Investigating the interaction of emotional reactivity and neural reward processing in patients with complex Post-Traumatic Stress Disorder

创伤后应激障碍（PTSD）是一种严重的、潜在的使人衰弱的疾病，可能在经历创伤性事件后发生。复杂创伤后应激障碍是创伤后应激障碍的一种亚型，多重的、长期的、通常是人际的创伤经历会在情绪处理、自我组织以及人际关系方面造成额外的干扰。功能失调的情绪处理在复杂创伤后应激障碍的发展和维持中起着重要作用，被认为会导致奖励动机减少和认知障碍。然而，这些症状的潜在神经机制仍然知之甚少。先前的研究表明，情绪大脑网络的过度反应会导致对威胁的注意偏向，以及恐惧反应的增加。因此，本研究的目的是揭示在复杂的创伤后应激障碍中，恐惧诱发的对环境显著性的功能障碍归因是如何导致认知加工和基于奖励的决策受损的。更好地了解这些心理生物学机制是制定改进的预防和治疗策略的基本要求。这将通过使用功能神经成像程序和实验任务来实现，该任务允许调查情感，奖励和认知过程之间的直接相互作用。这个范例将允许评估观察到的恐惧网络的超反应性是否是认知和奖励处理减少的因果因素。

Post-Traumatic Stress Disorder (PTSD) is a serious, potentially debilitating condition that can develop after experiencing a traumatic event. Complex PTSD is a sub-type of PTSD where multiple, prolonged and often interpersonal traumatic experiences cause additional disturbances in the domains of emotional processing, self-organization, as well as interpersonal relationships. Dysfunctional emotional processing plays a fundamental role in the development and maintenance of complex PTSD, and is thought to cause reduced reward motivation as well as cognitive impairments. However, the underlying neural mechanisms of these symptoms are still poorly understood. Previous studies suggest a hyper-reactivity of emotional brain networks causing attentional bias toward threat, as well as an increased fear response. Therefore, the aim of the proposed study is to unravel how fear-induced dysfunctional attribution of saliency to the environment contributes to impaired cognitive processing and reward-based decision making in complex PTSD. A better understanding of these psychobiological mechanisms is a fundamental requirement for the development of improved prevention and treatment strategies. This will be achieved by employing a functional neuroimaging procedure with an experimental task which allows investigating the direct interaction between emotional, reward and cognitive processes. This paradigm will allow assessing if the observed hyper-reactivity of the fear network is a causal factor for both decreased cognitive as well as decreased reward processing.