Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder
Open accessAbstract
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.
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In an fMRI study, D-PTSD patients showed increased activity in amygdala, insula, and thalamus while fearful versus neutral facial expressions were presented nonconsciously.
“In another fMRI study [86], patients with D-PTSD showed increased activity in the amygdala, insula, and thalamus while fearful versus neutral facial expressions were presented nonconsciously.”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [86]
In the same study, when images were presented consciously, dissociative patients showed increased activity in ventral PFC and diminished activity in dorsomedial PFC.
“In the latter case, dissociative patients showed increased activity in ventral PFC and diminished activity in the dorsomedial PFC, suggesting a conscious over-modulation of emotions and suppression of self-referential processing [86].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [86]
Fear states can be induced by combinations of internal and external triggers, some of which will be accessible to conscious processing, and some not.
“Fear states can therefore be induced by combinations of internal and external triggers, some of which will be accessible to conscious processing, and some not.42”
From Fear and the Defense Cascade (2015) · cites this paper as [42]
In any particular situation the defense response is a function of the species-specific defense repertoire, genetic variations among strains, characteristics of the threat, and context, all influenced by individual differences.
“In any particular situation the defense response will be a function of the species-specific defense repertoire,8 genetic variations among strains,26 characteristics of the threat, and context in which it occurs, all influenced by individual differences.§,27”
From Fear and the Defense Cascade (2015) · cites this paper as [27]
A review of available data suggests that tonic immobility, peritraumatic dissociation, and dissociative PTSD may be mediated by a shared neural network involving amygdala deactivation, absence of sympathetically mediated arousal symptoms, parasympathetic activation, and analgesia.
“A review of available data suggests that tonic immobility, peritraumatic dissociation, and dissociative PTSD may be mediated by a shared neural network involving amygdala deactivation, absence of sympathetically mediated arousal symptoms (decreased skin conductance and an absence of heart rate increases), parasympathetic activation (a decrease in heart rate in some studies, presumably reflecting a”
From Fear and the Defense Cascade (2015) · cites this paper as [27]
Experimental neuroimaging studies to date either report inconsistent brain regions associated with trauma-related dissociation or fail to present any associated neural regions at all.
“The few experimental neuroimaging studies to date (Daniels et al., 2012; Felmingham et al., 2008; Hopper, Frewen, van der Kolk et al., 2007; Mertens et al., 2022) either report inconsistent brain regions associated with trauma-related dissociation or fail to present any associated neural regions at all.”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Felmingham et al., 2008
A state of defensive posturing may compromise one's ability to utilize typical sensory processing avenues to interpret external sensory information continuously received from their surroundings.
“This state of defensive posturing may compromise one’s ability to utilize typical sensory processing avenues to interpret external sensory information continuously received from their surroundings (Bryant et al., 2005; Felmingham et al., 2008; Medford and Critchley, 2010; Ionta et al., 2011; Terpou et al., 2018).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Felmingham et al., 2008
Cites
Tzourio-Mazoyer, N., Landeau, B., Papathanassiou, D., Crivello, F., Etard, O., Delcroix, N., Mazoyer, B., & Joliot, M. (2002) · NeuroImage · doi:10.1006/nimg.2001.0978 · Cited by 16,319 · see citing works
Cognitive and emotional influences in anterior cingulate cortex
Bush, G., Luu, P., & Posner, M. I. (2000) · Trends in Cognitive Sciences · doi:10.1016/s1364-6613(00)01483-2 · Cited by 6,259 · see citing works
Functional neuroanatomy of emotion: A meta-analysis of emotion activation studies in PET and fMRI
Phan, K. L., Wager, T., Taylor, S. F., & Liberzon, I. (2002) · NeuroImage · doi:10.1006/nimg.2002.1087 · Cited by 3,502 · see citing works
Neural systems supporting interoceptive awareness
Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004) · Nature Neuroscience · doi:10.1038/nn1176 · Cited by 3,406 · cited 1× · see citing works
“Convergent imaging evidence in humans implicates regions of the insula in mediating interoceptive awareness (viscera, musculoskeletal and autonomic) that may contribute to arousal or emotional reactions (Craig, 2004 ; Critchley et al. 2004).”
