Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging

BMC Psychiatry

Thomas Elbert¹  Maggie Schauer¹  James Moran¹  Inga Schalinski¹ 

[1]Department of Psychology, University of Konstanz, P.O. Box 905, 78457 Konstanz, Germany

关键词: Depression;    Dissociation;    Shutdown;    IAPS;    MEG;    PTSD;   

Others  :  1123479
DOI  :  10.1186/1471-244X-14-193

 received in 2014-01-30, accepted in 2014-07-03,  发布年份 2014

【 摘 要 】

Background

Traumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group.

Methods

Event-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation.

Results

For the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread.

Conclusion

We conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.

【 授权许可】

   
2014 Schalinski et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Marx BP, Forsyth JP, Lexington JM: Tonic immobility as an evolved predator defense: implications for sexual assault survivors. Sci Pract 2008, 15:74-90.
• [2]Briere J, Scott C, Weathers F: Peritraumatic and persistent dissociation in the presumed etiology of PTSD. Am J Psychiat 2005, 162:2295-2301.
• [3]Panasetis P, Bryant RA: Peritraumatic versus persistent dissociation in acute stress disorder. J Trauma Stress 2003, 16:563-566.
• [4]Werner KB, Griffin MG: Peritraumatic and persistent dissociation as predictors of PTSD symptoms in a female cohort. J Trauma Stress 2012, 25:401-407.
• [5]Bremner JD, Southwick S, Brett E, Fontana A, Rosenheck R, Charney DS: Dissociation and posttraumatic stress disorder in Vietnam combat veterans. Am J Psychiat 1992, 149:328-332.
• [6]Ginzburg K, Koopman C, Butler LD, Palesh O, Kraemer HC, Classen CC, Spiegel D: Evidence for a dissociative subtype of Post-traumatic stress disorder among help-seeking childhood sexual abuse survivors. J Trauma Dissociation 2006, 7:7-27. doi:10.1300/J229v07n02_02
• [7]Murray J, Ehlers A, Mayou RA: Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors. Br J Psychiatry 2002, 180:363-368.
• [8]Feeny NC, Zoellner LA, Fitzgibbons LA, Foa EB: Exploring the roles of emotional numbing, depression, and dissociation in PTSD. J Trauma Stress 2005, 13:489-498. doi:10.1023/A:1007789409330
• [9]van der Hart O, Nijenhuis E, Steele K, Brown D: Trauma-related dissociation: conceptual clarity lost and found. Aust N Z J Psychiatry 2004, 38:906-914.
• [10]Schauer M, Elbert T: Dissociation following traumatic stress: etiology and treatment. J Psychol 2010, 218:109-127. doi:10.1027/0044-3409/a000018
• [11]Bracha HS: Freeze, flight, fight, fright, faint: adaptationist perspectives on the acute stress response spectrum. CNS Spectr 2004, 9:679-685.
• [12]Noyes R, Kletti R: Depersonalization in response to life-threatening danger. Compr Psychiatry 1977, 18:375-384.
• [13]Lanius RA, Vermetten E, Loewenstein RJ, Brand B, Schmahl C, Bremner JD, Spiegel D: Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. Am J Psychiatry 2010, 167:640-647. doi:10.1176/appi.ajp.2009.09081168
• [14]Adenauer H, Pinösch S, Catani C, Gola H, Keil J, Kissler J, Neuner F: Early processing of threat cues in Posttraumatic Stress disorder—evidence for a cortical vigilance-avoidance reaction. Biol Psychiatry 2010, 68:451-458. doi:10.1016/j.biopsych.2010.05.015
• [15]Catani C, Adenauer H, Keil J, Aichinger H, Neuner F: Pattern of cortical activation during processing of aversive stimuli in traumatized survivors of war and torture. Eur Arch Psychiatry Clin Neurosci 2009, 259:340-351. doi:10.1007/s00406-009-0006-4
• [16]Elbert TR, Schauer M, Ruf M, Weierstall R, Neuner F, Rockstroh B, Junghöfer M: The tortured brain: imaging neutral representation of the traumatic tress experiences using RSVP with affective pictorial stimuli. J Psychol 2011, 219:167-174. doi:10.1027/21512604/a000064
• [17]Junghöfer M, Schauer M, Neuner F, Odenwald M, Rockstroh B, Elbert T: Enhanced fear-network in torture survivors activated by RVSP of aversive material can be monitored by MEG. Psychophysiology 2003, 40(Suppl):51.
• [18]Matz K, Junghöfer M, Elbert T, Weber K, Wienbruch C, Rockstroh B: Adverse experiences in childhood influence brain responses to emotional stimuli in adult psychiatric patients. Int J Psychophysiol 2010, 75:277-286. doi:10.1016/j.ijpsycho.2009.12.010
• [19]Moratti S, Rubio G, Campo P, Keil A, Ortiz T: Hypofunction of right temporoparietal cortex during emotional arousal in depression. Arch Gen Psychiatry 2008, 65:532-541. doi:10.1001/archpsyc.65.5.532
• [20]Hopper JW, Frewen PA, van der Kolk BA, Lanius RA: Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: Symptom dimensions and emotion dysregulation in responses to script-driven trauma imagery. J Trauma Stress 2007, 20:713-725. doi:10.1002/jts.20284
