Evidence map›Paper›PMID 35177485›Full record

ArticleJournal of psychiatry & neuroscience : JPN

Moral wounds run deep: exaggerated midbrain functional network connectivity across the default mode network in posttraumatic stress disorder.

Braeden A Terpou, Chantelle S Lloyd, Maria Densmore, Margaret C McKinnon, Jean Théberge, Richard W J Neufeld, Rakesh Jetly, Ruth A Lanius

Open access · diamondAbstract read
In one paragraph

Article in Journal of psychiatry & neuroscience : JPN. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
3.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 24 citations in OpenAlex.

  1. Resting-State Neural Signatures of Moral Injury: Associations With Rumination.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2026
    Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. War trauma impacts in Ukrainian combat and civilian populations: Moral injury and associated mental health symptoms.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2024
    Article
  7. Civilian Moral Injury and Amygdala Functional Connectivity During Attention to Threat.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2024
    Article
  8. Review
  9. Article
  10. Article
  11. Beneath, Beyond Burnout: Solving for Causes.The Permanente journal · 2023
    Article
  12. Neuroscientific account of Guilt- and Shame-Driven PTSD phenotypes.European journal of psychotraumatology · 2023
    Article
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 2 countries.

Braeden A TerpouFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Chantelle S LloydFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Maria DensmoreFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Margaret C McKinnonFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Jean ThébergeFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Richard W J NeufeldFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Rakesh JetlyFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
Ruth A LaniusFrom the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont. ruth.lanius@lhsc.on.ca.
Western University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA moral injury occurs when a deeply held moral code has been violated, and it can lead to the development of symptoms of posttraumatic stress disorder (PTSD). However, the neural correlates that differentiate moral injury and PTSD remain largely unknown. Intrinsic connectivity networks such as the default mode network (DMN) appear to be altered in people with PTSD who have experienced moral injury. However, brainstem, midbrain and cerebellar systems are rarely integrated into the intrinsic connectivity networks; this is a critical oversight, because these systems display marked differences in people with PTSD and are thought to underlie strong moral emotions such as shame, guilt and betrayal.

methodsWe conducted an independent component analysis on data generated during script-driven memory recall of moral injury in participants with military- or law enforcement-related PTSD (

resultsWe found stronger functional network connectivity in the midbrain periaqueductal grey ( LIMITATIONS: The significant clusters were large, but resolution is generally lower for subcortical structures.

conclusionIn PTSD, the DMN appears to be biased toward lower-level, midbrain systems, which may drive toxic shame and related moral emotions that are common in PTSD, highlighting the depth at which moral injuries are represented neurobiologically.

Indexed as

Stress Disorders, Post-TraumaticBrainDefault Mode NetworkHumansMagnetic Resonance ImagingMesencephalonMorals

Identifiers

PMID35177485
PMCPMC8865964
OpenAlexW4212764706

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.