Abstract
This study tested the extent to which coached participants can simulate the neural responses of participants with posttraumatic stress disorder (PTSD) when they are presented with signals of fear. Functional magnetic resonance imaging (fMRI) was used to study blood oxygenation level-dependent signal during the presentations of fearful and neutral faces under both conscious and nonconscious (masked) conditions. Participants comprised 12 patients with PTSD and 12 trauma-exposed controls who were instructed to simulate PTSD. During conscious fear processing, simulators showed greater activation in the left amygdala and medial prefrontal cortex (MPFC) than PTSD participants. By contrast, during nonconscious processing, PTSD participants had greater MPFC activation than simulators. These findings suggest that coached simulators produce a profile of ‘over-responding’ to fear when controlled conscious processing is possible, but are not able to simulate the exaggerated medial prefrontal responses observed in PTSD participants under conditions of nonconscious processing.
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Armony, J. L., Corbo, V., Clement, M. H., & Brunet, A. (2005). Amygdala response in patients with acute PTSD to masked and unmasked emotional facial expressions. The American Journal of Psychiatry, 162, 1961–1963.
Blake, D. D., Weathers, F., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., et al. (1995). The development of a clinician administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.
Bremner, J. D. (1999). Alterations in brain structure and function associated with post traumatic stress disorder. Seminars in Clinical Neuropsychiatry, 4, 249–255.
Bryant, R. A., & Harvey, A. G. (1998). Traumatic memories and pseudomemories in posttraumatic stress disorder. Applied Cognitive Psychology, 12, 81–88.
Bryant, R. A., Kemp, A. H., Felmingham, K. L., Liddell, B., Olivieri, G., Peduto, A., et al. (2008). Enhanced amygdala and medial prefrontal activation during nonconscious processing of fear in posttraumatic stress disorder: An fMRI study. Human Brain Mapping, 29, 517–523.
Carter, C. S., Braver, T. S., Barch, D. M., Botvinick, M. M., Noll, D., & Cohen, J. D. (1998). Anterior cingulate cortex, error detection, and the online monitoring of performance. Science, 280, 747–749.
Carter, C. S., Botvinick, M. M., & Cohen, J. D. (1999). The contribution of the anterior cingulate cortex to executive processes in cognition. Reviews in the Neurosciences, 10, 49–57.
Davis, M. (1997). Neurobiology of fear responses: The role of the amygdala. The Journal of Neuropsychiatry and Clinical Neurosciences, 9, 382–402.
Declerck, C. H., Boone, C., & De Brabander, B. (2006). On feeling in control: A biological theory for individual differences in control perception. Brain and Cognition, 62, 143–176.
First, M. B., Gibbon, M., Spitzer, R. L., & Williams, J. B. (1996). Structured clinical interview for DSM-IV: Axis I disorders. Multi-Health Systems. New York: American Psychiatric Press, Inc.
Friedman, M. J. (1991). Biological approaches to the diagnosis and treatment of post traumatic disorder. Journal of Traumatic Stress, 4, 67–91.
Gerardi, R. J., Blanchard, E. B., & Kolb, L. C. (1989). Ability of Vietnam veterans to dissimulate a psychophysiological assessment for post-traumatic stress disorder. Behavior Therapy, 20, 229–243.
Gordon, E., Cooper, N., Rennie, C., Hermens, D., & Williams, L. M. (2005). Integrative neuroscience: The role of a standardized database. Clinical EEG and Neuroscience, 36, 64–75.
Gur, R. C., Sara, R., Hagendoorn, M., Marom, O., Hughett, P., Macy, L., et al. (2002). A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies. Journal of Neuroscience Methods, 115, 137–143.
Lanius, R. A., Williamson, P. C., Densmore, M., Boksman, K., Gupta, M. A., Neufeld, R. W., et al. (2001). Neural correlates of traumatic memories in posttraumatic stress disorder: A functional MRI investigation. The American Journal of Psychiatry, 158, 1920–1922.
Lanius, R. A., Bluhm, R., Lanius, U., & Pain, C. (2006). A review of neuroimaging studies in PTSD: Heterogeneity of response to symptom provocation. Journal of Psychiatric Research, 40, 709–729.
Liberzon, I., Taylor, S. F., Amdur, R., Jung, T. D., Chamberlain, K. R., Minoshima, S., et al. (1999). Brain activation in PTSD in response to trauma-related stimuli. Biological Psychiatry, 45, 817–826.
Liddell, B. J., Brown, K. J., Kemp, A. H., Barton, M. J., Das, P., Peduto, A., et al. (2005). A direct brainstem-amygdala-cortical ‘alarm’ system for subliminal signals of fear. Neuroimage, 24, 235–243.
Macmillan, N. (1986). The psychophysics of nonconscious perception. The Behavioral and Brain Sciences, 9, 38–39.
Milad, M. R., & Quirk, G. J. (2002). Neurons in medial prefrontal cortex signal memory for fear extinction. Nature, 420, 70–74.
