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Esopenko C, Jain D, Adhikari SP, Dams-O'Connor K, Ellis M, Haag HL, Hovenden ES, Keleher F, Koerte IK, Lindsey HM, Marshall AD, Mason K, McNally JS, Menefee DS, Merkley TL, Read EN, Rojcyk P, Shultz SR, Sun M, Toccalino D, Valera EM, van Donkelaar P, Wellington C, Wilde EA. Intimate Partner Violence-Related Brain Injury: Unmasking and Addressing the Gaps. J Neurotrauma 2024. [PMID: 38323539 DOI: 10.1089/neu.2023.0543] [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: 02/08/2024] Open
Abstract
Intimate partner violence (IPV) is a significant, global public health concern. Women, individuals with historically underrepresented identities, and disabilities are at high risk for IPV and tend to experience severe injuries. There has been growing concern about the risk of exposure to IPV-related head trauma, resulting in IPV-related brain injury (IPV-BI), and its health consequences. Past work suggests that a significant proportion of women exposed to IPV experience IPV-BI, likely representing a distinct phenotype compared with BI of other etiologies. An IPV-BI often co-occurs with psychological trauma and mental health complaints, leading to unique issues related to identifying, prognosticating, and managing IPV-BI outcomes. The goal of this review is to identify important gaps in research and clinical practice in IPV-BI and suggest potential solutions to address them. We summarize IPV research in five key priority areas: (1) unique considerations for IPV-BI study design; (2) understanding non-fatal strangulation as a form of BI; (3) identifying objective biomarkers of IPV-BI; (4) consideration of the chronicity, cumulative and late effects of IPV-BI; and (5) BI as a risk factor for IPV engagement. Our review concludes with a call to action to help investigators develop ecologically valid research studies addressing the identified clinical-research knowledge gaps and strategies to improve care in individuals exposed to IPV-BI. By reducing the current gaps and answering these calls to action, we will approach IPV-BI in a trauma-informed manner, ultimately improving outcomes and quality of life for those impacted by IPV-BI.
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Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Divya Jain
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shambhu Prasad Adhikari
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Ellis
- Department of Surgery, Section of Neurosurgery, University of Manitoba, Pan Am Clinic, Winnipeg, Manitoba, Canada
| | - Halina Lin Haag
- Faculty of Social Work, Wilfrid Laurier University, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Elizabeth S Hovenden
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Finian Keleher
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Mass General Brigham, Harvard Medical School, Somerville, Massachusetts, USA
| | - Hannah M Lindsey
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Amy D Marshall
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Karen Mason
- Supporting Survivors of Abuse and Brain Injury through Research (SOAR), Kelowna, British Columbia, Canada
| | - J Scott McNally
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Deleene S Menefee
- Michael E. DeBakey VA Medical Center, The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Tricia L Merkley
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Emma N Read
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Philine Rojcyk
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Mass General Brigham, Harvard Medical School, Somerville, Massachusetts, USA
| | - Sandy R Shultz
- Health Sciences, Vancouver Island University, Nanaimo, Canada
- Department of Neuroscience, Monash University, Alfred Centre, Melbourne, Australia
| | - Mujun Sun
- Department of Neuroscience, Monash University, Alfred Centre, Melbourne, Australia
| | - Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Eve M Valera
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Cheryl Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Elisabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen ,VA Salt Lake City Heathcare System, Salt Lake City, Utah, USA
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Vasileva AV. [Posttraumatic stress disorder clinical guidelines and treatment standards: focus on the symptoms of the psychophysiological arousal]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:58-68. [PMID: 38884431 DOI: 10.17116/jnevro202412405158] [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] [Indexed: 06/18/2024]
Abstract
The article describes the main diagnostic criteria and principles of posttraumatic stress disorder (PTSD) diagnostic with the consideration of risk factors and specific clinical features. The main biomarkers search trends and existing limitations are considered. The role of the psychophysiological arousal symptoms claster is highlighted in the clinical picture of PTSD as well as in connection with the main cluster of re-experiencing symptoms activation and slowing of sanogenesis process. The necessity of PTSD detection in somatic medicine is thoroughly described. The article presents therapeutic algorithms of the latest international and Russian PTSD treatment clinical guidelines based on the individual combination of psychotherapy and psychopharmacotherapy treatment choice. Additionally the accumulated during the last decades national clinical experience of the anxiety disorders treatment, including the symptoms of psychophysiological arousal is highlighted that determined the list of the recommended drugs indicating the evidence level, in the PTSD treatment standards and guidelines. The treatment choices possibilities with the consideration of different PTSD symptoms cluster expression and comorbid states and individual case distress level specific are presented. Main evidence based psychotherapeutic methods are described.
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Affiliation(s)
- A V Vasileva
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
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3
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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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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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5
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Alteration of early attentional processing after analogue trauma exposure: evidence from event-related potentials. Exp Brain Res 2021; 239:3671-3686. [PMID: 34618196 DOI: 10.1007/s00221-021-06234-1] [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: 08/12/2020] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
The present study aimed to determine whether exposure to an analogue traumatic event affects attentional processing of emotional information. Two groups of non-clinical participants matched on anxiety level, depression symptoms and stressful life events viewed either a trauma or a neutral film. They then performed an emotional Stroop task during which both continuous electroencephalographic activity was recorded and intrusive memories were measured. Results revealed that the valence effect (measured by the difference between emotional and neutral conditions) for the P1 amplitude was significantly greater in participants who viewed the trauma film than in participants who viewed the neutral film. This interaction was specific to words semantically related to the analogue trauma event and did not extend to all negative words. Further analyses revealed a relationship between intrusions frequency, P1 amplitude and emotional Stroop interference, indicating a link between attention and intrusive memories. Our findings suggest that exposure to potentially traumatic events has an important impact on neurocognitive function, even in the absence of psychopathology, and that this impact occurs at an early, possibly automatic stage of processing.
