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Phillips K, Callaghan BL, Webb A, Kan J, Ooi CY, Kasparian NA. MEDIC: Development and validation of a new instrument to assess emotional reactivity to medical stimuli in a representative community sample of adults. J Psychiatr Res 2024; 176:265-275. [PMID: 38901391 DOI: 10.1016/j.jpsychires.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/05/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
To support investigation of the etiology and psychophysiology of medical traumatic stress, we developed a standardized set of emotionally-salient medical images, called the 'MEDical Image Collection' (MEDIC), for use in neuroimaging or psychological research. This study aimed to establish internal consistency, test re-test reliability, and congruent validity of the image set. A representative sample of 300 adults in the United States were recruited via research recruitment platform, Prolific. Participants rated 124 images depicting medical stimuli on one of two dimensions: emotional arousal (i.e., how strongly an evoked emotion is felt) or affective valence (i.e., how positive or negative the evoked emotion is). Sociodemographic and health-related characteristics, including experiences during the COVID-19 pandemic, were also assessed. To assess test re-test reliability, a subset (n = 200) rated the images on the same dimension a second time, 3 months later. The MEDIC image set was found to: (a) elicit a range of emotional arousal and valence ratings, (b) have excellent inter-rater reliability, (c) moderate test-retest reliability, and (d) good face validity. Results indicate the new MEDIC 124-image set is a reliable and valid instrument, enabling researchers to provide context-specific and emotionally-salient stimuli to individuals when studying affective responses in relation to health and medicine.
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Affiliation(s)
- Katelyn Phillips
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales (UNSW Sydney). UNSW Sydney, High St, Kensington, NSW, 2052, Australia
| | - Bridget L Callaghan
- Department of Psychology, University of California Los Angeles, 1285 Psychology Building Box, Los Angeles, CA, 951563, USA
| | - Annabel Webb
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, Faculty of Health and Medicine, The University of Sydney, Sydney, 88 Mallett St, Camperdown, NSW, 2050, Australia
| | - Janice Kan
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, TAS, 7001, Australia
| | - Chee Y Ooi
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales (UNSW Sydney). UNSW Sydney, High St, Kensington, NSW, 2052, Australia; Department of Gastroenterology, Sydney Children's Hospital, Randwick, Australia; Sydney Children's Hospital, High St, Randwick, NSW, 2031, Australia
| | - Nadine A Kasparian
- Heart and Mind Wellbeing Center, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Tillman GD, Morris EE, Bass C, Turner M, Watson K, Brooks JT, Rawlinson T, Kozel FA, Kraut MA, Motes MA, Hart J. P3a amplitude to trauma-related stimuli reduced after successful trauma-focused PTSD treatment. Biol Psychol 2023; 182:108648. [PMID: 37482132 DOI: 10.1016/j.biopsycho.2023.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023]
Abstract
An elevated P3a amplitude to trauma-related stimuli is strongly associated with posttraumatic stress disorder (PTSD), yet little is known about whether this response to trauma-related stimuli is affected by treatment that decreases PTSD symptoms. As an analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the P3a in responses in a three-condition oddball visual task that included trauma-related (combat scenes) and trauma-unrelated (threatening animals) distractors. Fifty-five U.S. veterans diagnosed with combat-related PTSD were randomized to receive either active or sham repetitive transcranial magnetic stimulation (rTMS). All received cognitive processing therapy, CPT+A, which requires a written account of the index trauma. They were tested before and 6 months after protocol completion. P3a amplitude and response time decreases were driven largely by the changes in the responses to the trauma-related stimuli, and this decrease correlated to the decrease in PTSD symptoms. The amplitude changes were greater in those who received rTMS + CPT than in those who received sham rTMS + CPT, suggesting that rTMS plays beneficial role in reducing arousal and threat bias, which may allow for more effective engagement in trauma-focused PTSD treatment.
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Affiliation(s)
- Gail D Tillman
- Callier Center, University of Texas at Dallas, Dallas, TX, USA.
| | | | - Christina Bass
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Mary Turner
- Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kelsey Watson
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Jared T Brooks
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Tyler Rawlinson
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - F Andrew Kozel
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - Michael A Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael A Motes
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - John Hart
- Callier Center, University of Texas at Dallas, Dallas, TX, USA; Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA; Departments of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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DeGutis J, Agnoli S, Bernstein JPK, Jagger-Rickels A, Evans TC, Fortier CB, McGlinchey RE, Milberg WP, Esterman M. Poorer Inhibitory Control Uniquely Contributes to Greater Functional Disability in Post-9/11 Veterans. Arch Clin Neuropsychol 2023; 38:944-961. [PMID: 36781401 PMCID: PMC10456219 DOI: 10.1093/arclin/acad012] [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] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE Post-9/11 Veterans endorse greater self-reported functional disability than 80% of the adult population. Previous studies of trauma-exposed populations have shown that increased post-traumatic stress disorder (PTSD) and depressive symptoms are consistently associated with greater disability. Additionally, poorer cognitive performance in the domain of executive functions, particularly inhibitory control, has been associated with disability, though it is unclear if this effect is independent of and/or interacts with PTSD and depression. METHOD Three overlapping samples of n = 582, 297, and 183 combat-deployed post-9/11 Veterans completed comprehensive assessments of executive functions, PTSD and depressive symptoms, and self-reported World Health Organization Disability Assessment Schedule-II (WHODAS II). RESULTS Poorer performance on measures of inhibitory control (Delis-Kaplan Executive Functioning System Color-Word Interference-CWI Test and gradual-onset Continuous Performance Test-gradCPT), but not other executive functions, were significantly associated with greater disability on the WHODAS II (ρ's = -.13 and -.13, p = .002 and .026, respectively). CWI inhibitory control measures accounted for unique variance in disability after controlling for PTSD and depressive symptoms (R2 change = 0.02, p < .001). Further, CWI significantly moderated the effect of depressive symptoms on disability, such that better inhibitory control weakened the relationship between depression and disability. CONCLUSIONS Inhibitory control deficits are uniquely associated with increased disability in combat-deployed post-9/11 Veterans, and better inhibitory control abilities may serve as a protective factor for depressive symptoms leading to increased disability. KEY POINTS
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Affiliation(s)
- Joseph DeGutis
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
- Boston Attention and Learning (BAL) Lab, VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sam Agnoli
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
- Boston Attention and Learning (BAL) Lab, VA Boston Health Care System, Boston, MA, USA
| | - John P K Bernstein
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
| | - Audreyana Jagger-Rickels
- Boston Attention and Learning (BAL) Lab, VA Boston Health Care System, Boston, MA, USA
- National Center for PTSD, VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Travis C Evans
- Boston Attention and Learning (BAL) Lab, VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Michael Esterman
- Boston Attention and Learning (BAL) Lab, VA Boston Health Care System, Boston, MA, USA
- National Center for PTSD, VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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4
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Yetter M, Philippi CL, Bruce SE. Altered functional connectivity between cortical networks associated with inhibitory control in trauma-exposed females. Psychiatry Res Neuroimaging 2023; 333:111671. [PMID: 37348291 PMCID: PMC10330570 DOI: 10.1016/j.pscychresns.2023.111671] [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: 01/29/2023] [Revised: 04/18/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
Post-traumatic stress disorder (PTSD) is associated with impaired inhibitory control and alterations in large-scale brain network connectivity. However, few studies to date have examined the construct of inhibitory control as it relates to resting-state functional connectivity (rsFC) in a population with PTSD or trauma-exposure. The present study investigated the relationship between impaired inhibitory control and rsFC within the default mode network (DMN), central executive network (CEN), and salience network (SN) in a sample of females exposed to interpersonal trauma with and without PTSD (n = 67). Participants completed a classic Color-Word Stroop task as a measure of inhibitory control and two resting-state fMRI scans. We conducted voxelwise rsFC analyses with seed regions in the DMN, CEN, and SN and voxelwise linear regression analyses to examine the relationship between inhibitory control and rsFC of these networks across the sample. Better Stroop performance was negatively associated with total self-reported PTSD symptoms. An analysis of PTSD symptom clusters indicated that better Stroop performance was also associated with re-experiencing and hyperarousal symptoms, but not avoidance PTSD symptoms. Decreased coupling between the CEN and the DMN was associated with better inhibitory control in this sample of trauma-exposed females. These findings lend support to the hypothesis that efficient switching between these networks may contribute to better performance on cognitive and attentional tasks in trauma-exposed individuals.
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Affiliation(s)
- Marissa Yetter
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO, 63121, USA, University of Missouri - St. Louis
| | - Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO, 63121, USA, University of Missouri - St. Louis
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO, 63121, USA, University of Missouri - St. Louis.
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Kimble M, Cappello O, Fleming K. Hypervigilance and depression as predictors of eye tracking to ambiguous pictures in trauma survivors. Int J Psychophysiol 2023; 187:27-33. [PMID: 36738931 DOI: 10.1016/j.ijpsycho.2023.01.007] [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: 10/06/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023]
Abstract
Hypervigilance, attentional bias, and negative views of the world play a significant role in post trauma symptomatology and can be associated with both clinical depression and posttraumatic stress. However, both theory and research suggest there may be discernible differences in attentional patterns between these two outcomes. While depression may be associated with a general negativity bias, posttraumatic stress may be specifically associated with visual scanning, hypervigilance, and threat detection. In this study, seventy-seven community trauma survivors completed self-assessments for hypervigilance, depression, and posttraumatic cognitions and then had their eyes tracked while looking at a series of thirty neutral but ambiguous and complex pictures on a computer screen. Mean age of the sample was 36.3 with 52 % of the sample identifying as female. We found that hypervigilance scores and negative views of the world predicted both the number of fixations and area of the picture covered. These factors did not predict pupil size. These findings suggest that there are discernable gaze patterns after trauma associated with posttraumatic stress but not depression. Specifically, ambiguous pictures generate more fixations and scanning that is associated with vigilance but not depression.
