Impact of alcohol use disorder comorbidity on defensive reactivity to errors in veterans with posttraumatic stress disorder.

Abstract

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.

The error-related negativity (ERN) moderates the association between interpersonal stress and anxiety symptoms six months later

“…Lastly, because we used a composite measure of anxiety symptoms, our results cannot speak to the ability of the ERN and interpersonal stress to interact to predict specific symptoms of anxiety. This composite included symptoms associated with disorders that have been consistently linked to an enhanced ERN (e.g., OCD and SAD symptoms;Carrasco et al, 2013;Endrass et al, 2010;Hajcak and Simons, 2002;Weinberg et al, 2012Weinberg et al, , 2015bEndrass et al, 2014;Kujawa et al, 2016), but also symptoms less consistently associated with a heightened ERN (e.g., trauma-related symptoms; Gorka et al, 2016;Khan et al, 2018;Lackner et al, 2018;Meyer et al, 2013;Rabinak et al, 2013;Swick et al, 2015). It is possible that certain categories of anxiety symptoms are better predicted by an interaction between ERN magnitude and interpersonal stress.…”

Error-related brain activity and internalizing disorder symptom dimensions in depression and anxiety

“…Standard eye blink and ocular corrections were performed (Miller, Gratton, & Yee, 1988). Data were segmented beginning 500 ms before each response onset and continuing for 1,500 ms. Standard artifact rejection procedures were used (see Gorka et al., ). Baseline correction for each trial was performed using the 500 to 300 ms prior to response onset.…”

Error-related Brain Activity as a Treatment Moderator and Index of Symptom Change during Cognitive-Behavioral Therapy or Selective Serotonin Reuptake Inhibitors

“…Detailed descriptions of our EEG recording and processing procedures have been published elsewhere (eg, Gorka et al, 2017;Gorka et al, 2016). In brief, EEG was recorded during the task using the ActiveTwo BioSemi system (BioSemi, Amsterdam, the Netherlands).…”

“…Data were re-referenced to the average of the two mastoids and high-pass (0.1 Hz) and low-pass (30 Hz) filtered. Data were segmented beginning 500 ms before each response onset and continuing for 1500 ms. Standard artifact rejection procedures were used (see Gorka et al, 2017;Gorka et al, 2016). Baseline correction for each trial was performed using the 500 to 300 ms prior to response onset.…”