How brains beware: neural mechanisms of emotional attention

Trait anxiety is related to Nx4's efficacy on stress-induced changes in amygdala-centered resting state functional connectivity: a placebo-controlled cross-over trial in mildly to moderately stressed healthy volunteers

BACKGROUND

The multicomponent drug Neurexan (Nx4) was shown to reduce the neural stress network activation. We now investigated its effects on stress-induced resting state functional connectivity (RSFC) in dependence of trait anxiety (TA), an acknowledged vulnerability factor for stress-induced psychopathologies.

METHODS

Nx4 was tested in a randomized placebo-controlled crossover trial. Resting state fMRI scans were performed before and after a psychosocial stress task and exploratively analyzed for amygdala centered RSFC. Effects of Nx4 on stress-induced RSFC changes were evaluated and correlated to TA levels. A subgroup analysis based on TA scores was performed.

RESULTS

Multiple linear regression analysis revealed a significant correlation between TA and Nx4 effect on stress-induced RSFC changes between right amygdala and pregenual anterior cingulate cortex (pgACC) and ventro-medial prefrontal cortex (vmPFC). For participants with above average TA, a significant amelioration of the stress-induced RSFC changes was observed.

CONCLUSIONS

The data add evidence to the hypothesis that Nx4's clinical efficacy is based on a dampened activation of the neural stress network, with a greater neural response in subjects with anxious personality traits. Further studies assessing clinically relevant outcome measures in parallel to fMRI are encouraged to evaluate the real-world benefit of Nx4. Trial registration NCT02602275.

Effects of a three-week executive control training on adaptation to task difficulty and emotional interference

Intact executive functions are characterized by flexible adaptation to task requirements, while these effects are reduced in internalizing disorders. Furthermore, as executive functions play an important role in emotion regulation, deficits in executive functions may contribute to symptom generation in psychological disorders through increased emotional interference. Thus, the present study investigated transfer effects of a three-week executive control training on adaptation to task difficulty and emotional interference in healthy participants (n = 24) to further explore the training's suitability for clinical application. To assess the adaptation to task difficulty, the proportion congruency effect on behavioral data (response times, error rates) and ERP measures (N2, CRN) was assessed in a flanker task with varying frequency of incompatible trials (25%, 75%). To quantify emotional interference, flanker stimuli were superimposed on neutral or negative pictures. Replicating previous results, the training increased interference control as indexed by decreased response times and errors rates, increased N2 amplitude and decreased CRN amplitude in incompatible trials after training. Proportion congruency effects were weaker than expected and not affected by the training intervention. The training lead to a shift in the time-point of emotional interference: before training negative pictures lead to a reduction in CRN amplitude, while after training this reduction was observed for the N2. This pattern illustrates that the training leads to a change in task processing mode from predominant response-related cognitive control to predominant stimulus-related cognitive control (N2), indicating a proactive processing mode.

Abnormal Regional Spontaneous Neural Activity and Functional Connectivity in Unmedicated Patients with Narcolepsy Type 1: A Resting-State fMRI Study

BACKGROUND

Previous Resting-state functional magnetic resonance imaging (fMRI) studies have mainly focused on cerebral functional alteration in processing different emotional stimuli in patients with narcolepsy type 1 (NT1), but were short of exploration of characteristic brain activity and its remote interaction patterns. This study aimed to investigate the spontaneous blood oxygen fluctuations at rest and to elucidate the neural mechanisms underlying neuropsychiatric behavior.

METHOD

A total of 18 unmedicated patients with NT1 and matched healthy individuals were recruited in a resting-state fMRI study. Magnetic resonance imaging (MRI) data were first analyzed using fractional low-frequency amplitude of low-frequency fluctuation (fALFF) to detect changes in local neural activity, and regions with group differences were taken as regions of interest (ROIs). Secondly, functional connectivity (FC) analysis was used to explore altered connectivity between ROIs and other areas. Lastly, the relationship between functional brain activity and neuropsychiatric behaviors was analyzed with correlation analysis.

RESULTS

fALFF analysis revealed enhanced neural activity in bilateral fusiform gyrus (FFG), right precentral gyrus, and left postcentral gyrus (PoCG) in the NT1 group. The patients indicated reduced activity in the bilateral temporal pole middle temporal gyrus (TPOmid), left caudate nucleus (CAU), left parahippocampus, left precuneus (PCUN), right amygdala, and right anterior cingulate and paracingulate gyri. ESS score was negatively correlated with fALFF in the right FFG. The NT1 group revealed decreased connectivity between left TPOmid and right PoCG, the bilateral middle frontal gyrus, left superior frontal gyrus, medial, and right supramarginal gyrus. Epworth Sleepiness Scale (ESS) was negatively correlated with FC of the left TPOmid with left putamen (PUT) in NT1. Compared with healthy controls (HCs), enhanced FC of the left CAU with right FFG was positively associated with MSLT-SOREMPs in patients. Furthermore, increased FC of the left PCUN with right PoCG was positively correlated with SDS score.

CONCLUSIONS

We found that multiple functional activities related to the processing of emotional regulation and sensory information processing were abnormal, and some were related to clinical characteristics. fALFF in the left postcentral or right precentral gyrus may be used as a biomarker of narcolepsy, whereas fALFF in the right fusiform and the FC strength of the left temporal pole middle temporal gyrus with the putamen may be clinical indicators to assess the drowsiness severity of narcolepsy.

Emotional body postures affect inhibitory control only when task-relevant

A classical theoretical frame to interpret motor reactions to emotional stimuli is that such stimuli, particularly those threat-related, are processed preferentially, i.e., they are capable of capturing and grabbing attention automatically. Research has recently challenged this view, showing that the task relevance of emotional stimuli is crucial to having a reliable behavioral effect. Such evidence indicated that emotional facial expressions do not automatically influence motor responses in healthy young adults, but they do so only when intrinsically pertinent to the ongoing subject's goals. Given the theoretical relevance of these findings, it is essential to assess their generalizability to different, socially relevant emotional stimuli such as emotional body postures. To address this issue, we compared the performance of 36 right-handed participants in two different versions of a Go/No-go task. In the Emotional Discrimination task, participants were required to withhold their responses at the display of emotional body postures (fearful or happy) and to move at the presentation of neutral postures. Differently, in the control task, the same images were shown, but participants had to respond according to the color of the actor/actress' t-shirt, disregarding the emotional content. Results showed that participants made more commission errors (instances in which they moved even though the No-go signal was presented) for happy than fearful body postures in the Emotional Discrimination task. However, this difference disappeared in the control task. Such evidence indicates that, like facial emotion, emotional body expressions do not influence motor control automatically, but only when they are task-relevant.

