Psychological Medicine最新文献

{"title":"Exposure profiles of social-environmental neighborhood factors and persistent distressing psychotic-like experiences across four years among young adolescents in the US.","authors":"Benson S Ku, Qingyue E Yuan, Grace Christensen, Lina V Dimitrov, Benjamin Risk, Anke Huels","doi":"10.1017/S0033291725000224","DOIUrl":"10.1017/S0033291725000224","url":null,"abstract":"<p><strong>Background: </strong>Recent research has demonstrated that domains of social determinants of health (SDOH) (e.g. air pollution and social context) are associated with psychosis. However, SDOHs have often been studied in isolation. This study investigated distinct exposure profiles, estimated their associations with persistent distressing psychotic-like experiences (PLE), and evaluated whether involvement in physical activity partially explains this association.</p><p><strong>Methods: </strong>Analyses included 8,145 young adolescents from the Adolescent Brain and Cognitive Development Study. Data from the baseline and three follow-ups were included. Area-level geocoded variables spanning various domains of SDOH, including socioeconomic status, education, crime, built environment, social context, and crime, were clustered using a self-organizing map method to identify exposure profiles. Generalized linear mixed modeling tested the association between exposure profiles and persistent distressing PLE and physical activities (i.e. team and individual sports), adjusting for individual-level covariates including age, sex, race/ethnicity, highest level of parent education, family-relatedness, and study sites.</p><p><strong>Results: </strong>Five exposure profiles were identified. Compared to the reference Profile 1 (suburban affluent areas), Profile 3 (rural areas with low walkability and high ozone), and Profile 4 (urban areas with high SES deprivation, high crime, and high pollution) were associated with greater persistent distressing PLE. Team sports mediated 6.14% of the association for Profile 3.</p><p><strong>Conclusions: </strong>This study found that neighborhoods characterized by rural areas with low walkability and urban areas with high socioeconomic deprivation, pollution concentrations, and crime were associated with persistent distressing PLE. Findings suggest that various social-environmental factors may differentially impact the development of psychosis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e53"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulsivity facets and substance use involvement: insights from genomic structural equation modeling.","authors":"Laura Vilar-Ribó, Alexander S Hatoum, Andrew D Grotzinger, Travis T Mallard, Sarah Elson, Pierre Fontanillas, Abraham A Palmer, Daniel E Gustavson, Sandra Sanchez-Roige","doi":"10.1017/S0033291725000145","DOIUrl":"10.1017/S0033291725000145","url":null,"abstract":"<p><strong>Background: </strong>Impulsivity is a multidimensional trait associated with substance use disorders (SUDs), but the relationship between distinct impulsivity facets and stages of substance use involvement remains unclear.</p><p><strong>Methods: </strong>We used genomic structural equation modeling and genome-wide association studies (<i>N</i> = 79,729-903,147) to examine the latent genetic architecture of nine impulsivity traits and seven substance use (SU) and SUD traits.</p><p><strong>Results: </strong>We found that the SU and SUD factors were strongly genetically inter-correlated (<i>r_G</i>=0.77) but their associations with impulsivity facets differed. Lack of premeditation, negative and positive urgency were equally positively genetically correlated with both the SU (<i>r_G</i>=.0.30-0.50) and SUD (<i>r_G=</i>0.38-0.46) factors; sensation seeking was more strongly genetically correlated with the SU factor (<i>r_G</i>=0.27 versus <i>r_G</i>=0.10); delay discounting was more strongly genetically correlated with the SUD factor (<i>r_G</i>=0.31 versus <i>r_G</i>=0.21); and lack of perseverance was only weakly genetically correlated with the SU factor (<i>r_G</i>=0.10). After controlling for the genetic correlation between SU/SUD, we found that lack of premeditation was independently genetically associated with both the SU (β=0.42) and SUD factors (β=0.21); sensation seeking and positive urgency were independently genetically associated with the SU factor (β=0.48, β=0.33, respectively); and negative urgency and delay discounting were independently genetically associated with the SUD factor (β=0.33, β=0.36, respectively).