Altered neural encoding of prediction errors in assault-related posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is widely associated with deficits in extinguishing learned fear responses, which relies on mechanisms of reinforcement learning (e.g., updating expectations based on prediction errors). However, the degree to which PTSD is associated with impairments in general reinforcement learning (i.e., outside of the context of fear stimuli) remains poorly understood. Here, we investigate brain and behavioral differences in general reinforcement learning between adult women with and without a current diagnosis of PTSD. 29 adult females (15 PTSD with exposure to assaultive violence, 14 controls) underwent a neutral reinforcement-learning task (i.e., two arm bandit task) during fMRI. We modeled participant behavior using different adaptations of the Rescorla-Wagner (RW) model and used Independent Component Analysis to identify timecourses for large-scale a priori brain networks. We found that an anticorrelated and risk sensitive RW model best fit participant behavior, with no differences in computational parameters between groups. Women in the PTSD group demonstrated significantly less neural encoding of prediction errors in both a ventral striatum/mPFC and anterior insula network compared to healthy controls. Weakened encoding of prediction errors in the ventral striatum/mPFC and anterior insula during a general reinforcement learning task, outside of the context of fear stimuli, suggests the possibility of a broader conceptualization of learning differences in PTSD than currently proposed in current neurocircuitry models of PTSD.