Nx4 Modulated Resting-State Functional Connectivity Between Amygdala and Prefrontal Cortex in a Placebo-Controlled, Crossover Trial

Background: The basic functional organization of the resting brain, assessed as resting-state functional connectivity (rsFC), can be affected by previous stress experience and it represents the basis on which subsequent stress experience develops. Notably, the rsFC between the amygdala and the cortical regions associated with emotion regulation and anxiety are affected during stress. The multicomponent drug Neurexan^® (Nx4) has previously demonstrated a reduction in amygdala activation in an emotional face matching task and it ameliorated stress-related symptoms. We, thus, investigated the effect of Nx4 on rsFC of the amygdala before stress induction compared with baseline in mildly to moderately stressed participants. Methods: In a randomized, placebo-controlled, double-blind, crossover trial 39 participants received a single dose of placebo or Nx4. Resting-state functional magnetic resonance imaging scans were performed pre-dose and 40 to 60 min post-dose, before any stress induction. First, highly connected functional hubs were identified by global functional connectivity density (gFCD) analysis. Second, by using a seed-based approach, rsFC maps of the left centromedial amygdala (CeMA) were created. The effect of Nx4 on both was evaluated. Results: The medial prefrontal cortex was identified as a relevant functional hub affected by Nx4 in an explorative whole brain gFCD analysis. Using the seed-based approach, we then demonstrated that Nx4 significantly enhanced the negative connectivity between the left CeMA and two cortical regions: the dorsolateral and medial prefrontal cortices. Conclusions: In a resting-state condition, Nx4 reduced the prefrontal cortex gFCD and strengthened the functional coupling between the amygdala and the prefrontal cortex that is relevant for emotion regulation and the stress response. Further studies should elaborate whether this mechanism represents enhanced regulatory control of the amygdala at rest and, consequently, to a diminished susceptibility to stress. ClinicalTrials.gov ID: NCT02602275.

Maternal stress and development of infant attention to threat-related facial expressions

Attentional biases to threat-related stimuli, such as fearful and angry facial expressions, are important to survival and emerge early in development. Infants demonstrate an attentional bias to fearful facial expressions by 5-7 months of age and an attentional bias toward anger by 3 years of age that are modulated by experiential factors. In a longitudinal study of 87 mother-infant dyads from families predominantly experiencing low income, we examined whether maternal stress and depressive symptoms were associated with trajectories of attentional biases to threat, assessed during an attention disengagement eye-tracking task when infants were 6-, 9-, and 12-month old. By 9 months, infants demonstrated a generalized bias toward threat (both fearful and angry facial expressions). Maternal perceived stress was associated with the trajectory of the bias toward angry facial expressions between 6 and 12 months. Specifically, infants of mothers with higher perceived stress exhibited a greater bias toward angry facial expressions at 6 months that decreased across the next 6 months, compared to infants of mothers with lower perceived stress who displayed an increased bias to angry facial expressions over this age range. Maternal depressive symptoms and stressful life events were not associated with trajectories of infant attentional bias to anger or fear. These findings highlight the role of maternal perceptions of stress in shaping developmental trajectories of threat-alerting systems.

Spontaneous instrumental avoidance learning in social contexts

Adaptation to our social environment requires learning how to avoid potentially harmful situations, such as encounters with aggressive individuals. Threatening facial expressions can evoke automatic stimulus-driven reactions, but whether their aversive motivational value suffices to drive instrumental active avoidance remains unclear. When asked to freely choose between different action alternatives, participants spontaneously-without instruction or monetary reward-developed a preference for choices that maximized the probability of avoiding angry individuals (sitting away from them in a waiting room). Most participants showed clear behavioral signs of instrumental learning, even in the absence of an explicit avoidance strategy. Inter-individual variability in learning depended on participants' subjective evaluations and sensitivity to threat approach feedback. Counterfactual learning best accounted for avoidance behaviors, especially in participants who developed an explicit avoidance strategy. Our results demonstrate that implicit defensive behaviors in social contexts are likely the product of several learning processes, including instrumental learning.

Behavioral correlates of temporal attention biases during emotional prosody perception

Emotional prosody perception (EPP) unfolds in time given the intrinsic temporal nature of auditory stimuli, and has been shown to be modulated by spatial attention. Yet, the influence of temporal attention (TA) on EPP remains largely unexplored. TA studies manipulate subject’s motor preparedness according to an upcoming event, with targets to discriminate during short attended trials arriving quickly, and, targets to discriminate during long unattended trials arriving at a later time point. We used here a classic paradigm manipulating TA to investigate its influence on behavioral responses to EPP (n = 100) and we found that TA bias was associated with slower reaction times (RT) for angry but not neutral prosodies and only during short trials. Importantly, TA biases were observed for accuracy measures only for angry voices and especially during short trials, suggesting that neutral stimuli are less subject to TA biases. Importantly, emotional facilitation, with faster RTs for angry voices in comparison to neutral voices, was observed when the stimuli were temporally attended and during short trials, suggesting an influential role of TA during EPP. Together, these results demonstrate for the first time the major influence of TA in RTs and behavioral performance while discriminating emotional prosody.

Frequency-specific gaze modulation of emotional face processing in the human amygdala

Determining the social significance of emotional face expression is of major importance for adaptive behavior, and gaze direction provides critical information in this process. The amygdala is implicated in both emotion and gaze processing, but how and when it integrates expression and gaze cues remains unresolved. We tackled this question using intracranial electroencephalography in epileptic patients to assess both amygdala (n = 12) and orbitofrontal cortex (OFC; n = 11) time-frequency evoked responses to faces with different emotional expressions and different gaze directions. As predicted, self-relevant threat signals (averted fearful and directed angry faces) elicited stronger amygdala activity than self-irrelevant threat (directed fearful and averted angry faces). Fear effects started at early latencies in both amygdala and OFC (~110 and 160 ms, respectively), while gaze direction effects and their interaction with emotion occurred at later latencies. Critically, the amygdala showed differential gamma band increases to fearful averted gaze (starting ~550 ms) and to angry directed gaze (~470 ms). Moreover, when comparing the 2 self-relevant threat conditions among them, we found higher gamma amygdala activity for averted fearful faces and higher beta OFC activity for angry directed faces. Together, these results reveal for the first time frequency-specific effects of emotion and gaze on amygdala and OFC neural activity.

Towards Parallel Selective Attention Using Psychophysiological States as the Basis for Functional Cognition

Attention is a complex cognitive process with innate resource management and information selection capabilities for maintaining a certain level of functional awareness in socio-cognitive service agents. The human-machine society depends on creating illusionary believable behaviors. These behaviors include processing sensory information based on contextual adaptation and focusing on specific aspects. The cognitive processes based on selective attention help the agent to efficiently utilize its computational resources by scheduling its intellectual tasks, which are not limited to decision-making, goal planning, action selection, and execution of actions. This study reports ongoing work on developing a cognitive architectural framework, a Nature-inspired Humanoid Cognitive Computing Platform for Self-aware and Conscious Agents (NiHA). The NiHA comprises cognitive theories, frameworks, and applications within machine consciousness (MC) and artificial general intelligence (AGI). The paper is focused on top-down and bottom-up attention mechanisms for service agents as a step towards machine consciousness. This study evaluates the behavioral impact of psychophysical states on attention. The proposed agent attains almost 90% accuracy in attention generation. In social interaction, contextual-based working is important, and the agent attains 89% accuracy in its attention by adding and checking the effect of psychophysical states on parallel selective attention. The addition of the emotions to attention process produced more contextual-based responses.