</p><p><strong>Conclusions: </strong>Our findings show that specific impulsivity facets confer risk for distinct stages of substance use involvement, with potential implications for SUDs prevention and treatment.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e51"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep and circadian difficulties in schizophrenia: presentations, understanding, and treatment.","authors":"Daniel Freeman, Felicity Waite","doi":"10.1017/S0033291725000297","DOIUrl":"https://doi.org/10.1017/S0033291725000297","url":null,"abstract":"<p><p>It is common in mental health care to ask about people's days but comparatively rare to ask about their nights. Most patients diagnosed with schizophrenia struggle at nighttime. The next-day effects can include a worsening of psychotic experiences, affective disturbances, and inactivity, which in turn affect the next night's sleep. Objective and subjective cognitive abilities may be affected too. Patients commonly experience a mix of sleep difficulties in a night and across a week. These difficulties include trouble falling asleep, staying asleep, or sleeping at all; nightmares and other awakenings; poor-quality sleep; oversleeping; tiredness; sleeping at the wrong times; and problems establishing a regular sleep pattern. The patient group is also more vulnerable to obstructive sleep apnea and restless legs syndrome. We describe in this article how the complex presentation of non-respiratory sleep difficulties arises from variation across five factors: timing, mental state, need for sleep, self-care, and environment. We set out 10 illustrative patterns of such difficulties experienced by patients with non-affective psychosis. These sleep problems are eminently treatable with intensive psychological therapy delivered over approximately eight sessions. We describe key techniques and their typical order of implementation by presentation. Sleep problems are an important issue for patients. Giving them the therapeutic attention patients often desire brings both real clinical benefits and improves views of services. Treatment is also very likely to lessen psychotic experiences and mood disturbances while improving daytime functioning and quality of life. Tackling sleep difficulties can be a route toward the successful treatment of psychosis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e47"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity of the clinical high-risk and familial high-risk approaches for psychotic disorders - a systematic review and meta-analysis.","authors":"Animesh Talukder, Ioanna Kougianou, Colm Healy, Ulla Lång, Valentina Kieseppä, Maria Jalbrzikowski, Kirstie O'Hare, Ian Kelleher","doi":"10.1017/S0033291724003520","DOIUrl":"https://doi.org/10.1017/S0033291724003520","url":null,"abstract":"<p><strong>Background: </strong>Psychosis prediction has been a key focus of psychiatry research for over 20 years. The two dominant approaches to identifying psychosis risk have been the clinical high-risk (CHR) and the familial high-risk (FHR) approaches. To date, the real-world sensitivity of these approaches - that is, the proportion of all future psychotic disorders in the population that they identify - has not been systematically reviewed.</p><p><strong>Methods: </strong>We systematically reviewed and meta-analysed studies in MEDLINE, Embase, PsychINFO, and Web of Science (from inception until September 2024) that reported data on the sensitivity of CHR and FHR approaches - i.e., individuals with a psychosis diagnosis preceded by a CHR diagnosis or a history of parental psychosis (PROSPERO: CRD42024542268).</p><p><strong>Results: </strong>We identified four CHR studies and four FHR studies reporting relevant data. The pooled estimate of the sensitivity of the CHR approach was 6.7% (95% CI: 1.5-15.0%) and of the FHR approach was 6.5% (95% CI: 4.4-8.9%). There was a high level of heterogeneity between studies. Most FHR studies had a low risk of bias, but most CHR studies had a high risk of bias.</p><p><strong>Conclusion: </strong>Pooled data suggest that CHR and FHR approaches, each, capture only about 6-7% of future psychotic disorders. These findings demonstrate the need for additional approaches to identify risk for psychosis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e46"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural subgroups in unaffected first-degree relatives of patients with bipolar disorder during emotion regulation.","authors":"Hanne Lie Kjærstad, Florien Ritsma, Klara Coello, Sharleny Stanislaus, Klaus Munkholm, Maria Faurholt-Jepsen, Julian Macoveanu, Anne Juul Bjertrup, Maj Vinberg, Lars Vedel Kessing, Kamilla Woznica Miskowiak","doi":"10.1017/S0033291724003593","DOIUrl":"https://doi.org/10.1017/S0033291724003593","url":null,"abstract":"<p><strong>Background: </strong>Impaired emotion regulation has been proposed as a putative endophenotype in bipolar disorder (BD). Functional magnetic resonance imaging (fMRI) studies investigating this in unaffected first-degree relatives (UR) have thus far yielded incongruent findings. Hence, the current paper examines neural subgroups among UR during emotion regulation.