Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample

Research on positive emotion disturbance has gained increasing attention, yet it is not clear which specific positive emotions are affected by mood symptoms, particularly during the critical period of adolescence. This is especially pertinent for identifying potential endophenotypic markers associated with mood disorder onset and course. The present study examined self-reported discrete positive and negative emotions in association with clinician-rated manic and depressive mood symptoms in a clinically and demographically diverse group of 401 outpatient adolescents between 11-18 years of age. Results indicated that higher self reported joy and contempt were associated with increased symptoms of mania, after controlling for symptoms of depression. Low levels of joy and high sadness uniquely predicted symptoms of depression, after controlling for symptoms of mania. Results were independent of age, ethnicity, gender and bipolar diagnosis. These findings extend work on specific emotions implicated in mood pathology in adulthood, and provide insights into associations between emotions associated with goal driven behavior with manic and depressive mood symptom severity in adolescence. In particular, joy was the only emotion associated with both depressive and manic symptoms across adolescent psychopathology, highlighting the importance of understanding positive emotion disturbance during adolescent development.

A Cross-Species Comparative Approach to Positive Emotion Disturbance

Recent discoveries stress the importance of studying positive emotion disturbances (PED) yet there remains little empirical work or integrative conceptual framework in this domain. We suggest that an ideally suited opportunity to advance the study of PED is to consider a cross-species evolutionary framework. We apply this framework—drawing from principles of stabilizing selection—to recent empirical findings in humans and nonhumans suggesting how positive emotion and associated play behaviors may lead to detrimental outcomes. This cross-species approach suggests a potential paradigm shift in the way psychologists and evolutionary biologists approach positive emotion functioning, opening the possibility for new conceptual opportunities and interdisciplinary dialogues and research.

Basic dimensions defining mania risk: A structural approach

Mania is the core criterion for bipolar disorder, a chronic and severe psychiatric illness centrally associated with positive affective disturbance. Many self-report measures have been created to assess symptoms of, and risk for, mania but there are notable disparities in their length, scope, and content. Thus, the goal of this study was to determine the structure and correlates of a number of widely used "bipolar-relevant" (BR) measures (e.g., Hypomanic Personality Scale, Altman Self-Rating Mania Scale, General Behavior Inventory, Mood Disorder Questionnaire). Data from a community sample (Study 1, N = 329) and a student sample assessed at two time points (Study 2; Ns = 382 and 308, respectively) provided strong evidence that the BR measures were characterized by both (a) a well-defined common dimension when a single factor was extracted, and (b) a clear structure of Emotional Lability and Activated Positive Affect upon extracting two factors. The general factor showed a relatively nonspecific pattern of associations with personality and psychopathology. In contrast, the Emotional Lability factor showed its strongest relations with neuroticism and depressive symptoms, displaying comparatively weaker relations with measures of extraversion and positive emotionality. Conversely, although Activated Positive Affect also associated positively with depressive symptoms and with neuroticism in some instances, its strongest relations were with measures of extraversion and high arousal positive emotionality. These findings suggest that measures defining Emotional Lability seem to assess mood volatility to a greater extent, whereas measures defining the Activated Positive Affect factor capture an intense, high arousal form of positive emotionality. (PsycINFO Database Record

Unseen positive and negative affective information influences social perception in bipolar I disorder and healthy adults

Bipolar disorder is fundamentally a disorder of emotion regulation, and associated with explicit processing biases for socially relevant emotional information in human faces. Less is known, however, about whether implicit processing of this type of emotional information directly influences social perception. We thus investigated group-related differences in the influence of unconscious emotional processing on conscious person perception judgments using a continuous flash suppression task among 22 individuals with remitted bipolar I disorder (BD; AgeM=30.82, AgeSD=7.04; 68.2% female) compared with 22 healthy adults (CTL; AgeM=20.86, AgeSD=9.91; 72.2% female). Across both groups, participants rated neutral faces as more trustworthy, warm, and competent when paired with unseen happy faces as compared to unseen angry and neutral faces; participants rated neutral faces as less trustworthy, warm, and competent when paired with unseen angry as compared to neutral faces. These findings suggest that emotion-related disturbances are not explained by early automatic processing stages, and that activity in the dorsal visual stream underlying implicit emotion processing is intact in bipolar disorder. Implications for understanding the etiology of emotion disturbance in BD are discussed.

