Social attachment systems are disrupted for refugees through trauma and forced displacement. This study tested how the attachment system mitigates neural responses to threat in refugees with posttraumatic stress disorder (PTSD). Refugees with PTSD (N = 28) and refugee trauma-exposed controls (N = 22) viewed threat-related stimuli primed by attachment cues during a functional magnetic resonance imaging scan. Group differences and the moderating effects of avoidant or anxious attachment style and grief related to separation from family on brain activity and connectivity patterns were examined. Separation grief was associated with increased amygdala but decreased ventromedial prefrontal cortical (VMPFC) activity to the attachment prime and decreased VMPFC and hippocampal activity to attachment primed threat in the PTSD (vs trauma-exposed control) group. Avoidant attachment style was connected with increased dorsal frontoparietal attention regional activity to attachment prime cues in the PTSD group. Anxious attachment style was associated with reduced left amygdala connectivity with left medial prefrontal regions to attachment primed threat in the PTSD group. Separation grief appears to reduce attachment buffering of threat reactivity in refugees with PTSD, while avoidant and anxious attachment style modulated attentional and prefrontal regulatory mechanisms in PTSD, respectively. Considering social attachments in refugees could be important to post-trauma recovery, based within changes in key emotion regulation brain systems.

中文翻译：

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激活依恋系统可以调节患有创伤后应激障碍（PTSD）的难民对威胁的神经反应

难民的社会依恋系统因创伤和被迫流离失所而受到破坏。这项研究测试了依恋系统如何减轻患有创伤后应激障碍（PTSD）的难民对威胁的神经反应。患有创伤后应激障碍 (PTSD) 的难民 (N = 28) 和遭受创伤的对照难民 (N = 22) 在功能性磁共振成像扫描期间观察到由依恋线索引发的与威胁相关的刺激。研究人员检查了群体差异以及回避或焦虑依恋风格以及与家人分离相关的悲伤对大脑活动和连接模式的调节作用。在 PTSD 组（与创伤暴露对照组相比），分离悲伤与杏仁核增加有关，但与依恋引发的腹内侧前额皮质（VMPFC）活动减少有关，并且与依恋引发威胁的 VMPFC 和海马活动减少有关。在 PTSD 组中，回避型依恋风格与背侧额顶注意力区域活动增加有关，以依恋主要线索。在 PTSD 组中，焦虑依恋风格与左杏仁核与左内侧前额叶区域的连接减少有关。分离悲伤似乎减少了患有 PTSD 的难民对威胁反应的依恋缓冲，而回避型和焦虑型依恋风格分别调节了 PTSD 的注意力和前额叶调节机制。基于关键情绪调节大脑系统的变化，考虑难民的社会依恋对于创伤后恢复可能很重要。