Neural Processes of Emotional Conflict Detection and Prediction of Posttraumatic Stress Disorder Symptom Clusters in Traumatic Injury Survivors

Objective: Given the prevalence and significant burden of posttraumatic stress disorder (PTSD), identifying early predictors of symptom development following trauma is critical. PTSD is a heterogeneous disorder com-prised of distinct symptom clusters—reexperiencing, avoidance, negative mood, and hyperarousal—that con-tribute to the broad range of possible symptom profiles. Affective and attentional regulation processes, such as emotional conflict detection, are impaired in individuals with PTSD; however, the neural mechanisms under-lying these alterations and their predictive utility for the development of PTSD symptoms remain unclear. Method: Traumatic injury survivors (N= 49) without traumatic brain injury were recruited from the emergency department of an urban, Level-1 trauma center. Within 1 month of trauma exposure, participants completed a well-characterized emotional conflict task during a functional magnetic resonance imaging scan. Participants returned 6-month later for a clinical assessment of PTSD symptoms. Using a region-of-interest mask derived from whole-brain voxelwise analyses during emotional conflict detection (vs. no emotional conflict detection) we examined whether differential neural activity predicted 6-month PTSD symptom cluster severity. Results: Greater activation of the right middle frontal gyrus during emotional conflict detection prospectively predicted lower PTSD avoidance symptom severity 6 months later (above and beyond the effects of self-reported baseline PTSD and depressive symptoms, previous traumatic life events, racial discrimination, age, sex, and injury severity). Conclusions: Neural processes of emotion conflict detection measured in the early aftermath of a potentially traumatic event are useful as predictors for the development of PTSD symptoms.

Duke Scholars

Author Kate Webb Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...