Task relevance and negative reward modulate the disengagement deficit of patients with spatial neglect

Though motivational value is a recognized trigger of approach and avoidance behavior, less is known about the potential of reward to capture attention. We here explored whether positive or negative reward modulates the characteristic deficit of patients with left spatial neglect to disengage attention from an ipsilesional distracter. We built our study on recent observations showing that the disengagement deficit is exaggerated for distracters with target-defining features, indicating that task-relevance captures attention. Patients with left neglect and matched healthy controls were asked to react to lateralized, colored targets preceded by a peripheral cue. Crucially, the cue either possessed the color of the target and was thus task-relevant, or was followed by a positive, negative, or neutral symbolic reward. Neglect patients only exhibited a disengagement deficit when cues were task-relevant or were followed by a negative reward. This finding indicates that attentional selection is driven by task-relevance and negative reward, possibly through interactions between limbic and attention networks.

Attentional bias in German Armed Forces veterans with and without posttraumatic stress symptoms - An eye-tracking investigation and group comparison

BACKGROUND AND OBJECTIVES

Most eye tracking based paradigms evidence patterns of sustained attention on threat coupled with low evidence for vigilance to or avoidance of threat in posttraumatic stress symptoms (PTSS). Still, eye tracking data on attention bias is particularly limited for military population. This eye tracking study investigated attentional bias in PTSS in a sample of German Armed Forces veterans.

METHODS

Veterans with deployment-related PTSS (N = 24), veterans with deployment-related traumatization without PTSS (N = 28), and never-deployed healthy veterans (N = 18) were presented with pairs of combat and neutral pictures, pairs of general threat and neutral pictures, and pairs of emotional and neutral faces. Their eye gazes were tracked during a free viewing task. 3 x 3 x 2 mixed general linear model analyses were conducted. Internal consistency of attention bias indicators was calculated for the entire sample and within groups.

RESULTS

Veterans with PTSS dwelled longer on general threat AOIs in contrast to non-exposed controls and shorter on general threat and combat associated neutral AOIs in contrast to both control groups. Veterans with PTSS entered faster to general threat AOIs than non-exposed controls. Veterans with PTSS showed circumscribed higher attention fluctuation in contrast to controls. Internal consistency varied across attention bias indicators.

LIMITATIONS

Statistical power was reduced due to recruitment difficulties.

CONCLUSIONS

Evidence is provided for the maintenance hypothesis in PTSS. No robust evidence is provided for hypervigilant behavior in PTSS. Findings on attention bias variability remain unclear, calling for more investigations in this field.

The interaction between depression diagnosis and BMI is related to altered activation pattern in the right inferior frontal gyrus and anterior cingulate cortex during food anticipation

BACKGROUND

Depression and overweight/obesity often cooccur but the underlying neural mechanisms for this bidirectional link are not well understood.

METHODS

In this functional magnetic resonance imaging study, we scanned 54 individuals diagnosed with depressive disorders (DD) and 48 healthy controls (HC) to examine how diagnostic status moderates the relationship between body mass index (BMI) and brain activation during anticipation and pleasantness rating of food versus nonfood stimuli.

RESULTS

We found a significant BMI-by-diagnosis interaction effect on activation in the right inferior frontal gyrus (RIFG) and anterior cingulate cortex (ACC) during food versus nonfood anticipation (p < .0125). Brain activation in these regions was greater in HC with higher BMI than in HC with lower BMI. Individuals with DD showed an opposite pattern of activation. Structural equation modeling revealed that the relationship between BMI, activation in the RIFG and ACC, and participants' desire to eat food items shown in the experiment depended on the diagnostic status.

CONCLUSIONS

Considering that food anticipation is an important component of appetitive behavior and that the RIFG and ACC are involved in emotion regulation, response inhibition and conflict monitoring necessary to control this behavior, we propose that future clinical trials targeting weight loss in DD should investigate whether adequate mental preparation positively affects subsequent food consumption behaviors in these individuals.

Irrelevant positive emotional information facilitates response inhibition only under a high perceptual load

Response inhibition involves suppressing those responses that are no longer needed. Previous research has separately studied the role of attentional resources and emotional information in response inhibition. Here, we simultaneously manipulate attentional resources and emotional information to investigate the interactive role of emotional information and attentional resources. Attentional resources were manipulated by changing the levels of perceptual load (low and high) of go signals. Emotional information was manipulated by changing the emotional content (irrelevant positive and negative emotional information) of the stop signals. Participants made a go response based on searching for a target letter in conditions of either low perceptual load or high perceptual load. They withheld their response on the presentation of a stop signal. The stop-signal stimulus was selected from two classes: arousal matched positive and negative IAPS images (Experiment 1) and happy, angry, and neutral faces (Experiment 2). The result showed a consistent interaction pattern of perceptual load and emotional information across the two experiments, such that irrelevant positive emotional information consistently improved inhibitory control, albeit only under high load. These results have theoretical implications for understanding the nature of emotional information and their interaction with attentional resources in cognitive control functions.

Evidence for dynamic attentional bias toward positive emotion-laden words: A behavioral and electrophysiological study

There has been no consensus on the neural dissociation between emotion-label and emotion-laden words, which remains one of the major concerns in affective neurolinguistics. The current study adopted dot-probe tasks to investigate the valence effect on attentional bias toward Chinese emotion-label and emotion-laden words. Behavioral data showed that emotional word type and valence interacted in attentional bias scores with an attentional bias toward positive emotion-laden words rather than positive emotion-label words and that this bias was derived from the disengagement difficulty in positive emotion-laden words. In addition, an attentional bias toward negative emotion-label words relative to positive emotion-label words was observed. The event-related potential (ERP) data demonstrated an interaction between emotional word type, valence, and hemisphere. A significant hemisphere effect was observed during the processing of positive emotion-laden word pairs rather than positive emotion-label, negative emotion-label, and negative emotion-laden word pairs, with positive emotion-laden word pairs eliciting an enhanced P1 in the right hemisphere as compared to the left hemisphere. Our results found a dynamic attentional bias toward positive emotion-laden words; individuals allocated more attention to positive emotion-laden words in the early processing stage and had difficulty disengaging attention from them in the late processing stage.