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Affiliation(s)
- Matthew Kimble
- Department of Psychology, Middlebury College, Middlebury, VT 05753, United States of America.
| | - Olivia Cappello
- Department of Psychology, Middlebury College, Middlebury, VT 05753, United States of America
| | - Kevin Fleming
- Department of Psychology, Norwich University, Northfield, VT 05663, United States of America
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Vyas K, Murphy D, Greenberg N. Cognitive biases in military personnel with and without PTSD: a systematic review. J Ment Health 2023; 32:248-259. [PMID: 32437214 DOI: 10.1080/09638237.2020.1766000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Some cognitive biases, such as excessive attention to threat, are associated with PTSD. However, they may be adaptive for military personnel; attending to threat may improve safety for deployed personnel. AIMS The extent to which military personnel with vs. without PTSD differ with respect to specific cognitive biases is currently unclear. This systematic review aimed to address this question. METHODS PRISMA guidelines were followed. Articles were identified using a comprehensive literature search; 21 studies (with 1977 participants) were reviewed. RESULTS All studies were of "moderate" or "strong" quality. Military personnel with vs. without PTSD used overgeneralised language when describing autobiographical memories and demonstrated impaired performance on a modified Stroop task. Studies using dot-probe paradigms conceptualised attentional response as a dynamic process, fluctuating between bias towards and away from threat; military personnel with vs. without PTSD demonstrated greater fluctuation. Studies using visual search tasks concluded that attentional bias in PTSD involves interference (difficulty disengaging from threat) rather than facilitation (enhanced threat detection). Finally, personnel with vs. without PTSD demonstrated interpretation bias, completing ambiguous sentences with negative rather than neutral endings. CONCLUSION The implications for military populations and recommendations for further research and clinical practice are considered. PROSPERO REGISTRATION PROSPERO 2018 CRD42018092235.
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Affiliation(s)
- Karishma Vyas
- Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | | | - Neil Greenberg
- King's Centre for Military Health Research, Weston Education Centre, King's College London, London, UK
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Eli B, Chen Y, Zhang J, Huang X, Wang Q, Ma Z, Yv Y, Liu Z. Time course of attentional bias and its relationship with PTSD symptoms in bereaved Chinese parents who have lost their only child. Eur J Psychotraumatol 2023; 14:2235980. [PMID: 37493173 PMCID: PMC10599259 DOI: 10.1080/20008066.2023.2235980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 07/27/2023] Open
Abstract
Background: The death of a child is a highly traumatic event for parents and often leads to posttraumatic stress disorder (PTSD). Attentional bias has been demonstrated in the onset and maintenance of PTSD symptoms.Objective: This study aimed to investigate the time course of attentional bias among bereaved Chinese parents who have lost their only child (Shidu parents), and to examine its relationship with PTSD symptoms and symptom clusters.Methods: Shidu parents (n = 38; 50-72 years of age) completed a dot-probe task with negative (trauma-related), positive, and neutral images at four stimulus presentation times (250, 500, 750, and 1250 ms). PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5).Results: We observed difficulty in disengaging from both negative and positive stimuli at 750 ms and attentional bias away from negative stimuli at 1250 ms. At 1250 ms, attentional avoidance of trauma-related stimuli was positively correlated with PCL-5 total and intrusion scores. Difficulty in disengaging from positive stimuli was negatively correlated with PCL-5 total and intrusion scores as well as negative alterations in cogniti and mood scores.Conclusions: These findings enhance our understanding of attentional bias and cognitive-affective processing in PTSD. This study provides evidence that attentional bias (difficulty in disengaging from positive stimuli and bias away from negative stimuli) are correlated with PTSD symptoms and certain symptom clusters.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Jing Zhang
- Gengdan Institute of Beijing University of Technology, Beijing, P.R. China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Qian Wang
- Beijing Key Laboratory of Behavior and Mental Health, Clinical and Health Psychology Department, School of Psychological and Cognitive Sciences, Peking University, Beijing, P.R. China
| | - Zhujiang Ma
- Beijing Wisdom Spirits Technology Co., Ltd, Beijing, P.R. China
| | - Yang Yv
- Yv Yang Psychological Service Center, Economic and Technological Development Zone, Huai'an, Jiangsu Province, P.R. China
| | - ZhengKui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
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Zaninotto F, Bossi F, Terry P, Riccaboni M, Galli G. The Evolution of Psychological and Behavioral Consequences of Self-Isolation During Lockdown: A Longitudinal Study Across United Kingdom and Italy. Front Psychiatry 2022; 13:826277. [PMID: 35722571 PMCID: PMC9198491 DOI: 10.3389/fpsyt.2022.826277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/10/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction Several countries imposed nationwide or partial lockdowns to limit the spread of COVID-19 and avoid overwhelming hospitals and intensive care units. Lockdown may involve restriction of movement, stay-at-home orders and self-isolation, which may have dramatic consequences on mental health. Recent studies demonstrated that the negative impact of lockdown restrictions depends on a wide range of psychological and socio-demographic factors. Aims This longitudinal study aimed to understand how internal factors such as personality and mindfulness traits, and external factors, such as daily habits and house features, affect anxiety, depression and general wellbeing indicators, as well as cognitive functions, during the course of a lockdown. Methods To address these questions, 96 participants in Italy and the United Kingdom filled out a survey, once a week for 4 weeks, during the first-wave lockdowns. The survey included questions related to their habits and features of the house, as well as validated questionnaires to measure personality traits, mindful attitude and post-traumatic symptoms. Indicators of wellbeing were the affective state, anxiety, stress and psychopathological indices. We also measured the emotional impact of the pandemic on cognitive ability by using two online behavioral tasks [emotional Stroop task (EST) and visual search]. Results We found that internal factors influenced participants' wellbeing during the first week of the study, while external factors affected participants in the last weeks. In the first week, internal variables such as openness, conscientiousness and being non-judgmental toward one's own thoughts and emotions were positively associated with wellbeing; instead, neuroticism and the tendency to observe and describe one's own thoughts and emotions had detrimental effects on wellbeing. Toward the end of the study, external variables such as watching television and movies, browsing the internet, walking the dog, and having a balcony showed a protective value, while social networking and engaging in video calls predicted lower values of wellbeing. We did not find any effects of wellbeing on cognitive functioning. Conclusion Recognizing specific traits and habits affecting individuals' wellbeing (in both short and long terms) during social isolation is crucial to identify people at risk of developing psychological distress and help refine current guidelines to alleviate the psychological consequences of prolonged lockdowns.
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Affiliation(s)
- Francesca Zaninotto
- Department of Psychology, Kingston University, Kingston upon Thames, United Kingdom
| | - Francesco Bossi
- MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Philip Terry
- Department of Psychology, Kingston University, Kingston upon Thames, United Kingdom
| | | | - Giulia Galli
- Department of Psychology, Kingston University, Kingston upon Thames, United Kingdom
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Mathew AS, Lotfi S, Bennett KP, Larsen SE, Dean C, Larson CL, Lee HJ. Association between spatial working memory and Re-experiencing symptoms in PTSD. J Behav Ther Exp Psychiatry 2022; 75:101714. [PMID: 34906826 PMCID: PMC9173718 DOI: 10.1016/j.jbtep.2021.101714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/13/2021] [Accepted: 12/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Few studies have evaluated the link between working memory (WM) and post-traumatic stress disorder (PTSD). Further, it is unknown whether this relationship is accounted for by other relevant variables including negative affect, emotional dysregulation, or general non-WM-related cognitive control deficits, which are associated with PTSD. The purpose of this study was to determine the extent to which a computerized WM task could predict PTSD symptomology incrementally beyond the contribution of other relevant variables associated with PTSD. METHODS Thirty veterans were eligible to complete emotional symptom questionnaires, a heart-rate variability measure, and computerized tasks (i.e., emotional Stroop and automated complex span tasks). A three-stage hierarchical regression was conducted with the PCL-5 total score and symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and negative cognition/mood) as the dependent variable. RESULTS Results revealed that only the re-experiencing symptom cluster was significantly predicted by executive, verbal, and visuospatial WM tasks, which explained an additional 29.7% of the variance over and above other relevant variables. Most notably, the visuospatial task was the only WM task that significantly explained PCL-5 re-experiencing symptoms. LIMITATIONS This study was based on a small sample of veterans with PTSD and causality cannot be determined with this cross-sectional study. CONCLUSIONS Overall, the results suggest that deficits in visuospatial WM are significantly associated with PTSD re-experiencing symptoms after controlling for other relevant variables. Further research should evaluate whether an intervention to improve visuospatial WM capacity can be implemented to reduce re-experiencing symptoms.
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Affiliation(s)
- Abel S Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Salahadin Lotfi
- Department of Psychology, University of Wisconsin-Milwaukee, USA; Rogers Behavioral Health, Research Center and Clinical Effectiveness Department, USA
| | | | - Sadie E Larsen
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | - Caron Dean
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | | | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, USA.
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10
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Marquardt CA, Pokorny VJ, Disner SG, Nelson NW, McGuire KA, Sponheim SR. Inefficient Attentional Control Explains Verbal-Memory Deficits Among Military Veterans With Posttraumatic Reexperiencing Symptoms. Clin Psychol Sci 2022; 10:499-513. [PMID: 38020495 PMCID: PMC10663645 DOI: 10.1177/21677026211025018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 05/16/2021] [Indexed: 12/01/2023]
Abstract
Among individuals with posttraumatic stress disorder (PTSD), verbal learning and memory are areas of weakness compared with other cognitive domains (e.g., visuospatial memory). In this study, previously deployed military veterans completed clinical assessments of word memory and vocabulary (n = 243) and a laboratory task measuring encoding, free recall, repetition priming, and recognition of words (n = 147). Impaired verbal memory was selectively related to reexperiencing symptoms of PTSD but was not associated with other symptom groupings or blast-induced traumatic brain injury. Implicit priming of response times following word repetition was also unrelated to clinical symptoms. Instead, slowed response times during encoding explained associations between reexperiencing and memory performance. These findings are consistent with alterations in attentional control explaining PTSD-related verbal-memory deficits. Such findings have implications for understanding trauma-focused psychotherapy and recovery, which may depend on efficient attentional processing of words to alter posttraumatic reexperiencing symptoms.
