Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging

Abstract

BackgroundTraumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group.MethodsEvent-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation.ResultsFor the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread.ConclusionWe conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.

The Shutdown Dissociation Scale (Shut-D)

“…The shutdown dissociation strength in response to rapidly presented pictures was assessed in a study designed to trigger trauma-specific processing (Schalinski et al, 2014 ). Those patients with PTSD or trauma-related depressive symptoms ( n= 40) who displayed high Shut-D scores in their daily lives also reported elevated shutdown dissociation during the exposure of emotional evocative pictures ( r= 0.66 and p< 0.001).…”

“…Out of the patient group, 42 fulfilled all criteria of the diagnosis; two fulfilled the DSM-IV criteria of PTSD (A, B and D, E, F) but met only two of three avoidance symptoms (criteria C); whereas the ten others fulfilled the criteria for depression and subclinical PTSD symptoms. Data of the same sample are presented in Schalinski et al ( 2013 , 2014) .…”

“…The tendency towards shutdown dissociation was rated on a Likert scale with possible scores of 0 (not at all), 1 (a little bit), 2 (moderately), 3 (strongly), and 4 (very strongly) during picture presentation using the 13-item Shut-D Intensity Scale. Although the unpleasant pictures were not personalized for the traumatic events, 60% of the PTSD sample experienced intrusive memories of their own trauma that were triggered by the stimulation (Schalinski et al, 2014 ).…”

“…The item generation of the Shut-D was based on patients’ symptom descriptions, clinical observations, and expert judgment, and was conceptualized on the basis of the outlined defense cascade model. The scale has been applied in several studies (Fiess, Steffen, Pietrek, & Rockstroh, 2013 ; Isele et al, 2014 ; Schalinski, Elbert, & Schauer, 2011 , 2013 ; Schalinski, Moran, Schauer, & Elbert, 2014 ) that have shown the close relationship between trauma-related psychopathology and shutdown dissociation.…”

Rapid brain responses to affective pictures indicate dimensions of trauma‐related psychopathology in adolescents

“…In major depressive disorder, a reduced arousal modulation of the right temporo‐parietal activation evoked by visual stimuli was found (Moratti, Rubio, Campo, Keil, & Ortiz, ). Modulated early visual processing of emotional stimuli was also recorded in individuals suffering from post‐traumatic stress disorder (PTSD), depression symptoms, and dissociation (Adenauer, Pinosch et al, ; Burgmer et al, ; Elbert et al, ; Keil, Adenauer, Catani, & Neuner, ; Schalinski, Moran, Schauer, & Elbert, ). Such deviations in neural activity are assumed to be characteristic for this psychopathology.…”