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Ruge J, Ehlers MR, Kastrinogiannis A, Klingelhöfer-Jens M, Koppold A, Abend R, Lonsdorf TB. How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms. eLife 2024; 13:e92700. [PMID: 39012794 PMCID: PMC11251725 DOI: 10.7554/elife.92700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 06/26/2024] [Indexed: 07/18/2024] Open
Abstract
Adverse childhood experiences (ACEs) are a major risk factor for the development of multiple psychopathological conditions, but the mechanisms underlying this link are poorly understood. Associative learning encompasses key mechanisms through which individuals learn to link important environmental inputs to emotional and behavioral responses. ACEs may impact the normative maturation of associative learning processes, resulting in their enduring maladaptive expression manifesting in psychopathology. In this review, we lay out a systematic and methodological overview and integration of the available evidence of the proposed association between ACEs and threat and reward learning processes. We summarize results from a systematic literature search (following PRISMA guidelines) which yielded a total of 81 articles (threat: n=38, reward: n=43). Across the threat and reward learning fields, behaviorally, we observed a converging pattern of aberrant learning in individuals with a history of ACEs, independent of other sample characteristics, specific ACE types, and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by diminished responding to conditioned threat cues. Furthermore, attenuated reward learning manifested in reduced accuracy and learning rate in tasks involving acquisition of reward contingencies. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization across both fields. We conclude that blunted threat and reward learning may represent a mechanistic route by which ACEs may become physiologically and neurobiologically embedded and ultimately confer greater risk for psychopathology. In closing, we discuss potentially fruitful future directions for the research field, including methodological and ACE assessment considerations.
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Affiliation(s)
- Julia Ruge
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
| | | | - Alexandros Kastrinogiannis
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Maren Klingelhöfer-Jens
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- University of BielefeldBielefeldGermany
| | - Alina Koppold
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
| | | | - Tina B Lonsdorf
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- University of BielefeldBielefeldGermany
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2
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Song Q, Tan Y. Knowledge mapping of the relationship between norepinephrine and memory: a bibliometric analysis. Front Endocrinol (Lausanne) 2023; 14:1242643. [PMID: 37955010 PMCID: PMC10634421 DOI: 10.3389/fendo.2023.1242643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Memory is a fundamental cognitive function for successful interactions with a complex environment. Norepinephrine (NE) is an essential component of catecholamine induced by emotional arousal, and numerous studies have demonstrated that NE is a key regulator in memory enhancement. We therefore conducted a bibliometric analysis to represent the knowledge pattern of the literature on the theme of NE-memory relationship. Methods The WOSCC database was selected to extract literature published during 2003-2022. The collected data of annual production, global cooperation, research structure and hotspots were analyzed and visualized. Results Our results showed that research on the links between NE and memory displayed a considerable development trend over the last two decades. The USA had a leading position in terms of scientific outputs and collaborations. Meanwhile, University of California Irvine contributed the most publications. Benno Roozendaal and James McGaugh were the most prolific authors in this field, and Neurobiology of Learning and Memory had the highest number of publications on this topic. The research emphasis has evolved from memory-related diseases and brain regions to neural mechanisms for different types of memory at neural circuit levels. Conclusion Our bibliometric analysis systematically analyzed the literature on the links between NE and memory from a bibliometric perspective. The demonstrated results of the knowledge mapping would provide valuable insights into the global research landscape.
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Affiliation(s)
- Qi Song
- Department of Pharmacy, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Yaqian Tan
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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3
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Keefe JR, Suarez-Jimenez B, Zhu X, Lazarov A, Durosky A, Such S, Marohasy C, Lissek S, Neria Y. Elucidating behavioral and functional connectivity markers of aberrant threat discrimination in PTSD. Depress Anxiety 2022; 39:891-901. [PMID: 36336894 PMCID: PMC10583266 DOI: 10.1002/da.23295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients with posttraumatic stress disorder (PTSD) tend to overgeneralize threat to safe stimuli, potentially reflecting aberrant stimuli discrimination. Yet, it is not clear whether threat overgeneralization reflects general discrimination deficits, or rather a specific bias related to aversive stimuli. Here we tested this question and characterized the neural correlates of threat discrimination. METHODS One-hundred and eight participants (33 PTSD; 43 trauma-exposed controls; 32 healthy controls) completed an emotionally neutral complex shape discrimination task involving identifying in 42 similar pairs the previously observed shape; and an emotionally aversive discrimination task, involving providing risk ratings for an aversive conditioned stimulus (CS+), and for several stimuli gradually differing in size from the original CS+. Resting state functional connectivity (rsFC) was collected before completing the tasks. RESULTS No group differences emerged on the emotionally neutral task. Conversely, on the emotionally aversive task, individuals with PTSD had steeper linear risk rating slopes as the stimuli more resembled the conditioned stimulus. Finally, lower rsFC of amygdala-default mode network (DMN) and DMN-salience network (SN) were associated with steeper risk slopes, while for hippocampus-SN, lower rsFC was found only among participants with PTSD. CONCLUSIONS Individuals with PTSD show deficits in discrimination only when presented with aversive stimuli. Dysregulated discrimination pattern may relate to a lack of input from regulatory brain areas (e.g., DMN/hippocampus) to threat-related brain areas (e.g., SN/amygdala).
