Existential neuroscience: self-esteem moderates neuronal responses to mortality-related stimuli.

According to terror management theory, self-esteem serves as a buffer against existential anxiety. This proposition is well supported empirically, but its neuronal underpinnings are poorly understood. Therefore, in the present neuroimaging study, our aim was to test how self-esteem affects our neural circuitry activation when death-related material is processed. Consistent with previous findings, the bilateral insula responded less to death-related stimuli relative to similarly unpleasant, but death-unrelated sentences, an effect that might reflect a decrease in the sense of oneself in the face of existential threat. In anterior parts of the insula, this 'deactivation' effect was more pronounced for high self-esteem individuals, suggesting that the insula might be of core importance to understanding the anxiety-buffering effect of self-esteem. In addition, low self-esteem participants responded with enhanced activation to death-related over unpleasant stimuli in bilateral ventrolateral prefrontal and medial orbitofrontal cortex, suggesting that regulating death-related thoughts might be more effortful to these individuals. Together, this suggests that the anxiety-buffering effect of self-esteem might be implemented in the brain in the form of both insula-dependent awareness mechanisms and prefrontal cortex-dependent regulation mechanisms.