Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada.
Homewood Research Institute, Guelph, ON N1E 6K9, Canada.
Soc Cogn Affect Neurosci. 2023 Oct 26;18(1). doi: 10.1093/scan/nsad053.
Direct eye contact is essential to understanding others' thoughts and feelings in social interactions. However, those with post-traumatic stress disorder (PTSD) and exposure to moral injury (MI) may exhibit altered theory-of-mind (ToM)/mentalizing processes and experience shame which precludes one's capacity for direct eye contact. We investigated blood oxygenation level-dependent (BOLD) responses associated with direct vs averted gaze using a virtual reality paradigm in individuals with PTSD (n = 28) relative to healthy controls (n = 18) following recall of a MI vs a neutral memory. Associations between BOLD responses and clinical symptomatology were also assessed. After MI recall, individuals with PTSD showed greater activation in the right temporoparietal junction as compared to controls (T = 4.83; pFDR < 0.001; k = 237) during direct gaze. No significant activation occurred during direct gaze after neutral memory recall. Further, a significant positive correlation was found between feelings of distress and right medial superior frontal gyrus activation in individuals with PTSD (T = 5.03; pFDR = 0.049; k = 123). These findings suggest that direct gaze after MI recall prompts compensatory ToM/mentalizing processing. Implications for future interventions aimed at mitigating the effects of PTSD on social functioning are discussed.
直接眼神交流对于理解社交互动中他人的想法和感受至关重要。然而，那些患有创伤后应激障碍（PTSD）和经历道德伤害（MI）的人可能会表现出改变的心理理论（ToM）/心理化过程，并感到羞耻，这会妨碍他们进行直接眼神交流的能力。我们使用虚拟现实范式，在回忆 MI 与中性记忆后，比较 PTSD 患者（n=28）与健康对照组（n=18）的血氧水平依赖（BOLD）反应，研究了直接注视与回避注视相关的 BOLD 反应。还评估了 BOLD 反应与临床症状之间的关联。在 MI 回忆后，与对照组相比，PTSD 患者在直接注视时右颞顶联合区的激活更强（T=4.83;pFDR<0.001;k=237）。在中性记忆回忆后，直接注视时没有发生显著的激活。此外，在 PTSD 患者中，痛苦感与右内侧额上回的激活之间存在显著的正相关（T=5.03;pFDR=0.049;k=123）。这些发现表明，MI 回忆后直接注视会引发补偿性的 ToM/心理化处理。讨论了旨在减轻 PTSD 对社交功能影响的未来干预措施的意义。