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Affiliation(s)
- John R. Keefe
- Psychiatry Research Institute at Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Amit Lazarov
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Ariel Durosky
- Department of Psychology, The University of Tulsa, Oklahoma, Tulsa, USA
| | - Sara Such
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Caroline Marohasy
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yuval Neria
- Neuroscience Department, University of Rochester, Rochester, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
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4
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Zoladz P, Reneau K, Weiser J, Cordes C, Virden E, Helwig S, Thebeault C, Pfister C, Getnet B, Boaz K, Niese T, Stanek M, Long K, Parker S, Rorabaugh B, Norrholm S. Childhood Maltreatment in Females Is Associated with Enhanced Fear Acquisition and an Overgeneralization of Fear. Brain Sci 2022; 12:1536. [PMID: 36421860 PMCID: PMC9688290 DOI: 10.3390/brainsci12111536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 06/27/2024] Open
Abstract
Childhood maltreatment may alter fear neurocircuitry, which results in pathological anxiety and depression. One alteration of fear-related behaviors that has been observed in several psychiatric populations is an overgeneralization of fear. Thus, we examined the association between childhood maltreatment and fear generalization in a non-clinical sample of young adults. Two hundred and ninety-one participants underwent differential fear conditioning in a fear-potentiated startle paradigm. One visual stimulus (CS+), but not another (CS-), was associated with an aversive airblast to the throat (US) during acquisition. The next day, participants were tested for their fear responses to the CS+, CS-, and several generalization stimuli (GS) without the presence of the US. Participants also completed questionnaires that assessed symptoms of childhood maltreatment, anxiety, depression, and post-traumatic stress disorder (PTSD). Participants reporting high childhood maltreatment (n = 71; 23 males, 48 females) exhibited significantly greater anxiety, depression, and symptoms of PTSD than participants reporting low childhood maltreatment (n = 220; 133 males, 87 females). Females reporting high childhood maltreatment demonstrated significantly enhanced fear learning and greater fear generalization, based on their fear-potentiated startle responses. Our findings suggest that childhood maltreatment may sex-dependently influence the development of fear neurocircuitry and result in greater fear generalization in maltreated females.
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Affiliation(s)
- Phillip Zoladz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kassidy Reneau
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Jordan Weiser
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Chloe Cordes
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Emma Virden
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sara Helwig
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Caitlin Thebeault
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Cassidy Pfister
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Bruktawit Getnet
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kayla Boaz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Taylor Niese
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Mercedes Stanek
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kristen Long
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sydney Parker
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Boyd Rorabaugh
- Department of Pharmaceutical Sciences, Marshall University School of Pharmacy, Huntington, WV 25755, USA
| | - Seth Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
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5
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Granata L, Parakoyi A, Brenhouse HC. Age- and sex-specific effects of maternal separation on the acoustic startle reflex in rats: early baseline enhancement in females and blunted response to ambiguous threat. Front Behav Neurosci 2022; 16:1023513. [PMID: 36386786 PMCID: PMC9643533 DOI: 10.3389/fnbeh.2022.1023513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/06/2022] [Indexed: 11/23/2022] Open
Abstract
Early life adversity (ELA) increases the incidence of later-life anxiety disorders. Dysregulated threat processing, including responsivity to ambiguous threats, is an indicator of anxiety disorders and can be influenced by childhood experiences. The acoustic startle response is a defensive reflex displayed by mammals when exposed to sudden intense stimuli reflecting individual variations in vigilance. These measures can be altered by previous experience and experimental modifications, including the introduction of unconditioned aversive stimuli. Rats emit ultrasonic vocalizations (USVs) in the 22 KHz range in negative contexts. As such, 22 KHz USVs are an ethologically relevant social cue of environmental threat shown to induce anxiety-like behavior in recipient rats. Because the timing of symptom manifestation after early life adversity can differ between sexes, the current study sought to identify the age- and sex-specific effects of daily maternal separation (MS) on responsivity to ambiguous threat in rats. In Experiment 1, rat pups underwent MS or control rearing from postnatal day (P) 2–20, then underwent behavioral testing beginning on P24, 34, or 54 to determine whether MS modified the baseline startle response or the modulation of startle by 22 KHz USVs. In Experiment 2, rats were tested in a light-enhanced startle paradigm at P54 after MS or control rearing to determine whether MS influenced light-enhanced startle. Results show an enhancement of the baseline startle magnitude by MS in females at P34. At P54, MS reduced the modulation of the startle response by 22 KHz USVs and prevented light-enhanced startle, indicating an MS-induced deficit in defensive responsivity when exposed to potential threat.
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6
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Yaeger JDW, Krupp KT, Summers TR, Summers CH. Contextual generalization of social stress learning is modulated by orexin receptors in basolateral amygdala. Neuropharmacology 2022; 215:109168. [PMID: 35724928 PMCID: PMC9285878 DOI: 10.1016/j.neuropharm.2022.109168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 01/22/2023]
Abstract
Fear-associated memories and behavior are often expressed in contexts/environments distinctively different from those in which they are created. This generalization process contributes to psychological disorders, particularly PTSD. Stress-related neurocircuits in the basolateral amygdala (BLA) receive inputs from hypothalamic orexin (Orx) neurons, which mediate neuronal activity by targeting orexin 1 (Orx1R) and orexin 2 (Orx2R) receptors via opposing functions. In BLA, inhibition of Orx1R or activation of Orx2R ameliorate stress responsiveness and behavior. We discovered that most Orx1R+ cells also express CamKIIα, while a majority of Orx2R+ cells are colocalized with GAD67. Further, Orx1R gene Hcrtr1 expression was positively correlated, and Orx2R gene Hcrtr2 expression was negatively correlated, with freezing in a phenotype-dependent fashion (Escape vs Stay) in the Stress Alternatives Model (SAM). The SAM consists of 4-days of social interaction between test mice and novel larger aggressors. Exits positioned at opposite ends of the SAM oval arena provide opportunities to actively avoid aggression. By Day 2, mice commit to behavioral phenotypes: Escape or Stay. Pharmacologically manipulating Orx receptor activity in the BLA, before Day 3 of the SAM, was followed with standard tests of anxiety: Open Field (OF) and Elevated Plus Maze (EPM). In Stay mice, freezing in response to social conflict and locomotion during SAM interaction (not home cage locomotion) were generalized to OF, and blocked by intra-BLA Orx1R antagonism, but not Orx2R antagonism. Moreover, patterns of social avoidance for Escape and Stay mice were recapitulated in OF, with generalization mediated by Orx1R and Orx2R antagonism, plus Orx2R stimulation.
