BackgroundPosttraumatic stress disorder (PTSD) is associated with abnormal hippocampal activity; however, the functional connectivity (FC) of the hippocampus with other brain regions in PTSD and its relations with symptoms warrants further attention. We investigated subregional hippocampal FC in PTSD during a resting state compared with a trauma-exposed control (TEC) group. Based on extant research, we targeted the FCs of the anterior and posterior hippocampal subregions with the amygdala, medial prefrontal cortex (mPFC), and the posterior cingulate (PCC).MethodsResting-state functional magnetic resonance images were acquired from 11 individuals with PTSD and 13 trauma-exposed controls. Anterior and posterior hippocampal FC was compared between groups. Within the PTSD and TEC groups, subregional hippocampal FC was correlated with scores on the Clinician-Administered PTSD Scale (CAPS) at time of scan and 4 months post-scan.ResultsThose with PTSD had significantly greater FC compared with the TEC group between the left posterior hippocampus and the bilateral PCC (g’s > .96). Direct contrasts of the Fisher z-transformed coefficients indicated that the correlations between CAPS scores 4 months post scan and the FC between the left hippocampal head and the right PCC (z = − 2.07, p = .039) as well as the FC between the right hippocampal tail and the right mPFC (z = − 2.19, p = .029) were significantly greater in the PTSD group compared to the TEC group.ConclusionsThese results support between-group differences in posterior hippocampal FC and different relations with PTSD future symptoms, underscoring associations with the anterior and posterior hippocampus. These findings enrich our understanding of PTSD pathophysiology and provide support for future investigations of imaging biomarkers predictive of disease progression.
A noteworthy number of treatment seekers with generalized anxiety disorder (GAD) do not achieve high end‐state functioning following cognitive‐behavioral therapy. Dialectical behavioral therapy (DBT) skills training may be an effective alternative treatment for GAD, especially for those with complex comorbidities and elevated emotion dysregulation. This article reviews the advantages of DBT skills training for GAD, including the emphasis on emotion dysregulation, inclusion of acceptance‐based strategies, and the dialectical approach. The theoretical support for DBT skills is reviewed, and treatments for GAD involving DBT skills are critically evaluated to assess the potential for DBT skills training for GAD. Further, this article conjectures on clinical presentations of GAD that would benefit from DBT skills training.
These findings provide additional support for previous research examining the relationship between psychological symptoms (e.g., anxiety and depression) and perceived cognitive impairment, and enrich our understanding of a potential mechanism driving these relationships. (PsycINFO Database Record
Chronic worry and generalized anxiety disorder (GAD) symptoms are associated with infrequent savoring, and high dampening, of positive emotions. The goal of the present study was to investigate the indirect role of GAD-relevant processes, including intolerance of uncertainty (IU), fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation, in the relationship between GAD symptom severity and the tendency to engage in dampening and not savor positive emotions. Community participants (
N
= 233) completed questionnaires online.
In separate models, IU, fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation fully mediated the relationships between GAD symptom severity and greater dampening and lower savoring. However, controlling for depression, only IU remained a significant mediator. A post hoc latent analysis of the mediators provided support for an underlying construct that may reflect intolerance of uncomfortable states. Intolerance of uncomfortable states was found to significantly mediate the relationship between GAD symptoms and greater dampening and lower savoring. Difficulty withstanding uncertainty may be particularly relevant in understanding why people with elevated GAD symptoms engage in efforts to avoid experiencing positive emotions. Further, the findings suggest that there may be a common factor underlying a variety of GAD-associated constructs reflecting a broad intolerance of uncomfortable inner states. Theoretical and clinical implications are discussed.
Supplementary Information
The online version contains supplementary material available at 10.1007/s41811-022-00145-x.
Negative interpretation bias, the propensity to make threatening interpretations of ambiguous information, is associated with symptoms of generalized anxiety disorder (GAD). Apart from its relationship with intolerance of uncertainty (IU), little is known about what explains the presence of this cognitive bias in GAD. One factor may be negative urgency (NU), the tendency to take rash action when distressed, which is related to GAD symptoms and to cognitive biases in nonclinical populations. The aim of the present study was to examine the relationship between NU and interpretation bias in individuals high in GAD symptoms (N = 111). IU, trait anxiety, and other forms of impulsivity were examined concurrently as competing correlates of interpretation bias. Greater NU and IU were found to be unique correlates of greater threatening interpretations of ambiguous scenarios. Greater NU was also a unique correlate of greater threatening interpretations of negative and positive scenarios. No other forms of impulsivity were uniquely related to interpretation bias. The findings suggest that greater NU may have a role in the tendency for individuals high in GAD symptoms to make threatening interpretations in response to ambiguous scenarios, overtly threatening situations, and situations without indication of threat or danger. Theoretical implications of these findings are discussed.
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