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Distinct neural mechanisms of emotional processing in prolonged grief disorder

Published online by Cambridge University Press:  07 January 2020

Richard A. Bryant Open the ORCID record for Richard A. Bryant [Opens in a new window] ,
Elpiniki Andrew  and
Mayuresh S. Korgaonkar
Richard A. Bryant*
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, Australia
Elpiniki Andrew
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, Australia
Mayuresh S. Korgaonkar
Affiliation:
Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, Australia Sydney Medical School, University of Sydney, Sydney, Australia
*
Author for correspondence: Richard A. Bryant, E-mail: r.bryant@unsw.edu.au
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Abstract

Background

Prolonged grief disorder (PGD) has recently been recognized as a separate psychiatric diagnosis, despite controversy over the extent to which it is distinctive from posttraumatic stress disorder (PTSD) and major depressive disorder (MDD).

Methods

This study investigated distinctive neural processes underpinning emotion processing in participants with PGD, PTSD, and MDD with functional magnetic resonance study of 117 participants that included PGD (n = 21), PTSD (n = 45), MDD (n = 26), and bereaved controls (BC) (n = 25). Neural responses were measured across the brain while sad, happy, or neutral faces were presented at both supraliminal and subliminal levels.

Results

PGD had greater activation in the pregenual anterior cingulate cortex (pgACC), bilateral insula, bilateral dorsolateral prefrontal cortices and right caudate and also greater pgACC–right pallidum connectivity relative to BC during subliminal processing of happy faces. PGD was distinct relative to both PTSD and MDD groups with greater recruitment of the medial orbitofrontal cortex during supraliminal processing of sad faces. PGD were also distinct relative to MDD (but not PTSD) with greater activation in the left amygdala, caudate, and putamen during subliminal presentation of sad faces. There was no distinction between PGD, PTSD, and MDD during processing of happy faces.

Conclusions

These results provide initial evidence of distinct neural profiles of PGD relative to related psychopathological conditions, and highlight activation of neural regions implicated in reward networks. This pattern of findings validates current models of PGD that emphasize the roles of yearning and appetitive processes in PGD.

Keywords

Diagnosisfunctional magnetic resonance imagingposttraumatic stress disorderprolonged grief disorder
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 587 - 595
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Copyright
Copyright © Cambridge University Press 2020

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