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Affiliation(s)
- Jazmine D W Yaeger
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA; Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, SD, 57104, USA
| | - Kevin T Krupp
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA
| | - Tangi R Summers
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA
| | - Cliff H Summers
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA.
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7
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Fraunfelter L, Gerdes ABM, Alpers GW. Fear one, fear them all: A systematic review and meta-analysis of fear generalization in pathological anxiety. Neurosci Biobehav Rev 2022; 139:104707. [PMID: 35643120 DOI: 10.1016/j.neubiorev.2022.104707] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
It is a defining feature of anxiety disorders that fear is elicited by a circumscribed class of stimuli rather than by only one specific exemplar of that class. Therefore, fear generalization, a mechanism by which associative fear extends from one conditioned stimulus to similar cues, has been central to theories on anxiety. Yet, experimental evidence for the link between generalization and pathological anxiety, as well as its moderators, has not been formally integrated. This systematic review and meta-analysis of empirical findings clarifies the relationship between fear generalization and pathological anxiety. In conclusion, enhanced fear generalization is associated with several anxiety disorders and stress-related disorders, which is supported statistically by a small, but robust effect size of g = 0.44 for risk ratings as an index of fear generalization. However, empirical results are inconsistent across disorders and they rarely allow for conclusions on their causality in the disorders' etiology. Therefore, based on theoretical considerations, we recommend directions for intensified research, especially on the causal relationship between overgeneralization and pathological fear.
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Affiliation(s)
- L Fraunfelter
- University of Mannheim, School of Social Sciences, Department of Psychology, L13, 17, 68131 Mannheim, Germany.
| | - A B M Gerdes
- University of Mannheim, School of Social Sciences, Department of Psychology, L13, 17, 68131 Mannheim, Germany.
| | - G W Alpers
- University of Mannheim, School of Social Sciences, Department of Psychology, L13, 17, 68131 Mannheim, Germany.
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8
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The effect of partial and continuous reinforcement on the generalization of conditioned fear in humans. LEARNING AND MOTIVATION 2022. [DOI: 10.1016/j.lmot.2022.101812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Millon EM, Lehrer PM, Shors TJ. Meditation and Aerobic Exercise Enhance Mental Health Outcomes and Pattern Separation Learning Without Changing Heart Rate Variability in Women with HIV. Appl Psychophysiol Biofeedback 2022; 47:27-42. [PMID: 35040014 PMCID: PMC8763305 DOI: 10.1007/s10484-021-09530-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 01/01/2023]
Abstract
Mental and physical (MAP) training targets the brain and the body through a combination of focused-attention meditation and aerobic exercise. The following feasibility pilot study tested whether 6 weeks of MAP training improves mental health outcomes, while enhancing discrimination learning and heart rate variability (HRV) in a group of women living with human immunodeficiency virus (HIV) and other stress-related conditions. Participants were assigned to training (n = 18) or no-training control (n = 8) groups depending on their ability and willingness to participate, and if their schedule allowed. Training sessions were held once a week for 6 weeks with 30 min of meditation followed by 30 min of aerobic exercise. Before and after 6 weeks of training, participants completed the Behavioral Pattern Separation Task as a measure of discrimination learning, self-report questionnaires of ruminative and trauma-related thoughts, depression, anxiety, and perceived stress, and an assessment of HRV at rest. After training, participants reported fewer ruminative and trauma-related thoughts, fewer depressive and anxiety symptoms, and less perceived stress (p’s < 0.05). The positive impact on ruminative thoughts and depressive symptoms persisted 6 months after training. They also demonstrated enhanced discrimination of similar patterns of information (p < 0.05). HRV did not change after training (p > 0.05). Combining mental and physical training is an effective program for enhancing mental health and aspects of cognition in women living with HIV, although not necessarily through variance in heart rate.
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Affiliation(s)
- Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.
| | - Paul M Lehrer
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.,W.M. Keck Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey, USA
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10
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Stress-induced generalization of negative memories is mediated by an extended hippocampal circuit. Neuropsychopharmacology 2022; 47:516-523. [PMID: 34493828 PMCID: PMC8674250 DOI: 10.1038/s41386-021-01174-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/20/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023]
Abstract
Memories of negative experiences exert important control of behavior in the face of actual or anticipated threat. Sometimes, however, this control extends to non-threatening situations, a phenomenon known as overgeneralization of negative memories. Overgeneralization is a reliable cognitive phenotype of major depressive disorder, generalized anxiety disorder, and post-traumatic stress disorder. We therefore sought to develop an animal model to study stress-induced generalization of negative memories (SIG) and determine its dependence on the episodic-like memory circuit. We found that male and female mice, which were trained to differentiate a threatening from neutral context, exhibited robust SIG in response to subsequent social stress. Using chemogenetic circuit manipulations during memory retrieval, we demonstrated that both excitatory afferents to the dorsal hippocampus (DH) from the ventral tegmental area (VTA), and excitatory efferents from the DH to the retrosplenial cortex (RSC) contribute to SIG. Based on the known roles of these projections, we suggest that (1) by targeting subcortical VTA circuits that provide valence signals to the DH, stress prioritizes the retrieval of negative over neutral memories, and (2) by forwarding such information to the RSC, stress engages cortical mechanisms that support the retrieval of general relative to specific memory features. Altogether, these results suggest that various components of the extended hippocampal circuit can serve as treatment targets for memory overgeneralization.
