{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:45:35Z","timestamp":1781790335106,"version":"3.54.5"},"reference-count":41,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Fire Fighting Safety & 119 Rescue Technology Research and Development Program funded by National Fire Agency","award":["MPSS-Firesafety-2015-80"],"award-info":[{"award-number":["MPSS-Firesafety-2015-80"]}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec id=\"S2056472422000321_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Firefighters are frequently exposed to stressful situations and are at high risk of developing post-traumatic stress disorder (PTSD). Hyperresponsiveness to threatening and emotional stimuli and diminishment of executive control have been suggested as manifestations of PTSD.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472422000321_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To examine brain activation in firefighters with PTSD by conducting an executive control-related behavioural task with trauma-related interferences.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472422000321_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Twelve firefighters with PTSD and 14 healthy firefighters underwent functional magnetic resonance imaging (fMRI) while performing a Stroop match-to-sample task using trauma-related photographic stimuli. Seed-based functional connectivity analysis was conducted using regions identified in fMRI contrast analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472422000321_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Compared with the controls, the participants with PTSD had longer reaction times when the trauma-related interferences were presented. They showed significantly stronger brain activation to interfering trauma-related stimuli in the left insula, and had weaker insular functional connectivity in the supplementary motor area and the anterior cingulate cortex than the controls. They also showed a significant correlation between left insula\u2013supplementary motor area connectivity strength and the hyperarousal subscale of the Clinician-Administered PTSD Scale.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472422000321_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Our findings indicate that trauma-related stimuli elicit excessive brain activation in the left insula among firefighters with PTSD. Firefighters with PTSD also appear to have weak left insular functional connectivity with executive control-related brain regions. This aberrant insular activation and functional connectivity could be related to the development and maintenance of PTSD symptoms in firefighters.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjo.2022.32","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T06:45:05Z","timestamp":1647326705000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":15,"title":["Insular activation and functional connectivity in firefighters with post-traumatic stress disorder"],"prefix":"10.1192","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-4677","authenticated-orcid":false,"given":"Deokjong","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung 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