A functional magnetic resonance imaging study of deliberate emotion regulation in resilience and posttraumatic stress disorder.
BACKGROUND
Sexual violence is an important public health problem in the United States, with 13% to 26% of women reporting a history of sexual assault. While unfortunately common, there is substantial individual variability in response to sexual assault. Approximately half of rape victims develop posttraumatic stress disorder (PTSD), while others develop no psychopathology (e.g., trauma-exposed non-PTSD). In this project, we examined the neural mechanisms underlying differences in response to sexual violence, focusing specifically on the deliberate modification of emotional responses to negative stimuli.


METHODS
Using functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent (BOLD) response, we examined the neural circuitry underlying effortful modification of emotional responses to negative pictures in 42 women: 14 with PTSD after sexual trauma, 14 with no psychiatric diagnosis after sexual trauma, and 14 nontraumatized control subjects.


RESULTS
In response to deliberate attempts to downregulate emotional responses, nontraumatized healthy control subjects were more successful than either trauma-exposed group (PTSD or non-PTSD) in downregulating responses to the negative pictures as measured by subjective rating and BOLD response in regions of prefrontal cortex (PFC). In contrast, after deliberate attempts to upregulate emotional responses, regions of PFC were activated by trauma-exposed non-PTSD subjects more than by healthy control subjects or PTSD subjects.


CONCLUSIONS
Successful downregulation of emotional responses to negative stimuli appears to be impaired by trauma exposure. In contrast, the ability to upregulate emotional responses to negative stimuli may be a protective factor in the face of trauma exposure and associated with resilience.
New
Antonia S
AS
Mental Health Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, New York 10468, USA. antonia.new@mssm.edu
Fan
Jin
J
Murrough
James W
JW
Liu
Xun
X
Liebman
Rachel E
RE
Guise
Kevin G
KG
Tang
Cheuk Y
CY
Charney
Dennis S
DS
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D001931:Brain Mapping; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D010775:Photic Stimulation / Q000379:methods; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology* / Q000503:physiopathology*; D055815:Young Adult
D010100:Oxygen