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Affiliation(s)
- Craig A. Marquardt
- Department of Psychiatry and Behavioral Sciences, University of Minnesota
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
| | - Victor J. Pokorny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
- Department of Psychology, University of Minnesota–Twin Cities
| | - Seth G. Disner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
| | | | | | - Scott R. Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
- Department of Psychology, University of Minnesota–Twin Cities
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11
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Imbriano G, Mohanty A, Rajaram S, Ruggero C, Miao J, Clouston S, Luft B, Kotov R, Mohanty A. Association of attention and memory biases for negative stimuli with post-traumatic stress disorder symptoms. J Anxiety Disord 2022; 85:102509. [PMID: 34891061 PMCID: PMC8996384 DOI: 10.1016/j.janxdis.2021.102509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 09/26/2021] [Accepted: 11/20/2021] [Indexed: 01/03/2023]
Abstract
Cognitive models have highlighted the role of attentional and memory biases towards negatively-valenced emotional stimuli in the maintenance of post-traumatic stress disorder (PTSD). However, previous research has focused mainly on attentional biases towards distracting (task-irrelevant) negative stimuli. Furthermore, attentional and memory biases have been examined in isolation and the links between them remain underexplored. We manipulated attention during encoding of trauma-unrelated negative and neutral words and examined the differential relationship of their encoding and recall with PTSD symptoms. Responders to the World Trade Center disaster (N = 392) performed tasks in which they read negative and neutral words and reported the color of another set of such words. Subsequently, participants used word stems to aid retrieval of words shown earlier. PTSD symptoms were associated with slower response times for negative versus neutral words in the word-reading task (r = 0.170) but not color-naming task. Furthermore, greater PTSD symptom severity was associated with more accurate recall of negative versus neutral words, irrespective of whether words were encoded during word-reading or color-naming tasks (F = 4.11, p = 0.044, ηp2 = 0.018). Our results show that PTSD symptoms in a trauma-exposed population are related to encoding of trauma-unrelated negative versus neutral stimuli only when attention was voluntarily directed towards the emotional aspects of the stimuli and to subsequent recall of negative stimuli, irrespective of attention during encoding.
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Affiliation(s)
| | - Aprajita Mohanty
- Department of Psychology, Stony Brook University, United States.
| | - Suparna Rajaram
- Department of Psychology, Stony Brook University, United States
| | - Camilo Ruggero
- Department of Psychology, University of North Texas, United States
| | - Jiaju Miao
- Department of Psychiatry, Stony Brook University, United States
| | - Sean Clouston
- Program in Public Health, Stony Brook University, United States
| | - Benjamin Luft
- Program in Public Health, Stony Brook University, United States
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, United States
| | - Aprajita Mohanty
- Department of Psychology, Stony Brook University, United States.
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12
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Rubin M, Bhattacharya N, Gwizdka J, Griffin Z, Telch M. The influence of PTSD symptoms on selective visual attention while reading. Cogn Emot 2021; 36:527-534. [PMID: 34923917 DOI: 10.1080/02699931.2021.2016639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A large body of research has provided evidence that Posttraumatic Stress Disorder (PTSD) symptoms are associated with broad changes in attentional processes which are in turn implicated in core facets of emotion regulation. However, prior research has primarily focused on specific task-based evaluations of attention. In the current study, we evaluated eye movement behaviour among adults that endorsed a traumatic event meeting Criterion A and were experiencing a range of PTSD symptoms (N = 55) while they read short trauma-related or neutral passages. We found evidence that PTSD symptoms were associated with a small difference in attentional processes between the two types of passages, with longer first fixations to words in trauma-related passages b = 1.92, 95% CI [0.31, 3.56]. Moreover, within the trauma-related texts we found that greater PTSD symptoms were associated with longer total fixation times b = 9.53, 95% CI [2.20, 16.83] and a greater number of regressions b = 0.07, 95% CI [0.01,0.13] to trauma-related words. Inclusion of an additional 25 participants not endorsing a trauma that met Criterion A did not influence the results in any meaningful way. For the first time, we provide evidence that PTSD symptoms are linked to bias for trauma-related information during a naturalistic, everyday activity - reading.
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Affiliation(s)
- Mikael Rubin
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | | | - Jacek Gwizdka
- School of Information, University of Texas at Austin, Austin, TX, USA
| | - Zenzi Griffin
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Michael Telch
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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13
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Espeleta HC, Taylor DL, Kraft JD, Grant DM. Child maltreatment and cognitive vulnerabilities: Examining the link to posttraumatic stress symptoms. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:759-766. [PMID: 31944931 DOI: 10.1080/07448481.2019.1706538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/18/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
Research attempting to identify pathways from childhood maltreatment to adulthood posttraumatic stress symptoms (PTSS) implicates cognitive vulnerabilities that may increase risk for mental health concerns. The present study examined two cognitive vulnerabilities and their relation to PTSS amongst individuals with and without childhood maltreatment histories: attentional control and repetitive negative thinking (RNT). This research surveyed college students (N = 376) on constructs of interest. Results revealed that attentional control and RNT demonstrated significant indirect effects on PTSS (95% CI =.0003, .0336 and 95% CI =.0643, .1857, respectively). Findings suggest that childhood maltreatment severity was related to decreased attentional control and increased RNT, which were then both related to increased PTSS. Interventions for increasing attentional control and decreasing RNT should be implemented and evaluated for young adults with early adversity currently experiencing PTSS.
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Affiliation(s)
- Hannah C Espeleta
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Danielle L Taylor
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Jacob D Kraft
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - DeMond M Grant
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
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14
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Leblanc-Sirois Y, Chouinard-Gaouette L, Grégoire L, Blanchette I. Perceptual processing of stimuli related to an analogue traumatic event: An ERP study. Brain Cogn 2021; 153:105774. [PMID: 34385084 DOI: 10.1016/j.bandc.2021.105774] [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: 02/05/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
Previous research has suggested that exposure to potentially traumatic events can lead to increased perceptual processing specific to trauma-related stimuli. Moreover, conceptual processing strategies during encoding may reduce the effect of trauma exposure on perceptual processing. The current study investigated the effect of a trauma film on perceptual processing with visual evoked potentials. Participants were primed with perceptual or conceptual processing strategies, then viewed a trauma film and a control film. Participants then looked at emotionally negative and neutral images that were related or unrelated to the films. The amplitude of the P1 evoked potential was measured during image presentation. P1 amplitude was more positive specifically for negative film-related stimuli. Moreover, this effect was stronger in participants primed with perceptual processing. These results suggest that potentially traumatic events increase perceptual processing specifically for trauma-related stimuli, and that conceptual encoding strategies attenuate the effect of exposure to potentially traumatic events on perception.
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Affiliation(s)
| | | | - Laurent Grégoire
- Department of Psychological and Brain Sciences, Texas A and M University, United States
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15
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Memel M, Lynch K, Lafleche G, Verfaellie M. Autobiographical recall of a stressful negative event in veterans with PTSD. Memory 2021; 29:719-728. [PMID: 34148527 PMCID: PMC10068628 DOI: 10.1080/09658211.2021.1940204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterised by alterations in autobiographical memory for traumatic and non-traumatic events. Studies that focus on event construction - the ability to search for and identify a specific event - have documented overgeneral memory in PTSD. However, the quality of autobiographical memory also depends on the ability to elaborate on an event once constructed by providing additional details. In a prior study, individuals with PTSD generated as many episodic (event-specific) details as trauma-exposed controls when demands on event construction were minimized, albeit the PTSD group generated more non-episodic details. The current study sought to further characterize PTSD-related alterations in event elaboration by asking participants to describe a stressful negative event specified by the experimenter, thus minimizing event construction demands. Narratives were scored for episodic and non-episodic details and relations with measures of executive function and self-reported avoidance were examined. Compared to controls, the PTSD group generated narratives with equivalent episodic detail but greater non-episodic detail, including semantic information and repeated or extended events. Non-episodic detail generation was associated with greater avoidance but not executive functions. Elaborated non-trauma memories may be perceived as overgeneral in PTSD due to greater generation of non-episodic details, rather than diminished episodic detail.
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Affiliation(s)
- Molly Memel
- San Francisco VA Medical Center, San Francisco, CA, USA
| | | | | | - Mieke Verfaellie
- VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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16
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Notebaert L, Clarke PJ, Macleod C. Does attentional bias to threat ameliorate or exacerbate the detrimental effect of trait anxiety on behavioural preparedness for real‐world danger? AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Lies Notebaert
- Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Crawley, Western Australia, Australia,
| | - Patrick J.f. Clarke
- Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Crawley, Western Australia, Australia,
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia,
| | - Colin Macleod
- Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Crawley, Western Australia, Australia,
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17
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Zhukova MA, Ovchinnikova IV, An I, Grigorenko EL. Altered neural processing of emotional words in adults with a history of institutionalization: Evidence from the emotional Stroop task. Eur J Neurosci 2020; 53:1487-1497. [PMID: 33080077 DOI: 10.1111/ejn.15015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
We investigated neural correlates of traumatic experience related to the lack of family care in adults with a history of institutionalization (IC) using the Emotional Stroop paradigm. The goals of our study were twofold: we investigated whether adults with IC history (n = 24; Mage = 22.17, SD = 6.7) demonstrate atypical processing of emotionally salient words in general, and whether they exhibit selective processing bias toward family related words compared to adults raised in biological families (BFC; n = 28; Mage = 22.25, SD = 4.9). Results demonstrated significant differences in accuracy but not response times between groups on the behavioral level, indicating that the IC group was overall less accurate in identifying the color of the font. Contrary to our prediction, there were no significant differences between neural response to family related versus unrelated words in the IC and BFC groups. The absence of group differences can be explained by the selection of stimuli, which were associated with family rather than institutional history. The IC group showed a larger N280-380 component in response to negative words compared to the BFC group, and larger negativity in the right parietal area in response to positive words in the same time window. Results demonstrate that institutional history is marked by altered emotional processing in the subpopulation of institutional care-leavers, but the footprint is not specific to traumatic experience and extends from general sensitivity to emotional words.