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Michaud K, Suurd Ralph C, Connick-Keefer SJA. Operational stressors, psychological distress, and turnover intentions: The impact of potentially morally injurious experiences. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1906075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kathy Michaud
- Department of National Defence, Ottawa, Ontario, Canada
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7
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Hien DA, López-Castro T, Fitzpatrick S, Ruglass LM, Fertuck EA, Melara R. A unifying translational framework to advance treatment research for comorbid PTSD and substance use disorders. Neurosci Biobehav Rev 2021; 127:779-794. [PMID: 34062208 DOI: 10.1016/j.neubiorev.2021.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 11/20/2022]
Abstract
We provide a unifying translational framework that can be used to synthesize extant lines of human laboratory research in four neurofunctional domains that underlie the co-occurrence of posttraumatic stress and substance use disorders (PTSD+SUD). We draw upon the Alcohol and Addiction Research Domain Criteria (AARDOC) to include executive functioning, negative emotionality, reward, and added social cognition from the National Institute of Mental Health (NIMH) Research Domain Criteria into our framework. We review research findings across each of the four domains, emphasizing human experimental studies in PTSD, SUD, and PTSD+SUD for each domain. We also discuss the implications of research findings for treatment development by considering new ways of conceptualizing risk factors and outcomes at the level of the individual patient, which will enhance treatment matching and advance innovations in intervention.
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Affiliation(s)
- Denise A Hien
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States.
| | - Teresa López-Castro
- Psychology Department, The City College of New York, New York, NY, United States
| | | | - Lesia M Ruglass
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States; Psychology Department, The City College of New York, New York, NY, United States
| | - Eric A Fertuck
- Psychology Department, The City College of New York, New York, NY, United States
| | - Robert Melara
- Psychology Department, The City College of New York, New York, NY, United States
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8
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Karadenizova Z, Dahle KP. Analyze This! Thematic Analysis: Hostility, Attribution of Intent, and Interpersonal Perception Bias. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:1068-1091. [PMID: 29294975 DOI: 10.1177/0886260517739890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research suggests that aggressive individuals exhibit a strong tendency to attribute hostile intent to the behavior of others when confronted with an ambiguous social situation. The vignettes method has become a standard procedure to assess hostile attributions. Vignettes represent incomplete ambiguous social stories, in which the subjects experience a negative outcome and are asked to attribute intent to the provocateur's action. This article explores the ways in which subjects perceive ambiguous social situations and other people's intentions, their tendency to refer negative outcome to oneself, and the components defining hostility in the interpersonal relationships. The sample consisted of male adolescent violent offenders (N = 45) recruited from the Social Therapy Department of the German correctional facility for juvenile offenders in Berlin. All offenders were incarcerated for a violent or sexual crime and were currently undergoing individual and group psychotherapy. The five hypothetical vignettes used in this study were originally designed to assess hostile attributions in both institutional and noninstitutional social situations. Participants' responses were analyzed using thematic analysis. Thematic analysis revealed three key themes regarding the social perception-positive, negative, and neutral-and two themes regarding the components of hostility-provocateur-related personality features and relationship type. Although the vignettes were originally developed to detect hostility-prone perception bias, they seem to be able to reveal a wider set of different attributions of intent, both positive and negative. Thus, vignettes are not limited to assessment of hostility specifically. They much rather seem to be a measure which is sensitive to diverse attributions of intent in general. The diagnostic qualities of the vignettes, their area of application, limitations of the study, and future perspective are discussed.
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Affiliation(s)
- Zhana Karadenizova
- Freie Universität Berlin, Germany
- University Hospital Charité Berlin, Germany
| | - Klaus-Peter Dahle
- Freie Universität Berlin, Germany
- University Hospital Charité Berlin, Germany
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9
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Developmental outcomes of early adverse care on amygdala functional connectivity in nonhuman primates. Dev Psychopathol 2021; 32:1579-1596. [PMID: 33427167 DOI: 10.1017/s0954579420001133] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite the strong link between childhood maltreatment and psychopathology, the underlying neurodevelopmental mechanisms are poorly understood and difficult to disentangle from heritable and prenatal factors. This study used a translational macaque model of infant maltreatment in which the adverse experience occurs in the first months of life, during intense maturation of amygdala circuits important for stress and emotional regulation. Thus, we examined the developmental impact of maltreatment on amygdala functional connectivity (FC) longitudinally, from infancy through the juvenile period. Using resting state functional magnetic resonance imaging (MRI) we performed amygdala-prefrontal cortex (PFC) region-of-interest and exploratory whole-brain amygdala FC analyses. The latter showed (a) developmental increases in amygdala FC with many regions, likely supporting increased processing of socioemotional-relevant stimuli with age; and (b) maltreatment effects on amygdala coupling with arousal and stress brain regions (locus coeruleus, laterodorsal tegmental area) that emerged with age. Maltreated juveniles showed weaker FC than controls, which was negatively associated with infant hair cortisol concentrations. Findings from the region-of-interest analysis also showed weaker amygdala FC with PFC regions in maltreated animals than controls since infancy, whereas bilateral amygdala FC was stronger in maltreated animals. These effects on amygdala FC development may underlie the poor behavioral outcomes associated with this adverse experience.
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Terpou BA, Densmore M, Théberge J, Frewen P, McKinnon MC, Nicholson AA, Lanius RA. The hijacked self: Disrupted functional connectivity between the periaqueductal gray and the default mode network in posttraumatic stress disorder using dynamic causal modeling. NEUROIMAGE-CLINICAL 2020; 27:102345. [PMID: 32738751 PMCID: PMC7394966 DOI: 10.1016/j.nicl.2020.102345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022]
Abstract
Posttraumatic stress disorder (PTSD) shows altered effective connectivity dynamics. Modeling between the periaqueductal gray (PAG) and the default mode network (DMN). In PTSD, stronger excitatory effective connectivity from the PAG towards the DMN. Trauma-related/neutral stimulus modulations to effective connectivity are compared. In PTSD, trauma-related stimulus modulations differ significantly to the controls.
