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Rethinking post-traumatic stress disorder - A predictive processing perspective


Kube, Tobias; Berg, Max; Kleim, Birgit; Herzog, Philipp (2020). Rethinking post-traumatic stress disorder - A predictive processing perspective. Neuroscience and Biobehavioral Reviews, 113:448-460.

Abstract

Predictive processing has become a popular framework in neuroscience and computational psychiatry, where it has provided a new understanding of various mental disorders. Here, we apply the predictive processing account to post-traumatic stress disorder (PTSD). We argue that the experience of a traumatic event in Bayesian terms can be understood as a perceptual hypothesis that is subsequently given a very high a-priori likelihood due to its (life-) threatening significance; thus, this hypothesis is re-selected although it does not fit the actual sensory input. Based on this account, we re-conceptualise the symptom clusters of PTSD through the lens of a predictive processing model. We particularly focus on re-experiencing symptoms as the hallmark symptoms of PTSD, and discuss the occurrence of flashbacks in terms of perceptual and interoceptive inference. This account provides not only a new understanding of the clinical profile of PTSD, but also a unifying framework for the corresponding pathologies at the neurobiological level. Finally, we derive directions for future research and discuss implications for psychological and pharmacological interventions.

Abstract

Predictive processing has become a popular framework in neuroscience and computational psychiatry, where it has provided a new understanding of various mental disorders. Here, we apply the predictive processing account to post-traumatic stress disorder (PTSD). We argue that the experience of a traumatic event in Bayesian terms can be understood as a perceptual hypothesis that is subsequently given a very high a-priori likelihood due to its (life-) threatening significance; thus, this hypothesis is re-selected although it does not fit the actual sensory input. Based on this account, we re-conceptualise the symptom clusters of PTSD through the lens of a predictive processing model. We particularly focus on re-experiencing symptoms as the hallmark symptoms of PTSD, and discuss the occurrence of flashbacks in terms of perceptual and interoceptive inference. This account provides not only a new understanding of the clinical profile of PTSD, but also a unifying framework for the corresponding pathologies at the neurobiological level. Finally, we derive directions for future research and discuss implications for psychological and pharmacological interventions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
Scopus Subject Areas:Social Sciences & Humanities > Neuropsychology and Physiological Psychology
Life Sciences > Cognitive Neuroscience
Life Sciences > Behavioral Neuroscience
Language:English
Date:June 2020
Deposited On:14 Dec 2020 12:38
Last Modified:24 May 2024 01:44
Publisher:Elsevier
ISSN:0149-7634
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.neubiorev.2020.04.014
PubMed ID:32315695
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