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Affiliation(s)
- Marina A Zhukova
- Saint-Petersburg State University, Saint-Petersburg, Russian Federation.,University of Houston, Houston, TX, USA
| | - Irina V Ovchinnikova
- Saint-Petersburg State University, Saint-Petersburg, Russian Federation.,University of Houston, Houston, TX, USA
| | - Iuliia An
- Saint-Petersburg State University, Saint-Petersburg, Russian Federation
| | - Elena L Grigorenko
- Saint-Petersburg State University, Saint-Petersburg, Russian Federation.,University of Houston, Houston, TX, USA.,Baylor College of Medicine, Houston, TX, USA.,Yale University, New Haven, CT, USA.,Moscow State University for Psychology and Education, Moscow, Russian Federation
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18
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Yip VT, Tong M. W. E. Self-compassion and attention: self-compassion facilitates disengagement from negative stimuli. THE JOURNAL OF POSITIVE PSYCHOLOGY 2020. [DOI: 10.1080/17439760.2020.1778060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Vania T. Yip
- Department of Psychology, Yale-National University of Singapore, Singapore, Singapore
| | - Eddie Tong M. W.
- Department of Psychology, National University of Singapore, Singapore, Singapore
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19
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Quinones MM, Gallegos AM, Lin FV, Heffner K. Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:455-480. [PMID: 32170605 PMCID: PMC7682894 DOI: 10.3758/s13415-020-00782-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.
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Affiliation(s)
- Maria M Quinones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Autumn M Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Feng Vankee Lin
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
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20
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Parker AM, Finucane ML, Ayer L, Ramchand R, Parks V, Clancy N. Persistent Risk-Related Worry as a Function of Recalled Exposure to the Deepwater Horizon Oil Spill and Prior Trauma. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:624-637. [PMID: 31858633 DOI: 10.1111/risa.13437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Large oil spills are disasters associated with psychological effects for exposed communities. The amount of worry that individuals experience after a disaster may be influenced by many factors, such as the type and extent of exposure to disaster impacts, prior trauma, and sociodemographic characteristics. This study examined the nature and predictors of worry about ongoing impacts of the 2010 Deepwater Horizon (DH) oil spill reported by Gulf of Mexico coastal residents. A random sample of 2,520 adult residents of Gulf of Mexico coastal counties were administered a telephone survey in 2016, including items about persistent worry and exposure to DH impacts, prior trauma, residence at the time of the spill, and sociodemographic characteristics. Respondents varied in the amount of worry they reported about ongoing health, social, and economic impacts. Controlling for sociodemographic characteristics, higher exposure to the DH oil spill was related to higher levels of worry about ongoing impacts, with past traumatic events related specifically to worry about health impacts. Unexpectedly, those who moved into the region after the spill showed similar levels of worry to residents exposed to the spill, and higher levels than residents who did not recall being exposed to the DH oil spill. This study highlights the impact of the DH oil spill on coastal residents many years after the DH disaster. The findings underscore the need to examine multiple pathways by which individuals experience disasters and for risk researchers to close knowledge gaps about long-term impacts of oil spills within a multi-dimensional framework.
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21
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Gonzalez-Mendez R, Yagual SN, Marrero H. Attentional bias towards resilience-related words is related to post-traumatic growth and personality traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2019.109715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment. Mindfulness (N Y) 2020; 11:975-990. [PMID: 32382357 DOI: 10.1007/s12671-020-01322-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives Individuals with a childhood maltreatment history tend to have various psychological symptoms and impaired social functioning. This study aimed to investigate the related therapeutic effects of a mindfulness-based intervention in this population. Methods We analyzed self-report questionnaire scores of the Mindful Attention Awareness Scale (MAAS), Non-Attachment Scale (NAS), Adult Rejection Sensitivity Questionnaire (A-RSQ), Interpersonal Reactivity Index (IRI), PTSD CheckList (PCL), and Anxiety Sensitivity Index (ASI), from 16 (3 males) young adults (age range 22-29) with mild to moderate childhood maltreatment, compared to 18 matched participants (6 males) on a waiting list, during both pre- and post-intervention/waiting periods. Analyses were conducted with linear mixed effects models, partial correlation analyses and t-tests. Results There were group by time interaction effects with the scores of MAAS, NAS, PCL, IRI-Fantasy, and A-RSQ (p < .05). The mindfulness group had significant increase in MAAS (17.325%) and NAS (8.957%) scores, as well as reduction in PCL (15.599%) and A-RSQ (23.189%) scores (p < .05). Changes in non-attachment, but not mindfulness, had significant contributions to the score changes of PCL (16.375%), ASI (36.244%), IRI-Personal Distress (24.141%), IRI-Empathic Concern (16.830%), and A-RSQ (10.826%) (p < .05). The number of intervention sessions attended was correlated with score changes of NAS (r = .955, p < .001), and ASI (r = -.887, p < .001), suggesting a dose-dependent effect. Conclusions Findings from this pilot study suggest that the mindfulness-based intervention improved mindfulness, non-attachment and empathy, which contributed to reduced interpersonal distress, rejection sensitivity and other psychological symptoms.
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23
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Wilson KM, Millner AJ, Auerbach RP, Glenn CR, Kearns JC, Kirtley OJ, Najmi S, O’Connor RC, Stewart JG, Cha CB. Investigating the psychometric properties of the Suicide Stroop Task. Psychol Assess 2019; 31:1052-1061. [PMID: 31070448 PMCID: PMC7011179 DOI: 10.1037/pas0000723] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Behavioral measures are increasingly used to assess suicidal thoughts and behaviors. Some measures, such as the Suicide Stroop Task, have yielded mixed findings in the literature. An understudied feature of these behavioral measures has been their psychometric properties, which may affect the probability of detecting significant effects and reproducibility. In the largest investigation of its kind, we tested the internal consistency and concurrent validity of the Suicide Stroop Task in its current form, drawing from seven separate studies (N = 875 participants, 64% female, aged 12 to 81 years). Results indicated that the most common Suicide Stroop scoring approach, interference scores, yielded unacceptably low internal consistency (rs = -.09-.13) and failed to demonstrate concurrent validity. Internal consistency coefficients for mean reaction times (RTs) to each stimulus type ranged from rs = .93-.94. All scoring approaches for suicide-related interference demonstrated poor classification accuracy (AUCs = .52-.56) indicating that scores performed near chance in their ability to classify suicide attempters from nonattempters. In the case of mean RTs, we did not find evidence for concurrent validity despite our excellent reliability findings, highlighting that reliability does not guarantee a measure is clinically useful. These results are discussed in the context of the wider implications for testing and reporting psychometric properties of behavioral measures in mental health research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Kelly M. Wilson
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons
| | - Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Jaclyn C. Kearns
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | | | - Sadia Najmi
- Department of Psychology, San Diego State University Department of Psychiatry
| | - Rory C. O’Connor
- Suicidal Behavior Research Laboratory, Institute of Health & Wellbeing, University of Glasgow
| | - Jeremy G. Stewart
- Center for Depression, Anxiety and Stress Research, McLean Hospital
- Department of Psychiatry, Harvard Medical School
| | - Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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24
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Abstract
There is substantial evidence that heightened anxiety vulnerability is characterized by increased selective attention to threatening information. The reliability of this anxiety-linked attentional bias has become the focus of considerable recent interest. We distinguish between the potential inconsistency of anxiety-linked attentional bias and inconsistency potentially reflecting the psychometric properties of the assessment approaches used to measure it. Though groups with heightened anxiety vulnerability often exhibit, on average, elevated attention to threat, the evidence suggests that individuals are unlikely to each display a stable, invariant attentional bias to threat. Moreover, although existing assessment approaches can differentiate between groups, they do not exhibit the internal consistency or test-retest reliability necessary to classify individuals in terms of their characteristic pattern of attentional responding to threat. We discuss the appropriate uses of existing attentional bias assessment tasks and propose strategies for enhancing classification of individuals in terms of their tendency to display an attentional bias to threat.
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Affiliation(s)
- Colin MacLeod
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Western Australia 6009, Australia
| | - Ben Grafton
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Western Australia 6009, Australia
| | - Lies Notebaert
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Western Australia 6009, Australia
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25
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Joyal M, Wensing T, Levasseur-Moreau J, Leblond J, T. Sack A, Fecteau S. Characterizing emotional Stroop interference in posttraumatic stress disorder, major depression and anxiety disorders: A systematic review and meta-analysis. PLoS One 2019; 14:e0214998. [PMID: 30964902 PMCID: PMC6456228 DOI: 10.1371/journal.pone.0214998] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 03/25/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder is a debilitating psychiatric disorder characterized by symptoms of intrusive re-experiencing of trauma, avoidance and hyper-arousal. Diagnosis and treatment of PTSD is further complicated by concurrently occurring disorders, the most frequent being major depressive disorder and anxiety disorders. Previous research highlights that attentional processing in posttraumatic stress disorder is associated with substantial interference by emotional stimuli, a phenomenon also observed in these concurrently occurring psychiatric disorders. However, the diagnosis-relevance of this interference remains elusive. Here, we investigated the emotional Stroop interference for diagnosis-related stimuli, generally negative stimuli, and generally positive stimuli in posttraumatic stress disorder, major depressive disorder and anxiety disorders. METHODS We performed a systematic database search in PubMed (Medline), Cochrane Library and PsycINFO on emotional Stroop performance in individuals with a diagnosis of posttraumatic stress disorder, major depressive disorder or anxiety disorders separately. Mean effect sizes, standard errors and confidence intervals were estimated for each clinical group and healthy control group comparison using random effect models. RESULTS As compared to healthy control group, the posttraumatic stress disorder group displayed greater interference by diagnosis-related stimuli and positive stimuli but not for generally negative stimuli. The major depressive disorder and anxiety disorders groups showed greater interference by diagnosis-related and negative stimuli, but not by positive stimuli. The age and sex had no significant impact on interference. CONCLUSIONS These findings highlight the importance of diagnosis-relevant information on attentional processing in all three clinical populations, posttraumatic stress disorder, major depressive disorder and anxiety disorders. Further, the impact of generally negative stimuli but not generally positive stimuli in major depressive disorder and anxiety disorders indicate impaired attentional bias for mood-congruent stimuli but not for general stimuli. Finally, it remains to be studied whether the influence of generally positive stimuli in posttraumatic stress disorder indicate that positive stimuli are perceived as PTSD related.
