Converging lines of evidence suggest that individuals with comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) may be characterized by heightened defensive reactivity, which serves to maintain drinking behaviors and anxiety/hyperarousal symptoms. Notably, however, very few studies have directly tested whether individuals with PTSD and AUD exhibit greater defensive reactivity compared with individuals with PTSD without AUD. The aim of the current study was to therefore test this emerging hypothesis by examining individual differences in error related negativity (ERN), an event-related component that is larger among anxious individuals and is thought to reflect defensive reactivity to errors. Participants were sixty-six military veterans who completed a well-validated flanker task known to robustly elicit the ERN. Veterans were comprised of three groups: controls (i.e., no PTSD or AUD), PTSD-AUD (i.e., current PTSD but no AUD), and PTSD+AUD (i.e., current comorbid PTSD and AUD). Results indicated that in general, individuals with PTSD and controls did not differ in ERN amplitude. However, among individuals with PTSD, those with comorbid AUD had significantly larger ERNs than those without AUD. These findings suggest that PTSD+AUD is a neurobiologically unique subtype of PTSD and the comorbidity of AUD may enhance defensive reactivity to errors in individuals with PTSD.
Visual formaesthesias (hallucinations) are a common symptom of neurological insult. Research on emotional valances and the laterality of emotional valence extends to clinical populations experiencing visual hallucinations. The purpose of this project was to evaluate the relationship of reported hemispace of visual formaesthesia and associated emotional valence. Based on current literature exploring asymmetries in the processing of emotional valence, it was predicted that right visual formaesthesias would be predominantly associated with positive emotion and that left visual formaesthesias would largely be associated with negative emotion. Review of archival data on 150 neuropsychological patients from a rehabilitation unit in a tertiary care regional medical center resulted in 25 men and women, ages 25 to 93, endorsing visual formaesthesia upon neuropsychological interview. Analysis of variance results indicate the associated affective valence of the visual formaesthesia is a function of location, F(1, 24) = 8.33, p < .008. Additionally, the majority (84%) of sensory deficits detected were left-sided, regardless of the location of the formaesthesia. Patients specifically evidencing visual and tactile deficits had essentially exclusive left-sided deficits regardless of the location of the formaesthesia.
Hostile men have reliably displayed an exaggerated sympathetic stress response across multiple experimental settings, with cardiovascular reactivity for blood pressure and heart rate concurrent with lateralized right frontal lobe stress (Trajanoski et al., in Diabetes Care 19(12):1412–1415, 1996; see Heilman et al., in J Neurol Neurosurg Psychiatry 38(1):69–72, 1975). The current experiment examined frontal lobe regulatory control of glucose in high and low hostile men with concurrent left frontal lobe (Control Oral Word Association Test [verbal]) or right frontal lobe (Ruff Figural Fluency Test [nonverbal]) stress. A significant interaction was found for Group × Condition, F (1,22) = 4.16, p ≤ .05 with glucose levels (mg/dl) of high hostile men significantly elevated as a function of the right frontal stressor (M = 101.37, SD = 13.75) when compared to the verbal stressor (M = 95.79, SD = 11.20). Glucose levels in the low hostile group remained stable for both types of stress. High hostile men made significantly more errors on the right frontal but not the left frontal stressor (M = 17.18, SD = 19.88) when compared to the low hostile men (M = 5.81, SD = 4.33). These findings support our existing frontal capacity model of hostility (Iribarren et al., in J Am Med Assoc 17(19):2546–2551, 2000; McCrimmon et al., in Physiol Behav 67(1):35–39, 1999; Brunner et al., in Diabetes Care 21(4):585–590, 1998), extending the role of the right frontal lobe to regulatory control over glucose mobilization.
The thalamus has been described as a "relay station" for sensory information from most sensory modalities projecting to cortical areas. Therefore injury to the thalamus may result in multimodal sensory and motor deficits. In the present study, a 61-year-old woman suffered a right thalamic cerebral vascular accident (CVA; as evidenced by a computerised tomography [CT] scan). Secondary to this incident, she complained of altered sensations across multiple sensory modalities, including olfactory, visual, auditory, tactile, temperature, and pain sensation. Interestingly, during recovery from the thalamic CVA, the patient reported hallucinations in all the modalities cited above. Multimodal dysaethesias (odd sensations) and hallucinations showed reliable laterality in the affective valence across modalities with positive associations within right hemispace and negative associations within left hemispace. Overall, the results support multimodal role of the thalamus and provide evidence for lateralisation of positive and negative affect within the right and left hemispheres respectively.
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