Morgan, M. A., & LeDoux, J. E. (1995). Differential contribution of dorsal and ventral medial prefrontal cortex to the acquisition and extinction of conditioned fear in rats. Behavioral Neuroscience, 109, 681–688.
Orr, S. P., & Kaloupek, D. G. (1997). Psychophysiological assessment of posttraumatic stress disorder. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 69–97). New York: Guilford.
Orr, S. P., & Pitman, R. K. (1993). Psychophysiologic assessment of attempts to simulate posttraumatic stress disorder. Biological Psychiatry, 33, 127–129.
Phan, K. L., Wager, T., Taylor, S. F., & Liberzon, I. (2002). Functional neuroanatomy of emotion: A meta-analysis of emotion activation studies in PET and fMRI. Neuroimage, 16, 331–348.
Pissiota, A., Frans, O., Michelgard, A., Appel, L., Langstrom, B., Flaten, M. A., et al. (2003). Amygdala and anterior cingulate cortex activation during affective startle modulation: A PET study of fear. The European Journal of Neuroscience, 18, 1325–1331.
Pitman, R. K., & Orr, S. P. (1993). Psychophysiologic testing for post-traumatic stress disorder Forensic psychiatric application. The Bulletin of the American Academy of Psychiatry and the Law, 21, 37–52.
Rauch, S. L. (2003). Neuroimaging and neurocircuitry models pertaining to the neurosurgical treatment of psychiatric disorders. Neurosurgery Clinics of North America, 14, 213–223.
Rauch, S. L., Whalen, P. J., Shin, L. M., McInerney, S. C., Macklin, M. L., Lasko, N. B., et al. (2000). Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study. Biological Psychiatry, 47, 769–776.
Rogers, R. (1997). Researching dissimulation. In R. Rogers (Ed.), Clinical assessment of malingering and deception (pp. 398–426). New York: Guilford.
Semple, W. E., Goyer, P. F., McCormick, R., Donovan, B., Muzic, R. F., Jr., Rugle, L., et al. (2000). Higher brain blood flow at amygdala and lower frontal cortex blood flow in PTSD patients with comorbid cocaine and alcohol abuse compared with normals. Psychiatry, 63, 65–74.
Shin, L. M., McNally, R. J., Kosslyn, S. M., Thompson, W. L., Rauch, S. L., Alpert, N. M., et al. (1999). Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: A PET investigation. The American Journal of Psychiatry, 156, 575–584.
Shin, L. M., Orr, S. P., Carson, M. A., Rauch, S. L., Macklin, M. L., Lasko, N. B., et al. (2004). Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. Archives of General Psychiatry, 61, 168–176.
Shin, L. M., Wright, C. I., Cannistraro, P. A., Wedig, M. M., McMullin, K., Martis, B., et al. (2005). A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Archives of General Psychiatry, 62, 273–281.
Simon, R. I. (Ed.). (2002). Posttraumatic stress disorder in litigation: Guidelines for forensic assessment (2nd ed.). Washington, DC: American Psychiatric Press.
Sparr, L., & Pankratz, L. D. (1983). Factitious posttraumatic stress disorder. The American Journal of Psychiatry, 140, 1016–1019.
Tzourio-Mazoyer, N., Landaeau B., Papthanasciou D., Crivello F., Etard O., Delcroix N., Mazoyer B., Joliot M. (2002). Automated anatomical labelling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage, 15, 273–289.
Williams, L. M., Liddell, B. J., Rathjen, J., Brown, K. J., Gray, J., Phillips, M., et al. (2004). Mapping the time course of nonconscious and conscious perception of fear: An integration of central and peripheral measures. Human Brain Mapping, 21, 64–74.
Williams, L. M., Das, P., Liddell, B. J., Kemp, A. H., Rennie, C. J., & Gordon, E. (2006). Mode of functional connectivity in amygdala pathways dissociates level of awareness for signals of fear. The Journal of Neuroscience, 26, 9264–9271.
Williams, L. M., Kemp, A. H., Felmingham, K., Barton, M., Olivieri, G., Peduto, A., et al. (2006). Trauma modulates amygdala and medial prefrontal responses to consciously attended fear. Neuroimage, 29, 347–357.
Williams, L. M., Liddell, B. J., Kemp, A. H., Bryant, R. A., Meares, R. A., Peduto, A. S., et al. (2006). Amygdala-prefrontal dissociation of subliminal and supraliminal fear. Human Brain Mapping, 27, 652–661.
Acknowledgments
This study was funded by an ARC Linkage Grant (LP0212048) and a NHMRC Program Grant (300403). We acknowledge the collaboration with the Brain Resource International Database (BRID) in recruitment and testing of participants.
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Bryant, R.A., Kemp, A., Felmingham, K. et al. Simulating Emotional Responses in Posttraumatic Stress Disorder: An fMRI Study. Psychol. Inj. and Law 3, 111–117 (2010). https://doi.org/10.1007/s12207-010-9071-2
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DOI: https://doi.org/10.1007/s12207-010-9071-2