Efficient multiblock star polymer synthesis from photo-induced copper-mediated polymerization with up to 21 arms

Photo-induced copper-mediated polymerization (photoCMP) is employed for the synthesis of multiarm-multiblock star copolymers. Based on a core-first approach, star polymers with four, six and twenty-one arms have been synthesized.

I don't want to come back down: Undoing versus maintaining of reward recovery in older adolescents

Adolescence is characterized by heightened and sometimes impairing reward sensitivity, yet less is known about how adolescents recover from highly arousing positive states. This is particularly important given high onset rates of psychopathology associated with reward sensitivity during late adolescence and early adulthood. The current study thus utilized a novel reward sensitivity task in order to examine potential ways in which older adolescent females (ages 18-21; N = 83) might recover from high arousal positive reward sensitive states. Participants underwent a fixed incentive reward sensitivity task and subsequently watched a neutral, sad, or a low approach-motivated positive emotional film clip during which subjective and physiological recovery was assessed. Results indicated that the positive and negative film conditions were associated with maintained physiological arousal while the neutral condition facilitated faster physiological recovery from the reward sensitivity task. It is interesting to note that individual differences in self-reported positive emotion during the reward task were associated with faster recovery in the neutral condition. Findings suggest elicited emotion (regardless of valence) may serve to maintain reward sensitivity whereas self-reported positive emotional experience may be a key ingredient facilitating physiological recovery or undoing. Understanding the nuances of reward recovery provides a critical step in understanding the etiology and persistence of reward dysregulation more generally.

Elevated striatal reactivity across monetary and social rewards in bipolar I disorder

Bipolar disorder (BD) is associated with increased reactivity to rewards and heightened positive affectivity. It is less clear to what extent this heightened reward sensitivity is evident across contexts and what the associated neural mechanisms might be. The present investigation used both a monetary and social incentive delay task among adults with remitted BD Type I (n = 24) and a healthy nonpsychiatric control group (HC; n = 25) using fMRI. Both whole-brain and region-of-interest analyses revealed elevated reactivity to reward receipt in the striatum, a region implicated in incentive sensitivity, in the BD group. Post hoc analyses revealed that greater striatal reactivity to reward receipt, across monetary and social reward tasks, predicted decreased self-reported positive affect when anticipating subsequent rewards in the HC but not in the BD group. Results point toward elevated striatal reactivity to reward receipt as a potential neural mechanism of persistent reward pursuit in BD.

Heart rate variability as a potential indicator of positive valence system disturbance: A proof of concept investigation

One promising avenue toward a better understanding of the pathophysiology of positive emotional disturbances is to examine high-frequency heart rate variability (HRV-HF), which has been implicated as a potential physiological index of disturbances in positive emotional functioning. To date, only a few psychopathology relevant studies have systematically quantified HRV-HF profiles using more ecologically valid methods in everyday life. Using an experience-sampling approach, the present study examined both mean levels and intra-individual variability of HRV-HF - as well as comparison measures of cardiovascular arousal, sympathetic activity, and gross somatic movement - in everyday life, using ambulatory psychophysiological measurement across a six-day consecutive period among a spectrum of community adult participants with varying degrees of positive valence system disturbance, including adults with bipolar I disorder (BD; n=21), major depressive disorder (MDD; n=17), and healthy non-psychiatric controls (CTL; n=28). Groups did not differ in mean HRV-HF, but greater HRV-HF instability (i.e., intra-individual variation in HRV-HF) was found in the BD compared to both MDD and CTL groups. Subsequent analyses suggested that group differences in HRV-HF variability were largely accounted for by variations in clinician-rated manic symptoms. However, no association was found between HRV-HF variability and dimensional measures of positive affectivity. This work provides evidence consistent with a quadratic relationship between HRV-HF and positive emotional disturbance and represents a valuable step toward developing a more ecologically valid model of positive valence system disturbances and their underlying psychophysiological mechanisms within an RDoC framework.

