Neural indices of emotional reactivity and regulation predict course of PTSD symptoms in combat-exposed veterans

Fitzgerald, Jacklynn M.; Gorka, Stephanie M.; Kujawa, Autumn; DiGangi, Julia A.; Proescher, Eric; Greenstein, Justin E.; Aase, Darrin M.; Schroth, Christopher; Afshar, Kaveh; Kennedy, Amy E.; Hajcak, Greg; Phan, K. Luan

doi:10.1016/j.pnpbp.2017.11.005

Cited by 29 publications

(39 citation statements)

References 55 publications

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“…We found evidence for a nonlinear (i.e., quadratic) relationship between self‐reported, but not clinician‐assessed, PTSS and late LPP modulation by angry, but not fear or happy, face stimuli. This finding suggests that existing discrepant reports of inverse (DiGangi et al, ; MacNamara et al, ) and positive (Fitzgerald et al, ; Lobo et al, ) associations between threat‐related late LPP amplitude and PTSS severity may be due to variability in PTSS severity across samples. Further, the observed quadratic relationship between self‐reported PTSS and late LPP in response to angry face stimuli was not attributable to depression or anxiety symptoms and was comparable across each PTSS subscale (i.e., re‐experiencing, avoidance, hyperarousal), indicating that findings were driven by overall PTSS severity rather than specific symptom types or general distress.…”

Section: Discussionmentioning

confidence: 78%

“…Visual inspection of the grand‐averaged waveforms suggested that emotion‐related modulation of the LPP did not begin to emerge until approximately 700 ms, and thus the LPP was scored as the mean voltage at central‐parietal sites (Cz, CP1, CP2, Pz) in an early (700–1,000 ms) and late (1,000–3,000 ms) window (see Figure for waveforms and topographical maps). Early and late windows were separated for the following reasons: (a) based upon visual inspection, emotion‐related modulation of the LPP appeared to be more robust in the late relative to early window, (b) PTSS have demonstrated more robust associations with emotion‐related modulation of the LPP in the late relative to early window (Fitzgerald et al, ; MacNamara et al, ), (c) experimental data suggest that early versus late emotion‐related modulation of the LPP is differentially sensitive to emotion regulation strategies (Foti & Hajcak, ; MacNamara, Foti, & Hajcak, ; Thiruchselvam, Blechert, Sheppes, Rydstrom, & Gross, ).…”

Section: Methodsmentioning

confidence: 99%

“…High PTSS severity has also been linked with enhanced LPP amplitude during negative picture viewing among trauma‐exposed undergraduates (Lobo et al, ), whereas no significant differences were found between youth with and without PTSD (Grasso & Simons, ). To summarize, positive (Fitzgerald et al, ; Lobo et al, ), inverse (DiGangi et al, ; MacNamara et al, ), and null associations (Grasso & Simons, ) between PTSS and threat‐related LPP modulation have been found.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, we also explored the propensity to downregulate negative emotions in daily life as a moderator of the relationship between PTSS severity and threat‐related LPP to determine if it may impact the functional meaning of threat‐related LPP modulation in opposite directions (i.e., enhanced amplitude as indicative of dysregulation vs. adaptive nonavoidance of threat). Given our prior reports of the relevance of cognitive reappraisal‐related neural activity to PTSS (Fitzgerald et al, , ), the trait cognitive reappraisal subscale of the Emotion Regulation Questionnaire (ERQ; Melka, Lancaster, Bryant, & Rodriguez, ) was used to determine if cognitive reappraisal propensity moderated the relationship between PTSS and threat‐related LPP modulation.…”

Section: Introductionmentioning

confidence: 99%

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Nonlinear relations between post‐traumatic stress symptoms and electrocortical reactivity during emotional face processing in combat‐exposed veterans

et al. 2019

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Combat‐related post‐traumatic stress symptoms (PTSS) are prevalent among recently deployed veterans, making identification of biomarkers of PTSS in this population a public health priority. Given the link between threat processing neurobiology and PTSS, the threat‐related late positive potential (LPP), an ERP reflective of attentional processing sensitive to emotion and its regulation, may have utility as a cost‐effective biomarker. Existing PTSS/threat‐related LPP findings are mixed, possibly due to variability in PTSS across samples, but this has never been explicitly tested. To address this gap, LPP amplitudes to angry, fearful, and happy emotional face stimuli were recorded among 81 combat‐exposed veterans at a VA hospital. A quadratic relationship between self‐reported PTSS and LPP amplitude modulation by angry faces emerged such that greater PTSS was related to a decreased LPP response to angry faces among veterans with subthreshold PTSD and an enhanced LPP response to angry faces among veterans with probable PTSD. These results suggest that prior mixed findings may be due to variability in PTSS severity. In addition, exploratory moderation analysis revealed that PTSS was positively associated with late LPP modulation for veterans reporting low cognitive reappraisal use and negatively associated with late LPP modulation for veterans reporting high cognitive reappraisal use. All results were specific to the 1,000–3,000 ms LPP time window. Thus, the functional nature of LPP modulation by direct threat cues may depend upon PTSS severity and/or related variables (e.g., cognitive reappraisal utilization).

