Relevance of context-dependent extinction processes for the development of experimentally induced intrusions
General, Cognitive and Mathematical Psychology
Final Report Abstract
Context-dependent extinction processes in interaction with reduced pattern separation and dysfunctional emotion regulation are supposed to be crucial mechanisms in the development and maintenance of posttraumatic stress disorder (PTSD), leading to intrusive re-experiencing of the traumatic event even in safe contexts. In order to investigate the relevance of these processes and their neural basis for predicting intrusive re-experiencing, we used the trauma film paradigm in a sample of 94 healthy female participants and measured intrusive re-experiencing regarding the trauma film after one week (short-term) and 3 months (long-term). The trauma film paradigm provides a good opportunity to investigate the prediction questions mentioned above in an ecologically valid but still efficient design in healthy samples, while longitudinal studies concerning the development of PTSD e.g. in high risk groups could only be realized at great expense. In respect of context-dependent extinction processes, the current study found that especially decreased extinction recall in a rather safe context predicted more frequent intrusive re-experiencing in relation to the trauma film after three months. This was shown by stronger conditioned skin conductance responses (SCRs) and decreased activation of the ventromedial prefrontal cortex (vmPFC) during early extinction recall. Likewise, intrusions in response to real-life aversive events were associated with reduced conditioned SCRs and decreased vmPFC activation, validating our findings concerning the trauma film paradigm and corresponding with previous findings concerning reduced extinction recall in PTSD. As expected, we moreover found an association between pattern separation and context-dependent fear conditioning. In particular during extinction recall in a novel context (renewal), a better pattern separation ability was related to stronger activation of the dorsal anterior cingulate cortex (dACC) and the right insula. However, we did not find the expected activation in the hippocampus. Furthermore, we did not find an association between pattern separation ability and analogue intrusions in response to the trauma film as well as in response to real-life aversive events. These results indicate that hippocampus-dependent contextual processing deficits are no relevant predictors for the development of intrusions (at least in this analogue study), but rather might be acquired during the development of PTSD. Nevertheless, pattern separation ability might contribute indirectly to the etiology of PTSD by influencing context-dependent extinction processes. Regarding emotion regulation, the results of this study showed that lasting effects of emotion regulation especially appeared for the tactic of reinterpretation in terms of reduced negative feelings and enhanced activation of the amygdala and vmPFC. This effect might result from a stronger induction of positive feelings due to the tactic of positive reinterpretation or from enhanced inhibition processes. However, reinterpretation compared with distancing did not result in significant differences, limiting the specificity of our findings. Experimentally induced intrusions after 3 months were predicted from reduced negative feelings and decreased insula activation for the regulation tactic distancing during re-exposure. These results complement previous findings by showing a stronger tendency to spontaneously take an observer perspective when remembering the trauma predicting a stronger development of PTSD symptoms. The current findings furthermore indicate that a higher ability to use distancing in order to regulate emotions is associated with the development of intrusive re-experiencing. The findings of this study might contribute to differentiate predisposing factors of PTSD from acquired deficits, in order to improve the development of preventive procedures or early interventions after traumatic events. Future studies should examine the clinical relevance of these findings for example by conducting longitudinal studies regarding the development of intrusive re-experiencing after traumatic events in high risk groups.
Publications
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(2019). A matter of context? Neural correlates of context-dependent fear conditioning. European Meeting on Human Fear Conditioning, 06.-08.05.2019, Würzburg
Neudert, M.K., Zehtner, R.I., Fricke, S., Bohlender, R., Jänicke-Reißig, S., Stark, R., & Hermann, A.
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(2019). Neuronal correlates of fear conditioning and its association to pattern separation. 9th World Congress of Behavioural and Cognitive Therapies, 17.-20.07.2019, Berlin
Neudert, M.K., Zehtner, R.I., Fricke, S., Bohlender, R., Jänicke-Reißig, S., Stark, R., & Hermann, A.
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(2019). Welche Relevanz hat die Mustertrennungsfähigkeit für neuronale Korrelate der Furchtkonditionierung? 45. Tagung Psychologie und Gehirn, 20.-22.06.2019, Dresden
Neudert, M.K., Zehtner, R.I., Fricke, S., Bohlender, R., Jänicke-Reißig, S., Stark, R., & Hermann, A.
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(2019). Zusammenhang zwischen Pattern Separation und Hippocampus-Volumen. 45. Tagung Psychologie und Gehirn, 20.- 22.06.2019, Dresden
Küss, A.M., Neudert, M.K., Zehtner, R.I., Stark, R., Hermann, A.
