Processing of affective words in adolescent PTSD-Attentional bias toward social threat.

Fabian Klein,Benjamin Iffland,Rita Rosner,Frank Neuner,Sebastian Schindler,Babette Renneberg,Regina Steil

doi:10.1111/psyp.13444

Abstract

Post-traumatic stress disorder (PTSD) is associated with a hypersensitivity to potential threat. This hypersensitivity manifests through differential patterns of emotional information processing and has been demonstrated in behavioral and neurophysiological experimental paradigms. However, the majority of research has been focused on adult patients with PTSD. To examine possible differences in underlying neurophysiological patterns for adolescent patients with PTSD after childhood sexual and/or physical abuse (CSA/CPA), ERP correlates of emotional word processing in 38 healthy participants and 40 adolescent participants with PTSD after experiencing CSA/CPA were studied. The experimental paradigm consisted of a passive reading task with neutral, positive (e.g., paradise), physically threatening (e.g., torment), and socially threatening (i.e., swearing, e.g., son of a bitch) words. A modulation of P3 amplitudes by emotional valence was found, with positive words inducing less elevated amplitudes over both groups. Interestingly, in later processing, the PTSD group showed augmented early late positive potential (LPP) amplitudes for socially threatening stimuli, while there were no modulations within the healthy control group. Also, region-specific emotional modulations for anterior and posterior electrode clusters were found. For the anterior LPP, highest activations have been found for positive words, while socially and physically threatening words led to strongest modulations in the posterior LPP cluster. There were no modulations by group or emotional valence at the P1 and EPN stage. The findings suggest an enhanced conscious processing of socially threatening words in adolescent patients with PTSD after CSA/CPA, pointing to the importance of a disjoined examination of threat words in emotional processing research.

Highlights

Post‐traumatic stress disorder (PTSD) is a disorder that may occur after the experience of a traumatic, life‐threatening event
The present study examined differential cortical responses to emotional and neutral words and tried to assess different patterns between adolescent patients with PTSD and healthy adolescents
We discovered an interaction between groups and emotional valence in the analyzed early time window of the late positive potential (LPP), indicating a partially heightened LPP response for socially threatening stimuli in the PTSD group

Summary

Introduction

Post‐traumatic stress disorder (PTSD) is a disorder that may occur after the experience of a traumatic, life‐threatening event (e.g., physical or sexual assault, combat, or natural disasters). Psychophysiological research could provide evidence for increased amygdala activation and decreased activation in prefrontal cortical areas as well as reduced hippocampal volumes in PTSD (Etkin & Wager, 2007), leading to a supposedly over‐reactive threat detection (amygdala: e.g., Phelps, 2004; Vuilleumier, 2005), possibly diminished regulatory control (prefrontal cortex: e.g., Kane & Engle, 2002), and disrupted adaptive memory processes (hippocampus: e.g., Furini, Myskiw, & Izquierdo, 2014). There are studies using different methodologies (e.g., magneto‐encephalogram [MEG] and flickering aversive pictures: Catani, Adenauer, Keil, Aichinger, & Neuner, 2009; EEG and affective facial expressions: Felmingham, Bryant, & Gordon, 2003), which argue for a decreased visual processing of aversive stimuli in PTSD. The variability of reported attentional biases seems to be empirically observable in PTSD (Naim et al, 2015) and may be associated with differences in traumatic events, PTSD severity, or type of examined sample (e.g., adults vs. adolescents)

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