Chantelle S Lloyd1,2,3,4, Andrew A Nicholson4,5, Maria Densmore2,6, Jean Théberge2,6,7, Richard W J Neufeld2,8,9, Rakesh Jetly10, Margaret C McKinnon3,4,5, Ruth A Lanius2,4,6,9. 1. Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada. 2. Department of Psychiatry, Western University, London, Ontario, Canada. 3. Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada. 4. Homewood Research Institute, Homewood Health, Guelph, Ontario, Canada. 5. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. 6. Imaging Division, Lawson Health Research Institute, London, Ontario, Canada. 7. Department of Medical Biophysics, Western University, London, Ontario, Canada. 8. Department of Psychology, Western University, London, Ontario, Canada. 9. Department of Neuroscience, Western University, London, Ontario, Canada. 10. Canadian Forces, Health Services, Ottawa, Ontario, Canada.
Abstract
BACKGROUND: Moral injury (MI) is consistently associated with adverse mental health outcomes, including the development of posttraumatic stress disorder (PTSD) and suicidality. METHODS: We investigated neural activation patterns associated with MI event recall using functional magnetic resonance imaging in participants with military and public safety-related PTSD, relative to civilian MI-exposed controls. RESULTS: MI recall in the PTSD as compared to control group was associated with increased neural activation among salience network nodes involved in viscerosensory processing and hyperarousal (right posterior insula, dorsal anterior cingulate cortex; dACC), regions involved in defensive responding (left postcentral gyrus), and areas responsible for top-down cognitive control of emotions (left dorsolateral prefrontal cortex; dlPFC). Within the PTSD group, measures of state and trait shame correlated negatively with activity among default mode network regions associated with self-related processing and moral cognition (dorsomedial prefrontal cortex; dmPFC) and salience network regions associated with viscerosensory processing (left posterior insula), respectively. CONCLUSIONS: These findings suggest that MI event processing is altered in military and public safety-related PTSD, relative to MI-exposed controls. Here, it appears probable that as individuals with PTSD recall their MI event, they experience a surge of blame-related processing of bodily sensations within salience network regions, including the right posterior insula and the dACC, which in turn, prompt regulatory strategies at the level of the left dlPFC aimed at increasing cognitive control and inhibiting emotional affect. These results are consistent with previous findings showing enhanced sensory processing and altered top-down control in PTSD samples during autobiographical memory recall.
BACKGROUND:Moral injury (MI) is consistently associated with adverse mental health outcomes, including the development of posttraumatic stress disorder (PTSD) and suicidality. METHODS: We investigated neural activation patterns associated with MI event recall using functional magnetic resonance imaging in participants with military and public safety-related PTSD, relative to civilian MI-exposed controls. RESULTS: MI recall in the PTSD as compared to control group was associated with increased neural activation among salience network nodes involved in viscerosensory processing and hyperarousal (right posterior insula, dorsal anterior cingulate cortex; dACC), regions involved in defensive responding (left postcentral gyrus), and areas responsible for top-down cognitive control of emotions (left dorsolateral prefrontal cortex; dlPFC). Within the PTSD group, measures of state and trait shame correlated negatively with activity among default mode network regions associated with self-related processing and moral cognition (dorsomedial prefrontal cortex; dmPFC) and salience network regions associated with viscerosensory processing (left posterior insula), respectively. CONCLUSIONS: These findings suggest that MI event processing is altered in military and public safety-related PTSD, relative to MI-exposed controls. Here, it appears probable that as individuals with PTSD recall their MI event, they experience a surge of blame-related processing of bodily sensations within salience network regions, including the right posterior insula and the dACC, which in turn, prompt regulatory strategies at the level of the left dlPFC aimed at increasing cognitive control and inhibiting emotional affect. These results are consistent with previous findings showing enhanced sensory processing and altered top-down control in PTSD samples during autobiographical memory recall.
Authors: Yuanxin Xue; Jillian Lopes; Kimberly Ritchie; Andrea M D'Alessandro; Laura Banfield; Randi E McCabe; Alexandra Heber; Ruth A Lanius; Margaret C McKinnon Journal: Front Psychiatry Date: 2022-06-13 Impact factor: 5.435
Authors: Braeden A Terpou; Chantelle S Lloyd; Maria Densmore; Margaret C McKinnon; Jean Théberge; Richard W J Neufeld; Rakesh Jetly; Ruth A Lanius Journal: J Psychiatry Neurosci Date: 2022-02-17 Impact factor: 6.186
Authors: Andrea M D'Alessandro; Kimberly Ritchie; Randi E McCabe; Ruth A Lanius; Alexandra Heber; Patrick Smith; Ann Malain; Hugo Schielke; Charlene O'Connor; Fardous Hosseiny; Sara Rodrigues; Margaret C McKinnon Journal: Front Psychiatry Date: 2022-02-14 Impact factor: 4.157
Authors: Andrew A Nicholson; Magdalena Siegel; Jakub Wolf; Sandhya Narikuzhy; Sophia L Roth; Taylor Hatchard; Ruth A Lanius; Maiko Schneider; Chantelle S Lloyd; Margaret C McKinnon; Alexandra Heber; Patrick Smith; Brigitte Lueger-Schuster Journal: Eur J Psychotraumatol Date: 2022-02-28