Posttraumatic stress disorder (PTSD) is characterized by heightened avoidance, cognitive inflexibility, and impaired reward processing. Maladaptive behavior in PTSD may reflect an imbalance between approach and avoidance, but no research has investigated approach-avoidance conflict (AAC) in PTSD. The current study investigated approach-avoidance behavior in PTSD using a trauma-related AAC (trAAC) task in two independent samples. In Study 1, 43 women with a current diagnosis of PTSD and 18 healthy comparison subjects were recruited from the community. In Study 2, 53 women with trauma exposure and a range of PTSD symptoms were recruited from a correctional institution. Trials were separated into two phases: conflict (the option most likely to win points was most likely to show a trauma-related image) and congruent (the option most likely to win points was least likely to show a trauma-related image). In Study 1, reward obtainment varied with the task manipulation (i.e., fewer points earned during conflict compared to congruent Phase) in PTSD but not healthy subjects. These results indicate that when avoidance is advantageous (congruent phase), individuals with PTSD show increased task performance, whereas when avoidance is maladaptive (conflict phase), individuals with PTSD show increased sacrifice of reward. In Study 2, higher PTSD symptoms predicted decreased reward earning during the conflict phase, again indicating a sacrifice of reward when avoidance is maladaptive. Across both studies, PTSD associated with increased AAC and sacrifice of reward in the presence of trauma-related stimuli. These studies shed light on AAC in PTSD and could inform more targeted therapy approaches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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牺牲奖励以避免威胁：在创伤相关的进近避免冲突任务中表征PTSD。

创伤后应激障碍（PTSD）的特征是回避能力增强，认知僵化和奖励处理受损。创伤后应激障碍中的适应不良行为可能反映了进近与回避之间的不平衡，但是尚无研究调查过创伤后应激障碍中的进近与避免冲突（AAC）。当前的研究使用两个独立样本中的创伤相关AAC（trAAC）任务调查了PTSD中的避免进近行为。在研究1中，从社区招募了43名目前诊断为PTSD的妇女和18名健康的比较受试者。在研究2中，从惩教机构招募了53名遭受外伤和一系列PTSD症状的妇女。试验分为两个阶段：冲突（最可能赢得积分的选项最有可能显示与创伤相关的图像）和全等（最可能赢得积分的选项最不可能显示与创伤相关的图像）。在研究1中，在PTSD中，奖励的获得随任务操纵而变化（即，与一致阶段相比，冲突期间获得的积分更少），但健康受试者却没有。这些结果表明，当回避是有利的（一致阶段）时，患有PTSD的人表现出更高的任务绩效，而当回避是适应不良的人（冲突阶段）时，具有PTSD的人表现出更大的奖励牺牲。在研究2中，较高的PTSD症状预示着在冲突阶段会减少奖励收入，再次表明在回避行为不当时会牺牲奖励。在两项研究中，在创伤相关刺激的存在下，PTSD与AAC增加和牺牲牺牲有关。这些研究揭示了PTSD中的AAC，可以为更具针对性的治疗方法提供参考。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。