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The nested hierarchical model of self and its non-relational vs relational posttraumatic manifestation: an fMRI meta-analysis of emotional processing

Molecular Psychiatry (2024)Cite this article

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Abstract

Different kinds of traumatic experiences like natural catastrophes vs. relational traumatic experiences (e.g., sex/physical abuse, interpersonal partner violence) are involved in the development of the self and PTSD psychopathological manifestations. Looking at a neuroscience approach, it has been proposed a nested hierarchical model of self, which identifies three neural-mental networks: (i) interoceptive; (ii) exteroceptive; (iii) mental. However, it is still unclear how the self and its related brain networks might be affected by non-relational vs relational traumatic experiences. Departing from this background, the current study aims at conducting a meta-analytic review of task-dependent fMRI studies (i.e., emotional processing task) among patients with PTSD due to non-relational (PTSD-NR) and relational (PTSD-R) traumatic experiences using two approaches: (i) a Bayesian network meta-analysis for a region-of-interest–based approach; (ii) a coordinated-based meta-analysis. Our findings suggested that the PTSD-NR mainly recruited areas ascribed to the mental self to process emotional stimuli. Whereas, the PTSD-R mainly activated regions associated with the intero-exteroceptive self. Accordingly, the PTSD-R compared to the PTSD-NR might not reach a higher symbolic capacity to process stimuli with an emotional valence. These results are also clinically relevant in support of the development of differential treatment approaches for non-relational vs. relational PTSD.

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Fig. 1
Fig. 2: Visual representation of network meta-analysis results.
Fig. 3: Visual representation of ALE contrast analysis.

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  1. These authors contributed equally: Andrea Scalabrini, Marco Cavicchioli.

Authors and Affiliations

  1. Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, Bergamo, 24129, Italy

    Andrea Scalabrini & Clara Mucci

  2. University Vita- Salute San Raffaele, Milan, Via Olgettina, 58, Milan, 20132, Italy

    Marco Cavicchioli & Francesco Benedetti

  3. Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona, 20, 20127, Milan, Italy

    Francesco Benedetti

  4. The Royal’s Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, ON, K1Z 7K412, Canada

    Georg Northoff

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AS and MC designed the theoretical framework and the logic of the study, analyzed the data and wrote a first draft of the manuscript that was critically revised by GN. All authors approved the final version of the manuscript.

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Correspondence to Andrea Scalabrini or Marco Cavicchioli.

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Scalabrini, A., Cavicchioli, M., Benedetti, F. et al. The nested hierarchical model of self and its non-relational vs relational posttraumatic manifestation: an fMRI meta-analysis of emotional processing. Mol Psychiatry (2024). https://doi.org/10.1038/s41380-024-02520-w

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