Self-related processes define assorted self-relevant or social-cognitive functions that allow us to gather insight and to draw inferences related to our own mental conditions. Self-related processes are mediated by the default mode network (DMN), which, critically, shows altered functionality in individuals with posttraumatic stress disorder (PTSD). In PTSD, the midbrain periaqueductal gray (PAG) demonstrates stronger functional connectivity with the DMN [i.e., precuneus (PCN), medial prefrontal cortex (mPFC)] as compared to healthy individuals during subliminal, trauma-related stimulus processing. Here, we analyzed the directed functional connectivity between the PAG and the PCN, as well as between the PAG and the mPFC to more explicitly characterize the functional connectivity we have observed previously on the corresponding sample and paradigm. We evaluated three models varying with regard to context-dependent modulatory directions (i.e., bi-directional, bottom-up, top-down) among individuals with PTSD (n = 26) and healthy participants (n = 20), where Bayesian model selection was used to identify the most optimal model for each group. We then compared the effective connectivity strength for each parameter across the models and between our groups using Bayesian model averaging. Bi-directional models were found to be favoured across both groups. In PTSD, we revealed the PAG to show stronger excitatory effective connectivity to the PCN, as well as to the mPFC as compared to controls. In PTSD, we further demonstrated that PAG-mediated effective connectivity to the PCN, as well as to the mPFC were modulated more strongly during subliminal, trauma-related stimulus conditions as compared to controls. Clinical disturbances towards self-related processes are reported widely by participants with PTSD during trauma-related stimulus processing, where altered functional connectivity directed by the PAG to the DMN may elucidate experiential links between self- and trauma-related processing in traumatized individuals.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, ON, Canada.
| | - Maria Densmore
- Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada.
| | - Jean Théberge
- Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Department of Medical Biophysics, Western University, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada.
| | - Paul Frewen
- Department of Neuroscience, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada.
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Homewood Research Institute, Guelph, ON, Canada.
| | - Andrew A Nicholson
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Wien, Austria.
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada.
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11
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Acute Posttrauma Resting-State Functional Connectivity of Periaqueductal Gray Prospectively Predicts Posttraumatic Stress Disorder Symptoms. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:891-900. [PMID: 32389746 DOI: 10.1016/j.bpsc.2020.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/04/2020] [Accepted: 03/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is characterized by hyperarousal, avoidance, and intrusive/re-experiencing symptoms. The periaqueductal gray (PAG), which generates behavioral responses to physical and psychological stressors, is also implicated in threat processing. Distinct regions of the PAG elicit opposing responses to threatening or stressful stimuli; the ventrolateral PAG evokes passive coping strategies (e.g., analgesia), whereas the dorsolateral PAG (dlPAG) promotes active responses (e.g., fight or flight). We investigated whether altered PAG resting-state functional connectivity (RSFC) prospectively predicted PTSD symptoms. METHODS A total of 48 trauma-exposed individuals underwent an RSFC scan 2 weeks posttraumatic injury. Self-report measures, including the visual analog scale for pain and the Impact of Event Scale, were collected at 2 weeks and 6 months posttrauma. We analyzed whether acute bilateral PAG RSFC was a marker of risk for total 6-month symptom severity and specific symptom clusters. In an exploratory analysis, we investigated whether dlPAG RSFC predicted PTSD symptoms. RESULTS After adjusting for physical pain ratings, greater acute posttrauma PAG-frontal pole and PAG-posterior cingulate cortex connectivity was positively associated with 6-month total PTSD symptoms. Weaker dlPAG-superior/inferior parietal lobule connectivity predicted both higher hyperarousal and higher intrusive symptoms, while weaker dlPAG-supramarginal gyrus RSFC was associated with only hyperarousal symptoms. CONCLUSIONS Altered connectivity of the PAG 2 weeks posttrauma prospectively predicted PTSD symptoms. These findings suggest that aberrant PAG function may serve as a marker of risk for chronic PTSD symptoms, possibly by driving specific symptom clusters, and more broadly that connectivity of specific brain regions may underlie specific symptom profiles.
