Relevance of context-dependent extinction processes for the development of experimentally induced intrusions

创伤性事件的侵入性再体验是创伤后应激障碍（PTSD）的一个关键症状。经典条件反射过程导致创伤期间中性刺激与厌恶后果的关联，被认为有助于侵入性记忆的发展。在这里，条件反应的短期和长期功能失调似乎特别相关。与此同时，有关创伤性事件的情境信息在自传式记忆中储存得很差。创伤后应激障碍的实验室研究进一步表明，环境信息对消退的调节存在缺陷。这也许可以解释在安全环境中对创伤相关线索的反应增强。然而，目前还没有研究调查情境依赖的灭绝过程是否预测了侵入性再体验的发生。此外，关于情境信息辨别和认知情绪调节的基本差异对情境依赖性消退过程和入侵发展的影响，目前的研究还很少。由于在临床样本中对这些关联的调查只有通过复杂的纵向设计才有可能，创伤-膜范式构成了在健康样本中调查此类研究问题的生态学上有效和有效的替代方案。本研究对67名健康女性进行了功能性磁共振成像（fMRI）研究。在参与情境依赖性消退过程及其神经基础的条件反射范式之前，将进行行为模式分离和认知情绪调节的神经相关评估任务。之后，在创伤-电影范式中，将厌恶电影片段呈现给参与者，并在接下来的一周内评估实验诱导的侵入性再体验。本研究的主要问题是通过情境依赖的消退过程和相关的恐惧和消退回路的激活来解决实验诱导的入侵的潜在预测。此外，还将研究行为模式分离的影响以及认知情绪调节的即时效应和长期效应。本研究结果有助于更好地了解创伤后侵入性再体验的相关影响因素及其潜在机制。从长远来看，这些发现可能有助于优化PTSD的预防干预和治疗。

Intrusive re-experiencing of a traumatic event is a key symptom of posttraumatic stress disorder (PTSD). Classical conditioning processes, which lead to the association of neutral stimuli with aversive consequences during the trauma, are assumed to contribute to the development of intrusive memories. Here, dysfunctional short- and long-term extinction of conditioned responses seems to be especially relevant. At the same time, contextual information concerning the traumatic event is poorly stored in autobiographical memory. Laboratory studies in PTSD furthermore indicate a deficient modulation of extinction by contextual information. This might explain the enhanced responses towards trauma associated cues in safe contexts. However, there are no studies investigating if context-dependent extinction processes predict the occurrence of intrusive re-experiencing. Additionally, there are only few insights about the influence of basic differences in the discrimination of contextual information and in cognitive emotion regulation on context-dependent extinction processes and the development of intrusions. As the investigation of these associations in clinical samples is only possible with sophisticated longitudinal designs, the trauma-film paradigm constitutes an ecologically valid and efficient alternative for the investigation of such research questions in healthy samples.Sixty-seven healthy females are to be investigated in this functional magnetic resonance imaging (fMRI) study. Before participating in a conditioning paradigm measuring context-dependent extinction processes and their neural basis, tasks for assessing behavioral pattern separation as well as the neural correlates of cognitive emotion regulation will be conducted. Afterwards, aversive film-clips will be presented to the participants during the trauma-film paradigm, and experimentally induced intrusive re-experiencing will be assessed during the following week. The main question of this study addresses the potential prediction of developing experimentally induced intrusions by context-dependent extinction processes and related activation of the fear and extinction circuit. Furthermore, the effect of behavioral pattern separation as well as immediate and prolonged effects of cognitive emotion regulation will be studied. The results of this study might contribute to a better understanding of relevant factors influencing the development of intrusive re-experiencing after traumatic events and its underlying mechanisms. In the long term, these findings might help to optimize preventive interventions as well as treatments for PTSD.