Journal of Emergency Health Care
Formerly known as: International Journal of Medical Investigation
Volume 15, Issue 1 (2-2026)
J Emerg Health Care 2026, 15(1): 0-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Khaksarian M, Keshavarz A, Ahmadi H. The Neurobiology of Acute Emotional Dysregulation in Emergency Trauma Care: A Psychophysiological Perspective. J Emerg Health Care 2026; 15 (1)
URL: http://intjmi.com/article-1-1360-en.html
URL: http://intjmi.com/article-1-1360-en.html
Department of Physiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
Abstract: (42 Views)
Frontal alpha asymmetry (FAA) is an electroencephalographic marker that reflects approach-avoidance motivation in the brain. In this review, we consolidate divergent findings on FAA from studies on people with PTSD, individuals with trauma exposure but no PTSD diagnosis (trauma-exposed healthy controls), and people with no significant trauma history (non-trauma healthy controls). FAA has been examined during tasks combining emotional stimuli (threatening and neutral images) with cognitive demands such as distraction or working memory load.
Notably, PTSD is associated with increased left frontal activity (linked to approach motivation) in response to threatening images when cognitive demands are low. The trauma-exposed individuals without PTSD group shows a similar but attenuated pattern. In contrast, NTHC tends to show right frontal activity (associated with withdrawal tendencies) regardless of stimulus type. Interestingly, this right-lateralized pattern—which is absent in the PTSD group—tends to disappear under higher cognitive load, such as when filtering out distractions. Under these conditions, the PTSD group maintains a left frontal bias even for neutral stimuli, while the other two groups either reduce left-sided activity or maintain a balanced pattern.
Overall, these findings suggest that PTSD alters the typical response to threat and impairs emotion regulation under cognitive strain. Simply having a trauma history may produce a milder form of this approach bias without meeting criteria for full disorder. We discuss implications for prefrontal threat processing and the potential of neurofeedback to retrain these patterns.
Notably, PTSD is associated with increased left frontal activity (linked to approach motivation) in response to threatening images when cognitive demands are low. The trauma-exposed individuals without PTSD group shows a similar but attenuated pattern. In contrast, NTHC tends to show right frontal activity (associated with withdrawal tendencies) regardless of stimulus type. Interestingly, this right-lateralized pattern—which is absent in the PTSD group—tends to disappear under higher cognitive load, such as when filtering out distractions. Under these conditions, the PTSD group maintains a left frontal bias even for neutral stimuli, while the other two groups either reduce left-sided activity or maintain a balanced pattern.
Overall, these findings suggest that PTSD alters the typical response to threat and impairs emotion regulation under cognitive strain. Simply having a trauma history may produce a milder form of this approach bias without meeting criteria for full disorder. We discuss implications for prefrontal threat processing and the potential of neurofeedback to retrain these patterns.
Keywords: Emotional Dysregulation, Trauma, Psychophysiology, Heart Rate Variability, Skin Conductance, Emergency Care, PTSD, Autonomic Nervous System, Intervention
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |