How Does PTSD Change the Way Veterans Process Rewards and Punishments?

What you need to know

• Combat veterans with PTSD show differences in how their brains process uncertain rewards and punishments compared to veterans without PTSD
• The severity of emotional numbing symptoms is linked to reduced activity in brain areas involved in evaluating choices
• Veterans with PTSD may focus more on how significant or intense outcomes are rather than whether they are good or bad

Understanding How PTSD Affects Decision-Making

Imagine having to choose between a sure $5 gain and a 50% chance of winning $10. How would you decide? For most people, this kind of decision involves weighing potential rewards against risks. But for individuals with post-traumatic stress disorder (PTSD), the brain may process these choices quite differently.

How the Research Was Conducted

Researchers studied 48 male combat veterans with varying levels of PTSD symptoms. While in an MRI scanner, participants made a series of choices between certain and uncertain monetary gains or losses. For example, choosing between definitely gaining $5 versus a 50% chance of gaining $10, or definitely losing $5 versus a 50% chance of losing $10.

Key Findings About Brain Activity

The study found that veterans with more severe PTSD symptoms showed less activity in a brain region called the ventromedial prefrontal cortex (vmPFC) when making decisions. This area helps us evaluate choices and regulate emotions. Interestingly, this reduction in activity was most strongly linked to emotional numbing symptoms - the diminished ability to experience positive emotions that often occurs in PTSD.

A Different Way of Processing Information

Perhaps the most striking finding was how differently the brains of veterans with PTSD processed uncertain outcomes. In veterans without PTSD, a brain region called the ventral striatum showed increased activity for better outcomes and decreased activity for worse outcomes - essentially tracking whether something was good or bad. However, in veterans with PTSD, this same brain region responded more to how significant or intense the outcome was, regardless of whether it was positive or negative.

What This Means for You

These findings help explain why individuals with PTSD may:

• Have difficulty making decisions involving uncertainty
• Focus more on how intense or significant outcomes might be rather than whether they’re positive or negative
• Experience challenges in processing rewards and positive experiences due to emotional numbing

The research suggests that PTSD doesn’t just affect how people process trauma-related experiences - it can change how the brain evaluates everyday decisions involving risk and reward.

Conclusions

• PTSD symptoms are associated with fundamental changes in how the brain processes decisions and evaluates outcomes
• Emotional numbing symptoms particularly affect brain regions involved in decision-making
• Understanding these brain changes could lead to better treatments that help restore normal reward processing in individuals with PTSD