An exploratory study of emotional forecasting and experience disparities in PTSD: insights from a virtual reality paradigm

<b>Background:</b> Emotional disturbances are central to post-traumatic stress disorder (PTSD) and shape how individuals anticipate and experience events.<b>Objective:</b> This study investigates affective forecasting and emotional experience among PTSD patients, trauma-exposed controls (TEC), and healthy controls (HC) using a novel virtual reality paradigm.<b>Method:</b> Eighty-six participants (30 PTSD, 28 TEC, 28 HC) rated their predicted and actual emotional responses (valence and arousal) to unpleasant, neutral, and pleasant virtual scenarios. Physiological measures included heart rate and skin conductance responses (SCR).<b>Results:</b> PTSD participants showed alterations in their affective forecasting and emotional experience, assigning significantly lower valence scores to pleasant and neutral scenarios and exhibiting amplified SCR to emotionally charged stimuli. Their arousal ratings for neutral stimuli were also more elevated compared to HC. In their forecasting, PTSD participants anticipated more positive - or less negative - emotions compared to what they experienced next.<b>Conclusions:</b> These findings reveal critical emotional processing differences in PTSD, both during affective forecasting and emotional experience, supporting cognitive models that emphasize biased processing of emotional information in this psychiatric condition.