Abstract:
Post-Traumatic Stress Disorder (PTSD) is a debilitating condition often associated with deficits in regulating emotion, particularly in reappraising negative emotions. These deficits have been associated with differences in neural activation in emotion processing regions such as the amygdala and regulatory medial (mPFC) and dorsolateral prefrontal cortices (dlPFC). This study assessed neural mechanisms associated with emotion regulation and appraisal in veterans following treatment for PTSD symptoms. Thirty six veterans with PTSD were assigned to evidence-based treatments and completed a series of emotion regulation and appraisal tasks while undergoing fMRI scanning prior to and following treatment. The Emotion Regulation Task (ERT) assessed neural activation during passive viewing, maintenance of emotional response, and reappraisal of emotional response to distressing images. PTSD symptom ratings were also taken for participants prior to and following treatment. ERT results for activation during “maintain” trials subtracted from activation during “reappraise” trials revealed that individuals with PTSD (M = 0.24, SD = 0.43) showed greater dmPFC activation than trauma-exposed combat controls (CC; M= 0.04, SD = 0.38; t(51.89)= 2.01, p = .05). In concert, symptom improvement over time was inversely related (F(3, 36) = 3.66, p = .02, R2 = .17) to activation in the dmPFC (t(39)= -2.84, p < .01), bilateral amygdala (t(39) = -2.38, p = .02), and dlPFC (t(39) = -2.26, p = .03). Present findings suggest that those who demonstrate greater reduction of symptoms over time with treatment may exhibit less pretreatment activation in the amygdala and prefrontal regions of interest during cognitive reappraisal compared to maintenance of emotion. . This is one of the first studies to examine neural activation across different treatments for PTSD and provides greater insight into emotion regulation and processing in PTSD.