Neural correlates of self-reflection in post-traumatic stress disorder.
OBJECTIVE
Disturbances in self-referential processing (SRP) are increasingly recognized in post-traumatic stress disorder (PTSD). In healthy adults, SRP tasks engage the medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC) brain regions that have shown altered function in PTSD. We hypothesized that individuals with PTSD would differ from controls in functional activation of the MPFC and PCC during SRP.


METHODS
We compared neural activation in healthy controls (n = 15) and participants with PTSD (n = 20) during a SRP task, using fMRI at 4.0T.


RESULTS
Controls made faster responses to the self-relevance of personal characteristics than to the accuracy of general facts, whereas response times did not differ between these conditions in PTSD. Controls also demonstrated greater MPFC (dorsal and ventral) and PCC response when considering the self-relevance of personal characteristics in comparison with the accuracy of general facts. Individuals with PTSD demonstrated less MPFC response than did healthy controls for the contrast of self-relevance of personal characteristics relative to general facts.


CONCLUSIONS
These results implicate MPFC in SRP disturbances associated with PTSD. These findings are relevant to current proposals for including symptoms of negative self-referential cognition and identity-existential disturbance as diagnostically relevant to PTSD.
Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA, USA.
R L
RL
Bluhm
P A
PA
Frewen
N C
NC
Coupland
M
M
Densmore
A N
AN
Schore
R A
RA
Lanius
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology*; D011597:Psychomotor Performance; D011930:Reaction Time; D012649:Self Concept; D012647:Self-Assessment; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology / Q000503:physiopathology*