbone of Amsterdam Neuroscience, combining knowledge from fundamental brain research, immune processes, preclinical work, stress biology, advanced data analytics, as well as clinical trials with patients. In my new position as faculty chair, I will seek those collaborations to go into unpaved territory. Amsterdam is a perfect environment to do that, and I am very much looking forward it.”

 

Photography: Digidaan

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Psychiatrist and neuroscientist Christiaan Vinkers addresses the affects traumatic childhood events have on an adult’s stress system.

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