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11
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Friedmann F, Hill H, Santangelo P, Ebner-Priemer U, Neubauer AB, Rausch S, Steil R, Müller-Engelmann M, Lis S, Fydrich T, Priebe K. Women with abuse-related PTSD sleep more fitfully but just as long as healthy controls: an actigraphic study. Sleep 2021; 45:6473455. [PMID: 34932818 DOI: 10.1093/sleep/zsab296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results. METHODS We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a group of 31 mentally healthy women with a history of CA (healthy trauma controls, HTC group) and a group of 36 non-traumatized mentally healthy women (healthy controls, HC group). RESULTS The PTSD group reported lower sleep quality, more nights with nightmares, and shorter sleep duration than both HTC and HC. Actigraphic measures showed more and longer sleep interruptions in the PTSD group compared to HTC and HC, but no difference in sleep duration. While the PTSD group underestimated their sleep duration, both HTC and HC overestimated their sleep duration. HTC did not differ from HC regarding sleep impairments. CONCLUSIONS Sleep in women with PTSD after CA seems to be more fragmented but not shorter compared to sleep patterns of mentally healthy control subjects. The results suggest a stronger effect of PTSD psychopathology on sleep compared to the effect of trauma per se.
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Affiliation(s)
- Franziska Friedmann
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Holger Hill
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Philip Santangelo
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Andreas B Neubauer
- Department of Education and Human Development, DIPF
- Leibniz Institute for Research and Information in Education, P.O. Box 900270, 60442 Frankfurt am Main, Germany
| | - Sophie Rausch
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Regina Steil
- Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany
| | - Meike Müller-Engelmann
- Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany
| | - Stefanie Lis
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Kathlen Priebe
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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12
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Ross MC, Heilicher M, Cisler JM. Functional imaging correlates of childhood trauma: A qualitative review of past research and emerging trends. Pharmacol Biochem Behav 2021; 211:173297. [PMID: 34780877 DOI: 10.1016/j.pbb.2021.173297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
Childhood trauma exposure is common and is associated with poor clinical outcomes in adolescence along with mental health and sociodemographic challenges in adulthood. While many strategies exist to investigate the biological imprint of childhood trauma exposure, functional neuroimaging is a robust and growing technology for non-invasive studies of brain activity following traumatic experience and the relationship of childhood trauma exposure with psychopathology, cognition, and behavior. In this review, we discuss three popular approaches for discerning functional neural correlates to early life trauma, including regional activation, bivariate functional connectivity, and network-based connectivity. The breadth of research in each method is discussed, followed by important limitations and considerations for future research. We close by considering emerging trends in functional neuroimaging research of childhood trauma, including the use of complex decision-making tasks to mimic clinically-relevant behaviors, data-driven techniques such as multivariate pattern analysis and whole-brain network topology, and the applications of real-time neurofeedback for treatment of trauma-related mental disorders. We aim for this review to provide a framework for understanding the relationship between atypical neural functioning and adverse outcomes following childhood trauma exposure, with a focus on improving consistency in research methods and translatability of research findings for clinical settings.
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Affiliation(s)
- Marisa C Ross
- Northwestern Neighborhood & Network Initiative, Institute for Policy Research, Northwestern University, United States of America.
| | | | - Josh M Cisler
- University of Texas at Austin, Department of Psychiatry
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13
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Mullins JL, Zhou E, Glenn DE, Moroney E, Lee SS, Michalska KJ. Paternal expressed emotion influences psychobiological indicators of threat and safety learning in daughters: A preliminary study. Dev Psychobiol 2021; 63:e22205. [PMID: 34674231 DOI: 10.1002/dev.22205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 12/27/2022]
Abstract
This preliminary study examined the association of children's anxiety, paternal expressed emotion (EE), and their interaction with psychophysiological indices of children's threat and safety learning. Participants included 24 father-daughter dyads. Daughters (ages 8-13 years, 100% Latina) self-reported their anxiety levels and completed a differential threat conditioning and extinction paradigm, during which psychophysiological responding was collected. Fathers completed a Five-Minute Speech Sample, from which paternal EE (i.e., criticism, emotional overinvolvement) was assessed. Anxiety-dependent associations emerged between paternal EE and individual differences in daughters' psychophysiological responding to safety signals during threat conditioning. Paternal EE was positively associated with psychophysiological responding to safety in daughters with high and mean, but not low, levels of anxiety. Although previous work suggests that chronic harsh maternal parenting is a potential risk factor for children's general threat and safety learning, these preliminary findings implicate milder forms of negative parenting behavior in fathers, particularly for highly anxious children.
