Neural correlates of levels of emotional awareness during trauma script-imagery in posttraumatic stress disorder

Objective: To examine individual differences in levels of emotional awareness as a predictor of the blood oxygenation level dependent (BOLD) response to trauma script-driven imagery in trauma-exposed individuals with (n = 25) and without (n = 16) posttraumatic stress disorder (PTSD). Methods: Participants completed the Levels of Emotional Awareness Scale (LEAS) and a functional magnetic resonance imaging trauma script-driven imagery paradigm. Results: Patients with PTSD exhibited lower LEAS scores in comparison with the control group. LEAS scores correlated positively with BOLD activity during trauma script-imagery in the ventral anterior cingulate cortex (vACC) in healthy controls, whereas LEAS scores correlated negatively with activation of vACC in individuals with PTSD. Conclusion: Patients with PTSD exhibit lower than average levels of emotional awareness. Levels of emotional awareness are differentially associated with vACC response during trauma script-driven imagery in healthy controls versus individuals with PTSD.