Automaticity of Early Sexual Attention: An Event-Related Potential Study

A promising line of research on forensic assessment of paraphilic sexual interest focuses on behavioral measures of visual attention using sexual stimuli as distractors. The present study combined event-related potentials (ERPs) with behavioral measures to investigate whether detection of a hidden sexual preference can be improved with ERPs. Normal variants of sexual orientation were used for a proof-of-concept investigation. Accordingly, 40 heterosexual and 40 gay men participated in the study. Within each group, half of the participants were instructed to hide their sexual orientation. The results showed that a match between sexual orientation and stimulus delays responses and influences ERP before motor responses. Late ERP components showed higher potential in differentiating hidden sexual preferences than motor responses, thereby showing how ERPs can be used in combination with reaction time measures to potentially facilitate the detection of hidden sexual preferences.

Auditory and cross-modal attentional bias toward positive natural sounds: Behavioral and ERP evidence

Recently, researchers have expanded the investigation into attentional biases toward positive stimuli; however, few studies have examined attentional biases toward positive auditory information. In three experiments, the present study employed an emotional spatial cueing task using emotional sounds as cues and auditory stimuli (Experiment 1) or visual stimuli (Experiment 2 and Experiment 3) as targets to explore whether auditory or visual spatial attention could be modulated by positive auditory cues. Experiment 3 also examined the temporal dynamics of cross-modal auditory bias toward positive natural sounds using event-related potentials (ERPs). The behavioral results of the three experiments consistently demonstrated that response times to targets were faster after positive auditory cues than they were after neutral auditory cues in the valid condition, indicating that healthy participants showed a selective auditory attentional bias (Experiment 1) and cross-modal attentional bias (Experiment 2 and Experiment 3) toward positive natural sounds. The results of Experiment 3 showed that N1 amplitudes were more negative after positive sounds than they were after neutral sounds, which further provided electrophysiological evidence that positive auditory information enhances attention at early stages in healthy adults. The results of the experiments performed in the present study suggest that humans exhibit an attentional bias toward positive natural sounds.

Face processing and efficient recognition of facial expressions are impaired following right but not left anteromedial temporal lobe resections: Behavioral and fMRI evidence

Anteromedial temporal lobe structures seem to support processing of faces and facial expressions. However, differential effects of unilateral left or right temporal lobe resections (TLR) on face processing, recognition of facial expressions, and on BOLD response to faces in intact brain areas are not yet fully understood. Therefore, we compared 39 patients with unilateral TLR (18 left, 21 right) and 20 healthy controls regarding recognition of facial identity and emotional facial expressions as well as BOLD response to fearful and neutral faces. We found impaired recognition of facial identity following right TLR, which was paralleled by reduced BOLD response to faces irrespective of expression in the right fusiform and lingual gyrus in postsurgical fMRI. Right TLR patients also exhibited subtle impairments of emotion recognition as they needed higher intensity of facial expressions for correct responses in a morphing task. Accuracy of emotion recognition and subjective appraisals of facial expressions did not differ between groups. There was no specific reduction of BOLD response to fearful versus neutral faces in either patient group. Our results underline the specific role of the right anteromedial temporal lobe in processing of faces and facial expressions by showing changes in face processing following right TLR in behavioral as well as imaging data.

Emotion and attention in face processing: Complementary evidence from surface event-related potentials and intracranial amygdala recordings

Face processing is biased by emotional and voluntarily directed attention, both of which modulate processing in distributed cortical areas. The amygdala is assumed to contribute to an attentional bias for emotional faces, although its interaction with directed attention awaits further clarification. Here, we studied the interaction of emotion and attention during face processing via scalp EEG potentials of healthy participants and intracranial EEG (iEEG) recordings of the right amygdala in one patient. Three randomized blocks consisting of angry, neutral, and happy facial expressions were presented, and one expression was denoted as the target category in each block. Happy targets were detected fastest and most accurately both in the group study and by the iEEG patient. Occipital scalp potentials revealed emotion differentiation for happy faces in the early posterior negativity (EPN) around 300 ms after stimulus onset regardless of the target condition. A similar response to happy faces occurred in the amygdala only for happy targets. On the scalp, a late positive potential (LPP, around 600 ms) enhancement for targets occurred for all target conditions alike. A simultaneous late signal in the amygdala was largest for emotional targets. No late signal enhancements were found for neutral targets in the amygdala. Cortical modulations, by contrast, showed both attention-independent effects of emotion and emotion-independent effects of attention. These results demonstrate an attention-dependence of amygdala activity during the processing of facial expressions and partly independent cortical mechanisms.

Spatiotemporal Dynamics of Covert vs. Overt Emotional Face Processing in Dysphoria

People at risk of developing clinical depression exhibit attentional biases for emotional faces. To clarify whether such effects occur at an early, automatic, or at a late, deliberate processing stage of emotional processing, the present study used high-density electroencephalography during both covert and overt processing of sad, fearful, happy, and neutral expressions in healthy participants with high dysphoria (n = 16) and with low dysphoria (n = 19). A state-of-the-art non-parametric permutation-based statistical approach was then used to explore the effects of emotion, attentional task demands, and group. Behaviorally, participants responded faster and more accurately when overtly categorizing happy faces and they were slower and less accurate when categorizing sad and fearful faces, independent of the dysphoria group. Electrophysiologically, in an early time-window (N170: 140-180 ms), there was a significant main effect for the dysphoria group, with greater negative voltage for the high vs. low dysphoria group over the left-sided temporo-occipital scalp. Furthermore, there was a significant group by emotional interaction, with the high dysphoria group displaying greater negative amplitude N170 for happy than fearful faces. Attentional task demands did not influence such early effects. In contrast, in an intermediate time-window (EPN: 200-400 ms) and in a late time-window (LPP: 500-750 ms) there were no significant main effects nor interactions involving the dysphoria Group. The LPP results paralleled the behavioral results, with greater LPP voltages for sad and fearful relative to happy faces only in the overt task, but similarly so in the two dysphoria groups. This study provides novel evidence that alterations in face processing in dysphoric individuals can be seen at the early stages of face perception, as indexed by the N170, although not in the form of a typical pattern of mood-congruent attentional bias. In contrast, intermediate (EPN) and late (LPP) stages of emotional face processing appear unaffected by dysphoria. Importantly, the early dysphoria effect appears to be independent of the top-down allocation of attention, further supporting the idea that dysphoria may influence a stage of automatic emotional appraisal. It is proposed that it may be a consequence of a shift from holistic to feature-based processing of facial expressions, or may be due to the influence of negative schemas acting as a negative context for emotional facial processing.