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12
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Haim-Nachum S, Levy-Gigi E. A chink in the armor: The influence of training on generalization learning impairments after viewing traumatic stimuli. Cognition 2019; 193:104021. [DOI: 10.1016/j.cognition.2019.104021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 02/07/2023]
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13
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Miles SR, Dillon KH, Jacoby VM, Hale WJ, Dondanville KA, Wachen JS, Yarvis JS, Peterson AL, Mintz J, Litz BT, Young‐McCaughan S, Resick PA. Changes in anger and aggression after treatment for PTSD in active duty military. J Clin Psychol 2019; 76:493-507. [DOI: 10.1002/jclp.22878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shannon R. Miles
- James A. Haley Veterans’ Hospital Tampa Florida
- Department of Psychiatry & Behavioral Neurosciences, Morsani College of Medicine University of South Florida Tampa Florida
| | - Kirsten H. Dillon
- Research and Development Durham VA Medical Center Durham North Carolina
- Department of Psychiatry and Behavioral Sciences Duke University Medical Center Durham North Carolina
| | - Vanessa M. Jacoby
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Willie J. Hale
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
- Department of Psychology University of Texas at San Antonio San Antonio Texas
| | - Katherine A. Dondanville
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Jennifer Schuster Wachen
- National Center for PTSD VA Boston Healthcare System Boston Massachusetts
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts
| | - Jeffrey S. Yarvis
- Department of Behavioral Health Carl R. Darnall Army Medical Center Fort Hood Texas
| | - Alan L. Peterson
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
- Research and Development Service South Texas Veterans Health Care System San Antonio Texas
| | - Jim Mintz
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
- Department of Epidemiology and Biostatistics University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Brett T. Litz
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts
- Massachusetts Veterans Epidemiological Research and Information Center VA Boston Healthcare System Boston Massachusetts
| | - Stacey Young‐McCaughan
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Patricia A. Resick
- Department of Psychiatry and Behavioral Sciences Duke University Medical Center Durham North Carolina
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14
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Connor DF, Newcorn JH, Saylor KE, Amann BH, Scahill L, Robb AS, Jensen PS, Vitiello B, Findling RL, Buitelaar JK. Maladaptive Aggression: With a Focus on Impulsive Aggression in Children and Adolescents. J Child Adolesc Psychopharmacol 2019; 29:576-591. [PMID: 31453715 PMCID: PMC6786344 DOI: 10.1089/cap.2019.0039] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Aggressive behavior is among the most common reasons for referral to psychiatric clinics and confers significant burden on individuals. Aggression remains poorly defined; there is currently no consensus on the best ways to recognize, diagnose, and treat aggression in clinical settings. In this review, we synthesize the available literature on aggression in children and adolescents and propose the concept of impulsive aggression (IA) as an important construct associated with diverse and enduring psychopathology. Methods: Articles were identified and screened from online repositories, including PubMed, PsychInfo, the Cochrane Database, EMBase, and relevant book chapters, using combinations of search terms such as "aggression," "aggressive behavio(u)r," "maladaptive aggression," "juvenile," and "developmental trajectory." These were evaluated for quality of research before being incorporated into the article. The final report references 142 sources, published from 1987 to 2019. Results: Aggression can be either adaptive or maladaptive in nature, and the latter may require psychosocial and biomedical interventions when it occurs in the context of central nervous system psychopathology. Aggression can be categorized into various subtypes, including reactive/proactive, overt/covert, relational, and IA. IA in psychiatric or neurological disorders is reviewed along with current treatments, and an algorithm for systematic evaluation of aggression in the clinical setting is proposed. Conclusions: IA is a treatable form of maladaptive aggression that is distinct from other aggression subtypes. It occurs across diverse psychiatric and neurological diagnoses and affects a substantial subpopulation. IA can serve as an important construct in clinical practice and has considerable potential to advance research.
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Affiliation(s)
- Daniel F. Connor
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, University of Connecticut Medical School, Farmington, Connecticut.,Address correspondence to: Daniel F. Connor, MD, Department of Psychiatry, Division of Child & Adolescent Psychiatry, University of Connecticut Medical School, 263 Farmington Avenue, MC 1410, Farmington, CT 06030-1410
| | - Jeffrey H. Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Lawrence Scahill
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Adelaide S. Robb
- Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, Washington, District of Columbia.,Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, District of Columbia
| | - Peter S. Jensen
- Department of Psychiatry, University of Arkansas for Medical Science, Little Rock, Arkansas
| | - Benedetto Vitiello
- Section of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Robert L. Findling
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland.,Department of Psychiatry and Behavioral Sciences, Kennedy Krieger Institute, Baltimore, Maryland
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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15
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Morin EL, Howell BR, Meyer JS, Sanchez MM. Effects of early maternal care on adolescent attention bias to threat in nonhuman primates. Dev Cogn Neurosci 2019; 38:100643. [PMID: 31170549 PMCID: PMC6969349 DOI: 10.1016/j.dcn.2019.100643] [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] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 03/28/2019] [Accepted: 04/05/2019] [Indexed: 12/11/2022] Open
Abstract
Attention bias towards threat using dot-probe tasks has mainly been reported in adults with stress-related disorders such as PTSD and other anxiety disorders, in some cases associated with early life stress or traumatic experiences. Studies during adolescence are scarce and inconsistent, which highlights the need to increase our understanding of the developmental processes that predict attentional biases, given that this is a time of emergence of psychopathology. Here, we use a translational nonhuman primate model of early life stress in the form of infant maltreatment to examine its long-term impact on attentional biases during adolescence using the dot-probe task and identify interactions with early life risk factors, such as prenatal exposure to stress hormones and emotional/stress reactivity during infancy. Maltreated animals showed higher reaction times to social threat than animals that experienced competent maternal care, suggesting interference of negative valence stimuli on attentional control and cognitive processes. Higher emotional reactivity during infancy in Maltreated animals predicted attention bias towards threat, whereas higher levels of prenatal cortisol exposure was associated with bias away (avoidance of) threat in maltreated and control groups. Our findings suggest that different postnatal experiences and early biobehavioral mechanisms regulate the development of emotional attention biases during adolescence.
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Affiliation(s)
- Elyse L Morin
- Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta GA, 30329, United States; Department of Psychiatry & Behavioral Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322, United States.
| | - Brittany R Howell
- Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta GA, 30329, United States; Department of Psychiatry & Behavioral Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322, United States; Insititute of Child Development, University of Minnesota, 51 E River Rd, Minneapolis, MN 55455, United States.
| | - Jerrold S Meyer
- Department of Psychological and Brain Sciences, University of Massachusetts, 441 Tobin Hall, Amherst, MA 01003, United States.
| | - Mar M Sanchez
- Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta GA, 30329, United States; Department of Psychiatry & Behavioral Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322, United States.
