Emotional face processing in adolescents with childhood sexual abuse-related posttraumatic stress disorder, internalizing disorders and healthy controls

Abstract

Childhood Sexual Abuse related posttraumatic stress disorder (CSA-related PTSD), and anxiety and depressive disorders (clinical depression) have profound though differential impact on adolescent emotion regulation, attention bias and emotional face processing. We hypothesized increased negative attention bias for emotional faces and altered brain functioning in CSA-related PTSD compared to internalizing disorders and healthy controls in a cross-sectional fMRI study using an emotional face processing task in 19 12-20-year-old adolescents with CSA-related PTSD, 26 with internalizing disorders and 26 healthy controls.Outcome measures were reaction times, subjective ratings of emotional faces, and brain activation patterns for whole brain and for regions of interest. Compared to both other groups adolescents with CSA-related PTSD showed significantly slower reaction times and the highest subjective rating of emotional faces. On whole brain and ROI level, no significant group differences were found. Self-reported depressive, posttraumatic or dissociative symptoms were not associated with differences in task-related brain activity. Results support the hypothesis of increased negative attention bias for fearful and neutral faces in CSA-related PTSD versus both other groups. The absence of neural differences might indicate a brain-behavior neuro-imaging gap to be closed by larger and IQ matched samples or more sensitive paradigms to elicit emotion processing.