BackgroundContributions of anterior cingulate cortex to behaviour
Devinsky, O., Morrell, M. J., & Vogt, B. A. (1995) · Brain · doi:10.1093/brain/118.1.279 · Cited by 3,377 · see citing works
Clinician-administered PTSD scale: A review of the first ten years of research
Weathers, F. W., Keane, T. M., & Davidson, J. R. T. (2001) · Depression and Anxiety · doi:10.1002/da.1029 · Cited by 1,903 · see citing works
Phelps, E. A., Delgado, M. R., Nearing, K. I., & LeDoux, J. E. (2004) · Neuron · doi:10.1016/j.neuron.2004.08.042 · Cited by 1,753 · see citing works
A clinician rating scale for assessing current and lifetime PTSD. The CAPS-1
Blake, D. D., Weathers, F. W., Nagy, L., Kaloupek, D. G., Klauminzer, G. W., Charney, D. S., & Keane, T. M. (1990) · Behavior Therapy · Cited by 1,123 · see citing works
Rauch, S. L., Whalen, P. J., Shin, L. M., McInerney, S. C., Macklin, M. L., Lasko, N. B., Orr, S. P., & Pitman, R. K. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00828-3 · Cited by 1,111 · see citing works
Shin, L. M., Wright, C. I., Cannistraro, P. A., Wedig, M. M., McMullin, K., Martis, B., Macklin, M. L., Lasko, N. B., Cavanagh, S. R., Krangel, T. S., et al. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.3.273 · Cited by 960 · see citing works
Extinction of emotional learning: contribution of medial prefrontal cortex
Morgan, M. A., Romanski, L. M., & LeDoux, J. E. (1993) · Neuroscience Letters · doi:10.1016/0304-3940(93)90241-c · Cited by 897 · cited 1× · see citing works
“Animal and human imaging studies suggest that these ventromedial prefrontal regions inhibit amygdala activity and have a role in fear extinction (Morgan et al. 1993; Phelps et al. 2004).”
BackgroundBremner, J. D., Krystal, J. H., Putnam, F. W., Southwick, S. M., Marmar, C., Charney, D. S., & Mazure, C. M. (1998) · Journal of Traumatic Stress · doi:10.1023/a:1024465317902 · Cited by 817 · see citing works
Shin, L. M., Orr, S. P., Carson, M. A., Rauch, S. L., Macklin, M. L., Lasko, N. B., Peters, P. M., Metzger, L. J., Dougherty, D. D., Cannistraro, P. A., et al. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.2.168 · Cited by 790 · see citing works
A direct brainstem–amygdala–cortical ‘alarm’system for subliminal signals of fear.
Liddell, B. J., Brown, K. J., Kemp, A. H., Barton, M. J., Das, P., Peduto, A., Gordon, E., & Williams, L. M. (2005) · NeuroImage · doi:10.1016/j.neuroimage.2004.08.016 · Cited by 670 · see citing works
Self-citationGur, R. C., Šára, R., Hagendoorn, M., Marom, O., Hughett, P., Macy, L., Turner, T. H., Bajcsy, R., Posner, A., & Gur, R. E. (2002) · Journal of Neuroscience Methods · doi:10.1016/s0165-0270(02)00006-7 · Cited by 647 · see citing works
Brain activation in PTSD in response to trauma-related stimuli
Liberzon, I., Taylor, S. F., Amdur, R., Jung, T. D., Chamberlain, K. R., Minoshima, S., Koeppe, R. A., & Fig, L. M. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00246-7 · Cited by 635 · see citing works
Lanius, R. A., Williamson, P. C., Densmore, M., Boksman, K., Gupta, M. A., Neufeld, R. W., Gati, J. S., & Menon, R. S. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.11.1920 · Cited by 521 · see citing works
Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., & Menon, R. S. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01367-7 · Cited by 505 · cited 13× · see citing works
“This finding replicates previous imaging findings in dissociative PTSD that used trauma narratives (Lanius et al. 2002).”
