Differential Neural Responsivity in Highly Resilient Individuals during Reward Anticipation

Background. The capacity to experience positive emotions supports psychological resilience. Thefunctioning of reward neural circuitry plays a significant role in positive emotionality and tends to bedampened in individuals with posttraumatic stress disorder (PTSD). However, neuroimaging studieshave scarcely examined neural correlates of reward processing associated with being highly resilient inthe face of trauma exposure.Method. We recruited World Trade Center rescue and recovery workers (N=94) from three groups:“Highly Resilient” (higher WTC-related trauma exposure plus no current/lifetime psychopathology;n=34), “Lower WTC-exposed” (lower WTC-related trauma exposure plus no current/lifetimepsychopathology; n=31), and “PTSD” (chronic WTC-related PTSD; n=32). We examined rewardanticipation during the Incentive Flanker Task, focusing on regions of interest associated with rewardsalience (nucleus accumbens) and reward valuation (ventromedial prefrontal cortex; vmPFC).Results. Activation of the left nucleus accumbens was significantly greater in the Highly Resilient groupcompared to the Lower WTC-exposed group (Cohen’s d=0.70) and, after statistically adjusting forpsychotropic medication, the PTSD group (d=0.62), Similar results were observed for the vmPFC. Incontrast, Highly Resilient and Lower WTC-exposed scored comparably on self-report measures ofpositive emotionality, and higher than those in the chronic WTC-related PTSD group.Conclusions. Findings support the idea that neural responsivity to potential rewards may enableresilience, potentially by buffering negative effects of substantial trauma exposure. Integratingneurobiological assessments with psychological measures may help better understand how positiveemotionality is linked to psychological resilience. Improved understanding of this link could beleveraged for clinical assessment and intervention in trauma-exposed populations