title: Blunted responses to reward in remitted post-traumatic stress disorder.
abstract: BACKGROUND
  Recent evidence suggests blunted responses to rewarding stimuli in patients with post-traumatic stress disorder (PTSD). However, it is not clear whether these alterations in reward processing normalize in remitted PTSD patients.
  
  
  METHODS
  We tested behavioral and physiological responses to monetary reward in a spatial memory task in 13 accident survivors with remitted PTSD, 14 accident survivors who never had PTSD, and 16 nontrauma-exposed subjects. All accident survivors were recruited from two samples of severely physically injured patients, who had participated in previous prospective studies on the incidence of PTSD after accidental injury approximately 10 years ago. Reaction time, accuracy, skin conductance responses, and self-reported mood were assessed during the task.
  
  
  RESULTS
  Accident survivors who never had PTSD and nontrauma exposed controls reported significantly higher positive mood in the reinforced versus nonreinforced condition (P < 0.045 and P < 0.001, respectively), while there was no effect of reinforcement in remitted PTSD subjects.
  
  
  CONCLUSIONS
  Our findings suggest an alteration of the reward system in remitted PTSD. Further research is needed to investigate whether altered reward processing is a residual characteristic in PTSD after remission of symptoms or, alternatively, a preexisting risk factor for the development of PTSD after a traumatic event.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Zurich, Switzerland.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Kalebasi
authors.affiliation: Cantonal Hospital of Tessin Bellinzona, Switzerland.
authors.forename: Eveline
authors.initials: E
authors.lastname: Kuelen
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Zurich, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Zurich, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Schumacher
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Zurich, Switzerland ; Center of Education and Research (COEUR), Psychiatric Services of the County of St. Gallen-North Wil, Switzerland ; Department of Psychiatry, Massachusetts General Hospital Boston, Massachusetts.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mueller-Pfeiffer
authors.affiliation: Division of Clinical Psychology, Psychotherapy and Health Psychology, University of Salzburg Salzburg, Austria.
authors.forename: Frank H
authors.initials: FH
authors.lastname: Wilhelm
authors.affiliation: Center for Integrative Neurosciences, University of California San Francisco San Francisco, California.
authors.forename: Jegath
authors.initials: J
authors.lastname: Athilingam
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich Zurich, Switzerland.
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Moergeli
authors.affiliation: Division of Clinical and Health Psychology, Department of Psychology, University of Fribourg Fribourg, Switzerland.
authors.forename: Chantal
authors.initials: C
authors.lastname: Martin-Soelch
mesh_terms: D000067290:Behavior Rating Scale; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011603:Psychophysiology / Q000379:methods; D020127:Recovery of Function; D012054:Reinforcement, Psychology; D012201:Reward; D065852:Spatial Memory; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*
keywords: Experimental; motivation; post-traumatic stress disorder; psychopathology; remitted; residual symptoms; reward