Together with evidence that psychotic features are highly recurrent, these data show 1) that psychotic features denote a lifetime illness of greater severity and 2) that within individuals, psychotic features may emerge in only the more severe episodes.

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Highlights We found neurofeedback-specific attenuation of amygdala responses. Trauma symptoms and the affective state improved in patients at one-month follow-up. Reduced amygdala responses were associated with improved well-being at follow-up. 75% of individuals with PTSD used the learned strategies in daily life. Left lateral prefrontal cortex responses were reduced during neurofeedback training.

The autonomic nervous system (ANS) receives modulatory input from high-level supra-tentorial brain structures, which affects peripheral physiological measures such as heart rate variability (HRV), respiration, and electrodermal activity (see Beissner, Meissner, Bär, & Napadow, 2013 for a meta-analysis). For instance, in the neurovisceral integration model for HRV (Thayer & Lane, 2009), neocortical areas such as the prefrontal and cingulate cortex exert tonic inhibitory control over brainstem circuitry underlying the ANS regulation. A similar cortico-limbic model has been proposed for sensorimotor integration of respiration (Evans, 2010), with an interplay of volitional respiratory control (pre-motor and supplementary motor area (SMA)) and interoceptive integration areas (anterior cingulate cortex (ACC), insula, and amygdala). These models overlap in core autonomic network areas, including the cingulate cortex, insula, and amygdala