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标题：Fear conditioning and early life vulnerabilities: two distinct pathways of emotional dysregulation and brain dysfunction in PTSD
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作者：Ruth A. Lanius ; Paul A. Frewen ; Eric Vermetten 等
期刊名称：European Journal of Psychotraumatology
印刷版ISSN：2000-8198
电子版ISSN：2000-8066
出版年度：2010
卷号：1
DOI：10.3402/ejpt.v1i0.5467
语种：English
出版社：Taylor & Francis Group
摘要：The newly proposed criteria for posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual (DSM-V) include dysregulation of a variety of emotional states including fear, anger, guilt, and shame, in addition to dissociation and numbing. Consistent with these revisions, we postulate two models of emotion dysregulation in PTSD in which fear is not the prevailing emotion but is only one of several components implicated in a dysregulated emotional system that also mediates problems regulating anger, guilt, shame, dissociation, and numbing. We discuss whether there is a relationship between fear and other emotion regulation systems that may help further our understanding of PTSD and its underlying neurocircuitry. Two pathways describing the relationship between fear and other emotion regulation systems in PTSD are proposed. The first pathway describes emotion dysregulation as an outcome of fear conditioning through stress sensitization and kindling. The second pathway views emotion dysregulation as a distal vulnerability factor and hypothesizes a further exacerbation of fear and other emotion regulatory problems, including the development of PTSD after exposure to one or several traumatic event(s) later in life. Future research and treatment implications are discussed. Keywords: Anterior cingulate cortex; medial prefrontal cortex; amygdale; DSM-V; emotion; attachment; HPA-axis; infant development (Published: 10 December 2010) Citation: European Journal of Psychotraumatology 2010, 1: 5467 - DOI: 10.3402/ejpt.v1i0.5467 For the abstract or full text in other languages, please see Supplementary files to the right (under Reading Tools).