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Affiliation(s)
- Marilyne Joyal
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Tobias Wensing
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Jean Levasseur-Moreau
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Jean Leblond
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Alexander T. Sack
- Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
| | - Shirley Fecteau
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- * E-mail:
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26
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Lazarov A, Suarez-Jimenez B, Tamman A, Falzon L, Zhu X, Edmondson DE, Neria Y. Attention to threat in posttraumatic stress disorder as indexed by eye-tracking indices: a systematic review. Psychol Med 2019; 49:705-726. [PMID: 30178728 PMCID: PMC6399079 DOI: 10.1017/s0033291718002313] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive models of posttraumatic stress disorder (PTSD) implicate threat-related attentional biases in the etiology and phenomenology of the disorder. However, extant attentional research using reaction time (RT)-based paradigms and measures has yielded mixed results. Eye-tracking methodology has emerged in recent years to overcome several inherent drawbacks of RT-based tasks, striving to better delineate attentional processes. METHODS A systematic review of experimental studies examining threat-related attention biases in PTSD, using eye-tracking methodology and group-comparison designs, was conducted conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were selected following a systematic search for publications between 1980 and December 2017 in PsycINFO, MEDLINE and the National Center for PTSD Research's Published International Literature on Traumatic Stress (PILOTS) database. Additional records were identified by employing the Similar Articles feature in PubMed, and the Cited Reference Search in ISI Web of Science. Reference sections of review articles, book chapters and studies selected for inclusion were searched for further studies. Ongoing studies were also sought through Clinicaltrials.gov. RESULTS A total of 11 studies (n = 456 participants in total) were included in the final review. Results indicated little support for enhanced threat detection, hypervigilance and attentional avoidance. However, consistent evidence emerged for sustained attention on threat (i.e. attention maintenance) in PTSD. CONCLUSIONS This review is the first to systematically evaluate extant findings in PTSD emanating from eye-tracking studies employing group-comparison designs. Results suggest that sustained attention on threat might serve as a potential target for therapeutic intervention.
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Affiliation(s)
- Amit Lazarov
- Department of Psychiatry,Columbia University Medical Center,New York Psychiatric Institute,New York, NY,USA
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry,Columbia University Medical Center,New York Psychiatric Institute,New York, NY,USA
| | | | - Louise Falzon
- Department of Medicine,Columbia University Medical Center,New York, NY,USA
| | - Xi Zhu
- Department of Psychiatry,Columbia University Medical Center,New York Psychiatric Institute,New York, NY,USA
| | - Donald E Edmondson
- Department of Medicine,Columbia University Medical Center,New York, NY,USA
| | - Yuval Neria
- Department of Psychiatry,Columbia University Medical Center,New York Psychiatric Institute,New York, NY,USA
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27
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Iffland B, Weitkämper A, Weitkämper NJ, Neuner F. Attentional avoidance in peer victimized individuals with and without psychiatric disorders. BMC Psychol 2019; 7:12. [PMID: 30795803 PMCID: PMC6387543 DOI: 10.1186/s40359-019-0284-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/13/2019] [Indexed: 12/28/2022] Open
Abstract
Background Attentional biases are a relatively robust phenomenon among clinical populations but less pronounced in healthy participants. However, regarding the components of attentional biases and the directions of attention allocation, there are several inconsistencies in the literature. The present study examined whether these inconsistencies can be traced back to previous experiences of relational peer victimization in clinical populations. Methods Participants were subjects with a diagnosed psychiatric disorder (n = 30) and healthy controls (n = 31). Additionally, the sample was divided into two subgroups according to the participants’ reports of previous relational peer victimization (high peer victimization: n = 28; low peer victimization: n = 33). Attentional biases were measured by the Emotional Stroop task and a dot-probe task. Results In both samples, peer victimized participants showed delayed response times when color-naming negative and positive compared to neutral adjectives in the Emotional Stroop task. Likewise, the dot-probe task indicated attentional avoidance of both negative and positive words in peer victimized participants with and without a psychiatric disorder. Interestingly, presence of a psychiatric disorder did not have a significant effect on attentional biases. Conclusion Both tasks could detect that attentional processes were linked to the experience of peer victimization rather than to the current diagnostic status of the participants. Attentional avoidance of emotional stimuli may prevent victimized individuals from responding adequately to environmental stimuli, which may increase the risk for the development of psychopathology.
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Affiliation(s)
- Benjamin Iffland
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany.
| | - Angelina Weitkämper
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany
| | - Nicolai J Weitkämper
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany
| | - Frank Neuner
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany
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Ashley V, Swick D. Angry and Fearful Face Conflict Effects in Post-traumatic Stress Disorder. Front Psychol 2019; 10:136. [PMID: 30804838 PMCID: PMC6370733 DOI: 10.3389/fpsyg.2019.00136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/15/2019] [Indexed: 11/13/2022] Open
Abstract
In the presence of threatening stimuli, post-traumatic stress disorder (PTSD) can manifest as hypervigilance for threat and disrupted attentional control. PTSD patients have shown exaggerated interference effects on tasks using trauma-related or threat stimuli. In studies of PTSD, faces with negative expressions are often used as threat stimuli, yet angry and fearful facial expressions may elicit different responses. The modified Eriksen flanker task, or the emotional face flanker, has been used to examine response interference. We compared 23 PTSD patients and 23 military controls on an emotional face flanker task using angry, fearful and neutral expressions. Participants identified the emotion of a central target face flanked by faces with either congruent or incongruent emotions. As expected, both groups showed slower reaction times (RTs) and decreased accuracy on emotional target faces, relative to neutral. Unexpectedly, both groups showed nearly identical interference effects on fearful and neutral target trials. However, post hoc testing suggested that PTSD patients showed faster RTs than controls on congruent angry faces (target and flanker faces both angry) relative to incongruent, although this finding should be interpreted with caution. This possible RT facilitation effect with angry, but not fearful faces, also correlated positively with self-report measures of PTSD symptoms. These results suggest that PTSD patients may be more vigilant for, or primed to respond to, the appearance of angry faces, relative to fearful, but further study is needed.
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Affiliation(s)
- Victoria Ashley
- Research Service, Veterans Affairs Northern California Health Care System, Martinez, CA, United States
| | - Diane Swick
- Research Service, Veterans Affairs Northern California Health Care System, Martinez, CA, United States.,Department of Neurology, University of California, Davis, Davis, CA, United States
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Terpou BA, Densmore M, Thome J, Frewen P, McKinnon MC, Lanius RA. The Innate Alarm System and Subliminal Threat Presentation in Posttraumatic Stress Disorder: Neuroimaging of the Midbrain and Cerebellum. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2019; 3:2470547018821496. [PMID: 32440590 PMCID: PMC7219880 DOI: 10.1177/2470547018821496] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/28/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND The innate alarm system, a network of interconnected midbrain, other brainstem, and thalamic structures, serves to rapidly detect stimuli in the environment prior to the onset of conscious awareness. This system is sensitive to threatening stimuli and has evolved to process these stimuli subliminally for hastened responding. Despite the conscious unawareness, the presentation of subliminal threat stimuli generates increased activation of limbic structures, including the amygdala and insula, as well as emotionally evaluative structures, including the cerebellum and orbitofrontal cortex. Posttraumatic stress disorder (PTSD) is associated with an increased startle response and decreased extinction learning to conditioned threat. The role of the innate alarm system in the clinical presentation of PTSD, however, remains poorly understood. METHODS Here, we compare midbrain, brainstem, and cerebellar activation in persons with PTSD (n = 26) and matched controls (n = 20) during subliminal threat presentation. Subjects were presented with masked trauma-related and neutral stimuli below conscious threshold. Contrasts of subliminal brain activation for the presentation of neutral stimuli were subtracted from trauma-related brain activation. Group differences in activation, as well as correlations between clinical scores and PTSD activation, were examined. Imaging data were preprocessed utilizing the spatially unbiased infratentorial template toolbox within SPM12. RESULTS Analyses revealed increased midbrain activation in PTSD as compared to controls in the superior colliculus, periaqueductal gray, and midbrain reticular formation during subliminal threat as compared to neutral stimulus presentation. Controls showed increased activation in the right cerebellar lobule V during subliminal threat presentation as compared to PTSD. Finally, a negative correlation emerged between PTSD patient scores on the Multiscale Dissociation Inventory for the Depersonalization/Derealization subscale and activation in the right lobule V of the cerebellum during the presentation of subliminal threat as compared to neutral stimuli. CONCLUSION We interpret these findings as evidence of innate alarm system overactivation in PTSD and of the prominent role of the cerebellum in the undermodulation of emotion observed in PTSD.
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Affiliation(s)
- Braeden A. Terpou
- Department of Neuroscience, Western
University, London, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
| | - 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
| | - Paul Frewen
- Department of Neuroscience, Western
University, London, Ontario, Canada
- Department of Psychology, 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 Neuroscience, Western
University, London, Ontario, Canada
- Department of Psychiatry, Western
University, London, Ontario, Canada
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30
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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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31
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Zhang W, De Beuckelaer A, Chen L, Zhou R. ERP Evidence for Inhibitory Control Deficits in Test-Anxious Individuals. Front Psychiatry 2019; 10:645. [PMID: 31551835 PMCID: PMC6743369 DOI: 10.3389/fpsyt.2019.00645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/08/2019] [Indexed: 01/02/2023] Open
Abstract
Introduction: Individuals with test anxiety [i.e., high test anxiety (HTA)] always treat tests/examinations as a potential threat. This cognitive mode impairs these individuals' ability of inhibitory control and leads to a high level of anxiety. However, characterizing aspects of HTA's impaired inhibitory control ability are unclear and need to be studied. Methods: Forty-six participants were recruited and divided into a HTA (N = 26) and low test anxiety (LTA; i.e., healthy control; N = 20) group. Self-reports (Test Anxiety Scale, State-Trait Anxiety Inventory for negative emotions) were obtained. An emotional Stroop (ES) task and a numerical Stroop (NS) task, causing different types of interferences, were used for assessing the emotional and cognitive aspects of attentional control ability (behavioral data). Event-related brain potentials (ERPs) were registered to further assess processing stages related to different aspects of attentional control ability. Results: Compared with the LTA group, the HTA group has inhibitory control deficits of both emotional (see ERP components P1-P2-N2 and P3) and cognitive (see ERP component P3) interference. Compared with the LTA group, the HTA doesn't have lower accuracy in neither ES nor NS but displays longer reaction times only in ES. Additionally, the HTA group's ES results also show that (1) the degree of emotional interference indicates the level of an individual's anxiety, and (2) the ERP component P2 may serve as an index of the level of test anxiety. Conclusion: HTA individuals have extensive inhibitory deficits for both emotional and cognitive aspects; however, impairment impacts more on emotional aspects than on cognitive aspects. Additionally, as compared to NS, the negative impact of more impaired processing stages on task performance is more substantial in ES.