Comparing Happiness and Hypomania Risk: A Study of Extraversion and Neuroticism Aspects

Positive affect has long been considered a hallmark of subjective happiness. Yet, high levels of positive affect have also been linked with hypomania risk: a set of cognitive, affective, and behavioral characteristics that constitute a dispositional risk for future episodes of hypomania and mania. At a personality level, two powerful predictors of affective experience are extraversion and neuroticism: extraversion has been linked to positive affect, and neuroticism to negative affect. As such, a single personality trait--extraversion--has been linked to both beneficial and harmful outcomes associated with positivity. It is clear that positive affect, in different forms, has divergent consequences for well-being, but previous research has struggled to articulate the nature of these differences. We suggest that the relationship between affect and well-being needs to be situated within the psychological context of the individual--both in terms of more specific forms of extraversion and neuroticism, but also in terms of interactions among personality aspects. Consistent with this idea, we found that two aspects of extraversion (enthusiasm and assertiveness) differentially predicted subjective happiness from hypomania risk and two aspects of neuroticism (volatility and withdrawal) interacted to predict hypomania risk: the highest levels of hypomania risk were associated with the combination of high volatility and low withdrawal. These findings underscore the importance of examining personality at the right level of resolution to understand well-being and dysfunction.

Seeing the world through rose-colored glasses: People who are happy and satisfied with life preferentially attend to positive stimuli

Given the many benefits conferred by trait happiness and life satisfaction, a primary goal is to determine how these traits relate to underlying cognitive processes. For example, visual attention acts as a gateway to awareness, raising the question of whether happy and satisfied people attend to (and therefore see) the world differently. Previous work suggests that biases in selective attention are associated with both trait negativity and with positive affect states, but to our knowledge, no previous work has explored whether trait-happy individuals attend to the world differently. Here, we employed eye tracking as a continuous measure of sustained overt attention during passive viewing of displays containing positive and neutral photographs to determine whether selective attention to positive scenes is associated with measures of trait happiness and life satisfaction. Both trait measures were significantly correlated with selective attention for positive (vs. neutral) scenes, and this general pattern was robust across several types of positive stimuli (achievement, social, and primary reward), and not because of positive or negative state affect. Such effects were especially prominent during the later phases of sustained viewing. This suggests that people who are happy and satisfied with life may literally see the world in a more positive light, as if through rose-colored glasses. Future work should investigate the causal relationship between such attention biases and one's happiness and life satisfaction.

Hypersomnia subtypes, sleep and relapse in bipolar disorder

BACKGROUND

Though poorly defined, hypersomnia is associated with negative health outcomes and new-onset and recurrence of psychiatric illness. Lack of definition impedes generalizability across studies. The present research clarifies hypersomnia diagnoses in bipolar disorder by exploring possible subgroups and their relationship to prospective sleep data and relapse into mood episodes.

METHOD

A community sample of 159 adults (aged 18-70 years) with bipolar spectrum diagnoses, euthymic at study entry, was included. Self-report inventories and clinician-administered interviews determined features of hypersomnia. Participants completed sleep diaries and wore wrist actigraphs at home to obtain prospective sleep data. Approximately 7 months later, psychiatric status was reassessed. Factor analysis and latent profile analysis explored empirical groupings within hypersomnia diagnoses.

RESULTS

Factor analyses confirmed two separate subtypes of hypersomnia ('long sleep' and 'excessive sleepiness') that were uncorrelated. Latent profile analyses suggested a four-class solution, with 'long sleep' and 'excessive sleepiness' again representing two separate classes. Prospective sleep data suggested that the sleep of 'long sleepers' is characterized by a long time in bed, not long sleep duration. Longitudinal assessment suggested that 'excessive sleepiness' at baseline predicted mania/hypomania relapse.

CONCLUSIONS

This study is the largest of hypersomnia to include objective sleep measurement, and refines our understanding of classification, characterization and associated morbidity. Hypersomnia appears to be comprised of two separate subgroups: long sleep and excessive sleepiness. Long sleep is characterized primarily by long bedrest duration. Excessive sleepiness is not associated with longer sleep or bedrest, but predicts relapse to mania/hypomania. Understanding these entities has important research and treatment implications.

