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

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). Participants completed the Levels of Emotional Awareness Scale (LEAS) and a functional magnetic resonance imaging trauma script-driven imagery paradigm. 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. 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.