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Affiliation(s)
- Wenpei Zhang
- Department of Psychology, Nanjing University, Nanjing, China.,Department of Business Administration, School of Business, Anhui University of Technology, Maanshan, China
| | - Alain De Beuckelaer
- Institute for Management Research, Radboud University, Nijmegen, Netherlands.,Department of Personnel Management, Work and Organizational Psychology, Ghent University, Ghent, Belgium
| | - Lirong Chen
- Department of Psychology, Nanjing University, Nanjing, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, China.,Key Laboratory for NeuroInformation of Ministry of Education, University of Electronic Science and Technology of China, Chengdu, China
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Dutra SJ, Marx BP, McGlinchey R, DeGutis J, Esterman M. Reward Ameliorates Posttraumatic Stress Disorder-Related Impairment in Sustained Attention. ACTA ACUST UNITED AC 2018; 2. [PMID: 30706031 PMCID: PMC6350805 DOI: 10.1177/2470547018812400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Posttraumatic stress disorder is associated with impairments in
sustained attention, a fundamental cognitive process
important for a variety of social and occupational tasks. To date, however,
the precise nature of these impairments and the posttraumatic stress
disorder symptoms associated with them have not been well understood. Methods Using a well-characterized sample of returning United States military
OEF/OIF/OND Veterans who varied in posttraumatic stress disorder symptoms,
we employed a validated sustained attention paradigm designed to probe
fluctuations across two attentional states characterized by prior research,
including a peak state termed “in the zone” and a less efficient, more
error-prone state termed “out of the zone.” Rewarded and nonrewarded
conditions were employed to examine whether motivating strong task
performance could ameliorate sustained attention deficits. Analyses examined
associations between attentional state, availability of reward, and
posttraumatic stress disorder symptoms. Results Results indicated that, consistent with prior findings, higher levels of
posttraumatic stress disorder symptoms were broadly associated with impaired
task performance. This impairment was driven largely by performance deficits
during individuals' optimal (“in the zone”) attentional state, and follow-up
analyses indicated that the performance deficit was primarily associated
with anhedonia and emotional numbing symptoms. However, the deficit was
partially ameliorated when better performance was rewarded. Conclusion Our results provide a more complex understanding of the sustained attention
deficits associated with posttraumatic stress disorder and suggest that
external incentives may help to enhance sustained attention performance for
affected individuals.
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Affiliation(s)
- Sunny J Dutra
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Department of Clinical Psychology, William James College, Newton, MA, USA
| | - Brian P Marx
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph DeGutis
- Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston, MA, USA
| | - Michael Esterman
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.,Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston, MA, USA.,Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
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33
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Gladwin TE, Vink M. Freeze or Forget? Virtual Attack Effects in an Emotional Sternberg Task. EUROPES JOURNAL OF PSYCHOLOGY 2018; 14:342-358. [PMID: 30008950 PMCID: PMC6016026 DOI: 10.5964/ejop.v14i2.1473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/16/2017] [Indexed: 11/24/2022]
Abstract
Emotionally salient stimuli have the ability to disrupt cognitive processing. This kind of disruption involves effects on working memory and may be related to mental health problems. To explore the nature of such emotional interference on working memory, a Virtual Attack Emotional Sternberg Task (VAEST) was used. Neutral faces were presented as distractors and warning signals, which were sometimes followed by a virtual attack, created by having the neutral face turn angry while the image was enlarged. The attack was hypothesized to have one of two effects: to disrupt cognitive processing and thereby increase interference effects, or to terminate a state of freezing and thereby reduce interference effects. The task was successfully completed online by a sample of 59 students. Results clearly show that the virtual attack caused a reduction of interference relative to no-attack trials. The apparent cognitive disruption caused by emotional distractors may thus reflect freezing, which can be reversed by a freeze-terminating stimulus.
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Affiliation(s)
- Thomas Edward Gladwin
- Department of Psychology and Counseling, University of Chichester, Chichester, United Kingdom
| | - Matthijs Vink
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Center, Utrecht, The Netherlands.,Departments of Developmental and Experimental Psychology, Utrecht University, Utrecht, The Netherlands
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Ford JD, Delker BC. Polyvictimization in childhood and its adverse impacts across the lifespan: Introduction to the special issue. J Trauma Dissociation 2018; 19:275-288. [PMID: 29547074 DOI: 10.1080/15299732.2018.1440479] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although much empirical work has focused on the adverse impact of specific types of childhood victimization (e.g., sexual, physical, or emotional abuse), researchers and clinicians increasingly are recognizing the prevalence of polyvictimization, or exposure to multiple types of victimization. Polyvictimization during formative developmental periods may have detrimental and potentially lifelong biopsychosocial impacts over and above the effects of exposure to specific types of adversity. In this guest editorial, we summarize the key questions and findings for six empirical studies on polyvictimization included in this Special Issue of the Journal of Trauma & Dissociation. These empirical studies further our understanding of the nature, consequences, and assessment of polyvictimization. We conclude with recommendations for continued scientific research and clinical inquiry on polyvictimization.
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Affiliation(s)
- Julian D Ford
- a Department of Psychiatry, University of Connecticut Schools of Medicine and Law, Farmington, Connecticut, USA
| | - Brianna C Delker
- b Department of Psychology, Western Washington University, Bellingham, Washington, USA
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35
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Wilkerson AK, Uhde TW, Leslie K, Freeman WC, LaRowe SD, Schumann A, Cortese BM. Paradoxical olfactory function in combat veterans: The role of PTSD and odor factors. MILITARY PSYCHOLOGY 2018; 30:120-130. [PMID: 30220788 DOI: 10.1080/08995605.2018.1425063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Stress- and trauma-related disorders, including posttraumatic stress disorder (PTSD), are characterized by an increased sensitivity to threat cues. Given that threat detection is a critical function of olfaction and that combat trauma is commonly associated with burning odors, we sought a better understanding of general olfactory function as well as response to specific trauma-related (i.e. burning) odors in combat-related PTSD. Trauma-exposed combat veterans with (N = 22) and without (N = 25) PTSD were assessed for general and specific odor sensitivities using a variety of tools. Both groups had similar general odor detection thresholds. However, the combat veterans with PTSD, compared to combat veterans with comparable trauma exposure, but without PTSD, had increased ratings of odor intensity, negative valence, and odor-triggered PTSD symptoms, along with a blunted heart rate in response to burning rubber odor. These findings are discussed within the context of healthy versus pathological changes in olfactory processing that occur over time after psychological trauma.
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Affiliation(s)
| | - Thomas W Uhde
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US
| | - Kimberly Leslie
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US
| | | | - Steven D LaRowe
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US.,Ralph H. Johnson VAMC, Charleston, SC, US
| | - Aicko Schumann
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US
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36
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To WT, De Ridder D, Menovsky T, Hart J, Vanneste S. The role of the dorsal Anterior Cingulate Cortex (dACC) in a cognitive and emotional counting Stroop task: Two cases. Restor Neurol Neurosci 2018; 35:333-345. [PMID: 28598859 DOI: 10.3233/rnn-170730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The anterior cingulate cortex (ACC) has been implicated in both cognitive and emotional processing, with cognitive information proposed to be processed through the dorsal/caudal ACC and emotional information through the rostral/ventral ACC. OBJECTIVE The objective of this study is to investigate the role of the dorsal anterior cingulate cortex (dACC) in cognitive and emotional processing using a cognitive and emotional counting Stroop task in two patients in whom abnormalities in the dACC were identified and treated. METHODS Two patients performed the cognitive and emotional counting Stroop task before and after treatment to examine whether the dACC has a specific or more general processing function. RESULTS We observed an overall improvement in the emotional, cognitive, and neutral trials of the counting Stroop task after the intervention, indicating that the dACC is not a subregion of the ACC that only contributes to a specific domain. CONCLUSION This study reveals that the dACC is not just a subregion of the ACC that contributes to a specific cognitive function, but is rather part of a salience network that influences general brain functioning, influencing cognitive as well as emotional processing.
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Affiliation(s)
- Wing Ting To
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Tomas Menovsky
- Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium
| | - John Hart
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
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37
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Schäfer J, Zvielli A, Höfler M, Wittchen HU, Bernstein A. Trauma, attentional dysregulation, and the development of posttraumatic stress: An investigation of risk pathways. Behav Res Ther 2018; 102:60-66. [DOI: 10.1016/j.brat.2018.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 12/25/2017] [Accepted: 01/08/2018] [Indexed: 11/30/2022]
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Swick D, Ashley V. Enhanced Attentional Bias Variability in Post-Traumatic Stress Disorder and its Relationship to More General Impairments in Cognitive Control. Sci Rep 2017; 7:14559. [PMID: 29109521 PMCID: PMC5673957 DOI: 10.1038/s41598-017-15226-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/23/2017] [Indexed: 01/08/2023] Open
Abstract
Hypervigilance towards threat is one of the defining features of post-traumatic stress disorder (PTSD). This symptom predicts that individuals with PTSD will be biased to attend to potential dangers in the environment. However, cognitive tasks designed to assess visual-spatial attentional biases have shown mixed results. A newer proposal suggests that attentional bias is not a static phenomenon, but rather is characterized by fluctuations towards and away from threat. Here, we tested 28 combat Veterans with PTSD and 28 control Veterans on a dot probe task with negative-neutral word pairs. Combat-related words and generically negative words were presented in separate blocks. Replicating previous results, neither group showed a bias to attend towards or away from threat, but PTSD patients showed greater attentional bias variability (ABV), which correlated with symptom severity. However, the cognitive processes indexed by ABV are unclear. The present results indicated that ABV was strongly correlated with standard deviation at the reaction time (RT) level and with excessively long RTs (ex-Gaussian tau) related to cognitive failures. These findings suggest an overall increase in response variability unrelated to threat-related biases in spatial attention, and support a disruption in more general cognitive control processes in PTSD.