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Affiliation(s)
- Jordan L Mullins
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Elayne Zhou
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Dana E Glenn
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Elizabeth Moroney
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Steve S Lee
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Kalina J Michalska
- Department of Psychology, University of California, Riverside, Riverside, California, USA
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14
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Cohodes EM, Kribakaran S, Odriozola P, Bakirci S, McCauley S, Hodges HR, Sisk LM, Zacharek SJ, Gee DG. Migration-related trauma and mental health among migrant children emigrating from Mexico and Central America to the United States: Effects on developmental neurobiology and implications for policy. Dev Psychobiol 2021; 63:e22158. [PMID: 34292596 PMCID: PMC8410670 DOI: 10.1002/dev.22158] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/11/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Children make up over half of the world's migrants and refugees and face a multitude of traumatic experiences prior to, during, and following migration. Here, we focus on migrant children emigrating from Mexico and Central America to the United States and review trauma related to migration, as well as its implications for the mental health of migrant and refugee children. We then draw upon the early adversity literature to highlight potential behavioral and neurobiological sequalae of migration-related trauma exposure, focusing on attachment, emotion regulation, and fear learning and extinction as transdiagnostic mechanisms underlying the development of internalizing and externalizing symptomatology following early-life adversity. This review underscores the need for interdisciplinary efforts to both mitigate the effects of trauma faced by migrant and refugee youth emigrating from Mexico and Central America and, of primary importance, to prevent child exposure to trauma in the context of migration. Thus, we conclude by outlining policy recommendations aimed at improving the mental health of migrant and refugee youth.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sahana Kribakaran
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah Bakirci
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Lucinda M Sisk
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sadie J Zacharek
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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15
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Neural substrates of human fear generalization: A 7T-fMRI investigation. Neuroimage 2021; 239:118308. [PMID: 34175426 DOI: 10.1016/j.neuroimage.2021.118308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/16/2021] [Accepted: 06/23/2021] [Indexed: 12/30/2022] Open
Abstract
Fear generalization - the tendency to interpret ambiguous stimuli as threatening due to perceptual similarity to a learned threat - is an adaptive process. Overgeneralization, however, is maladaptive and has been implicated in a number of anxiety disorders. Neuroimaging research has indicated several regions sensitive to effects of generalization, including regions involved in fear excitation (e.g., amygdala, insula) and inhibition (e.g., ventromedial prefrontal cortex). Research has suggested several other small brain regions may play an important role in this process (e.g., hippocampal subfields, bed nucleus of the stria terminalis [BNST], habenula), but, to date, these regions have not been examined during fear generalization due to limited spatial resolution of standard human neuroimaging. To this end, we utilized the high spatial resolution of 7T fMRI to characterize the neural circuits involved in threat discrimination and generalization. Additionally, we examined potential modulating effects of trait anxiety and intolerance of uncertainty on neural activation during threat generalization. In a sample of 31 healthy undergraduate students, significant positive generalization effects (i.e., greater activation for stimuli with increasing perceptual similarity to a learned threat cue) were observed in the visual cortex, thalamus, habenula and BNST, while negative generalization effects were observed in the dentate gyrus, CA1, and CA3. Associations with individual differences were underpowered, though preliminary findings suggested greater generalization in the insula and primary somatosensory cortex may be correlated with self-reported anxiety. Overall, findings largely support previous neuroimaging work on fear generalization and provide additional insight into the contributions of several previously unexplored brain regions.
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16
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Müller I, Adams DD, Sangha S, Chester JA. Juvenile stress facilitates safety learning in male and female high alcohol preferring mice. Behav Brain Res 2020; 400:113006. [PMID: 33166568 DOI: 10.1016/j.bbr.2020.113006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/18/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Abstract
Adversities during juvenility increase the risk for stress-related disorders, such as post-traumatic stress disorder (PTSD) and alcohol use disorder. However, stress can also induce coping mechanisms beneficial for later stressful experiences. We reported previously that mice selectively bred for high alcohol preference (HAP) exposed to stress during adolescence (but not during adulthood) showed enhanced fear-conditioned responses in adulthood, as measured by fear-potentiated startle (FPS). However, HAP mice also showed enhanced responding to safety cues predicting the absence of foot shocks in adulthood. Here, we pursue these findings in HAP mice by investigating in further detail how juvenile stress impacts the acquisition of safety and fear learning. HAP mice were subjected to three days of juvenile stress (postnatal days 25, 27, 28) and discriminative safety/fear conditioning in adulthood. FPS was used to assess safety versus fear cue discrimination, fear learning, and fear inhibition by the safety cue. Both stressed and unstressed HAP mice were able to discriminate between both cues as well as learn the fear cue-shock association. Interestingly, it was only the previously stressed mice that were able to inhibit their fear response when the fear cue was co-presented with the safety cue, thus demonstrating safety learning. We also report an incidental finding of alopecia in the juvenile stress groups, a phenotype seen in stress-related disorders. These results in HAP mice may be relevant to understanding the influence of juvenile trauma for individual risk and resilience toward developing PTSD and how individuals might benefit from safety cues in behavioral psychotherapy.
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Affiliation(s)
- Iris Müller
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA.
| | - Demitra D Adams
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA.
| | - Susan Sangha
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA.
| | - Julia A Chester
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA.
