Human & Social

Testing the boundaries of trauma

SoriyaSeedatSoraya Seedat always has fresh roses in her office – quite an optimistic gesture for someone who daily deals with how others handle traumatic events such as rape, abuse and the diagnosis of life-threatening diseases such as HIV or cancer.

“Psychiatry requires a lot of art in both clinical practice and research; a more artistic approach to science,” believes this incumbent of the South African Research Chair (SARChI) in Posttraumatic Stress, chair of the Department of Psychiatry and co-director of the Medical Research Council (MRC) Unit on Anxiety and Stress Disorders in the Faculty of Medicine and Health Sciences.

“It’s in many ways different from other medical disciplines as it doesn’t just purely have a mechanical approach to medicine, but allows for engagement and consultation with other medical professions,” says Seedat, who is quick to add that she doesn’t have specifically honed artistic talents herself.

Her talents lie in endeavours such as developing assessment and interventional methods, and mentoring young scientists.

“You are only as good as the researchers you mentor and develop,” she says in her measured way. “I enjoy working with postgraduate students, particularly those who are ambitious and driven.”

Her father, Hoosen, inspired her career path. He was a dentist turned doctor, who in his fifties left private practice to train as a maxillo-facial surgeon. He completed his PhD at Stellenbosch University (SU) at the same time as she enrolled for medical studies at the University of Natal.

Paediatrics and psychiatry intrigued her from the word go. “Those were fields in which I had very good teachers who were supportive and passionate about their fields,” she remembers fondly.

Stints as a medical officer at Lentegeur Hospital in Cape Town, as a clinician in the United Kingdom, and as a research fellow in the United States ultimately won her over to the field of psychiatry, and research in particular.

“I found it to a very holistic discipline and one that tackles the mind-brain-body integration,” explains Seedat, who completed her PhD at SU and has been a researcher in the Department of Psychiatry for the better part of her career.

She has since received several awards and fellowships, including ones from the World Federation of the Society of Biological Psychiatry, the MRC, and an Anxiety Disorders Association of America Career Development Award. In 2012 she received a Humboldt Research Award. And this year,  Seedat was also among the recipients of prestige awards from the National Science and Technology Forum (NSTF) and BHB-Billiton.

Seedat currently directs two major basic and clinical neuroscience programmes – one on anxiety disorders in general, and the other on posttraumatic stress disorder (PTSD), a form of anxiety specifically associated with exposure to types of trauma. Some of these projects are done collaboratively with colleagues in the United States, Europe, and African countries such as Uganda, Kenya, Zambia and Nigeria.

“Anxiety and trauma are cross-cutting problems that can be studied through a very broad spectrum of approaches,” she explains her on-going clinical, interventional and neuroimaging studies on gender-based violence, such as intimate partner violence and rape, and PTSD within the context of adolescent populations, people infected with HIV and tuberculosis, early life adversity, and foetal alcohol spectrum disorders.

This is all done in an effort to develop adequate, culturally sensitive interventions for South Africans.

“For far too long we’ve had treatments that were discovered by chance, almost serendipitously,” she frowns. “They’ve been found to work, but we don’t really understand how.”

And, she adds, these may actually be wrong.

“Aside from the traumatic event itself, we do not yet know with certainty what causes PTSD in some people and not in others,” she explains. “There must be specific biological and environmental factors that contribute to it, such as changes in the expression of genes, lack of social support, exposure to other forms of traumas, gender, repeated life stressors or poverty.”

“The bulk of research into HIV and PTSD, for instance, has been done in North America and Europe, where HIV is mainly homosexually transmitted,” she elaborates on one of her more recent research areas. “There’s a lot of scope to try and understand it in our population, where the mode of transmission is generally heterosexual and where women bear the brunt of the disease.”

Double the number of women suffers from PTSD in a general population than men.

Molecular psychiatry techniques, brain imaging and genetic testing are tools of the trade for this editor of the Journal of Child and Adolescent Mental Health and her postgraduate students, many of whom come from the field of genetics.

Seedat’s interest in biomedical sciences has led to her fascination with the emerging field of epigenetics, in which environmental factors is shown to cause genetic changes without structurally alternating DNA.

“A decade ago we thought that your DNA is what you inherited and that it was stable, but now we know that one’s genetic make-up can change over the life course through one’s personal experiences,” she explains.

And sometimes even because of trauma.

This is the full-length version of an article that first appeared in Research@Stellenbosch 2012 of Stellenbosch University.


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