30 maart 2020
European Journal of Psychotraumatology
Sigurd Wiingaard Uldall, Mette Ødegaard Nielsen, Jessica Carlsson, Birte Glenthøj, Hartwig Roman Siebner, Kristoffer Hougaard Madsen, Camilla Gøbel Madsen, Anne-Mette Leffers, Ayna Baladi Nejad & Egill Rostrup
https://doi.org/10.1080/20008198.2020.1730091
Background: Psychological traumatic experiences can lead to posttraumatic stress disorder (PTSD). Secondary psychotic symptoms are not common but may occur.
Objectives: Since psychotic symptoms of schizophrenia have been related to aberrant reward processing in the striatum, using the same paradigm we investigate whether the same finding extends to psychotic and anhedonic symptoms in PTSD.
Methods: A total of 70 male refugees: 18 PTSD patients with no secondary psychotic symptoms (PTSD-NSP), 21 PTSD patients with secondary psychotic symptoms (PTSD-SP), and 31 healthy controls (RHC) were interviewed and scanned with functional magnetic resonance imaging (fMRI) during a monetary incentive delay task. Using region of interest analysis of the prefrontal cortex and ventral striatum, we investigated reward-related activity.
Results: Compared to RHC, participants with PTSD had decreased neural activity during monetary reward. Also, participants with PTSD-SP exhibited decreased activity in the associative striatum relative to participants with PTSD-NSP during processing of motivational reward anticipation which correlated with severity of psychotic symptoms. However, the difference between the two PTSD groups disappeared when PTSD severity and trauma exposure were accounted for.
Conclusions: Anhedonia and secondary psychotic symptoms in PTSD are characterized by dysfunctional reward consumption and anticipation processing, respectively. The latter may reflect a mechanism by which abnormal reward signals in the basal ganglia facilitates psychotic symptoms across psychiatric conditions.
Keywords: PTSD; psychotic symptoms; reward; salience; Refugees; anhedonia
Received 24 Jun 2019, Accepted 06 Feb 2020, Published online: 04 Mar 2020
Het European Journal of Psychotraumatology (EJPT) is een peer-reviewed, interdisciplinair wetenschappelijk tijdschrift dat deel uitmaakt van de European Society for Traumatic Stress Studies (ESTSS).
Het EJPT heeft als doel om wetenschappers, behandelaren en experts te betrekken bij de belangrijkste vraagstukken rond stress en trauma, waaronder individuele gebeurtenissen, herhaalde of chronische trauma's, grootschalige rampen en geweld.