Attention- versus significance-driven memory formation: Taxonomy, neural substrates, and meta-analyses

Functional neuroimaging data on episodic memory formation have expanded rapidly over the last 30 years, which raises the need for an integrative framework. This study proposes a taxonomy of episodic memory formation to address this need. At the broadest level, the taxonomy distinguishes between attention-driven vs. significance-driven memory formation. The three subtypes of attention-driven memory formation are selection-, fluctuation-, and level-related. The three subtypes of significance-driven memory formation are novelty-, emotion-, and reward-related. Meta-analytic data indicated that attention-driven memory formation affects the functioning of the extra-medial temporal lobe more strongly than the medial temporal lobe (MTL) regions. In contrast, significance-driven memory formation affects the functioning of the MTL more strongly than the extra-MTL regions. This study proposed a model in which attention has a stronger impact on the formation of neocortical traces than hippocampus/MTL traces, whereas significance has a stronger impact on the formation of hippocampus/MTL traces than neocortical traces. Overall, the taxonomy and model provide an integrative framework in which to place diverse encoding-related findings into a proper perspective.

Fronto—Parietal Regions Predict Transient Emotional States in Emotion Modulated Response Inhibition via Low Frequency and Beta Oscillations

The current study evaluated the impact of task-relevant emotion on inhibitory control while focusing on midline cortical regions rather than brain asymmetry. Single-trial time-frequency analysis of electroencephalography recordings linked with response execution and response inhibition was done while thirty-four participants performed the emotion modulated stop-signal task. To evaluate individual differences across decision-making processes involved in inhibitory control, a hierarchical drift-diffusion model was used to fit data from Go-trials for each of the 34 participants. Response threshold in the early processing stage for happy and disgust emotions could be distinguished from the later processing stage at the mid-parietal and mid-frontal regions, respectively, by the single-trial power increments in low frequency (delta and theta) bands. Beta desynchronization in the mid-frontal region was specific for differentiating disgust from neutral emotion in the early as well as later processing stages. The findings are interpreted based on the influence of emotional stimuli on early perceptual processing originating as a bottom-up process in the mid-parietal region and later proceeding to the mid-frontal region responsible for cognitive control processing, which resulted in enhanced inhibitory performance. The results show the importance of mid-frontal and mid-parietal regions in single-trial dynamics of inhibitory control processing.

Effect of automatic emotional processing on response inhibition among heroin abstainers

Previous studies have explored effects of the conscious processing of emotional information on the interaction between emotion and executive control. However, the conscious processing of emotional information introduces "defensive responses," which might limit the emotional effect. To avoid the limitations, this study aimed to explore the effect of automatic emotional processing on response inhibition among heroin abstainers. Individuals experiencing heroin withdrawal symptoms are not entirely exempt from the influence of drugs, and it is challenging to find heroin addicts in practice. Therefore, similar to previous studies, we recruited heroin abstainers in this study. In Experiment 1, for the heroin abstainers group, 30 participants meeting the inclusion criteria were recruited from a compulsory isolated detoxification center, whereas 30 age- and education-matched participants were recruited from the community as the control group. These participants completed the Go/No-Go task by supraliminal emotional priming. In Experiment 2, the heroin abstainers group comprised 33 eligible participants and control group comprised 33 eligible participants. These participants completed the Go/No-Go task by subliminal emotional priming. We compared the participants' rates of commission errors in the Go/No-Go tasks. The rate of commission errors was lowest upon the activation of positive emotion. Moreover, under subliminal emotional priming, the rate of commission errors for the heroin abstainers group was significantly lower than that for the control group. However, regarding supraliminal emotional priming, there was no significant difference between the rates of commission errors for the two groups. These results suggest automatic positive emotional processing can enhance response inhibition among heroin abstainers. Moreover, under subliminal emotional priming, heroin abstainers had more enhanced response inhibition than the control groups. This study plays a significant role in understanding the effect of automatic emotional processing on response inhibition among drug addicts. This study also provides a theoretical basis for ensuring enhanced response inhibition among drug addicts.

Comparison of Slides and Video Clips as Different Methods for Inducing Emotions: An Electroencephalographic Alpha Modulation Study

Films, compared with emotional static pictures, represent true-to-life dynamic stimuli that are both ecological and effective in inducing an emotional response given the involvement of multimodal stimulation (i.e., visual and auditory systems). We hypothesized that a direct comparison between the two methods would have shown greater efficacy of movies, compared to standardized slides, in eliciting emotions at both subjective and neurophysiological levels. To this end, we compared these two methods of emotional stimulation in a group of 40 young adults (20 females). Electroencephalographic (EEG) Alpha rhythm (8–12 Hz) was recorded from 64 scalp sites while participants watched (in counterbalanced order across participants) two separate blocks of 45 slides and 45 clips. Each block included three groups of 15 validated stimuli classified as Erotic, Neutral and Fear content. Greater self-perceived arousal was found after the presentation of Fear and Erotic video clips compared with the same slide categories. sLORETA analysis showed a different lateralization pattern: slides induced decreased Alpha power (greater activation) in the left secondary visual area (Brodmann Area, BA, 18) to Erotic and Fear compared with the Neutral stimuli. Instead, video clips elicited reduced Alpha in the homologous right secondary visual area (BA 18) again to both Erotic and Fear contents compared with Neutral ones. Comparison of emotional stimuli showed smaller Alpha power to Erotic than to Fear stimuli in the left precuneus/posterior cingulate cortex (BA 7/31) for the slide condition, and in the left superior parietal lobule (BA 7) for the clip condition. This result matched the parallel analysis of the overlapped Mu rhythm (corresponding to the upper Alpha band) and can be interpreted as Mu/Alpha EEG suppression elicited by greater motor action tendency to Erotic (approach motivation) compared to Fear (withdrawal motivation) stimuli. Correlation analysis found lower Alpha in the left middle temporal gyrus (BA 21) associated with greater pleasantness to Erotic slides (r38 = –0.62, p = 0.009), whereas lower Alpha in the right supramarginal/angular gyrus (BA 40/39) was associated with greater pleasantness to Neutral clips (r38 = –0.69, p = 0.012). Results point to stronger emotion elicitation of movies vs. slides, but also to a specific involvement of the two hemispheres during emotional processing of slides vs. video clips, with a shift from the left to the right associative visual areas.

Intersection between social inequality and emotion regulation on emerging adult cannabis use

Emerging adulthood (EA; ages 18-25) is characterized by socioemotional and neurodevelopmental challenges. Cannabis is a widely used substance among EAs, and hazardous use may increase risk for sustained use patterns and related health consequences. Research shows differential increases in hazardous use by objective as well as subjective measures of social inequality, with more concerning trajectories for youth with greater experiences of social inequality. Learning how to flexibly monitor and modify emotions in proactive ways (i.e., emotion regulation) is a central developmental task navigated during the EA window. Challenges to and with emotion regulation processes can contribute to the emergence of mental health symptoms during EA, including hazardous cannabis use. In this perspective, we highlight emotion dysregulation and social inequality as two critical factors that interact to either buffer against or exacerbate cannabis use during the EA period, noting critical gaps in the literature that merit additional research. We recommend novel methods and longitudinal designs to help clarify how dynamic cognition-emotion interplay predicts trajectories of negative emotional experiences and cannabis use in EA.