The collective benefits of feeling good and letting go: positive emotion and (dis)inhibition interact to predict cooperative behavior

Cooperation is central to human existence, forming the bedrock of everyday social relationships and larger societal structures. Thus, understanding the psychological underpinnings of cooperation is of both scientific and practical importance. Recent work using a dual-process framework suggests that intuitive processing can promote cooperation while deliberative processing can undermine it. Here we add to this line of research by more specifically identifying deliberative and intuitive processes that affect cooperation. To do so, we applied automated text analysis using the Linguistic Inquiry and Word Count (LIWC) software to investigate the association between behavior in one-shot anonymous economic cooperation games and the presence inhibition (a deliberative process) and positive emotion (an intuitive process) in free-response narratives written after (Study 1, N = 4,218) or during (Study 2, N = 236) the decision-making process. Consistent with previous results, across both studies inhibition predicted reduced cooperation while positive emotion predicted increased cooperation (even when controlling for negative emotion). Importantly, there was a significant interaction between positive emotion and inhibition, such that the most cooperative individuals had high positive emotion and low inhibition. This suggests that inhibition (i.e., reflective or deliberative processing) may undermine cooperative behavior by suppressing the prosocial effects of positive emotion.

Valuing happiness is associated with bipolar disorder

Although people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for bipolar disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1 and 2), increased likelihood of past diagnosis of BD (Studies 2 and 3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1-3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health.

A Positive Affective Neuroendocrinology Approach to Reward and Behavioral Dysregulation

Emerging lines of research suggest that both testosterone and maladaptive reward processing can modulate behavioral dysregulation. Yet, to date, no integrative account has been provided that systematically explains neuroendocrine function, dysregulation of reward, and behavioral dysregulation in a unified perspective. This is particularly important given specific neuroendocrine systems are potential mechanisms underlying and giving rise to reward-relevant behaviors. In this review, we propose a forward-thinking approach to study the mechanisms of reward and behavioral dysregulation from a positive affective neuroendocrinology (PANE) perspective. This approach holds that testosterone increases reward processing and motivation, which increase the likelihood of behavioral dysregulation. Additionally, the PANE framework holds that reward processing mediates the effects of testosterone on behavioral dysregulation. We also explore sources of potential sex differences and the roles of age, cortisol, and individual differences within the PANE framework. Finally, we discuss future prospects for research questions and methodology in the emerging field of affective neuroendocrinology.

[DRESS syndrome following sulfasalazine treatment]

A female patient developed systemic rash, lung edema, electrocardiogram (ECG) abnormalities and fulminant hepatitis with partial liver failure 4 weeks after the start of sulfasalazine treatment. Peripheral T-cell activation, a positive PCR test for human herpesvirus (HHV) 6 as well as eosinophilia in bronchial lavage and a differential blood count were also present. After initiation of systemic corticosteroid therapy and cessation of accompanying medication the clinical symptoms and abnormal laboratory test levels were gradually resolved. A DRESS syndrome (drug rash with eosinophilia and systemic symptoms) was confirmed in accordance with the diagnostic criteria.

DESPERATELY SEEKING HAPPINESS: VALUING HAPPINESS IS ASSOCIATED WITH SYMPTOMS AND DIAGNOSIS OF DEPRESSION

Culture shapes the emotions people feel and want to feel. In Western cultures, happiness is an emotion that many people want to feel. Although experiencing happiness is associated with increased well-being and psychological health, recent evidence suggests wanting to feel happy to an extreme degree, or, highly valuing happiness, leads to decreased well-being. To examine whether these effects of valuing happiness might extend to clinical outcomes, we examined the hypothesis that depression is associated with highly valuing happiness. To do so, we examined the relationship between valuing happiness and depression in two U.S. samples. As hypothesized, valuing happiness was associated with increased depressive symptoms in a community sample with remitted major depressive disorder (MDD), even when controlling for social desirability and neuroticism (Study 1). Furthermore, valuing happiness was elevated in a remitted MDD sample (vs. healthy controls), even when controlling for current depressive symptoms, general affect valuation, and extreme goal pursuit (Study 2). Taken together, these findings suggest that the culturally-pervasive value placed on attaining happiness can represent a risk factor for symptoms and a diagnosis of depression. More broadly, they indicate that a cultural approach can meaningfully extend our understanding of clinical phenomena.