</p><p><strong>Methods: </strong>71 UR of patients with BD and 66 healthy controls (HC) underwent fMRI scanning while performing an emotion regulation task. Hierarchical cluster analysis was performed on extracted signal change during emotion down-regulation in pre-defined regions of interest (ROIs). Identified subgroups were compared on neural activation, demographic, clinical, and cognitive variables.</p><p><strong>Results: </strong>Two subgroups of UR were identified: subgroup 1 (39 UR; 55%) was characterized by <i>hypo</i>-activity in the dorsolateral, dorsomedial, and ventrolateral prefrontal cortex and the bilateral amygdalae, but comparable activation to HC in the other ROIs; subgroup 2 (32 UR; 45%) was characterized by <i>hyperactivity</i> in all ROIs. Subgroup 1 had lower success in emotion regulation compared to HC and reported more childhood trauma compared to subgroup 2 and HC. Subgroup 2 reported more anxiety, lower functioning, and greater attentional vigilance toward fearful faces compared to HC. Relatives from both subgroups were poorer in recognizing positive faces compared to HC.</p><p><strong>Conclusions: </strong>These findings may explain the discrepancy in earlier fMRI studies on emotion regulation in UR, showing two different subgroups of UR that both exhibited aberrant neural activity during emotion regulation, but in opposite directions. Furthermore, the results suggest that impaired recognition of positive facial expressions is a broad endophenotype of BD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e45"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between cannabis and depression: an updated Systematic Review and Meta-analysis.","authors":"Victoria Churchill, Caroline Sutton Chubb, Lucy Popova, Claire A Spears, Terri Pigott","doi":"10.1017/S0033291724003143","DOIUrl":"https://doi.org/10.1017/S0033291724003143","url":null,"abstract":"<p><strong>Background: </strong>Cannabis is one of the most commonly used drugs globally, although its legal status varies across regions. Public support for its decriminalization has increased, but gaps in our understanding of the health consequences of cannabis use remain, particularly related to its impact on mental health. This article provides an updated systematic review and meta-analysis (previous being Lev-Ran et al., ) looking at the relationship between cannabis and depression.</p><p><strong>Methods: </strong>Literature available before March 2023 was screened for longitudinal studies that included cannabis use and depression. Cross-sectional studies and those only looking at special populations were excluded. Studies must have also controlled for depression at baseline to allow for investigation of a temporal relationship. Extracted data included cannabis measures, depression outcomes, adjusted odds ratios, and study settings. Meta-analysis employed a random effects model with multilevel meta-regression for effect size moderators.</p><p><strong>Results: </strong>The search yielded 1,599 titles from various databases, resulting in 22 studies for meta-analysis, including 14 from Lev-Ran et al. Eleven studies were US-based, with participants mostly under 18. Meta-analysis showed a higher risk of depression among cannabis users (OR: 1.29, 95% CI: 1.13-1.46). Risk of bias assessment showed medium risk across studies with exposure measurement being a key bias area. The funnel plot and Egger's Sandwich test did not suggest publication bias.</p><p><strong>Conclusions: </strong>This study underscores the association between cannabis use and depression but also emphasizes the need for further research, especially in understanding usage patterns, heavy use definitions, and long-term effects on depression risk amidst changing cannabis trends.