They're watching you: the impact of social evaluation and anxiety on threat-related perceptual decision-making

In day-to-day social interactions, we frequently use cues and contextual knowledge to make perceptual decisions regarding the presence or absence of threat in facial expressions. Such perceptual decisions are often made in socially evaluative contexts. However, the influence of such contexts on perceptual discrimination of threatening and neutral expressions has not been examined empirically. Furthermore, it is unclear how individual differences in anxiety interact with socially evaluative contexts to influence threat-related perceptual decision-making. In the present study, participants completed a 2-alternative forced choice perceptual decision-making task in which they used threatening and neutral cues to discriminate between threatening and neutral faces while being socially evaluated by purported peers or not. Perceptual sensitivity and reaction time were measured. Individual differences in state anxiety were assessed immediately after the task. In the presence of social evaluation, higher state anxiety was associated with worse perceptual sensitivity, i.e., worse discrimination of threatening and neutral faces. These findings suggest that individual differences in anxiety interact with social evaluation to impair the use of threatening cues to discriminate between threatening and neutral expressions. Such impairment in perceptual decision-making may contribute to maladaptive social behavior that often accompanies evaluative social contexts.

Correlations Between Psychological Status and Perception of Facial Expression

OBJECTIVE

Facial affect recognition is associated with neuropsychological status and psychiatric diseases. We hypothesized that facial affect recognition is associated with psychological status and perception of other affects.

METHODS

A total of 80 images depicting facial affect, including 20 Neutral, 20 Angry, 20 Fear, and 20 Sad, were screened for use in our research. A total of 100 healthy individuals were asked to rate these images using a 10-point Likert scale and complete psychological scales assessing the emotional statuses and cognitive functions.

RESULTS

The participants' emotional state of aggression, attention, and impulsivity may have been associated with their interpretation of the Angry facial expressions. The participants often rated the Angry facial expressions as Fear. The participants rated Fear images as Angry or Sad. In response to a Sad facial expression, the participants reported psychological statuses of attention and impulsivity which were associated with the facial expression rating. The participants rated the Sad expression as Angry or Fear.

CONCLUSION

The psychological statuses of the participants were significantly correlated with their interpretation of facial affects. In particular, a psychological state of attention was often correlated with incorrect affect ratings. Attention and impulsivity could affect the rating of the sad facial expressions.

Attentional bias to threat and gray matter volume morphology in high anxious individuals

In a sample of highly anxious individuals, the relationship between gray matter volume brain morphology and attentional bias to threat was assessed. Participants performed a dot-probe task of attentional bias to threat and gray matter volume was acquired from whole brain structural T1-weighted magnetic resonance imaging scans. The results replicate previous findings in unselected samples that elevated attentional bias to threat is linked to greater gray matter volume in the middle frontal gyrus and superior frontal gyrus. In addition, we provide novel evidence that elevated attentional bias to threat is associated with greater gray matter volume in the inferior frontal gyrus, insula, cerebellum, and other distributed regions. Lastly, exploratory analyses provide initial evidence that distinct subregions of the right posterior parietal cortex may contribute to attentional bias in a sex-specific manner. Our results illuminate how differences in gray matter volume morphology relate to attentional bias to threat in anxious individuals. This knowledge could inform neurocognitive models of anxiety-related attentional bias to threat.

The Role of Emotional Information in Banner Blindness

Modern theories in affective science postulate that emotional stimuli can affect subject’s attention. Emotional stimuli can guide and capture visual attention, which may be related to evolutional importance of quick reactions for emotional objects in the real life. The study examined the influence of valence and arousal of advertisement on the banner blindness phenomenon—ignoring the advertisement or interface details similar to it on the website. In two experiments participants were asked to find the information on the website, where different banners were placed. In the first experiment banners had the same valence, but different arousal. In the second experiment, the banners had different valence, but equal arousal. Contrary to the classical studies in affective science, we found that banners with neutral valence were recognized better as compared to negative and positive ones. The results are discussed in terms of user experience contributing to banner blindness occurrence.

Weaker inhibition after happy faces: evidence from an attentional blink task with emotional and neutral faces

In two experiments using a Rapid Serial Visual Presentation (RSVP) we investigated how emotional and neutral faces (T1) modulate temporal attention for a following neutral face (T2). Typically, performance for T2 is spared when T2 immediately follows T1 (lag 1 sparing) but it is impaired when T2 is presented within 500 ms from T1 (Attentional Blink). Experiment 1 shows a shorter attentional blink following happy faces, relative to neutral and sad faces, which did not differ. Experiment 2 shows a lag 1 sparing only after happy T1s, but not after angry or neutral T1s, and a greater attentional blink following happy and angry T1-faces, compared to neutral T1-faces. Results indicate that happy faces exert different effects on temporal attention than negative (angry or sad) faces. Findings are discussed in terms of an interplay of resource depletion, due to emotional salience, and emotion-specific inhibitory mechanisms.

Music to My Senses: Functional Magnetic Resonance Imaging Evidence of Music Analgesia Across Connectivity Networks Spanning the Brain and Brainstem

Pain is often viewed and studied as an isolated perception. However, cognition, emotion, salience effects, and autonomic and sensory input are all integrated to create a comprehensive experience. Music-induced analgesia has been used for thousands of years, with moderate behavioural effects on pain perception, yet the neural mechanisms remain ambiguous. The purpose of this study was to investigate the effects of music analgesia through individual ratings of pain, and changes in connectivity across a network of regions spanning the brain and brainstem that are involved in limbic, paralimbic, autonomic, cognitive, and sensory domains. This is the first study of its kind to assess the effects of music analgesia using complex network analyses in the human brain and brainstem. Functional MRI data were collected from 20 healthy men and women with concurrent presentation of noxious stimulation and music, in addition to control runs without music. Ratings of peak pain intensity and unpleasantness were collected for each run and were analysed in relation to the functional data. We found that music alters connectivity across these neural networks between regions such as the insula, thalamus, hypothalamus, amygdala and hippocampus (among others), and is impacted by individual pain sensitivity. While these differences are important for how we understand pain and analgesia, it is essential to note that these effects are variable across participants and provide moderate pain relief at best. Therefore, a therapeutic strategy involving music should use it as an adjunct to pain management in combination with healthy lifestyle changes and/or pharmaceutical intervention.

Do Subliminal Fearful Facial Expressions Capture Attention?