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17
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Thome J, Terpou BA, McKinnon MC, Lanius RA. The neural correlates of trauma-related autobiographical memory in posttraumatic stress disorder: A meta-analysis. Depress Anxiety 2020; 37:321-345. [PMID: 31815346 DOI: 10.1002/da.22977] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/02/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autobiographical memory (AM) refers to memories of events that are personally relevant and are remembered from one's own past. The AM network is a distributed brain network comprised largely by prefrontal medial and posteromedial cortical brain regions, which together facilitate AM. Autobiographical memories with high arousal and negatively valenced emotional states are thought to be retrieved more readily and re-experienced more vividly. This is critical in the case of trauma-related AMs, which are related to altered phenomenological experiences as well as aberrations to the underlying neural systems in posttraumatic stress disorder (PTSD). Critically, these alterations to the AM network have not been explored recently and have never been analyzed with consideration to the different processes of AM, them being retrieval and re-experiencing. METHODS We conducted a series of effect-size signed differential mapping meta-analyses across twenty-eight studies investigating the neural correlates of trauma-related AMs in participants with PTSD as compared with controls. Studies included either trauma-related scripts or trauma-related materials (i.e., sounds, images, pictures) implemented to evoke the recollection of a trauma-related memory. RESULTS The meta-analyses revealed that control and PTSD participants displayed greater common brain activation of prefrontal medial and posteromedial cortices, respectively. Whereby the prefrontal medial cortices are suggested to facilitate retrieval monitoring, the posteromedial cortices are thought to enable the visual imagery processes of AM. CONCLUSIONS Taken together, reduced common activation of prefrontal cortices may be interpreted as a bias toward greater re-experiencing, where the more salient elements of the traumatic memory are relived as opposed to retrieved in a controlled manner in PTSD.
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Affiliation(s)
- Janine Thome
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Neuroscience, Western University, London, Ontario, Canada
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18
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Lecei A, van Winkel R. Hippocampal pattern separation of emotional information determining risk or resilience in individuals exposed to childhood trauma: Linking exposure to neurodevelopmental alterations and threat anticipation. Neurosci Biobehav Rev 2020; 108:160-170. [DOI: 10.1016/j.neubiorev.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 12/29/2022]
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19
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Tschoeke S, Steinert T, Bichescu-Burian D. Causal connection between dissociation and ongoing interpersonal violence: A systematic review. Neurosci Biobehav Rev 2019; 107:424-437. [PMID: 31562923 DOI: 10.1016/j.neubiorev.2019.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/12/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To identify evidence for dissociation as a cause of ongoing interpersonal violence. METHOD A systematic review of the literature retrieved from ten databases. RESULTS Fifteen studies yielded from our search strategy have been included in the review; eleven of these were longitudinal and four were experimental. The evidence indicates that pathological dissociation may contribute towards enduring interpersonal violence. Thus, dissociation may account for instances of repeated victimisation. There are similar indications concerning offenders, but study designs in this area allow one to draw fewer causal conclusions. There is some evidence that dissociation decreases information processing from the limbic system, which may be one underlying neurofunctional mechanism of persistent violence. CONCLUSION There is growing evidence for dissociation as a cause of interpersonal violence. However, the available evidence is still limited, and our review rather reveals an important research gap. Future longitudinal and experimental studies aimed at clarifying the role of dissociation in the context of violence should take into account the theoretical and empirical complexity around the concept of dissociation.
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Affiliation(s)
- Stefan Tschoeke
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
| | - Tilman Steinert
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
| | - Dana Bichescu-Burian
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
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20
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Terpou BA, Harricharan S, McKinnon MC, Frewen P, Jetly R, Lanius RA. The effects of trauma on brain and body: A unifying role for the midbrain periaqueductal gray. J Neurosci Res 2019; 97:1110-1140. [PMID: 31254294 DOI: 10.1002/jnr.24447] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/09/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
Post-traumatic stress disorder (PTSD), a diagnosis that may follow the experience of trauma, has multiple symptomatic phenotypes. Generally, individuals with PTSD display symptoms of hyperarousal and of hyperemotionality in the presence of fearful stimuli. A subset of individuals with PTSD; however, elicit dissociative symptomatology (i.e., depersonalization, derealization) in the wake of a perceived threat. This pattern of response characterizes the dissociative subtype of the disorder, which is often associated with emotional numbing and hypoarousal. Both symptomatic phenotypes exhibit attentional threat biases, where threat stimuli are processed preferentially leading to a hypervigilant state that is thought to promote defensive behaviors during threat processing. Accordingly, PTSD and its dissociative subtype are thought to differ in their proclivity to elicit active (i.e., fight, flight) versus passive (i.e., tonic immobility, emotional shutdown) defensive responses, which are characterized by the increased and the decreased expression of the sympathetic nervous system, respectively. Moreover, active and passive defenses are accompanied by primarily endocannabinoid- and opioid-mediated analgesics, respectively. Through critical review of the literature, we apply the defense cascade model to better understand the pathological presentation of defensive responses in PTSD with a focus on the functioning of lower-level midbrain and extended brainstem systems.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | | | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Paul Frewen
- Department of Psychology, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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21
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Lis S, Thome J, Kleindienst N, Mueller-Engelmann M, Steil R, Priebe K, Schmahl C, Hermans D, Bohus M. Generalization of fear in post-traumatic stress disorder. Psychophysiology 2019; 57:e13422. [PMID: 31206738 DOI: 10.1111/psyp.13422] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022]
Abstract
Overgeneralization (i.e., the transfer of fear to stimuli not related to an aversive event) is part of alterations in associative fear learning in mental disorders. In the present experimental study, we investigated whether this holds true for post-traumatic stress disorder (PTSD) related to childhood abuse. We expected that fear generalization under experimental conditions reflects generalization of aversive stimuli to different social domains in real life. Sixty-four women with PTSD after childhood abuse and 30 healthy participants (HC) underwent a differential fear conditioning and generalization paradigm. Online risk ratings, reaction time, and fear-potentiated startle served as dependent variables. Based on the subjectively assessed generalization of triggered intrusions across different domains of life, PTSD participants were split into two groups reporting low (low-GEN) and high (high-GEN) generalization. PTSD patients reported a higher expectation of an aversive event. During fear conditioning, they assessed the risk of danger related to a safety cue slower and showed a blunted fear-potentiated startle toward the danger cue. During generalization testing, reaction time increased in the high-GEN patients and decreased in the HC group with increasing similarity of a stimulus with the conditioned safety cue. Alterations of fear learning in PTSD suggest impaired defensive responses in case of a high threat probability. Moreover, our findings bridge the gap between the generalization of aversive cues during everyday life and laboratory-based experimental parameters: impairments in the processing of cues signaling safety generalize particularly in those patients who report a spreading of PTSD symptoms across different domains of everyday life.