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Affiliation(s)
- Diane Swick
- VA Northern California Health Care System, Martinez, CA, USA.
- University of California, Davis, USA.
| | - Victoria Ashley
- VA Northern California Health Care System, Martinez, CA, USA.
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39
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Associations Among Posttraumatic Stress Disorder Symptoms, Substance Use, and Affective Attentional Processing in OEF/OIF/OND Veterans. J Nerv Ment Dis 2017; 205:725-731. [PMID: 28661934 PMCID: PMC9040388 DOI: 10.1097/nmd.0000000000000702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The majority of research examining affective attentional bias in posttraumatic stress disorder (PTSD) has not examined the influence of co-occurring psychiatric disorders. This study examined the individual and interactive effects of PTSD symptoms and substance use disorders (SUDs) on affective attentional processing among 323 veterans deployed to Iraq or Afghanistan. Participants were divided into those with SUD (SUD+, n = 46) and those without (SUD-, n = 277). Substance use disorder was determined using the Structured Clinical Interview for DSM-IV. Posttraumatic stress disorder was measured using the Clinician Administered PTSD Scale. A computerized go/no-go task (Robbins et al., 1994, Robbins et al.,1998) assessed affective attentional processing. Relative to those without SUD, those with SUD showed a significant association between PTSD symptoms and increased omission and commission accuracy rates and decreased d prime. No effects of valence were found. Findings suggest the need to consider co-occurring SUD when investigating the effects of PTSD on attentional control.
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Zinchenko A, Al-Amin MM, Alam MM, Mahmud W, Kabir N, Reza HM, Burne THJ. Content specificity of attentional bias to threat in post-traumatic stress disorder. J Anxiety Disord 2017; 50:33-39. [PMID: 28551393 DOI: 10.1016/j.janxdis.2017.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 03/12/2017] [Accepted: 05/17/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Attentional bias to affective information and reduced cognitive control may maintain the symptoms of post-traumatic stress disorder (PTSD) and impair cognitive functioning. However, the role of content specificity of affective stimuli (e.g., trauma-related, emotional trauma-unrelated) in the observed attentional bias and cognitive control is less clear, as this has not been tested simultaneously before. Therefore, we examined the content specificity of attentional bias to threat in PTSD. METHODS PTSD participants (survivors of a multistory factory collapse, n=30) and matched controls (n=30) performed an Eriksen Flanker task. They identified the direction of a centrally presented target arrow, which was flanked by several task-irrelevant distractor arrows pointed to the same (congruent) or opposite direction (incongruent). Additionally, participants were presented with a picture of a face (neutral, emotional) or building (neutral=normal, emotional=collapsed multistory factory) as a task-irrelevant background image. RESULTS We found that PTSD participants produced overall larger conflict effects and longer reaction times (RT) to emotional than to neutral stimuli relative to their healthy counterparts. Moreover, PTSD, but not healthy participants showed a stimulus specific dissociation in processing emotional stimuli. Emotional faces elicited longer RTs compared to neutral faces, while emotional buildings elicited faster responses, compared to neutral buildings. CONCLUSIONS PTSD patients show a content-sensitive attentional bias to emotional information and impaired cognitive control.
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Affiliation(s)
- A Zinchenko
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1A, 04103 Leipzig, Germany; Department of General and Experimental Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - M M Al-Amin
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - M M Alam
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - W Mahmud
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - N Kabir
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - H M Reza
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - T H J Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Richlands, QLD 4077, Australia.
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Swick D, Cayton J, Ashley V, Turken AU. Dissociation between working memory performance and proactive interference control in post-traumatic stress disorder. Neuropsychologia 2017; 96:111-121. [PMID: 28077328 DOI: 10.1016/j.neuropsychologia.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 12/20/2022]
Abstract
Deficits in working memory (WM) and cognitive control processes have been reported in post-traumatic stress disorder (PTSD), in addition to clinical symptoms such as hypervigilance, re-experiencing, and avoidance of trauma reminders. Given the uncontrollable nature of intrusive memories, an important question is whether PTSD is associated with altered control of interference in WM. Some studies also suggest that episodic memory shows a material-specific dissociation in PTSD, with greater impairments in verbal memory and relative sparing of nonverbal memory. It is unclear whether this dissociation applies to WM, as no studies have used identical task parameters across material. Here we tested 29 combat Veterans with PTSD and 29 age-matched control Veterans on a recent probes WM task with words and visual patterns in separate blocks. Participants studied four-item sets, followed by a probe stimulus that had been presented in the previous set (recent probe) or not (nonrecent probe). Participants with PTSD made more errors than controls, and this decrement was similar for verbal and visual stimuli. Proactive interference from items recently presented, but no longer relevant, was not significantly different in the PTSD group and showed no relationship to re-experiencing symptom severity. These results demonstrate that PTSD is not reliably associated with increased intrusions of irrelevant representations into WM when non-emotional stimuli are used. Future studies that use trauma-related material may provide insight into the flashbacks and intrusive thoughts that plague those with PTSD.
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Affiliation(s)
- Diane Swick
- VA Northern California Health Care System, Martinez, CA, USA; University of California, Davis, USA.
| | - Julien Cayton
- VA Northern California Health Care System, Martinez, CA, USA.
| | - Victoria Ashley
- VA Northern California Health Care System, Martinez, CA, USA.
| | - And U Turken
- VA Northern California Health Care System, Martinez, CA, USA.
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Gladwin TE. Negative effects of an alternating-bias training aimed at attentional flexibility: a single session study. Health Psychol Behav Med 2016. [DOI: 10.1080/21642850.2016.1266634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Thomas E. Gladwin
- Research Center – Military Mental Health, Ministry of Defense, Utrecht, The Netherlands
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Khanna MM, Badura-Brack AS, McDermott TJ, Shepherd A, Heinrichs-Graham E, Pine DS, Bar-Haim Y, Wilson TW. Attention training normalises combat-related post-traumatic stress disorder effects on emotional Stroop performance using lexically matched word lists. Cogn Emot 2016; 30:1521-1528. [PMID: 26309165 PMCID: PMC5177534 DOI: 10.1080/02699931.2015.1076769] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We examined two groups of combat veterans, one with post-traumatic stress disorder (PTSD) (n = 27) and another without PTSD (n = 16), using an emotional Stroop task (EST) with word lists matched across a series of lexical variables (e.g. length, frequency, neighbourhood size, etc.). Participants with PTSD exhibited a strong EST effect (longer colour-naming latencies for combat-relevant words as compared to neutral words). Veterans without PTSD produced no such effect, t < .918, p > .37. Participants with PTSD then completed eight sessions of attention training (Attention Control Training or Attention Bias Modification Training) with a dot-probe task utilising threatening and neutral faces. After training, participants-especially those undergoing Attention Control Training-no longer produced longer colour-naming latencies for combat-related words as compared to other words, indicating normalised attention allocation processes after treatment.
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Affiliation(s)
- Maya M Khanna
- a Department of Psychology , Creighton University , Omaha , NE , USA
| | | | | | - Alex Shepherd
- a Department of Psychology , Creighton University , Omaha , NE , USA
| | | | - Daniel S Pine
- c National Institute of Mental Health , Rockville , MD , USA
| | - Yair Bar-Haim
- d Department of Psychology and Neuroscience, School of Psychological Sciences , Tel-Aviv University , Tel Aviv-Yafo , Isreal
| | - Tony W Wilson
- e Department of Pharmacology and Experimental Neuroscience, Department of Neurological Sciences, and the Center for Magnetoencephalography , University of Nebraska Medical Center , Omaha , NE , USA
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Goodman AM, Katz JS, Dretsch MN. Military Affective Picture System (MAPS): A new emotion-based stimuli set for assessing emotional processing in military populations. J Behav Ther Exp Psychiatry 2016; 50:152-61. [PMID: 26255051 DOI: 10.1016/j.jbtep.2015.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/24/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Emotionally relevant pictorial stimuli utilized in studies to characterize both normal and pathological emotional responses do not include military scenarios. Failures to replicate consistent findings for military populations have led to speculation that these image sets do not capture personally relevant experiences. METHODS The Military Affective Picture System (MAPS) was developed consisting of 240 images depicting scenes common among military populations. A Self-Assessment Manikin was administered to a 1) U.S. Army soldiers and a 2) non-military population. RESULTS Findings revealed gender differences in valence and dominance dimensions, but not arousal, for both samples. Valence scores were higher for the military. Arousal ratings decrease as a product of combat exposure. Civilian females demonstrated stronger correlations of valence and arousal when viewing positive or negative images. LIMITATIONS Given the limited power achieved in the current studies' gender comparisons; it would be difficult to draw major conclusions regarding the interaction of combat exposure or military status with gender for each of the categories. Without having included the IAPS ratings for comparison it is difficult to conclude whether effects only pertain to viewing MAPS images, or if there was unintentional selection bias. Additional ratings would provide better assessments for these effects in both males and females. CONCLUSIONS The MAPS has potential as a screening instrument and clinical evaluation tool for assessing treatment outcomes for individuals with combat-related psychopathology. The MAPS is freely available for research to non-profit groups upon request at http://www.cla.auburn.edu/psychology/military-affective-picture-system/.