In two experiments, we tested whether fearful facial expressions capture attention in an awareness-independent fashion. In Experiment 1, participants searched for a visible neutral face presented at one of two positions. Prior to the target, a backward-masked and, thus, invisible emotional (fearful/disgusted) or neutral face was presented as a cue, either at target position or away from the target position. If negative emotional faces capture attention in a stimulus-driven way, we would have expected a cueing effect: better performance where fearful or disgusted facial cues were presented at target position than away from the target. However, no evidence of capture of attention was found, neither in behavior (response times or error rates), nor in event-related lateralizations (N2pc). In Experiment 2, we went one step further and used fearful faces as visible targets, too. Thereby, we sought to boost awareness-independent capture of attention by fearful faces. However, still, we found no significant attention-capture effect. Our results show that fearful facial expressions do not capture attention in an awareness-independent way. Results are discussed in light of existing theories.

Sensorimotor inhibition during emotional processing

Visual processing of emotional stimuli has been shown to engage complex cortical and subcortical networks, but it is still unclear how it affects sensorimotor integration processes. To fill this gap, here, we used a TMS protocol named short-latency afferent inhibition (SAI), capturing sensorimotor interactions, while healthy participants were observing emotional body language (EBL) and International Affective Picture System (IAPS) stimuli. Participants were presented with emotional (fear- and happiness-related) or non-emotional (neutral) EBL and IAPS stimuli while SAI was tested at 120 ms and 300 ms after pictures presentation. At the earlier time point (120 ms), we found that fear-related EBL and IAPS stimuli selectively enhanced SAI as indexed by the greater inhibitory effect of somatosensory afferents on motor excitability. Larger early SAI enhancement was associated with lower scores at the Behavioural Inhibition Scale (BIS). At the later time point (300 ms), we found a generalized SAI decrease for all kind of stimuli (fear, happiness or neutral). Because the SAI index reflects integrative activity of cholinergic sensorimotor circuits, our findings suggest greater sensitivity of such circuits during early (120 ms) processing of threat-related information. Moreover, the correlation with BIS score may suggest increased attention and sensory vigilance in participants with greater anxiety-related dispositions. In conclusion, the results of this study show that sensorimotor inhibition is rapidly enhanced while processing threatening stimuli and that SAI protocol might be a valuable option in evaluating emotional-motor interactions in physiological and pathological conditions.

Evaluating the Effect of Semantic Congruency and Valence on Multisensory Integration

Previous studies have found that semantics, the higher-level meaning of stimuli, can impact multisensory integration; however, less is known about the effect of valence, an affective response to stimuli. This study investigated the effects of both semantic congruency and valence of non-speech audiovisual stimuli on multisensory integration via response time (RT) and temporal-order judgement (TOJ) tasks [assessing processing speed (RT), Point of Subjective Simultaneity (PSS), and time window when multisensory stimuli are likely to be perceived as simultaneous (temporal binding window; TBW)]. Through an online study with 40 participants (mean age: 26.25 years; females = 17), we found that both congruence and valence had a significant main effect on RT (congruency and positive valence decrease RT) and an interaction effect (congruent/positive valence condition being significantly faster than all others). For TOJ, there was a significant main effect of valence and a significant interaction effect where positive valence (compared to negative valence) and the congruent/positive condition (compared to all other conditions) required visual stimuli to be presented significantly earlier than auditory stimuli to be perceived as simultaneous. A subsequent analysis showed a positive correlation between TBW width and RT (as TBW widens, RT increases) for the categories that were furthest from true simultaneity in their PSS (Congruent/Positive and Incongruent/Negative). This study provides new evidence that supports previous research on semantic congruency and presents a novel incorporation of valence into behavioural responses.

Enhanced processing of aversive stimuli on embodied artificial limbs by the human amygdala

Body perception has been extensively investigated, with one particular focus being the integration of vision and touch within a neuronal body representation. Previous studies have implicated a distributed network comprising the extrastriate body area (EBA), posterior parietal cortex (PPC) and ventral premotor cortex (PMv) during illusory self-attribution of a rubber hand. Here, we set up an fMRI paradigm in virtual reality (VR) to study whether and how the self-attribution of (artificial) body parts is altered if these body parts are somehow threatened. Participants (N = 30) saw a spider (aversive stimulus) or a toy-car (neutral stimulus) moving along a 3D-rendered virtual forearm positioned like their real forearm, while tactile stimulation was applied on the real arm in the same (congruent) or opposite (incongruent) direction. We found that the PPC was more activated during congruent stimulation; higher visual areas and the anterior insula (aIns) showed increased activation during aversive stimulus presentation; and the amygdala was more strongly activated for aversive stimuli when there was stronger multisensory integration of body-related information (interaction of aversiveness and congruency). Together, these findings suggest an enhanced processing of aversive stimuli within the amygdala when they represent a bodily threat.

Effects of left and right medial temporal lobe resections on hemodynamic correlates of negative and neutral scene processing

Enhanced visual cortex activation by negative compared to neutral stimuli is often attributed to modulating feedback from the amygdala, but evidence from lesion studies is scarce, particularly regarding differential effects of left and right amygdala lesions. Therefore, we compared visual cortex activation by negative and neutral complex scenes in an event‐related fMRI study between 40 patients with unilateral temporal lobe resection (TLR; 19 left [lTLR], 21 right [rTLR]), including the amygdala, and 20 healthy controls. We found preserved hemodynamic emotion modulation of visual cortex in rTLR patients and only subtle reductions in lTLR patients. In contrast, rTLR patients showed a significant decrease in visual cortex activation irrespective of picture content. In line with this, healthy controls showed small emotional modulation of the left amygdala only, while their right amygdala was activated equally by negative and neutral pictures. Correlations of activation in amygdala and visual cortex were observed for both negative and neutral pictures in the controls. In both patient groups, this relationship was attenuated ipsilateral to the TLR. Our results support the notion of reentrant mechanisms between amygdala and visual cortex and suggest laterality differences in their emotion‐specificity. While right medial temporal lobe structures including the amygdala seem to influence visual processing in general, the left medial temporal lobe appears to contribute specifically to emotion processing. Still, effects of left TLR on visual emotion processing were relatively subtle. Therefore, hemodynamic correlates of visual emotion processing are likely supported by a distributed cerebral network, challenging an amygdalocentric view of emotion processing.

The influence of peripheral emotions on inhibitory control among children

In this study, we investigated the cognitive-emotional interplay by measuring the effects of executive competition (Pessoa, 2013), i.e., how inhibitory control is influenced when emotional information is encountered. Sixty-three children (8 to 9 years of age) participated in an inhibition task (central task) accompanied by happy, sad, or neutral emoticons (displayed in the periphery). Typical interference effects were found in the main task for speed and accuracy, but in general, these effects were not additionally modulated by the peripheral emoticons indicating that processing of the main task exhausted the limited capacity such that interference from the task-irrelevant, peripheral information did not show (Pessoa, 2013). Further analyses revealed that the magnitude of interference effects depended on the order of congruency conditions: when incongruent conditions preceded congruent ones, there was greater interference. This effect was smaller in sad conditions, and particularly so at the beginning of the experiment. These findings suggest that the bottom-up perception of task-irrelevant emotional information influenced the top-down process of inhibitory control among children in the sad condition when processing demands were particularly high. We discuss if the salience and valence of the emotional stimuli as well as task demands are the decisive characteristics that modulate the strength of this relation.