BackgroundMethodResultInfluentialNagai, Y., Critchley, H., Featherstone, E., Trimble, M., & Dolan, R. J. (2004) · NeuroImage · doi:10.1016/j.neuroimage.2004.01.019 · Cited by 465 · see citing works
Human feelings: why are some more aware than others?
Craig, A. D. (. (2004) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2004.04.004 · Cited by 445 · see citing works
Depersonalization: neurobiological perspectives.
Sierra, M., & Berrios, G. E. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00015-8 · Cited by 394 · see citing works
A review of neuroimaging studies in PTSD: heterogeneity of response to symptom provocation
Lanius, R. A., Bluhm, R., Lanius, U., & Pain, C. (2006) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2005.07.007 · Cited by 380 · see citing works
Trauma modulates amygdala and medial prefrontal responses to consciously attended fear
Williams, L. M., Kemp, A. H., Felmingham, K., Barton, M., Olivieri, G., Peduto, A., Gordon, E., & Bryant, R. A. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2005.03.047 · Cited by 351 · see citing works
Self-citationObjective assessment of peritraumatic dissociation: psychophysiological indicators
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.8.1081 · Cited by 347 · see citing works
Corticolimbic blood flow in posttraumatic stress disorder during script-driven imagery
Britton, J. C., Phan, K. L., Taylor, S. F., Fig, L. M., & Liberzon, I. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.12.025 · Cited by 265 · see citing works
Lanius, R. A., Williamson, P. C., Bluhm, R. L., Densmore, M., Boksman, K., Neufeld, R. W. J., Gati, J. S., & Menon, R. S. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.01.011 · Cited by 260 · see citing works
Williams, L. M., Liddell, B. J., Rathjen, J., Brown, K. J., Gray, J. A., Phillips, M. L., Young, A., & Gordon, E. (2003) · Human Brain Mapping · doi:10.1002/hbm.10154 · Cited by 251 · see citing works
Self-citationWilliams, L. M., Das, P., Liddell, B. J., Kemp, A. H., Rennie, C. J., & Gordon, E. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.1016-06.2006 · Cited by 232 · cited 4× · see citing works
“Convergent evidence suggests that controlled processing in dorsal medial prefrontal regions is prevented by the use of the backward masking paradigm (Rauch et al. 2000 ; Williams et al. 2006a).”
BackgroundMethodInfluentialSelf-citationDepersonalization in response to life-threatening danger
Noyes, R., & Kletti, R. (1977) · Comprehensive Psychiatry · doi:10.1016/0010-440x(77)90010-4 · Cited by 231 · see citing works
Depersonalization disorder: thinking without feeling.
Phillips, M. L., Medford, N., Senior, C., Bullmore, E. T., Suckling, J., Brammer, M. J., Andrew, C., Sierra, M., Williams, S. C. R., & David, A. S. (2001) · Psychiatry Research: Neuroimaging · doi:10.1016/s0925-4927(01)00119-6 · Cited by 215 · see citing works
Clark, C. R., McFarlane, A. C., Morris, P., Weber, D. L., Sonkkilla, C., Shaw, M., Marcina, J., Tochon-Danguy, H. J., & Egan, G. F. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01505-6 · Cited by 162 · see citing works
Dissociative states and epilepsy
Devinsky, O., Putnam, F., Grafman, J. H., Bromfield, E. B., & Theodore, W. H. (1989) · Neurology · doi:10.1212/wnl.39.6.835 · Cited by 116 · see citing works
Acute and Chronic Responses to Psychological Trauma: Where Do We Go From Here?