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16
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Loos E, Egli T, Coynel D, Fastenrath M, Freytag V, Papassotiropoulos A, de Quervain DJF, Milnik A. Predicting emotional arousal and emotional memory performance from an identical brain network. Neuroimage 2019; 189:459-467. [DOI: 10.1016/j.neuroimage.2019.01.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/07/2019] [Accepted: 01/10/2019] [Indexed: 12/17/2022] Open
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17
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Conducting a study to assess the long-term impacts of injury after 9/11: participation, recall, and description. Inj Epidemiol 2019; 6:8. [PMID: 31245257 PMCID: PMC6582679 DOI: 10.1186/s40621-019-0186-y] [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: 09/26/2018] [Accepted: 02/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background The World Trade Center (WTC) attacks on September 11, 2001 (9/11) resulted in over 2700 fatalities and thousands injured. Injury on 9/11 has been identified as a risk factor for physical and mental health conditions, but the reasons for this are not well understood. In a population exposed to 9/11 and since followed, an in-depth study on the impacts of injury on 9/11 was conducted to identify factors that contribute to long-term functional issues. This report sought to examine factors influencing participation, participant recall of injury status over time, and determinants of injury severity. Methods Enrollees from the World Trade Center Health Registry who completed all surveys between 2003 and 2016 and initially reported being injured (N = 2699) as well as a sample of non-injured (N = 2598) were considered to be eligible for the Health and Quality of Life 15 Years after 9/11 (HQoL) Study. Predictors of study non-participation and inconsistent recall of injury over time (i.e., discrepant reports) were identified through fitting log binomial models. Results Participation rates were high overall (76.1%) and did not vary by initially reported injury status, although younger (vs. older), non-White (vs. White), and less educated (vs. more educated) enrollees were less likely to participate in the HQoL Study. Discrepant reporting of 9/11 injury status was much more common among enrollees who initially reported being injured on 9/11 (49.6%) compared with those who did not (7.3%). However, those who incurred more severe injuries on 9/11 were less likely to have discrepant reporting over time compared with those with more minor injuries (broken bone vs. sprain: risk ratio = 0.33, 95% Confidence Interval: 0.19, 0.57). Among those who consistently reported that they were injured on 9/11, most injuries occurred as a result of descending down stairs (31.5%) or by tripping and falling (19.9%); although being hit by a falling object was most often associated with high severity injuries (63.2%) compared with other modes of injury. Conclusions These findings highlight the methodological issues involved in conducting a study on the long-term impact of injury more than a decade after the initial incident and may be relevant to future investigators. Factors affecting participation rates, such as demographic characteristics, and those related to discrepant reporting over time, such as injury severity, may affect both the internal and external validity of studies examining the long-term impact of injury.
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18
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Abstract
OBJECTIVE To examine the temporal consistency of self-reported deployment-related traumatic brain injury (TBI) and its association with posttraumatic stress disorder (PTSD) symptom severity. SETTING In-person interviews at US Army installations (postdeployment); phone interviews (long-term follow-up). PARTICIPANTS A total of 378 US Army soldiers and veterans deployed to Iraq; 14.3% (n = 54) reported TBI with loss of consciousness during an index deployment. DESIGN Participants were evaluated after returning from deployment and again 5 to 9 years later. MAIN MEASURES Temporal consistency of TBI endorsement based on TBI screening interviews; PTSD Checklist, Civilian Version. RESULTS The concordance of deployment-related TBI endorsement from the postdeployment to long-term follow-up assessment was moderate (κ = 0.53). Of the 54 participants reporting (predominantly mild) TBI occurring during an index deployment, 32 endorsed TBI inconsistently over time. More severe PTSD symptoms at postdeployment assessment were independently associated with discordant reporting (P = .0004); each 10-point increase in PCL scores increasing odds of discordance by 69% (odds ratio = 1.69; 95% confidence interval, 1.26-2.26). CONCLUSIONS Deployment-related TBI may not be reported reliably over time, particularly among war-zone veterans with greater PTSD symptoms. Results of screening evaluations for TBI history should be viewed with caution in the context of PTSD symptom history.
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19
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Melara RD, Ruglass LM, Fertuck EA, Hien DA. Regulation of threat in post-traumatic stress disorder: Associations between inhibitory control and dissociative symptoms. Biol Psychol 2018; 133:89-98. [DOI: 10.1016/j.biopsycho.2018.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 01/12/2018] [Accepted: 01/28/2018] [Indexed: 11/26/2022]
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20
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Bangel KA, van Buschbach S, Smit DJA, Mazaheri A, Olff M. Aberrant brain response after auditory deviance in PTSD compared to trauma controls: An EEG study. Sci Rep 2017; 7:16596. [PMID: 29185490 PMCID: PMC5707412 DOI: 10.1038/s41598-017-16669-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/16/2017] [Indexed: 12/19/2022] Open
Abstract
Part of the symptomatology of post-traumatic stress disorder (PTSD) are alterations in arousal and reactivity which could be related to a maladaptive increase in the automated sensory change detection system of the brain. In the current EEG study we investigated whether the brain's response to a simple auditory sensory change was altered in patients with PTSD relative to trauma-exposed matched controls who did not develop the disorder. Thirteen male PTSD patients and trauma-exposed controls matched for age and educational level were presented with regular auditory pure tones (1000 Hz, 200 ms duration), with 11% of the tones deviating in both duration (50 ms) and frequency (1200 Hz) while watching a silent movie. Relative to the controls, patients who had developed PTSD showed enhanced mismatch negativity (MMN), increased theta power (5-7 Hz), and stronger suppression of upper alpha activity (13-15 Hz) after deviant vs. standard tones. Behaviourally, the alpha suppression in PTSD correlated with decreased spatial working memory performance suggesting it might reflect enhanced stimulus-feature representations in auditory memory. These results taken together suggest that PTSD patients and trauma-exposed controls can be distinguished by enhanced involuntary attention to changes in sensory patterns.