ASD and ADHD Comorbidity: What Are We Talking About?

According to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD). From a clinical perspective, this high rate of comorbidity is intriguing. What is the real significance of this dual diagnosis? Is ADHD in fact always present in such cases? Might the attentional impairment reported among our ASD patients actually be a distinct trait of their ASD-namely, impaired joint attention-rather than an ADHD attention deficit? Could their agitation be the consequence of this joint attention impairment or related to a physical restlessness etiologically very different from the agitation typical of ADHD? The neurobiological reality of ASD-ADHD comorbidity is a subject of debate, and amphetamine-based treatment can have paradoxical or undesirable effects in the ASD population. Consequently, does a dual diagnosis, notwithstanding its currency in the literature, prevent us from shedding sufficient light on major physiopathologic questions raised by the clinical picture of ASD?

Perceptive and Affective Impairments In Emotive Eye-Region Processing in Alexithymia

Alexithymia is characterized by impairments in emotion processing, frequently linked to facial expressions of emotion. The eye-region conveys information necessary for emotion processing. It has been demonstrated that alexithymia is associated with reduced attention to the eyes, but little is known regarding the cognitive and electrophysiological mechanisms underlying emotive eye-region processing in alexithymia. Here, we recorded behavioral and electrophysiological responses of individuals with alexithymia (ALEX; n = 25) and individuals without alexithymia (NonALEX; n = 23) while they viewed intact and eyeless faces with angry and sad expressions during a dual-target rapid serial visual presentation task. Results showed different eye-region focuses and differentiating N1 responses between intact and eyeless faces to anger and sadness in NonALEX, but not in ALEX, suggesting deficient perceptual processing of the eye-region in alexithymia. Reduced eye-region focus and smaller differences in frontal alpha asymmetry in response to sadness between intact and eyeless faces were observed in ALEX than NonALEX, indicative of impaired affective processing of the eye-region in alexithymia. These findings highlight perceptual and affective abnormalities of emotive eye-region processing in alexithymia. Our results contribute to understanding the neuropsychopathology of alexithymia and alexithymia-related disorders.

Importance of communication in medical practice and medical education: An emphasis on empathy and attitudes and their possible influences

BACKGROUND

Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients. By focusing on what students should be able to perform one day as clinicians, we can bridge the gap between mere theoretical knowledge and its practical application. Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.

AIM

To determine sets of intellectual, personal, social, and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking, in order to identify training needs.

METHODS

An analysis of training clinicians’ conceptions with respect to optimal medical history taking was performed. The chosen study design also aimed to assess gender effects. Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna. Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews. Inductive category formation was applied. The main questions posed to the supervisors dealt with (1) Observed competencies of students in medical history taking; and (2) The supervisor’s own conceptions of "ideal medical history taking".

RESULTS

A total of 33 training clinicians (n = 33), engaged in supervising medical students according to the MedUni Vienna’s curriculum standards, agreed to be enrolled in the study and met inclusion criteria. The qualitative content analysis revealed the following themes relevant to taking an anamnesis: (1) Knowledge; (2) Soft skills (relationship-building abilities, trust, and attitude); (3) Methodical skills (structuring, precision, and completeness of information gathering); and (4) Environmental/contextual factors (language barrier, time pressure, interruptions). Overall, health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking. When looking at physicians’ theoretical conceptions, more general practitioners and psychiatrists mentioned attitude and empathy in the context of "ideal medical history taking", with a higher percentage of females. With respect to observations of students’ history taking, a positive impact from attitude and empathy was mainly described by male health care professionals, whereas no predominance of specialty was found. Representatives of general medicine and internal medicine, when observing medical students, more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior; no gender-specific difference was detected for this finding.

CONCLUSION

The analysis reveals that for clinicians engaged in medical student education, only a combination of skills, including adequate knowledge and methodical implementations, is supposed to guarantee acceptable performance. This study’s findings support the importance of concepts like relationship building, attitude, and empathy. However, there may be contextual factors in play as well, and transference of theoretical concepts into the clinical setting might prove challenging.

Right medial temporal lobe structures particularly impact early stages of affective picture processing

Human vision prioritizes emotional stimuli. This is reflected in stronger electrocortical activation in response to emotional than neutral stimuli, measurable on the surface of the head. Feedback projections from brain structures deep within the medial temporal lobes (mTLs), in particular the amygdala, are thought to give rise to this phenomenon, although causal evidence is rare. Given the many pathways involved in visual processing, the influence of mTL structures could be restricted to specific time windows. Therefore, we delineate the temporal dynamics of the impact of right mTL structures on affective picture processing, investigating event-related potentials (ERPs) in 19 patients (10 female) with right mTL resections and 19 individually matched healthy participants, while they viewed negative and neutral scenes. Groups differed significantly at early- and mid-latency processing stages. Patients with right mTL resection, unlike controls, showed no (P1: 90-140 ms) or marginal (N1: 170-220 ms) emotion modulation. At mid-latency (early posterior negativity: 220-370 ms), emotion modulation over the ipsi-resectional right hemisphere was smaller in patients than in controls, but groups did not differ over the left hemisphere. During late parietal positivities (400-650 ms and 650-900 ms), both groups had similar emotion modulation. Our results demonstrate that right mTL structures attenuate particularly early processing of affectively negative scenes. This is theoretically consistent with an initial amygdala-dependent feedforward sweep in visual emotion processing whose absence is successively compensated. Findings specify the impact of right mTL structures on emotional picture processing and highlight the value of time-resolved measures in affective neuroscience.

The role of the amygdala in processing social and affective touch

The amygdala plays a central role in emotion and social behavior, yet its role in processing social and affective touch is not well established. Longitudinal studies reveal that touch-deprived infants show later in life exaggerated emotional reactivity related to structural and functional changes in the amygdala and other brain structures. The internal organization and connectivity of the amygdala is well-suited to process the sensory features of tactile stimuli and also the socio-cognitive dimensions of the received touch. The convergent processing of bottom-up and top-down pathways that carry information about touch results in the elaboration of context appropriate autonomic responses. Indeed, the positive value of affective touch in humans and social grooming in non-human primates is correlated with vagal tone and the release of oxytocin and endogenous opioids. Grooming, the non-human primate equivalent of affective touch in humans, reduces vigilance, that depends on the amygdala. During touch-induced vagal tone and low vigilance, neural activity in the amygdala is substantially different from activity corresponding to the attentive processing of tactile stimuli. Under these circumstances neurons no longer respond phasically to each touch stimulus, rather they signal a sustained functional state in which the amygdala appears decoupled from monitoring the external environment.