Neural Correlates of Levels of Emotional Awareness During Trauma Script-Imagery in Posttraumatic Stress Disorder

Address correspondence and reprint requests to: Ruth Lanius, MD, PhD, E-mail: ruth.lanius{at}lhsc.on.ca.

	Abstract

Objective: To examine individual differences in levels of emotional awareness as a predictor of the blood oxygenation level dependent (BOLD) response to trauma script-driven imagery in trauma-exposed individuals with (n = 25) and without (n = 16) posttraumatic stress disorder (PTSD). Methods: Participants completed the Levels of Emotional Awareness Scale (LEAS) and a functional magnetic resonance imaging trauma script-driven imagery paradigm. Results: Patients with PTSD exhibited lower LEAS scores in comparison with the control group. LEAS scores correlated positively with BOLD activity during trauma script-imagery in the ventral anterior cingulate cortex (vACC) in healthy controls, whereas LEAS scores correlated negatively with activation of vACC in individuals with PTSD. Conclusion: Patients with PTSD exhibit lower than average levels of emotional awareness. Levels of emotional awareness are differentially associated with vACC response during trauma script-driven imagery in healthy controls versus individuals with PTSD.

Key Words: emotional awareness, alexithymia, posttraumatic stress disorder, script-driven imagery, anterior cingulate cortex, medial prefrontal cortex

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