Ongoing monitoring of mindwandering in avoidant grief through cortico-basal-ganglia interactions

An avoidant grief style is marked by repeated and often unsuccessful attempts to prevent thinking about loss. Prior work shows avoidant grief involves monitoring the external environment in order to avoid reminders of the loss. Here we sought to determine whether avoidant grievers also monitor the internal environment in attempts to minimize conscious awareness of loss-related thoughts. Individuals bereaved of a first-degree relative, spouse or partner within the last 14months participated in a functional magnetic resonance imaging (fMRI) study (N=29). We first applied machine learning to train neural patterns for attentional control and representation of the deceased (N=23). The attentional pattern was trained using fMRI data from a modified Stroop task assessing selective attention to reminders of the deceased. The representational pattern was trained using fMRI data from a task presenting pictures and stories of the deceased. We observed spontaneous fluctuations in these processes occurring during a neutral mindwandering fMRI task (N=27). At higher levels of avoidant grieving, activation of attentional control disrupted the relationship between the representational process and thoughts of loss. These findings show that avoidant grief involves attentional control to reduce the likelihood that deceased-related representations reach full conscious awareness.