title: Altered emotional interference processing in the amygdala and insula in women with Post-Traumatic Stress Disorder.
abstract: BACKGROUND
  Post-Traumatic Stress Disorder (PTSD) is characterized by distinct behavioral and physiological changes. Given the significant impairments related to PTSD, examination of the biological underpinnings is crucial to the development of theoretical models and improved treatments of PTSD.
  
  
  METHODS
  We used an attentional interference task using emotional distracters to test for top-down versus bottom-up dysfunction in the interaction of cognitive-control circuitry and emotion-processing circuitry. A total of 32 women with PTSD (based on an interpersonal trauma) and 21 matched controls were tested. Event-related functional magnetic resonance imaging was carried out as participants directly attended to, or attempted to ignore, fear-related stimuli.
  
  
  RESULTS
  Compared to controls, patients with PTSD showed hyperactivity in several brain regions, including the amygdala, insula, as well as dorsal lateral and ventral PFC regions.
  
  
  CONCLUSIONS
  These results are consistent with previous studies that have higher amygdala and insular activation in PTSD subjects. However, inhibition of suppression of PFC regions is inconsistent with the fear circuitry model hypothesized by prior research. We suggest that the specific emotional conflict task used appears to target implicit or automatic emotional regulation instead of explicit or effortful emotional regulation. This is particularly relevant as it posited that emotional regulatory difficulties in anxiety disorders such as PTSD appear to occur in implicit forms of emotion regulation.
authors.affiliation: Department of Psychology, University of Missouri, St. Louis, United States ; Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, United States.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Bruce
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Buchholz
authors.forename: Wilson J
authors.initials: WJ
authors.lastname: Brown
authors.forename: Laura
authors.initials: L
authors.lastname: Yan
authors.forename: Anthony
authors.initials: A
authors.lastname: Durbin
authors.forename: Yvette I
authors.initials: YI
authors.lastname: Sheline
keywords: Amygdala; Default mode network; Insula; PTSD; Trauma; fMRI