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Affiliation(s)
- Katrin A Bangel
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
| | - Susanne van Buschbach
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Dirk J A Smit
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Ali Mazaheri
- Center for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, 1112 XE Diemen, The Netherlands
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21
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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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22
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Miles SR, Menefee DS, Wanner J, Teten Tharp A, Kent TA. The Relationship Between Emotion Dysregulation and Impulsive Aggression in Veterans With Posttraumatic Stress Disorder Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:1795-1816. [PMID: 25681165 DOI: 10.1177/0886260515570746] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
While Veterans in general are no more dangerous than the civilian population, Veterans with posttraumatic stress disorder (PTSD) have stronger associations with anger and hostility and certain forms of aggression, such as intimate partner violence, than civilians with PTSD. This is alarming because up to 21% of Veterans seeking Veterans Affairs (VA) health care are diagnosed with PTSD. Emotion regulation difficulties (emotion dysregulation) are also related to increased PTSD symptom severity and may play a role in aggressive behavior. Because the predominant form of aggression in PTSD appears to be the impulsive subtype, the authors sought to clarify the relationship between PTSD, emotion dysregulation, and impulsive aggression. We examined how emotion dysregulation influenced impulsive aggression in a Veteran sample (N = 479) seeking treatment for trauma sequelae. All Veterans completed measures that assessed demographic information, emotion dysregulation, aggression frequency and subtype, and PTSD symptoms. Men generally reported more aggression than women. The emotion dysregulation, aggression, and PTSD measures were significantly correlated. Two cross-sectional mediation models showed emotion dysregulation fully accounted for the relationship between PTSD and impulsive aggression (indirect path for men: b = .07, SE = .026, bias-correct and accelerated confidence interval [BCa CI] = [0.02, 0.13]; indirect path for women: b = .08, SE = .022, BCa CI = [0.05, 0.13]). PTSD can increase negative emotions yet does not always lead to aggressive behaviors. The ability to regulate emotions may be pivotal to inhibiting aggression in those with PTSD. PTSD interventions may benefit from augmentation with emotion regulation skills training.
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Affiliation(s)
- Shannon R Miles
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA South Central Mental Illness, Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs, Houston, TX, USA
| | - Deleene S Menefee
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA South Central Mental Illness, Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs, Houston, TX, USA
| | - Jill Wanner
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andra Teten Tharp
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Thomas A Kent
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA South Central Mental Illness, Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs, Houston, TX, USA Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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23
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Nilsen AS, Hilland E, Kogstad N, Heir T, Hauff E, Lien L, Endestad T. Right temporal cortical hypertrophy in resilience to trauma: an MRI study. Eur J Psychotraumatol 2016; 7:31314. [PMID: 27473521 PMCID: PMC5055608 DOI: 10.3402/ejpt.v7.31314] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/28/2016] [Accepted: 06/29/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In studies employing physiological measures such as magnetic resonance imaging (MRI), it is often hard to distinguish what constitutes risk-resilience factors to posttraumatic stress disorder (PTSD) following trauma exposure and what the effects of trauma exposure and PTSD are. OBJECTIVE We aimed to investigate whether there were observable morphological differences in cortical and sub-cortical regions of the brain, 7-8 years after a single potentially traumatic event. METHODS Twenty-four participants, who all directly experienced the 2004 Indian Ocean Tsunami, and 25 controls, underwent structural MRI using a 3T scanner. We generated cortical thickness maps and parcellated sub-cortical volumes for analysis. RESULTS We observed greater cortical thickness for the trauma-exposed participants relative to controls, in a right lateralized temporal lobe region including anterior fusiform gyrus, and superior, middle, and inferior temporal gyrus. CONCLUSIONS We observed greater thickness in the right temporal lobe which might indicate that the region could be implicated in resilience to the long-term effects of a traumatic event. We hypothesize this is due to altered emotional semantic memory processing. However, several methodological and confounding issues warrant caution in interpretation of the results.
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Affiliation(s)
| | - Eva Hilland
- Institute of Psychology, University of Oslo, Oslo, Norway.,Diakonhjemmet Hospital, Oslo, Norway
| | | | - Trond Heir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Edvard Hauff
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lars Lien
- Innlandet Hospital Trust, Brumunddal, Norway.,Faculty of Public Health, Hedmark University College, Elverum, Norway
| | - Tor Endestad
- Institute of Psychology, University of Oslo, Oslo, Norway
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24
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Zhang Y, Liu F, Chen H, Li M, Duan X, Xie B, Chen H. Intranetwork and internetwork functional connectivity alterations in post-traumatic stress disorder. J Affect Disord 2015; 187:114-21. [PMID: 26331685 DOI: 10.1016/j.jad.2015.08.043] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/01/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND A large number of previous neuroimaging studies have explored the functional alterations of post-traumatic stress disorder (PTSD). However, abnormalities in the functional architecture of resting-state networks in PTSD were rarely elucidated. METHODS This study used independent component analysis to explore the resting-state intranetwork and internetwork functional connectivity differences between 20 PTSD patients and 20 matched healthy controls (HCs). RESULTS Selective alterations of intranetwork and internetwork intrinsic functional connectivities were found in the PTSD patients. Compared with HCs, the PTSD patients exhibited significantly decreased network connectivity within the anterior default mode network, posterior default mode network (pDMN), salience network (SN), sensory-motor network, and auditory network. Furthermore, the PTSD patients exhibited increased internetwork connectivity between SN and pDMN. LIMITATIONS This study lacked recruitment of trauma-exposed HCs, which limits our ability to determine whether the alterations are caused by PTSD or trauma exposure. CONCLUSION The findings suggested that the PTSD patients exhibited abnormal functional connectivity at the brain network level. Notably, the enhanced internetwork connectivity between SN and pDMN in the PTSD patients may be associated with hyperarousal and heightened anxiety in PTSD.
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Affiliation(s)
- Youxue Zhang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Heng Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Meiling Li
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Xujun Duan
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Bing Xie
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China; Department of Anatomy, Third Military Medical University, 30 Gaotanyan Street, Chongqing 400038, China.