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e44"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysfunction in the hierarchy of morphometric similarity network in Alzheimer's disease and its correlation with cognitive performance and gene expression profiles.","authors":"Chuchu Zheng, Wei Zhao, Zeyu Yang, Shuixia Guo","doi":"10.1017/S0033291725000091","DOIUrl":"https://doi.org/10.1017/S0033291725000091","url":null,"abstract":"<p><strong>Background: </strong>Previous research has shown abnormal functional network gradients in Alzheimer's disease (AD). Structural network gradient is capable of capturing continuous changes in brain morphology and has the ability to elucidate the underlying processes of neurodevelopment. However, it remains unclear whether structural network gradients are altered in AD and what associations exist between these changes and cognitive function, and gene expression profiles.</p><p><strong>Methods: </strong>By constructing an individualized structural network gradient decomposition framework, we calculated the morphological similarity network (MSN) gradients for 404 subjects (186 AD patients and 218 normal controls). We investigated AD-related alterations in MSN gradients, along with the associations between MSN gradients and cognitive function, MSN topological properties, and gene expression profiles.</p><p><strong>Results: </strong>Our findings indicated that the principal MSN gradient alterations in AD were primarily characterized by an increase in the primary and secondary sensory cortices and a decrease in the association cortex 1. The primary and higher-order cortices exhibited opposite associations with cognition, including executive function, language skills, and memory processes. Moreover, the principal MSN gradients were found to significantly predict cognitive function in AD. The altered gradient pattern was 14.8% attributable to gene expression profiles, and the genes demonstrating the highest correlation are involved in metabolic activity and synaptic signaling.</p><p><strong>Conclusions: </strong>Our results offered novel insights into the underlying mechanisms of structural brain network impairment in AD patients, enhancing our understanding of the neurobiological processes responsible for impaired cognition in patients with AD, and offering a new dimensional structural biomarker for AD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e42"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal depression during the perinatal period and its relationship with emotion regulation in young adulthood: An fMRI study in a prenatal birth cohort.","authors":"Klara Mareckova, Filip Trbusek, Radek Marecek, Jan Chladek, Zuzana Koscova, Filip Plesinger, Lenka Andrysková, Milan Brazdil, Yuliya S Nikolova","doi":"10.1017/S0033291725000042","DOIUrl":"https://doi.org/10.1017/S0033291725000042","url":null,"abstract":"<p><strong>Background: </strong>Maternal perinatal mental health is essential for optimal brain development and mental health of the offspring. We evaluated whether maternal depression during the perinatal period and early life of the offspring might be selectively associated with altered brain function during emotion regulation and whether those may further correlate with physiological responses and the typical use of emotion regulation strategies.</p><p><strong>Methods: </strong>Participants included 163 young adults (49% female, 28-30 years) from the ELSPAC prenatal birth cohort who took part in its neuroimaging follow-up and had complete mental health data from the perinatal period and early life. Maternal depressive symptoms were measured mid-pregnancy, 2 weeks, 6 months, and 18 months after birth. Regulation of negative affect was studied using functional magnetic resonance imaging, concurrent skin conductance response (SCR) and heart rate variability (HRV), and assessment of typical emotion regulation strategy.</p><p><strong>Results: </strong>Maternal depression 2 weeks after birth interacted with sex and showed a relationship with greater brain response during emotion regulation in a right frontal cluster in women. Moreover, this brain response mediated the relationship between greater maternal depression 2 weeks after birth and greater suppression of emotions in young adult women (ab = 0.11, SE = 0.05, 95% CI [0.016; 0.226]). The altered brain response during emotion regulation and the typical emotion regulation strategy were also as sociated with SCR and HRV.</p><p><strong>Conclusions: </strong>These findings suggest that maternal depression 2 weeks after birth predisposes female offspring to maladaptive emotion regulation skills and particularly to emotion suppression in young adulthood.