Fitzgerald Jacklynn M, Webb E Kate, Davis Kaley, Bennett Meghan, Benjamin Tristan, Pegau Boiana, Sangha Susan
Department of Psychology, Marquette University, United States of America.
Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, Durham, NC, United States of America.
J Affect Disord. 2025 Sep 15;385:119401. doi: 10.1016/j.jad.2025.119401. Epub 2025 May 12.
The ability to distinguish between threatening, rewarding, and neutral cues is adaptative and crucial for survival. However, individuals with posttraumatic stress disorder (PTSD) often show poor knowledge of cue contingencies and heightened fear responses even in the presence of cues that signify safety, potentially due to atypical perceptions of neutral cues. We investigated whether perceiving neutral cues as more rewarding or threatening influences conditioned inhibition of fear and whether PTSD symptoms moderate this relationship. Trauma-exposed adults (N = 84; 64 % female; 76 % non-Hispanic white) completed a Fear, Reward, and Neutral Discrimination (FRND) Task involving geometric shapes paired with outcomes (Fear: white noise; Reward: monetary gain; Neutral: no outcome) and conditioned inhibition trials (Fear+Neutral and Reward+Neutral: no outcome). Skin conductance responses (SCR) quantified psychophysiological arousal, and participants rated the valence of each cue. PTSD symptoms were evaluated with the PTSD Checklist for DSM-5. Linear regressions examined PTSD severity as a moderator of the relationship between Reward vs. Neutral or Fear vs. Neutral valence difference and SCR during inhibition. Among individuals with less severe PTSD symptoms, stronger fear inhibition effects were observed when neutral cues were rated more similarly to reward cues (β = 0.12, p = .022); however, this relationship was not significant at average or higher PTSD severity. Our results emphasize that perceptions of neutral cues contribute to fear inhibition and may underlie PTSD-related deficits in safety learning. Future investigations on PTSD and fear inhibition should consider incorporating measures of reward-related processing to examine the overlap between rewarding and inhibitory qualities of safety signals.
区分威胁性、奖励性和中性线索的能力具有适应性，对生存至关重要。然而，患有创伤后应激障碍（PTSD）的个体往往对线索的关联性了解不足，即使在存在表示安全的线索时，恐惧反应也会增强，这可能是由于对中性线索的非典型认知所致。我们研究了将中性线索视为更具奖励性或威胁性是否会影响恐惧的条件性抑制，以及PTSD症状是否会调节这种关系。经历过创伤的成年人（N = 84；64%为女性；76%为非西班牙裔白人）完成了一项恐惧、奖励和中性辨别（FRND）任务，该任务涉及将几何形状与结果配对（恐惧：白噪声；奖励：金钱收益；中性：无结果）以及条件性抑制试验（恐惧+中性和奖励+中性：无结果）。皮肤电导率反应（SCR）量化了心理生理唤醒水平，参与者对每个线索的效价进行了评分。使用DSM-5的PTSD检查表评估PTSD症状。线性回归分析了PTSD严重程度作为奖励与中性或恐惧与中性效价差异与抑制期间SCR之间关系的调节因素。在PTSD症状较轻的个体中，当中性线索的评分与奖励线索更相似时，观察到更强的恐惧抑制效应（β = 0.12，p = .022）；然而，在PTSD严重程度处于平均水平或更高时，这种关系并不显著。我们的结果强调，对中性线索的认知有助于恐惧抑制，可能是PTSD相关安全学习缺陷的基础。未来关于PTSD和恐惧抑制的研究应考虑纳入与奖励相关加工的测量方法，以检验安全信号的奖励性和抑制性特征之间的重叠。
