Abstract

Background: Posttraumatic stress disorder (PTSD) patients show heightened fear responses to trauma reminders and an inability to inhibit fear in the presence of safety reminders. Brain imaging studies suggest that this is in part due to amygdala over-reactivity as well as deficient top-down cortical inhibition of the amygdala. Consistent with these findings, previous studies, using fear-potentiated startle (FPS), have shown exaggerated startle and deficits in fear inhibition in PTSD participants. However, many PTSD studies using the skin conductance response (SCR) report no group differences in fear acquisition. Method: The study included 41 participants with PTSD and 70 without PTSD. The fear conditioning session included a reinforced conditioned stimulus (CS+, danger cue) paired with an aversive airblast, and a nonreinforced conditioned stimulus (CS−, safety cue). Acoustic startle responses and SCR were acquired during the presentation of each CS. Results: The results showed that fear conditioned responses were captured in both the FPS and SCR measures. Furthermore, PTSD participants had higher FPS to the danger cue and safety cue compared to trauma controls. However, SCR did not differ between groups. Finally, we found that FPS to the danger cue predicted re-experiencing symptoms, whereas FPS to the safety cue predicted hyper-arousal symptoms. However, SCR did not contribute to PTSD symptom variance. Conclusions: Replicating earlier studies, we showed increased FPS in PTSD participants. However, although SCR was a good measure of differential conditioning, it did not differentiate between PTSD groups. These data suggest that FPS may be a useful tool for translational research. Depression and Anxiety, 2011. © 2011 Wiley Periodicals, Inc.

Highlights

  • A three-way analysis of variance (ANOVA) examining the effects of Block by Trial Type between Diagnostic Group (PTSD, control) on startle revealed a main effect of Block, F(2, 218) 5 17.37, Po.001, Z2 5 .14, and Trial Type, F(1, 109) 5 11.42, P 5.001, Z2 5

  • There was a main effect of Group, F(1, 109) 5 5.02, Po.05, Z2 5 .04, with Posttraumatic stress disorder (PTSD) participants displaying greater levels of fear-potentiated startle (FPS) overall; there were no significant interactions between Group and Trial Type or Group and Block

  • PTSD is characterized by excessive fear responding to trauma reminders that persist in the presence of safety reminders

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Summary

Introduction

Traumatic memories may form via Pavlovian fear conditioning, whereby neutral environmental cues, or conditioned stimuli (CS), come to elicit fear- and anxiety-related behaviors, or conditioned fear responses (CR), due to their prior association with highly aversive cues, or unconditioned stimuli (US).[3] Animal and human fear conditioning studies have identified the amygdala, a dense collection of neurons located deep within the temporal lobes, as a critical neuroanatomical region responsible for conditioned fear memory processing.[4,5,6,7] In Pavlovian fear conditioning, sensory information about the CS and US converge in the lateral nucleus of the amygdala[8] with projections to the central nucleus of the amygdala, which is the primary output nucleus of the amygdala fear circuitry. Depression and Anxiety 28:1058–1066, 2011. r 2011 Wiley Periodicals, Inc

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