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Affiliation(s)
- S Lis
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Thome
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry, Western University, London, Canada.,Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - N Kleindienst
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Mueller-Engelmann
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University, Frankfurt, Frankfurt, Germany
| | - R Steil
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University, Frankfurt, Frankfurt, Germany
| | - K Priebe
- Department of Psychology, Faculty of Life Sciences, Humboldt University Berlin, Berlin, Germany
| | - C Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - D Hermans
- Faculty of Psychology and Educational Sciences, Leuven University, Flanders, Belgium
| | - M Bohus
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,McLean Hospital, Harvard Medical School, Boston, Massachusetts
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22
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Couto-Pereira NDS, Lampert C, Vieira ADS, Lazzaretti C, Kincheski GC, Espejo PJ, Molina VA, Quillfeldt JA, Dalmaz C. Resilience and Vulnerability to Trauma: Early Life Interventions Modulate Aversive Memory Reconsolidation in the Dorsal Hippocampus. Front Mol Neurosci 2019; 12:134. [PMID: 31191245 PMCID: PMC6546926 DOI: 10.3389/fnmol.2019.00134] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/09/2019] [Indexed: 01/01/2023] Open
Abstract
Early life experiences program lifelong responses to stress. In agreement, resilience and vulnerability to psychopathologies, such as posttraumatic stress disorder (PTSD), have been suggested to depend on the early background. New therapies have targeted memory reconsolidation as a strategy to modify the emotional valence of traumatic memories. Here, we used animal models to study the molecular mechanism through which early experiences may later affect aversive memory reconsolidation. Handling (H)—separation of pups from dams for 10 min—or maternal separation (MS) — 3-h separation—were performed from PDN1–10, using non-handled (NH) litters as controls. Adult males were trained in a contextual fear conditioning (CFC) task; 24 h later, a short reactivation session was conducted in the conditioned or in a novel context, followed by administration of midazolam 3 mg/kg i.p. (mdz), known to disturb reconsolidation, or vehicle; a test session was performed 24 h after. The immunocontent of relevant proteins was studied 15 and 60 min after memory reactivation in the dorsal hippocampus (dHc) and basolateral amygdala complex (BLA). Mdz-treated controls (NH) showed decreased freezing to the conditioned context, consistent with reconsolidation impairment, but H and MS were resistant to labilization. Additionally, MS males showed increased freezing to the novel context, suggesting fear generalization; H rats showed lower freezing than the other groups, in accordance with previous suggestions of reduced emotionality facing adversities. Increased levels of Zif268, GluN2B, β-actin and polyubiquitination found in the BLA of all groups suggest that memory reconsolidation was triggered. In the dHc, only NH showed increased Zif268 levels after memory retrieval; also, a delay in ERK1/2 activation was found in H and MS animals. We showed here that reconsolidation of a contextual fear memory is insensitive to interference by a GABAergic drug in adult male rats exposed to different neonatal experiences; surprisingly, we found no differences in the reconsolidation process in the BLA, but the dHc appears to suffer temporal desynchronization in the engagement of reconsolidation. Our results support a hippocampal-dependent mechanism for reconsolidation resistance in models of early experiences, which aligns with current hypotheses for the etiology of PTSD.
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Affiliation(s)
- Natividade de Sá Couto-Pereira
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Programa de Pós-graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Carine Lampert
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Aline Dos Santos Vieira
- Programa de Pós-graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Camilla Lazzaretti
- Programa de Pós-graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Grasielle Clotildes Kincheski
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Pablo Javier Espejo
- Instituto de Farmacología Experimental de Córdoba, Universidad Nacional de Cordoba (UNC), Cordoba, Argentina
| | - Victor Alejandro Molina
- Instituto de Farmacología Experimental de Córdoba, Universidad Nacional de Cordoba (UNC), Cordoba, Argentina
| | - Jorge Alberto Quillfeldt
- Programa de Pós-graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Carla Dalmaz
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Programa de Pós-graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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23
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Lange I, Goossens L, Bakker J, Michielse S, van Winkel R, Lissek S, Leibold N, Marcelis M, Wichers M, van Os J, van Amelsvoort T, Schruers K. Neurobehavioural mechanisms of threat generalization moderate the link between childhood maltreatment and psychopathology in emerging adulthood. J Psychiatry Neurosci 2019; 44:185-194. [PMID: 30540154 PMCID: PMC6488482 DOI: 10.1503/jpn.180053] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Childhood maltreatment is a transdiagnostic risk factor for later psychopathology and has been associated with altered brain circuitry involved in the processing of threat and safety. Examining threat generalization mechanisms in young adults with childhood maltreatment and psychiatric symptoms may elucidate a pathway linking early-life adversities to the presence of subclinical psychopathology. METHODS We recruited youth aged 16–25 years with subclinical psychiatric symptomatology and healthy controls. They were dichotomized into 2 groups: 1 with a high level of childhood maltreatment (n = 58) and 1 with no or a low level of childhood maltreatment (n = 55). Participants underwent a functional MRI threat generalization paradigm, measuring self-reported fear, expectancy of an unconditioned stimulus (US) and neural responses. RESULTS We observed interactions between childhood maltreatment and threat generalization indices on subclinical symptom load. In individuals reporting high levels of childhood maltreatment, enhanced generalization in self-reported fear and US expectancy was related to higher levels of psychopathology. Imaging results revealed that in the group with high levels of childhood maltreatment, lower activation in the left hippocampus during threat generalization was associated with a higher symptom load. Associations between threat generalization and psychopathology were nonsignificant overall in the group with no or low levels of childhood maltreatment. LIMITATIONS The data were acquired in a cross-sectional manner, precluding definitive insight into the causality of childhood maltreatment, threat generalization and psychopathology. CONCLUSION Our results suggest that threat generalization mechanisms may moderate the link between childhood maltreatment and subclinical psychopathology during emerging adulthood. Threat generalization could represent a vulnerability factor for developing later psychopathology in individuals being exposed to childhood maltreatment.