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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25
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Long-lasting memory abnormalities following exposure to the mouse defense test battery: An animal model of PTSD. Physiol Behav 2015; 146:67-72. [PMID: 26066724 DOI: 10.1016/j.physbeh.2015.03.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 11/21/2022]
Abstract
Memory dysfunctions are thought to play a crucial role both in the development and the maintenance of posttraumatic stress disorder (PTSD). Patients suffering from this condition persistently re-experience the traumatic event particularly when exposed to trauma-related cues and they display memory alterations. The objective of the present study was to investigate the long-term effects of a traumatic stress exposure on defensive behaviors and memory performance in mice confronted with a natural threat (i.e. a rat) in the defense test battery (MDTB), a procedure developed by the Blanchard group in the early nineties. The object recognition task,which addresses certain aspects of episodic memory, was used to assess the long-term consequences of stress on memory function. Mice were exposed to the MDTB followed two weeks later by a re-exposure to the test apparatus, but in the absence of the threat stimulus. Two hours after the second exposure to the MDTB apparatus, mice were exposed to the object recognition task (ORT). Another set of animals was used which were either exposed to the first or to the second MDTB session, before being tested in the ORT. Results showed that MDTB exposure produced long-lasting alterations in some defensive behaviors, such as escape attempts from the apparatus, which were increased during the re-exposure session at day 14 compared to non-exposed control mice.While exposure to the MDTB context only did not affect memory performance in the ORT, confrontation with the threat stimulus in the MDTB on day 1 impaired episodic memory two weeks after the stressful event. Finally, mice confronted both with the rat on day 1 and the MDTB context on day 14 displayed intact episodic memory performance in the ORT. We hypothesize that re-exposure to the context following a stressful event resulted in an increase of arousal, which subsequently led to an improvement in cognitive performance, a phenomenon also described in PTSD patients. The MDTB is a typical example of the tremendous efforts of Blanchard's lab to increase the translatability potential of the behavioral models of central nervous system disorders.
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26
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Holmes NM, Parkes SL, Killcross AS, Westbrook RF. The basolateral amygdala is critical for learning about neutral stimuli in the presence of danger, and the perirhinal cortex is critical in the absence of danger. J Neurosci 2013; 33:13112-25. [PMID: 23926265 PMCID: PMC6619729 DOI: 10.1523/jneurosci.1998-13.2013] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 06/29/2013] [Accepted: 07/02/2013] [Indexed: 11/21/2022] Open
Abstract
The perirhinal cortex (PRh) and basolateral amygdala (BLA) appear to mediate distinct aspects of learning and memory. Here, we used rats to investigate the involvement of the PRh and BLA in acquisition and extinction of associations between two different environmental stimuli (e.g., a tone and a light) in higher-order conditioning. When both stimuli were neutral, infusion of the GABAA, muscimol, or the NMDA receptor (NMDAR) antagonist ifenprodil into the PRh impaired associative formation. However, when one stimulus was neutral and the other was a learned danger signal, acquisition and extinction of the association between them was unaffected by manipulations targeting the PRh. Temporary inactivation of the BLA had the opposite effect: formation and extinction of an association between two stimuli was spared when both stimuli were neutral, but impaired when one stimulus was a learned danger signal. Subsequent experiments showed that the experience of fear per se shifts processing of an association between neutral stimuli from the PRh to the BLA. When training was conducted in a dangerous environment, formation and extinction of an association between neutral stimuli was impaired by BLA inactivation or NMDAR blockade in this region, but was unaffected by PRh inactivation. These double dissociations in the roles of the PRh and BLA in learning under different stimulus and environmental conditions imply that fear-induced activation of the amygdala changes how the brain processes sensory stimuli. Harmless stimuli are treated as potentially harmful, resulting in a shift from cortical to subcortical processing in the BLA.
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Affiliation(s)
- Nathan M. Holmes
- School of Psychology, University of New South Wales, Sydney 2052, New South Wales, Australia, and
| | - Shauna L. Parkes
- Brain and Mind Research Institute, University of Sydney, Camperdown 2050, New South Wales, Australia
| | - A. Simon Killcross
- School of Psychology, University of New South Wales, Sydney 2052, New South Wales, Australia, and
| | - R. Frederick Westbrook
- School of Psychology, University of New South Wales, Sydney 2052, New South Wales, Australia, and
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Neural response to errors in combat-exposed returning veterans with and without post-traumatic stress disorder: a preliminary event-related potential study. Psychiatry Res 2013; 213:71-8. [PMID: 23684979 DOI: 10.1016/j.pscychresns.2013.01.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 11/13/2012] [Accepted: 01/09/2013] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is characterized by sustained anxiety, hypervigilance for potential threat, and hyperarousal. These symptoms may enhance self-perception of one's actions, particularly the detection of errors, which may threaten safety. The error-related negativity (ERN) is an electrocortical response to the commission of errors, and previous studies have shown that other anxiety disorders associated with exaggerated anxiety and enhanced action monitoring exhibit an enhanced ERN. However, little is known about how traumatic experience and PTSD would affect the ERN. To address this gap, we measured the ERN in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with combat-related PTSD (PTSD group), combat-exposed OEF/OIF veterans without PTSD [combat-exposed control (CEC) group], and non-traumatized healthy participants [healthy control (HC) group]. Event-related potential and behavioral measures were recorded while 16 PTSD patients, 18 CEC, and 16 HC participants completed an arrow version of the flanker task. No difference in the magnitude of the ERN was observed between the PTSD and HC groups; however, in comparison with the PTSD and HC groups, the CEC group displayed a blunted ERN response. These findings suggest that (1) combat trauma itself does not affect the ERN response; (2) PTSD is not associated with an abnormal ERN response; and (3) an attenuated ERN in those previously exposed to combat trauma but who have not developed PTSD may reflect resilience to the disorder, less motivation to do the task, or a decrease in the significance or meaningfulness of 'errors,' which could be related to combat experience.
