Psychoanalysis.  2019 Oct;30(4):114-123. 10.18529/psychoanal.2019.30.4.114.

Effects of Unconscious Emotional Distracters on Conscious Working Memory Maintenance in Patients with Posttraumatic Stress Disorder and Early Childhood Trauma: A Preliminary Functional Magnetic Resonance Imaging Study

• Um ZS
• Yang JC
• Park JI
• Kim GW

• KMID: 2464970
• DOI: http://doi.org/10.18529/psychoanal.2019.30.4.114

Abstract

OBJECTIVES
Few studies have assessed the neural mechanisms of the effects of unconscious emotional distracter on cognition in posttraumatic stress disorder (PTSD) patients. Thus, this study used functional magnetic resonance imaging (fMRI) to investigate the effects of unconscious emotional distraction involving fear during conscious working memory (WM) maintenance in patients with PTSD.
METHODS
This study included 10 patients with PTSD and positive early trauma inventory diagnosed based on Diagnostic and Statistical Manual of Mental Disorders fourth edition-text revision criteria, and 10 matched healthy controls. Event-related fMRI data were obtained while the participants performed a WM task (face recognition) with neutral and unconscious emotional distracters.
RESULTS
Patients with PTSD may have sought to maintain WM function during the presentation of task-irrelevant emotional distractors that induced interruption and required attention. Compared to healthy controls, the PTSD patients exhibited significantly increased activity in the superior frontal gyrus, middle frontal gyrus, superior temporal gyrus, middle temporal gyrus, and lingual gyrus in a delayed-response WM task when presented with unconscious emotional and fearful stimuli relative to neutral distracters.
CONCLUSION
This study identified specific brain areas associated with the interaction between emotional regulation and cognitive functioning during unconscious emotional distracters presented while patients with PTSD performed a WM maintenance task. There was no difference in brain activation between the two groups at the conscious level of neutral distractors, but under the unconscious emotional distracters, PTSD patients showed a specific activation of the brain.

Keyword

Unconscious emotional distracter; Functional magnetic resonance imaging; Posttraumatic stress disorder; Conscious working memory; Early trauma

MeSH Terms

Brain
Cognition
Diagnostic and Statistical Manual of Mental Disorders
Humans
Magnetic Resonance Imaging*
Memory, Short-Term*
Occipital Lobe
Prefrontal Cortex
Stress Disorders, Post-Traumatic*
Temporal Lobe