Hippocampus, amygdala, and insula activation in response to romantic relationship dissolution stimuli: A case-case-control fMRI study on emerging adult students

A S J Van der Watt; S Du Plessis; F Ahmed; A Roos; E Lesch; S Seedat

doi:10.1016/j.jad.2024.04.059

Hippocampus, amygdala, and insula activation in response to romantic relationship dissolution stimuli: A case-case-control fMRI study on emerging adult students

J Affect Disord. 2024 Jul 1:356:604-615. doi: 10.1016/j.jad.2024.04.059. Epub 2024 Apr 16.

Authors

A S J Van der Watt¹, S Du Plessis², F Ahmed³, A Roos⁴, E Lesch⁵, S Seedat²

Affiliations

¹ Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa. Electronic address: bertevdwatt@sun.ac.za.
² Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa; SAMRC Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
³ Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa.
⁴ Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁵ Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.

PMID: 38631423
DOI: 10.1016/j.jad.2024.04.059

Abstract

Background: Romantic relationship dissolutions (RRDs) are associated with posttraumatic stress symptoms (PTSS). Functional magnetic resonance imaging in RRD studies indicate overlapping neural activation similar to posttraumatic stress disorder. These studies combine real and hypothetical rejection, and lack contextual information and control and/or comparison groups exposed to non-RRD or DSM-5 defined traumatic events.

Aim: We investigated blood oxygen level dependent (BOLD) activation in the hippocampus, amygdala, and insula of participants with RRDs compared with other traumatic or non-trauma stressors.

Methods: Emerging adults (mean age = 21.54 years; female = 74.7 %) who experienced an RRD (n = 36), DSM-5 defined trauma (physical and/or sexual assault: n = 15), or a non-RRD or DSM-5 stressor (n = 28) completed PTSS, depression, childhood trauma, lifetime trauma exposure, and attachment measures. We used a general and customised version of the International Affective Picture System to investigate responses to index-trauma-related stimuli. We used mixed linear models to assess between-group differences, and ANOVAs and Spearman's correlations to analyse factors associated with BOLD activation.

Results: BOLD activity increased between index-trauma stimuli as compared to neutral stimuli in the hippocampus and amygdala, with no significant difference between the DSM-5 Trauma and RRD groups. Childhood adversity, sexual orientation, and attachment style were associated with BOLD activation changes. Breakup characteristics (e.g., initiator status) were associated with increased BOLD activation in the hippocampus and amygdala, in the RRD group.

Conclusion: RRDs should be considered as potentially traumatic events. Breakup characteristics are risk factors for experiencing RRDs as traumatic.

Limitation: Future studies should consider more diverse representation across sex, ethnicity, and sexual orientation.

Keywords: Attachment; Emerging adult students; Physical assault; Posttraumatic stress; Sexual assault.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Amygdala* / diagnostic imaging
Amygdala* / physiopathology
Case-Control Studies
Cerebral Cortex / diagnostic imaging
Cerebral Cortex / physiopathology
Female
Hippocampus* / diagnostic imaging
Hippocampus* / physiopathology
Humans
Insular Cortex / diagnostic imaging
Insular Cortex / physiology
Insular Cortex / physiopathology
Interpersonal Relations
Magnetic Resonance Imaging*
Male
Object Attachment
Stress Disorders, Post-Traumatic* / diagnostic imaging
Stress Disorders, Post-Traumatic* / physiopathology
Students / psychology
Students / statistics & numerical data
Young Adult