Distinct neural mechanisms of emotional processing in prolonged grief disorder
Abstract
Background: Prolonged grief disorder (PGD) has recently been recognized as a separate psychiatric diagnosis, despite controversy over the extent to which it is distinctive from posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Methods: This study investigated distinctive neural processes underpinning emotion processing in participants with PGD, PTSD, and MDD with functional magnetic resonance study of 117 participants that included PGD (n = 21), PTSD (n = 45), MDD (n = 26), and bereaved controls (BC) (n = 25). Neural responses were measured across the brain while sad, happy, or neutral faces were presented at both supraliminal and subliminal levels. Results: PGD had greater activation in the pregenual anterior cingulate cortex (pgACC), bilateral insula, bilateral dorsolateral prefrontal cortices and right caudate and also greater pgACC–right pallidum connectivity relative to BC during subliminal processing of happy faces. PGD was distinct relative to both PTSD and MDD groups with greater recruitment of the medial orbitofrontal cortex during supraliminal processing of sad faces. PGD were also distinct relative to MDD (but not PTSD) with greater activation in the left amygdala, caudate, and putamen during subliminal presentation of sad faces. There was no distinction between PGD, PTSD, and MDD during processing of happy faces. Conclusions: These results provide initial evidence of distinct neural profiles of PGD relative to related psychopathological conditions, and highlight activation of neural regions implicated in reward networks. This pattern of findings validates current models of PGD that emphasize the roles of yearning and appetitive processes in PGD.
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Affected brain areas in prolonged grief disorder include the amygdala, the orbitofrontal cortex, the subgenual anterior cingulate cortex, the nucleus accumbens and the insula.
“Affected areas include the amygdala, the orbitofrontal cortex, the subgenual anterior cingulate cortex, the nucleus accumbens and the insula 96-101 .”
Neural responses of people with prolonged grief disorder are distinct from those of individuals with PTSD or depression.
“Notably, neural responses of people with prolonged grief disorder are distinct from those of individuals with PTSD or depression 96 .”
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Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., Brewin, C. R., King, D. L., Kraus, S. W., & Bryant, R. A. (2022) · World Psychiatry · doi:10.1002/wps.20960 · Cited by 182 · see citing works
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- Authors
- Bryant, R. A., Andrew, E., & Korgaonkar, M. S.
- Affiliations
- UNSW Sydney (AU)
- The University of Sydney (AU)
- Corresponding author
- Bryant, Richard A.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-01-07
- Volume
- 51
- Issue
- 4
- Pages
- 587-595
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2999268223
- Cited by
- 39
- References
- 48
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 1 · 2020: 2
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- prolonged grief disorder, emotional processing, post-traumatic stress disorder, major depressive disorder, bereavement, pregenual anterior cingulate cortex, insula, medial orbitofrontal cortex, amygdala, caudate nucleus, globus pallidus, reward network, longing, neural mechanisms
- MeSH terms
- Adult, Aged, Amygdala, Cerebral Cortex, Major Depressive Disorder, Emotions, Facial Expression, Female, Grief, Gyrus Cinguli, Happiness, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Putamen, Stress Disorders, Post-Traumatic, Prefrontal Cortex, Young Adult
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