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Affiliation(s)
- Iris Lange
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Liesbet Goossens
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Jindra Bakker
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Stijn Michielse
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Ruud van Winkel
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Shmuel Lissek
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Nicole Leibold
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Machteld Marcelis
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Marieke Wichers
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Jim van Os
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Therese van Amelsvoort
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
| | - Koen Schruers
- From the Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University, Maastricht, The Netherlands (Lange, Goossens, Bakker, Michielse, Leibold, Marcelis, van Os, van Amelsvoort, Schruers); Department of Neuroscience, Center for Contextual Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium (van Winkel); Department of Psychology, University of Minnesota, Minneapolis, MN, USA (Lissek); Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands (Marcelis); Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands (Wichers); Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK (van Os); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (van Os); Faculty of Psychology, Center for Experimental and Learning Psychology, KU Leuven, Leuven, Belgium Schruers)
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24
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Thome J, Densmore M, Koppe G, Terpou B, Théberge J, McKinnon MC, Lanius RA. Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2019; 3:2470547019873663. [PMID: 32440600 PMCID: PMC7219926 DOI: 10.1177/2470547019873663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/09/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Brainstem and midbrain neuronal circuits that control innate, reflexive responses and arousal are increasingly recognized as central to the neurobiological framework of post-traumatic stress disorder (PTSD). The reticular activation system represents a fundamental neuronal circuit that plays a critical role not only in generating arousal but also in coordinating innate, reflexive responding. Accordingly, the present investigation aims to characterize the resting state functional connectivity of the reticular activation system in PTSD and its dissociative subtype. METHODS We investigated patterns of resting state functional connectivity of a central node of the reticular activation system, namely, the pedunculopontine nuclei, among individuals with PTSD (n = 77), its dissociative subtype (PTSD+DS; n = 48), and healthy controls (n = 51). RESULTS Participants with PTSD and PTSD+DS were characterized by within-group pedunculopontine nuclei resting state functional connectivity to brain regions involved in innate threat processing and arousal modulation (i.e., midbrain, amygdala, ventromedial prefrontal cortex). Critically, this pattern was most pronounced in individuals with PTSD+DS, as compared to both control and PTSD groups. As compared to participants with PTSD and controls, individuals with PTSD+DS showed enhanced pedunculopontine nuclei resting state functional connectivity to the amygdala and the parahippocampal gyrus as well as to the anterior cingulate and the ventromedial prefrontal cortex. No group differences emerged between PTSD and control groups. In individuals with PTSD+DS, state derealization/depersonalization was associated with reduced resting state functional connectivity between the left pedunculopontine nuclei and the anterior nucleus of the thalamus. Altered connectivity in these regions may restrict the thalamo-cortical transmission necessary to integrate internal and external signals at a cortical level and underlie, in part, experiences of depersonalization and derealization. CONCLUSIONS The present findings extend the current neurobiological model of PTSD and provide emerging evidence for the need to incorporate brainstem structures, including the reticular activation system, into current conceptualizations of PTSD and its dissociative subtype.
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Affiliation(s)
- Janine Thome
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Department of Theoretical Neuroscience,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maria Densmore
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
| | - Georgia Koppe
- Department of Theoretical Neuroscience,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Braeden Terpou
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Department of Neuroscience, Western
University, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
- Department of Medical Biophysics,
Western University, London, Ontario, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph,
Ontario, Canada
- Mood Disorder Programs, St. Joseph's
Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioral
Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
- Department of Neuroscience, Western
University, London, Ontario, Canada
- Homewood Research Institute, Guelph,
Ontario, Canada
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25
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Fenster RJ, Lebois LAM, Ressler KJ, Suh J. Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man. Nat Rev Neurosci 2018; 19:535-551. [PMID: 30054570 PMCID: PMC6148363 DOI: 10.1038/s41583-018-0039-7] [Citation(s) in RCA: 244] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a prevalent, debilitating and sometimes deadly consequence of exposure to severe psychological trauma. Although effective treatments exist for some individuals, they are limited. New approaches to intervention, treatment and prevention are therefore much needed. In the past few years, the field has rapidly developed a greater understanding of the dysfunctional brain circuits underlying PTSD, a shift in understanding that has been made possible by technological revolutions that have allowed the observation and perturbation of the macrocircuits and microcircuits thought to underlie PTSD-related symptoms. These advances have allowed us to gain a more translational knowledge of PTSD, have provided further insights into the mechanisms of risk and resilience and offer promising avenues for therapeutic discovery.
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Affiliation(s)
- Robert J Fenster
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.
| | - Junghyup Suh
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.
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