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28
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Kimble MO, Fleming K, Bennion KA. Contributors to hypervigilance in a military and civilian sample. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:1672-92. [PMID: 23334188 PMCID: PMC4157995 DOI: 10.1177/0886260512468319] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Hypervigilance toward ambiguous or threatening stimuli is a prominent feature in many trauma survivors including active and returning soldiers. This study set out to investigate the factors that contribute to hypervigilance in a mixed sample. One hundred forty-five individuals, 50 of whom were war zone veterans, filled out a series of questionnaires including the Hypervigilance Questionnaire (HVQ; Kimble, Fleming, & Bennion, 2009). Other participants included military cadets, college undergraduates, and a traumatized community sample. In this sample, a history of military deployment and posttraumatic stress disorder symptoms independently predicted hypervigilance. The findings suggest that deployment to a war zone, in and of itself, can lead to hypervigilant behavior. Therefore, characterizing hypervigilance as pathological in a veteran sample must be done so with caution.
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Affiliation(s)
- Matthew O Kimble
- Psychology Department, Middlebury College, Middlebury, VT 05753, USA.
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29
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Fani N, Jovanovic T, Ely TD, Bradley B, Gutman D, Tone EB, Ressler KJ. Neural correlates of attention bias to threat in post-traumatic stress disorder. Biol Psychol 2012; 90:134-42. [PMID: 22414937 PMCID: PMC3340884 DOI: 10.1016/j.biopsycho.2012.03.001] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 02/28/2012] [Accepted: 03/02/2012] [Indexed: 11/20/2022]
Abstract
Attentional biases have been proposed to contribute to symptom maintenance in posttraumatic stress disorder (PTSD), although the neural correlates of these processes have not been well defined; this was the goal of the present study. We administered an attention bias task, the dot probe, to a sample of 37 (19 control, 18 PTSD+) traumatized African-American adults during fMRI. Compared to controls, PTSD+ participants demonstrated increased activation in the dorsolateral prefrontal cortex (dlPFC) in response to threat cue trials. In addition, attentional avoidance of threat corresponded with increased ventrolateral prefrontal cortex (vlPFC) and dorsal anterior cingulate cortex (dACC) activation in the PTSD group, a pattern that was not observed in controls. These data provide evidence to suggest that relative increases in dlPFC, dACC and vlPFC activation represent neural markers of attentional bias for threat in individuals with PTSD, reflecting selective disruptions in attentional control and emotion processing networks in this disorder.
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Affiliation(s)
- Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
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30
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Landré L, Destrieux C, Andersson F, Barantin L, Quidé Y, Tapia G, Jaafari N, Clarys D, Gaillard P, Isingrini M, El-Hage W. Working memory processing of traumatic material in women with posttraumatic stress disorder. J Psychiatry Neurosci 2012; 37:87-94. [PMID: 21971161 PMCID: PMC3297067 DOI: 10.1503/jpn.100167] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with medial frontal and amygdala functional alterations during the processing of traumatic material and frontoparietal dysfunctions during working memory tasks. This functional magnetic resonance imaging (fMRI) study investigated the effects of trauma-related words processing on working memory in patients with PTSD. METHODS We obtained fMRI scans during a 3-back task and an identity task on both neutral and trauma-related words in women with PTSD who had been sexually abused and in healthy, nonexposed pair-matched controls. RESULTS Seventeen women with PTSD and 17 controls participated in the study. We found no behavioural working memory deficit for the PTSD group. In both tasks, deactivation of posterior parietal midline regions was more pronounced in patients than controls. Additionally, patients with PTSD recruited the left dorsolateral frontal sites to a greater extent during the processing of trauma-related material than neutral material. LIMITATIONS This study included only women and did not include a trauma-exposed non-PTSD control group; the results may, therefore, have been influenced by sex or by effects specific to trauma exposure. CONCLUSION Our results broadly confirm frontal and parietal functional variations in women with PTSD and suggest a compensatory nature of these variations with regard to the retreival of traumatic memories and global attentional deficits, respectively, during cognitively challenging tasks.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Wissam El-Hage
- Correspondence to: W. El-Hage, Inserm U930 ERL CNRS 3106, Université François Rabelais de Tours, CHRU de Tours, Blvd. Tonnellé, 37044 Tours Cedex 9, France;
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31
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Franzen PL, Woodward SH, Bootzin RR, Germain A, Colrain IM. K-complexes are not preferentially evoked to combat sounds in combat-exposed Vietnam veterans with and without post-traumatic stress disorder. Int J Psychophysiol 2012; 83:393-8. [PMID: 22226900 PMCID: PMC3610318 DOI: 10.1016/j.ijpsycho.2011.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 12/13/2011] [Accepted: 12/22/2011] [Indexed: 11/21/2022]
Abstract
The primary objective was to compare the evoked K-complex response to salient versus non-salient auditory stimuli in combat-exposed Vietnam veterans with and without post-traumatic stress disorder (PTSD). Three categories of auditory stimuli (standard 1000Hz tones, trauma-related combat sounds, and affectively neutral environmental sounds) were presented during stage 2 sleep utilizing an oddball paradigm with probabilities of occurrence of 60%, 20% and 20% respectively. Twenty-four combat-exposed Vietnam veterans, 14 with PTSD and 10 without PTSD were studied in a sleep laboratory at the National Center for PTSD in Menlo Park, CA. While significantly fewer K-complexes overall were elicited in patients, there were no differences in the proportion of K-complexes elicited by tones and combat stimuli within either group. Patients produced significantly more K-complexes to neutral stimuli than to tone or combat stimuli. Examination of the N550 component of the evoked K-complex revealed significantly longer latencies in the patient group. Across the entire sample, N550 latencies were longer for combat stimuli relative to tone neutral stimuli. There were no group or stimulus category differences for N550 amplitude. The results suggest that salient information, as defined by trauma-related combat sounds, did not preferentially elicit K-complexes in either the PTSD group or the control group, suggesting that K-complexes function to protect sleep more than to endogenously process meaningful stimuli.
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Affiliation(s)
- Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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