• [21]Ray WJ, Odenwald M, Neuner F, Schauer M, Ruf M, Rockstroh B, Elbert T: Decoupling neural networks from reality: dissociative experiences in torture victims are reflected in abnormal brain waves in left frontal cortex. Psychol Sci 2006, 17:825-829.
• [22]Peyk P, Schupp HT, Elbert T, Junghöfer M: Emotional processing in the visual brain: a MEG analysis. Brain Topogr 2008, 20:205-215. doi:10.1007/s10548-008-0052-7
• [23]Schupp HT, Stockburger J, Codispoti M, Junghöfer M, Weike AI, Hamm AO: Stimulus novelty and emotion perception: the near absence of habituation in the visual cortex. Neuroreport 2006, 17:365-369.
• [24]Bradley MM: Natural selective attention: orienting and emotion. Psychophysiology 2009, 46:1-11. doi:10.1111/j.1469-8986.2008.00702.x
• [25]Öhman A, Flykt A, Esteves F: Emotion drives attention: detecting the snake in the grass. J Exp Psychol Gen 2001, 130:466-478.
• [26]Rockstroh B, Elbert T: Traces of fear in the neural web-Magnetoencephalographic responding to arousing pictorial stimuli. Int J Psychophysiol 2010, 78:14-19. doi:10.1016/j.ijpsycho.2010.01.012
• [27]Schalinski I, Elbert TR, Schauer M: Cardiac defense in response to imminent threat in women with multiple trauma and severe PTSD. Psychophysiology 2013, 50:691-700. doi:10.1111/psyp.12051
• [28]Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM: The development of a Clinician-Administered PTSD Scale. J Trauma Stress 1995, 8:75-90.
• [29]Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Dunbar GC: The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998, 59:22-33.
• [30]Williams JB: A structured interview guide for the Hamilton Depression Rating Scale. Arc Gen Psychiatry 1988, 45:742-747.
• [31]Lang PJ, Bradley MM, Cuthbert BN: International Affective Picture System (IAPS): Affective Ratings of Pictures and Instruction Manual. Technical Report A-8 . University of Florida, Gainesville, FL.FL: The Center for Research in Psychophysiology, University of Florida; 2008.
• [32]Oldfield RC: The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 1997, 9:97-113.
• [33]Bradley MM, Lang PJ: Measuring emotion: the self-assessment manikin and the semantic differential. J Behav Ther Exp Psychiatry 1994, 25:49-59.
• [34]Hämäläinen MS, Ilmoniemi RJ: Interpreting magnetic fields of the brain: Minimum norm estimates. Med Biol Eng Comput 1994, 32:35-42.
• [35]Rosenthal R: Meta-Analytic Procedures for Social Research (Vol. 6). Newbury Park, CA: SAGE Publications, Incorporated; 1991.
• [36]Wolf EJ, Miller MW, McKinney AE: Emotional processing in PTSD: heightened negative emotionality to unpleasant photographic stimuli. J Nerv Ment Dis 2009, 197:419-426. doi:10.1097/NMD.0b013e3181a61c68
• [37]Schauer M, Neuner F, Elbert T: Narrative Exposure Therapy. 2nd edition. Göttingen, Germany: Hogrefe & Huber; 2011.
• [38]Feeny NC, Zoellner LA, Foa EB: Anger, dissociation, and posttraumatic stress disorder among female assault victims. J Trauma Stress 2000, 13:89-100.
• [39]Neuner F, Schauer M, Karunakara U, Klaschik C, Robert C, Elbert T: Psychological trauma and evidence for enhanced vulnerability for PTSD through previous trauma among West Nile refugees. BMC Psychiatry 2004, 4:34. doi:10.1186/1471-244X-4-34
• [40]Schalinski I, Elbert T, Schauer M: Female dissociative responding to extreme sexual violence in a chronic crisis setting: The case of eastern congo. J Trauma Stress 2011, 24:235-238. doi:10.1002/jts.20631
• [41]Carlson EB, Dalenberg C, McDade-Montez E: Dissociation in posttraumatic stress disorder part I: definitions and review of research. Psychol Trauma Theory Res Pract Policy 2012, 4:479-489.
• [42]LeDoux JE: Synaptic Self: How our Brains Become Who We Are. New York: Viking Penquin; 2002.
• [43]Pessoa L, Adolphs R: Emotion processing and the amygdala: from a ‘low road’ to ‘many roads’ of evaluating biological significance. Nat Rev Neurosci 2010, 11:773-782. doi:10.1038/nrn2920
• [44]Steuwe C, Lanius RA, Frewen PA: Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depress Anxiety 2012, 29:689-700.
• [45]Heller W, Nitscke JB: Regional brain activity in emotion: a framework for understanding cognition in depression. Cogn Emot 1997, 11:637-661.
• [46]Kentgen LM, Tenke CE, Pine DS, Fong R, Klein RG, Bruder GE: Electroencephalographic asymmetries in adolescents with major depression: influence of comorbidity with anxiety disorders. J Abnorm Psychol 2000, 109:797-802.
• [47]Metzger LJ, Paige SR, Carson MA, Lasko NB, Paulus LA, Pitman RK, Orr SP: PTSD arousal and depression symptoms associated with increased right-sided parietal EEG asymmetry. J Abnorm Psychol 2004, 113:324-329.