Cited by 191Posttraumatic Stress Disorder ResearchChild Abuse and TraumaIntimate Partner and Family Violence

Functional Activation and Neural Networks in Women with Posttraumatic Stress Disorder Related to Intimate Partner Violence

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Simmons, Alan N., Paulus, Martin P., Thorp, Steven R., Matthews, Scott C., Norman, Sonya B., Stein, Murray B.·2008·Biological Psychiatry

Abstract

Background Intimate partner violence (IPV) is one of the most common causes of posttraumatic stress disorder (PTSD) in women. Victims of IPV are often preoccupied by the anticipation of impending harm. This investigation tested the hypothesis that IPV-related PTSD individuals show exaggerated insula reactivity to the anticipation of aversive stimuli.Methods Fifteen women with a history of IPV and consequent PTSD (IPV-PTSD) and 15 non-traumatized control (NTC) women performed a task involving cued anticipation to images of positive and negative events during functional magnetic resonance imaging.Results Both groups showed increased activation of bilateral anterior insula during anticipation of negative images minus anticipation of positive images. Activation in right anterior/middle insula was significantly greater in the IPV-PTSD relative to the NTC group. Functional connectivity analysis revealed that changes in activation in right middle insula and bilateral anterior insula were more strongly associated with amygdala activation changes in NTC than in IPV-PTSD subjects.Conclusions This study revealed increased activation in the anterior/middle insula during negative anticipation in women with IPV-related PTSD. These findings in women with IPV could be a consequence of the IPV exposure, reflect pre-existing differences in insular function, or be due to the development of PTSD. Thus, future longitudinal studies need to examine these possibilities.

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Crossref · 10.1016/j.biopsych.2008.05.027

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  • The insula is responsible for interoception, disgust, emotion processing, emotion recall and anticipation of aversive stimuli.

    “an area responsible for interoception,20 disgust,21 emotion processing,22 emotion recall9 and anticipation of aversive stimuli.19”
  • Functional MRI studies of individuals with PTSD have demonstrated aberrant activity in the insula.

    “Functional MRI studies of individuals with PTSD have also demonstrated aberrant activity in the insula”
  • Most studies have found diminished strength of connectivity in individuals with PTSD compared with controls, regardless of the direction of connectivity identified.

    “regardless of the direction of the connectivity identified (positive connectivity v. anticorrelation), most studies have found diminished strength of connectivity in individuals with PTSD compared with controls.2,16,18,19”
  • Recent fMRI studies have reported greater insula activation in anticipation of negative images and negative emotional faces in individuals with PTSD as well as enhanced coupling between the insula and amygdala during negative emotion induction in healthy volunteers and during symptom provocation in recently traumatized individuals.

    “Recent fMRI studies have reported greater insula activation in anticipation of negative images19 and negative emotional faces18 in individuals with PTSD as well as enhanced coupling between the insula and amygdala during negative emotion induction in healthy volunteers26 and during symptom provocation in recently traumatized individuals.16”
  • Insula responsivity to negative images in individuals with PTSD has been shown to be positively correlated with hyperarousal symptoms, re-experiencing symptoms and flashback intensity.

    “Indeed, insula responsivity to negative images in individuals with PTSD has previously been shown to be positively correlated with hyperarousal symptoms,19 re-experiencing symptoms63 and flashback intensity.64”

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Authors
Simmons, A. N., Paulus, M. P., Thorp, S. R., Matthews, S. C., Norman, S. B., & Stein, M. B.
Affiliations
University of California San Diego (US)
Corresponding author
Simmons, Alan N.
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2008-10
Volume
64
Issue
8
Pages
681-690
ISSN
0006-3223 (ISSN-L)
OpenAlex
W1971041158
Cited by
191
References
86
Citations by year
2026: 3 · 2025: 5 · 2024: 7 · 2023: 11 · 2022: 11 · 2021: 7 · 2020: 11 · 2019: 18 · 2018: 9 · 2017: 14 · 2016: 9 · 2015: 10 · 2014: 10 · 2013: 18 · 2012: 18
FWCI
11.13
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (MH64122, MH65413)
  • U.S. Department of Veterans Affairs
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Health › Intimate Partner and Family Violence
Keywords
post-traumatic stress disorder, intimate partner violence, women, anterior insula, amygdala, functional connectivity, artificial neural networks, threat anticipation
MeSH terms
Adult, Amygdala, Arousal, Brain Mapping, Cerebral Cortex, Female, Humans, Magnetic Resonance Imaging, Mental Processes, Middle Aged, Neural Pathways, Reference Values, Spouse Abuse, Stress Disorders, Post-Traumatic, Case-Control Studies

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