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Anterior prefrontal brain activity during emotion control predicts resilience to post-traumatic stress symptoms

Nature Human Behaviour volume 5, pages 1055–1064 (2021)Cite this article

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Abstract

Regulating social emotional actions is essential for coping with life stressors and is associated with control by the anterior prefrontal cortex (aPFC) over the amygdala. However, it remains unclear to what extent prefrontal emotion regulation capacities contribute to resilience against developing post-traumatic stress disorder (PTSD) symptoms. Here, 185 police recruits who experienced their core trauma in the line of duty participated in a prospective longitudinal study. Pre- and post-trauma, they performed a well-established functional magnetic resonance imaging (fMRI) approach–avoidance task, mapping impulsive and controlled emotional actions. Higher baseline aPFC, dorsal and medial frontal pole activity was related to lower PTSD symptoms after trauma exposure. aPFC activity predicted symptom development over and above self-reported and behavioural measures. Trauma exposure, but not trauma symptoms, predicted amygdala activation at follow-up. These findings suggest that prefrontal emotion regulation activity predicts increased resilience against developing post-traumatic stress symptoms and may provide fruitful starting points for prediction and intervention studies.

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Fig. 1: Study timeline, reported trauma exposure and symptoms.
Fig. 2: Experimental paradigm and main task effects.
Fig. 3: Predisposing effects for PTSD symptom development.
Fig. 4: Effects of trauma exposure on activation for incongruent > congruent responses.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

The computer code that supports the findings of this study is available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank all participants for their willingness to participate in this study. The authors thank A. Smit and other personnel of the Dutch Police Academy for their valuable help with recruiting participants and facilitating this study. The authors gratefully acknowledge contributions of I. Kersten, T. Döpp, N. de Valk, L. Bovy and L. Nuijen in participant recruitment and data acquisition, N. Garaux in assistance with data analysis and V. van Ast for her help with setting up the study. This study was funded by the Netherlands Organization for Scientific Research (NWO VICI-grant 453-12-0010) and a starting grant from the European Research Council (StG2012 313749), both awarded to K.R. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Donders Institute, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands

    Reinoud Kaldewaij, Saskia B. J. Koch, Mahur M. Hashemi, Wei Zhang, Floris Klumpers & Karin Roelofs

  2. Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands

    Reinoud Kaldewaij, Saskia B. J. Koch, Mahur M. Hashemi, Wei Zhang, Floris Klumpers & Karin Roelofs

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  1. Reinoud Kaldewaij
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Contributions

R.K., M.M.H., W.Z., S.B.J.K, F.K. and K.R. contributed to the study design. R.K., W.Z. and M.M.H. conducted the experiment. R.K. performed data analysis. R.K., S.B.J.K. and K.R. drafted the manuscript. R.K., M.M.H., W.Z., S.B.J.K, F.K. and K.R. edited the manuscript and approved the final version of the manuscript for submission.

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Correspondence to Reinoud Kaldewaij.

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Kaldewaij, R., Koch, S.B.J., Hashemi, M.M. et al. Anterior prefrontal brain activity during emotion control predicts resilience to post-traumatic stress symptoms. Nat Hum Behav 5, 1055–1064 (2021). https://doi.org/10.1038/s41562-021-01055-2

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