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Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder

Citation

Felmingham, KL and Kemp, AH and Williams, L and Falconer, E and Olivieri, G and Peduto, A and Bryant, R, Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder, Psychological Medicine, 2008, (38) pp. 1771-1780. ISSN 0033-2917 (2008) [Refereed Article]


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Copyright © 2008 Cambridge University Press

DOI: doi:10.1017/S0033291708002742

Abstract

Background. Dissociative reactions in post-traumatic stress disorder (PTSD) have been regarded as strategic responses that limit arousal. Neuroimaging studies suggest distinct prefrontal responses in individuals displaying dissociative and hyperarousal responses to threat in PTSD. Increased prefrontal activity may reflect enhanced regulation of limbic arousal networks in dissociation. If dissociation is a higher-order regulatory response to threat, there may be differential responses to conscious and automatic processing of threat stimuli. This study addresses this question by examining the impact of dissociation on fear processing at different levels of awareness. Method. Functional magnetic resonance imaging (fMRI) with a 1.5-T scanner was used to examine activation to fearful (versus neutral) facial expressions during consciously attended and non-conscious (using backward masking) conditions in 23 individuals with PTSD. Activation in 11 individuals displaying non-dissociative reactions was compared to activation in 12 displaying dissociative reactions to consciously and non-consciously perceived fear stimuli. Results. Dissociative PTSD was associated with enhanced activation in the ventral prefrontal cortex for conscious fear, and in the bilateral amygdala, insula and left thalamus for non-conscious fear compared to non-dissociative PTSD. Comparatively reduced activation in the dissociative group was apparent in dorsomedial prefrontal regions for conscious fear faces. Conclusions. These findings confirm our hypotheses of enhanced prefrontal activity to conscious fear and enhanced activity in limbic networks to non-conscious fear in dissociative PTSD. This supports the theory that dissociation is a regulatory strategy invoked to cope with extreme arousal in PTSD, but this strategy appears to function only during conscious processing of threat.

Item Details

Item Type:Refereed Article
Keywords:Dissociation, fear, fMRI, non-conscious, PTSD.
Research Division:Agricultural and Veterinary Sciences
Research Group:Agriculture, Land and Farm Management
Research Field:Agricultural Land Management
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
Author:Felmingham, KL (Professor Kim Felmingham)
ID Code:72063
Year Published:2008
Web of Science® Times Cited:53
Deposited By:Psychology
Deposited On:2011-08-18
Last Modified:2014-11-24
Downloads:849 View Download Statistics

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