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Section: Discussionmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nonlinear relations between post‐traumatic stress symptoms and electrocortical reactivity during emotional face processing in combat‐exposed veterans

et al. 2019

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“…Therefore, subclinical posttraumatic stress reactions may involve SN activation that is effectively modulated by EN activation whereas PTSD may occur if the EN cannot modulate SN emotional reactivity. This explanation is supported by both prospective and cross‐sectional research that has shown PTSD symptoms to be associated with difficulty in recruiting top‐down (EN to SN) cortical activation when an individual attempts to modulate reactivity via cognitive reappraisal (Fitzgerald et al., ; White et al., ). Moreover, trauma‐exposed young adults without PTSD have been found to have a superior rather than diminished ability to intentionally suppress the retrieval of both neutral and negative valence memories (i.e., to forget information that they are instructed not to remember; Hulbert & Anderson, ).…”

Section: Ptsd Neuroimaging Research Of Relevance For Tmpmentioning

confidence: 91%

Trauma Memory Processing in Posttraumatic Stress Disorder Psychotherapy: A Unifying Framework

Ford

2018

Journal of Traumatic Stress

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Trauma memory processing (TMP) is an empirically supported approach to psychotherapy for posttraumatic stress disorder (PTSD). However, TMP is not a single, uniform intervention but instead a paradigm that can be operationalized through a variety of component procedures that have not been systematically elucidated and formally tested. Based on findings from phenomenological/structural and neuroimaging research, a central feature of PTSD is theorized to be the involuntary immersion in trauma memories with diminished awareness or negative appraisals of self and current context. Such intrusive reexperiencing—which is epitomized by, but not limited to, flashbacks—is postulated to underlie PTSD's avoidance, altered emotions and cognitions, dissociative, and hyperarousal/hypervigilance symptoms; it is thus a logical target for TMP. The varied approaches to TMP for PTSD are conceptualized as having the common goal of activation of the neural networks in the brain that underlie two key capacities disrupted by intrusive reexperiencing in PTSD: intentional self‐referential retrieval of memories and suppression of memory retrieval. Therefore, TMP is postulated to involve two core functions (purposeful reflective remembering and memory awareness in situ) and three essential types (in vivo, imaginal, and cognitive reappraisal). Several implications of this framework for clinical practice and research on TMP for PTSD are discussed.

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Inflammatory dysregulation in women with an eating disorder: Relationships with altered emotional reactivity

Dı́az-Marsá

MacDowell

laTorre-Luque

et al. 2021

Intl J Eating Disorders

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BackgroundSome studies suggest that inflammatory signaling dysregulation may contribute to eating disorder (ED) pathophysiology. However, little is known about the influence of inflammatory response on altered processes seen among patients with ED, such as emotional processing and reactivity.ObjectivesThe objectives were: (a) to investigate the systemic inflammatory response in ED women; and (b) to analyze the role of inflammatory markers in emotional reactivity.MethodConcentrations of several intercellular and intracellular inflammatory mediators (cytokines, prostaglandin by‐products and enzymes, TBARS, and MAPK proteins) were quantified in plasma and PBMCs from 68 women with an ED (m = 22.01 years, SD = 9.15) and 35 healthy controls (m = 18.54 years, SD = 4.21). Moreover, emotional reactivity to affective pictures (those without either food or thinness content) was studied using the adult (>18 years old) sample (n = 41).ResultsBetween‐group differences were revealed for most markers (TNF‐α, PGE2, COX2, and ratio of activated MAPK proteins), pointing to increased inflammatory response in patients (p < .01). Women with ED showed heightened emotional reactivity, regardless of picture valence. Principal components derived from inflammatory markers showed an explanatory loading on patient's emotional reaction, in terms of valence and arousal.ConclusionThis study corroborates the altered systemic inflammatory response in patients with ED. The inflammatory dysregulation may contribute to ED phenotype, as seen by its relationship with heightened emotional reactivity, even though the inflammatory markers were not evaluated throughout the emotional reactivity protocol.

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Neural indices of emotional reactivity and regulation predict course of PTSD symptoms in combat-exposed veterans

Cited by 29 publications

References 55 publications

Nonlinear relations between post‐traumatic stress symptoms and electrocortical reactivity during emotional face processing in combat‐exposed veterans

Nonlinear relations between post‐traumatic stress symptoms and electrocortical reactivity during emotional face processing in combat‐exposed veterans

Trauma Memory Processing in Posttraumatic Stress Disorder Psychotherapy: A Unifying Framework

Inflammatory dysregulation in women with an eating disorder: Relationships with altered emotional reactivity

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