Bremner, J. D. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.3.349 · Cited by 110 · see citing works
Preconscious processing of threat in posttraumatic stress disorder
Harvey, A., Bryant, R., & Rapee, R. (1996) · Cognitive Therapy and Research · doi:10.1007/bf02227964 · Cited by 68 · see citing works
Self-citationLeft hemispheric activation in depersonalization disorder: A case report
Hollander, E., Carrasco, J. L., Mullen, L. S., Trungold, S., DeCaria, C. M., & Towey, J. P. (1992) · Biological Psychiatry · doi:10.1016/0006-3223(92)90161-r · Cited by 47 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09081168 · Cited by 1,123 · see citing works
Hakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., Ernst, M., & Pine, D. S. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.07.021 · Cited by 869 · see citing works
Evaluation of the evidence for the trauma and fantasy models of dissociation.
Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012) · Psychological Bulletin · doi:10.1037/a0027447 · Cited by 667 · see citing works
Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000065 · Cited by 468 · see citing works
“Fear states can therefore be induced by combinations of internal and external triggers, some of which will be accessible to conscious processing, and some not.(42) In this context it is important to note that, although we focus primarily on the role of phylogenetically old circuits underpinning innate animal and human…”
BackgroundLanius, R. A., Brand, B., Vermetten, E., Frewen, P. A., & Spiegel, D. (2012) · Depression and Anxiety · doi:10.1002/da.21889 · Cited by 459 · see citing works
Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man
Fenster, R. J., Lebois, L. A. M., Ressler, K. J., & Suh, J. (2018) · Nature Reviews Neuroscience · doi:10.1038/s41583-018-0039-7 · Cited by 456 · see citing works
Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.170021 · Cited by 407 · see citing works
Dissociative disorders in DSM-5
Spiegel, D., Loewenstein, R. J., Lewis-Fernández, R., Sar, V., Simeon, D., Vermetten, E., Cardeña, E., & Dell, P. F. (2011) · Depression and Anxiety · doi:10.1002/da.20874 · Cited by 330 · see citing works
Functional neuroimaging studies of post-traumatic stress disorder
Hughes, K. C., & Shin, L. M. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.198 · Cited by 290 · see citing works
Fonzo, G. A., Simmons, A. N., Thorp, S. R., Norman, S. B., Paulus, M. P., & Stein, M. B. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.04.028 · Cited by 235 · see citing works
Nicholson, A. A., Densmore, M., Frewen, P. A., Théberge, J., Neufeld, R. W., McKinnon, M. C., & Lanius, R. A. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.79 · Cited by 180 · see citing works
Felmingham, K., Williams, L. M., Kemp, A. H., Liddell, B., Falconer, E., Peduto, A., & Bryant, R. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0017551 · Cited by 179 · see citing works
Self-citationNicholson, A. A., Friston, K. J., Zeidman, P., Harricharan, S., McKinnon, M. C., Densmore, M., Neufeld, R. W. J., Théberge, J., Corrigan, F., Jetly, R., et al. (2017) · Human Brain Mapping · doi:10.1002/hbm.23748 · Cited by 159 · see citing works
Lanius, R. A., Terpou, B. A., & McKinnon, M. C. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1807703 · Cited by 164 · see citing works
Ludäscher, P., Valerius, G., Stiglmayr, C., Mauchnik, J., Lanius, R. A., Bohus, M., & Schmahl, C. (2010) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.090022 · Cited by 131 · see citing works
The innate alarm system in PTSD: conscious and subconscious processing of threat.
