Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies

Abstract

Posttraumatic stress disorder (PTSD) is a psychiatric syndrome that develops after exposure to terrifying and life-threatening events including warfare, motor-vehicle accidents, and physical and sexual assault. The emotional experience of psychological trauma can have long-term cognitive effects. The hallmark symptoms of PTSD involve alterations to cognitive processes such as memory, attention, planning, and problem solving, underscoring the detrimental impact that negative emotionality has on cognitive functioning. As such, an important challenge for PTSD researchers and treatment providers is to understand the dynamic interplay between emotion and cognition. Contemporary cognitive models of PTSD theorize that a preponderance of information processing resources are allocated toward threat detection and interpretation of innocuous stimuli as threatening, narrowing one's attentional focus at the expense of other cognitive operations. Decades of research have shown support for these cognitive models of PTSD using a variety of tasks and methodological approaches. The primary goal of this review is to summarize the latest neurocognitive and neuroimaging research of emotion-cognition interactions in PTSD. To directly assess the influence of emotion on cognition and vice versa, the studies reviewed employed challenge tasks that included both cognitive and emotional components. The findings provide evidence for memory and attention deficits in PTSD that are often associated with changes in functional brain activity. The results are reviewed to provide future directions for research that may direct better and more effective treatments for PTSD.

Binding neutral information to emotional contexts: Brain dynamics of long-term recognition memory

“…For instance, in patients suffering from posttraumatic stress disorder (PTSD), events associated with traumatizing contexts can involuntarily trigger vivid distressing memories in the form of intrusive thoughts, flashbacks, or nightmares (Parson & Ressler, 2012) and, on the other hand, can result in impaired episodic memory for the traumatic event itself (e.g., Brewin, 2013;Flor & Nees, 2014;Hayes, VanElzakker, & Shin, 2012;McNally, 2008;Wilker, Elbert, & Kolassa, 2014). A prominent hypothesis of PTSD etiology suggests that trauma memories are poorly integrated into their context (e.g., time and place) during encoding, thus resulting in retrieval distortions of trauma-related information (Dolcos, 2013;Pannu Hayes et al, 2011), overgeneralization and easy triggering of physically similar cues (Ehlers & Clark, 2000), which might relate to deficits in long-term contextual binding processes.…”

PACAP receptor gene polymorphism impacts fear responses in the amygdala and hippocampus

“…In particular, pretrauma reactivity of the amygdalaa brain region responsible for coordinating and maintaining multiple components of emotional arousal (13)-appears to be a predisposing risk factor for the maintenance of PTSD symptoms (14)(15)(16). Additional brain regions implicated in the pathophysiology of PTSD include the ventromedial and dorsolateral prefrontal cortex, the anterior cingulate cortex, the hippocampus, and the insula (17,18), each of which plays a role in regulating aspects of the emotional response.…”

Emotional Competence and Combat-Related PTSD Symptoms in Croatian Homeland War Veterans

“…Emotion regulation skills training may be a useful intervention strategy for trauma survivors, especially since it seems that these difficulties serve to maintain or exacerbate PTSD symptoms (Price et al, 2006;Tull et al, 2007). The importance of incorporating emotional competence and regulation skills training modules in PTSD treatments is highlighted in research that shows that emotion regulation difficulties reduce the effectiveness of the traditional treatments for PTSD (Brousse et al, 2011;Hayes, Vanelzakker, & Shin, 2012;Price et al, 2006;Tull et al, 2007).…”