title: Punishment Learning in U.S. Veterans With Posttraumatic Stress Disorder.
abstract: Learning processes have been implicated in the development and course of posttraumatic stress disorder (PTSD); however, little is currently known about punishment-based learning in PTSD. The current study investigated impairments in punishment-based learning in U.S. veterans. We expected that veterans with PTSD would demonstrate greater punishment-based learning compared to a non-PTSD control group. We compared a PTSD group with and without co-occurring depression (n = 27) to a control group (with and without trauma exposure) without PTSD or depression (n = 29). Participants completed a computerized probabilistic punishment-based learning task. Compared to the non-PTSD control group, veterans with PTSD showed significantly greater punishment-based learning. Specifically, there was a significant Block × Group interaction, F(1, 54) = 4.12, p = .047, η(2) = .07. Veterans with PTSD demonstrated greater change in response bias for responding toward a less frequently punished stimulus across blocks. The observed hypersensitivity to punishment in individuals with PTSD may contribute to avoidant responses that are not specific to trauma cues.
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Alice T
authors.initials: AT
authors.lastname: Sawyer
authors.affiliation: Department of Psychology, Suffolk University, Boston, Massachusetts, USA.
authors.forename: Gabrielle I
authors.initials: GI
authors.lastname: Liverant
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.|Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Janie J
authors.initials: JJ
authors.lastname: Jun
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.|Boston University School of Medicine, Boston, Massachusetts, USA.|Department of Psychology, Auburn University, Auburn, Alabama, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: McLean Hospital and, Harvard Medical School, Belmont, Massachusetts, USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Cohen
authors.affiliation: Department of Psychology, Yale University, New Haven, Connecticut, USA.
authors.forename: Sunny J
authors.initials: SJ
authors.lastname: Dutra
authors.affiliation: McLean Hospital and, Harvard Medical School, Belmont, Massachusetts, USA.
authors.forename: Diego A
authors.initials: DA
authors.lastname: Pizzagalli
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.|Boston University School of Medicine, Boston, Massachusetts, USA.|VA National Center for PTSD, Behavioral Science Division, Boston, Massachusetts, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Sloan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001362:Avoidance Learning; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011678:Punishment / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014728:Veterans / Q000523:psychology*