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Cognitive distortions in an acutely traumatized sample: an investigation of predictive power and neural correlates

Published online by Cambridge University Press:  04 March 2011

J. K. Daniels ,
K. Hegadoren ,
N. J. Coupland ,
B. H. Rowe ,
R. W. J. Neufeld  and
R. A. Lanius
J. K. Daniels
Affiliation:
Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada Department of Psychiatry, Division of Mind and Brain Research, Universitaetsklinik Charité, Berlin, Germany
K. Hegadoren
Affiliation:
Faculty of Nursing, The University of Alberta, Edmonton, Alberta, Canada
N. J. Coupland
Affiliation:
Department of Psychiatry, The University of Alberta, Edmonton, Alberta, Canada
B. H. Rowe
Affiliation:
Department of Emergency Medicine and School of Public Health, The University of Alberta, Edmonton, Alberta, Canada
R. W. J. Neufeld
Affiliation:
Department of Psychology, The University of Western Ontario, London, Ontario, Canada
R. A. Lanius*
Affiliation:
Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada
*
*Address for correspondence: R. A. Lanius, M.D., Ph.D., Department of Psychiatry, The University of Western Ontario, 339 Windermere Road, University Hospital, London, Ontario N6A 2A2, Canada. (Email: [email protected])
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Abstract

Background

Current theories of post-traumatic stress disorder (PTSD) place considerable emphasis on the role cognitive distortions such as self-blame, hopelessness or preoccupation with danger play in the etiology and maintenance of the disorder. Previous studies have shown that cognitive distortions in the early aftermath of traumatic events can predict future PTSD severity but, to date, no studies have investigated the neural correlates of this association.

Method

We conducted a prospective study with 106 acutely traumatized subjects, assessing symptom severity at three time points within the first 3 months post-trauma. A subsample of 20 subjects additionally underwent a functional 4-T magnetic resonance imaging (MRI) scan at 2 to 4 months post-trauma.

Results

Cognitive distortions proved to be a significant predictor of concurrent symptom severity in addition to diagnostic status, but did not predict future symptom severity or diagnostic status over and above the initial symptom severity. Cognitive distortions were correlated with blood oxygen level-dependent (BOLD) signal strength in brain regions previously implicated in visual processing, imagery and autobiographic memory recall. Intrusion characteristics accounted for most of these correlations.

Conclusions

This investigation revealed significant predictive value of cognitive distortions concerning concurrent PTSD severity and also established a significant relationship between cognitive distortions and neural activations during trauma recall in an acutely traumatized sample. These data indicate a direct link between the extent of cognitive distortions and the intrusive nature of trauma memories.

Keywords

Acute traumacognitive distortionfMRIpost-traumatic cognitionpost-traumatic stress disorderscript-driven imagery
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 10 , October 2011 , pp. 2149 - 2157
Copyright
Copyright © Cambridge University Press 2011

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