title: How understanding the neurobiology of complex post-traumatic stress disorder can inform clinical practice: a social cognitive and affective neuroscience approach.
abstract: OBJECTIVE
  In this review, we examine the relevance of the social cognitive and affective neuroscience (SCAN) paradigm for an understanding of the psychology and neurobiology of complex post-traumatic stress disorder (PTSD) and its effective treatment.
  
  
  METHODS
  The relevant literature pertaining to SCAN and PTSD was reviewed.
  
  
  RESULTS
  We suggest that SCAN offers a novel theoretical paradigm for understanding psychological trauma and its numerous clinical outcomes, most notably problems in emotional/self-awareness, emotion regulation, social emotional processing and self-referential processing. A core set of brain regions appear to mediate these collective psychological functions, most notably the cortical midline structures, the amygdala, the insula, posterior parietal cortex and temporal poles, suggesting that problems in one area (e.g. emotional awareness) may relate to difficulties in another (e.g. self-referential processing). We further propose, drawing on clinical research, that the experiences of individuals with PTSD related to chronic trauma often reflect impairments in multiple social cognitive and affective functions.
  
  
  CONCLUSIONS
  It is important that the assessment and treatment of individuals with complex PTSD not only addresses traumatic memories but also takes a SCAN-informed approach that focuses on the underlying deficits in emotional/self-awareness, emotion regulation, social emotional processing and self-referential processing.
authors.affiliation: Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada. ruth.lanius@lhsc.on.ca
authors.forename: R A
authors.initials: RA
authors.lastname: Lanius
authors.forename: R L
authors.initials: RL
authors.lastname: Bluhm
authors.forename: P A
authors.initials: PA
authors.lastname: Frewen
mesh_terms: D000342:Affective Symptoms / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology; D006801:Humans; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology; D012919:Social Behavior; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*