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e39"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The longitudinal relationship between psychological symptoms and social functioning in displaced refugees.","authors":"Angela Nickerson, Gulsah Kurt, Belinda Liddell, David Keegan, Randy Nandyatama, Atika Yuanita, Rizka Argadianti Rachmah, Joel Hoffman, Shraddha Kashyap, Natalie Mastrogiovanni, Vivian Mai, Anna Camilleri, Dessy Susanty, Diah Tricesaria, Hasti Rostami, Jenny Im, Marta Gurzeda, Mitra Khakbaz, Sarah Funnell, Zico Pestalozzi, Philippa Specker","doi":"10.1017/S0033291724003519","DOIUrl":"https://doi.org/10.1017/S0033291724003519","url":null,"abstract":"<p><strong>Background: </strong>Refugee experiences of trauma and displacement can significantly disrupt established social networks. While social functioning has been routinely associated with mental health, to our knowledge, no study has tested the direction of influence between social and psychological functioning within displaced refugee communities. This study investigated the temporal association between psychological symptoms (PTSD, depression, anger) and multiple facets of social functioning (including community connectedness, perceived social responsibility, positive social support and negative social support).</p><p><strong>Method: </strong>A culturally diverse sample of refugees (N = 1,235) displaced in Indonesia completed an online survey at four time-points, six months apart. Longitudinal structural equation modelling was used to investigate the temporal ordering between psychological symptoms and social functioning.</p><p><strong>Results: </strong>Findings revealed that greater psychological symptoms were associated with a subsequent deterioration in social functioning (decreased positive social support and community connectedness and increased negative social support and perceived social responsibility). Greater perceived social responsibility was also associated with subsequent increases in psychological symptoms, while positive social support and community connectedness were bi-directionally associated over-time.</p><p><strong>Conclusions: </strong>These findings highlight the potential utility of mental health interventions for displaced refugees as a means to improve social functioning and inclusion with host communities. Findings have important implications in guiding the development of interventions and allocation of resources to support refugee engagement and wellbeing in displacement contexts.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e40"},"PeriodicalIF":5.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural correlates of emotional processing in trauma-related narratives.","authors":"Minne Cao, Shengnan Zhu, Enze Tang, Chuang Xue, Kun Li, Hua Yu, Tao Zhong, Tao Li, Hui Chen, Wei Deng","doi":"10.1017/S0033291724003398","DOIUrl":"https://doi.org/10.1017/S0033291724003398","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic stress disorder (PTSD) is a mental health condition caused by the dysregulation or overgeneralization of memories related to traumatic events. Investigating the interplay between explicit narrative and implicit emotional memory contributes to a better understanding of the mechanisms underlying PTSD.</p><p><strong>Methods: </strong>This case-control study focused on two groups: unmedicated patients with PTSD and a trauma-exposed control (TEC) group who did not develop PTSD. Experiments included real-time measurements of blood oxygenation changes using functional near-infrared spectroscopy during trauma narration and processing of emotional and linguistic data through natural language processing (NLP).</p><p><strong>Results: </strong>Real-time fNIRS monitoring showed that PTSD patients (mean [SD] Oxy-Hb activation, 0.153 [0.084], 95% CI 0.124 to 0.182) had significantly higher brain activity in the left anterior medial prefrontal cortex (L-amPFC) within 10 s after expressing negative emotional words compared with the control group (0.047 [0.026], 95% CI 0.038 to 0.056; <i>p</i> < 0.001). In the control group, there was a significant time-series correlation between the use of negative emotional memory words and activation of the L-amPFC (latency 3.82 s, slope = 0.0067, peak value = 0.184, difference = 0.273; Spearman's <i>r</i> = 0.727, <i>p</i> < 0.001). In contrast, the left anterior cingulate prefrontal cortex of PTSD patients remained in a state of high activation (peak value = 0.153, difference = 0.084) with no apparent latency period.</p><p><strong>Conclusions: </strong>PTSD patients display overactivity in pathways associated with rapid emotional responses and diminished regulation in cognitive processing areas. Interventions targeting these pathways may alleviate symptoms of PTSD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e33"},"PeriodicalIF":5.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}