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Affiliation(s)
| | | | - Michael N Dretsch
- National Intrepid Center of Excellence, Bethesda, MD, USA; Army Aeromedical Research Laboratory, Fort Rucker, AL, USA
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Lowe R, Menzies R, Packman A, O'Brian S, Jones M, Onslow M. Assessing attentional biases with stuttering. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:84-94. [PMID: 26176777 DOI: 10.1111/1460-6984.12187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Many adults who stutter presenting for speech treatment experience social anxiety disorder. The presence of mental health disorders in adults who stutter has been implicated in a failure to maintain speech treatment benefits. Contemporary theories of social anxiety disorder propose that the condition is maintained by negative cognitions and information processing biases. Consistent with cognitive theories, the probe detection task has shown that social anxiety is associated with an attentional bias to avoid social information. This information processing bias is suggested to be involved in maintaining anxiety. Evidence is emerging for information processing biases being involved with stuttering. AIMS This study investigated information processing in adults who stutter using the probe detection task. Information processing biases have been implicated in anxiety maintenance in social anxiety disorder and therefore may have implications for the assessment and treatment of stuttering. It was hypothesized that stuttering participants compared with control participants would display an attentional bias to avoid attending to social information. METHODS & PROCEDURES Twenty-three adults who stutter and 23 controls completed a probe detection task in which they were presented with pairs of photographs: a face displaying an emotional expression-positive, negative or neutral-and an everyday household object. All participants were subjected to a mild social threat induction being told they would speak to a small group of people on completion of the task. OUTCOMES & RESULTS The stuttering group scored significantly higher than controls for trait anxiety, but did not differ from controls on measures of social anxiety. Non-socially anxious adults who stutter did not display an attentional bias to avoid looking at photographs of faces relative to everyday objects. Higher scores on trait anxiety were positively correlated with attention towards photographs of negative faces. CONCLUSION & IMPLICATIONS Attentional biases as assessed by the probe detection task may not be a characteristic of non-socially anxious adults who stutter. A vigilance to attend to threat information with high trait anxiety is consistent with findings of studies using the emotional Stroop task in stuttering and social anxiety disorder. Future research should investigate attentional processing in people who stutter who are socially anxious. It will also be useful for future studies to employ research paradigms that involve speaking. Continued research is warranted to explore information processing and potential biases that could be involved in the maintenance of anxiety and failure to maintain the benefits of speech treatment outcomes.
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Affiliation(s)
- Robyn Lowe
- The University of Sydney, Australian Stuttering Research Centre, Lidcombe, NSW, Australia
| | - Ross Menzies
- The University of Sydney, Australian Stuttering Research Centre, Lidcombe, NSW, Australia
| | - Ann Packman
- The University of Sydney, Australian Stuttering Research Centre, Lidcombe, NSW, Australia
| | - Sue O'Brian
- The University of Sydney, Australian Stuttering Research Centre, Lidcombe, NSW, Australia
| | - Mark Jones
- University of Queensland, Herston, QLD, Australia
| | - Mark Onslow
- The University of Sydney, Australian Stuttering Research Centre, Lidcombe, NSW, Australia
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Intact error monitoring in combat Veterans with post-traumatic stress disorder. Psychiatry Res 2015; 234:227-38. [PMID: 26481979 PMCID: PMC5645022 DOI: 10.1016/j.pscychresns.2015.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 08/22/2015] [Accepted: 09/17/2015] [Indexed: 12/20/2022]
Abstract
The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.
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Suárez-Pellicioni M, Núñez-Peña MI, Colomé À. Attentional bias in high math-anxious individuals: evidence from an emotional Stroop task. Front Psychol 2015; 6:1577. [PMID: 26539137 PMCID: PMC4609828 DOI: 10.3389/fpsyg.2015.01577] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/29/2015] [Indexed: 11/17/2022] Open
Abstract
Attentional bias toward threatening or emotional information is considered a cognitive marker of anxiety, and it has been described in various clinical and subclinical populations. This study used an emotional Stroop task to investigate whether math anxiety is characterized by an attentional bias toward math-related words. Two previous studies failed to observe such an effect in math-anxious individuals, although the authors acknowledged certain methodological limitations that the present study seeks to avoid. Twenty high math-anxious (HMA) and 20 low math-anxious (LMA) individuals were presented with an emotional Stroop task including math-related and neutral words. Participants in the two groups did not differ in trait anxiety or depression. We found that the HMA group showed slower response times to math-related words than to neutral words, as well as a greater attentional bias (math-related – neutral difference score) than the LMA one, which constitutes the first demonstration of an attentional bias toward math-related words in HMA individuals.
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Affiliation(s)
- Macarena Suárez-Pellicioni
- Department of Behavioural Sciences Methods, Faculty of Psychology, University of Barcelona Barcelona, Spain ; Institute for Brain, Cognition and Behaviour, University of Barcelona Barcelona, Spain
| | - Maria Isabel Núñez-Peña
- Department of Behavioural Sciences Methods, Faculty of Psychology, University of Barcelona Barcelona, Spain ; Institute for Brain, Cognition and Behaviour, University of Barcelona Barcelona, Spain
| | - Àngels Colomé
- Institute for Brain, Cognition and Behaviour, University of Barcelona Barcelona, Spain ; Department of Basic Psychology, Faculty of Psychology, University of Barcelona Barcelona, Spain
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48
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Saar-Ashkenazy R, Shalev H, Kanthak MK, Guez J, Friedman A, Cohen JE. Altered processing of visual emotional stimuli in posttraumatic stress disorder: an event-related potential study. Psychiatry Res 2015; 233:165-74. [PMID: 26138281 DOI: 10.1016/j.pscychresns.2015.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 02/06/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) display abnormal emotional processing and bias towards emotional content. Most neurophysiological studies in PTSD found higher amplitudes of event-related potentials (ERPs) in response to trauma-related visual content. Here we aimed to characterize brain electrical activity in PTSD subjects in response to non-trauma-related emotion-laden pictures (positive, neutral and negative). A combined behavioral-ERP study was conducted in 14 severe PTSD patients and 14 controls. Response time in PTSD patients was slower compared with that in controls, irrespective to emotional valence. In both PTSD and controls, response time to negative pictures was slower compared with that to neutral or positive pictures. Upon ranking, both control and PTSD subjects similarly discriminated between pictures with different emotional valences. ERP analysis revealed three distinctive components (at ~300, ~600 and ~1000 ms post-stimulus onset) for emotional valence in control subjects. In contrast, PTSD patients displayed a similar brain response across all emotional categories, resembling the response of controls to negative stimuli. We interpret these findings as a brain-circuit response tendency towards negative overgeneralization in PTSD.
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Affiliation(s)
- Rotem Saar-Ashkenazy
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Psychology and the School of Social-work, Ashkelon Academic College, Ashkelon, Israel; Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel
| | - Hadar Shalev
- Department of Psychiatry, Soroka University Medical Center, Beer-Sheva, Israel
| | - Magdalena K Kanthak
- Department of Biological Psychology, Technical University of Dresden, Dresden, Germany
| | - Jonathan Guez
- Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel; Beer-Sheva Mental Health Center, Beer-Sheva, Israel
| | - Alon Friedman
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jonathan E Cohen
- Sharett Institute of Oncology, Hadassah Medical Organization, Kiryat-Hadassah, POB 12000, Jerusalem 91120, Israel.
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Cui H, Liu X, Chen G, Shan M, Jia Y. An event-related potentials study on the attention function of posttraumatic stress disorder. Int J Clin Exp Med 2015; 8:10885-10892. [PMID: 26379882 PMCID: PMC4565265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/12/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE In order to examine the functional defects and attentional bias in post-traumatic stress disorder (PTSD) patients, event-related potentials (ERP) of attention was investigated. METHODS Three groups of emotion pictures, positive, negative (or violent) and neutral, were viewed by 19 PTSD patients and 15 normal controls. Each picture had a frame, and participants reacted to the color of the frame by clicking buttons. Electroencephalogram (EEG) and behavior data were recorded. Peak latencies and amplitudes of P2 were measured. RESULTS For the three groups of pictures, PTSD patients had longer reaction time than the controls. Significant difference was found between PTSD patients and controls in response to violent, positive and neutral pictures.
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Affiliation(s)
- Hong Cui
- Division of Medical Psychology, Chinese People's Liberation Army General Hospital and Medical School Chinese PLA Beijing 100853, China
| | - Xiaohui Liu
- Division of Medical Psychology, Chinese People's Liberation Army General Hospital and Medical School Chinese PLA Beijing 100853, China
| | - Guoliang Chen
- Division of Medical Psychology, Chinese People's Liberation Army General Hospital and Medical School Chinese PLA Beijing 100853, China
| | - Moshui Shan
- Division of Medical Psychology, Chinese People's Liberation Army General Hospital and Medical School Chinese PLA Beijing 100853, China
| | - Yanyan Jia
- Division of Medical Psychology, Chinese People's Liberation Army General Hospital and Medical School Chinese PLA Beijing 100853, China
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Cortese BM, Leslie K, Uhde TW. Differential odor sensitivity in PTSD: Implications for treatment and future research. J Affect Disord 2015; 179:23-30. [PMID: 25845746 PMCID: PMC4437877 DOI: 10.1016/j.jad.2015.03.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Given that odors enhance the retrieval of autobiographical memories, induce physiological arousal, and trigger trauma-related flashbacks, it is reasonable to hypothesize that odors play a significant role in the pathophysiology of posttraumatic stress disorder (PTSD). For these reasons, this preliminary study sought to examine self-reported, odor-elicited distress in PTSD. METHODS Combat veterans with (N=30) and without (N=22) PTSD and healthy controls (HC: N=21), completed an olfactory questionnaire that provided information on the hedonic valence of odors as well as their ability to elicit distress or relaxation. RESULTS Two main findings were revealed: Compared to HC, CV+PTSD, but not CV-PTSD, reported a higher prevalence of distress to a limited number of select odors that included fuel (p=.004), blood (p=.02), gunpowder (p=.03), and burning hair (p=.02). In contrast to this increased sensitivity, a blunting effect was reported by both groups of veterans compared to HC that revealed lower rates of distress and relaxation in response to negative hedonic odors (p=.03) and positive hedonic odors (p<.001), respectively. LIMITATIONS The study is limited by its use of retrospective survey methods, whereas future investigations would benefit from laboratory measures taken prior, during, and after deployment. CONCLUSION The present findings suggest a complex role of olfaction in the biological functions of threat detection. Several theoretical models are discussed. One possible explanation for increased sensitivity to select odors with decreased sensitivity to other odors is the co-occurrence of attentional bias toward threat odors with selective ignoring of distractor odors. Working together, these processes may optimize survival.
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Affiliation(s)
| | - Kimberly Leslie
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US
| | - Thomas W. Uhde
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, US
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