Lanius, R. A., Rabellino, D., Boyd, J. E., Harricharan, S., Frewen, P. A., & McKinnon, M. C. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2016.11.006 · Cited by 120 · see citing works
Krause-Utz, A., Frost, R., Winter, D., & Elzinga, B. M. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0757-y · Cited by 116 · see citing works
Biomarkers of Pathological Dissociation: A Systematic Review
Roydeva, M. I., & Reinders, A. A. T. S. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.11.019 · Cited by 116 · see citing works
Harricharan, S., McKinnon, M. C., & Lanius, R. A. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.625490 · Cited by 110 · see citing works
Reinders, A. A. T. S., Willemsen, A. T. M., den Boer, J. A., Vos, H. P. J., Veltman, D. J., & Loewenstein, R. J. (2014) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2014.05.005 · Cited by 96 · see citing works
Dissociation and posttraumatic stress disorder: a latent profile analysis
Blevins, C. A., Weathers, F. W., & Witte, T. K. (2014) · Journal of Traumatic Stress · doi:10.1002/jts.21933 · Cited by 85 · see citing works
The effects of trauma on brain and body: A unifying role for the midbrain periaqueductal gray
Terpou, B. A., Harricharan, S., McKinnon, M. C., Frewen, P., Jetly, R., & Lanius, R. A. (2019) · Journal of Neuroscience Research · doi:10.1002/jnr.24447 · Cited by 82 · see citing works
Beutler, S., Mertens, Y. L., Ladner, L., Schellong, J., Croy, I., & Daniels, J. K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2132599 · Cited by 64 · see citing works
“The few experimental neuroimaging studies to date (Daniels et al., 2012; Felmingham et al., 2008; Hopper, Frewen, van der Kolk et al., 2007; Mertens et al., 2022) either report inconsistent brain regions associated with traumarelated dissociation or fail to present any associated neural regions at…”
BackgroundRabellino, D., Densmore, M., Frewen, P. A., Théberge, J., & Lanius, R. A. (2016) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2015.12.005 · Cited by 67 · see citing works
Persistent Dissociation and Its Neural Correlates in Predicting Outcomes After Trauma Exposure
Lebois, L. A. M., Harnett, N. G., van Rooij, S. J. H., Ely, T. D., Jovanovic, T., Bruce, S. E., House, S. L., Ravichandran, C., Dumornay, N. M., Finegold, K. E., et al. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.21090911 · Cited by 60 · see citing works
Lotfinia, S., Soorgi, Z., Mertens, Y., & Daniels, J. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.05.006 · Cited by 53 · see citing works
The distinctive neural circuitry of complex posttraumatic stress disorder during threat processing
Bryant, R. A., Felmingham, K. L., Malhi, G., Andrew, E., & Korgaonkar, M. S. (2021) · Psychological Medicine · doi:10.1017/s0033291719003921 · Cited by 46 · see citing works
Self-citationNardo, D., Högberg, G., Flumeri, F., Jacobsson, H., Larsson, S. A., Hällström, T., & Pagani, M. (2011) · Psychological Medicine · doi:10.1017/s0033291711000912 · Cited by 41 · see citing works
Daniels, J. K., Frewen, P., Theberge, J., & Lanius, R. A. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12464 · Cited by 40 · see citing works
del Río-Casanova, L., González, A., Páramo, M., Van Dijke, A., & Brenlla, J. (2016) · Reviews in the Neurosciences · doi:10.1515/revneuro-2015-0045 · Cited by 32 · see citing works
Terpou, B. A., Densmore, M., Théberge, J., Thome, J., Frewen, P., McKinnon, M. C., & Lanius, R. A. (2019) · Chronic Stress · doi:10.1177/2470547019871369 · Cited by 26 · see citing works
Moser, D. A., Aue, T., Wang, Z., Rusconi Serpa, S., Favez, N., Peterson, B. S., & Schechter, D. S. (2013) · Stress · doi:10.3109/10253890.2013.816280 · Cited by 26 · see citing works
- Authors
- Felmingham, K., Kemp, A. H., Williams, L., Falconer, E., Olivieri, G., Peduto, A., & Bryant, R.
- Affiliations
- The University of Sydney (AU)
- Westmead Hospital (AU)
- Corresponding author
- Felmingham, K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-02-25
- Volume
- 38
- Issue
- 12
- Pages
- 1771-1780
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2144301044
- Cited by
- 165
- References
- 35
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 14 · 2019: 10 · 2018: 12 · 2017: 14 · 2016: 8 · 2015: 13 · 2014: 9 · 2013: 11 · 2012: 11
- FWCI
- 7.45
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, dissociation, fear processing, ventral prefrontal cortex, amygdala, insula, thalamus, hyperarousal, facial expressions, backward masking
- MeSH terms
- Adult, Aged, Brain, Consciousness, Dissociative Disorders, Facial Expression, Fear, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Stress Disorders, Post-Traumatic, Visual Perception, Prefrontal Cortex
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