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Attentional Biases and their Push and Pull with Rumination and Co-Rumination is Based on Depressive Symptoms: a Prospective Study of Adolescents. Res Child Adolesc Psychopathol 2023; 51:399-411. [PMID: 36422731 PMCID: PMC9686224 DOI: 10.1007/s10802-022-00991-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/27/2022]
Abstract
Emotion regulation (ER) is central to adolescent mental health and wellbeing. However, the mechanisms underlying two common ER strategies - rumination and its interpersonal counterpart, co-rumination - are insufficiently understood in youth. Past research has documented that attentional disengagement biases are associated with rumination in adults, particularly among individuals with elevated depressive symptoms. Extending this line of research, the current study investigated whether attentional disengagement biases predicted rumination and co-rumination in adolescents based on their symptoms of depression. Using a multi-wave prospective design, 91 early adolescents (47% female, Mage = 12.87) completed a measure of depressive symptoms and the Affective Posner Task to assess early and late attentional processes at baseline. Adolescents also completed measures of rumination and co-rumination at baseline and every 3-months for one year. A multivariate means-as-outcomes multilevel model indicated that early disengagement biases for sad and happy faces interacted with depressive symptoms to predict later rumination and co-rumination. Critically, the direction of findings across rumination and co-rumination differed based on depressive symptoms. Results are the first to delineate a distinct pattern of attentional disengagement biases that predict rumination versus co-rumination in early adolescents. Findings extend theoretical conceptualizations of rumination to youth and provide the first account of cognitive mechanisms underlying co-rumination.
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Radetzki PA, Wrath AJ, Le T, Adams GC. Alexithymia is a mediating factor in the relationship between adult attachment and severity of depression and social anxiety. J Affect Disord 2021; 295:846-855. [PMID: 34706455 DOI: 10.1016/j.jad.2021.08.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 07/20/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and social anxiety disorder (SAD) are commonly occurring conditions, either alone or together (MDD-SAD). Recent research linked insecure attachment and alexithymia to MDD and/or SAD, indicating that the way affected individuals relate interpersonally and their ability to identify and communicate emotions are pertinent issues. The current study investigated the mediating role of alexithymia in the relationship between insecure attachment and severity of MDD and SAD symptoms. METHOD Using the SCID-I, participants (N=159) were identified as MDD-only (n=43), MDD-SAD (n=56), or a healthy control (n=60). Participants completed measures of adult attachment, depression, social anxiety and alexithymia (defined as difficulty identifying and describing feelings). A two-step mediation analysis approach recommended by Shrout and Bolger determined if alexithymia mediates the relationship between attachment-depression and attachment-social anxiety. RESULTS While alexithymia was high in MDD-only and MDD-SAD groups, individuals with MDD-SAD had significantly greater difficulty describing feelings. Alexithymia was a full mediator between attachment avoidance and depression, but only a partial mediator between attachment anxiety and depression. Meanwhile, alexithymia was a partial mediator for both attachment dimensions and social anxiety. LIMITATIONS Causal inferences regarding insecure attachment, alexithymia, and MDD and SAD cannot be assumed given the cross-sectional data. The 'externally oriented thinking' component in alexithymia was also excluded from analyses due to low reliability. CONCLUSION The results suggest emotional awareness and expression play a role in the illness severity for MDD and SAD-particularly in those with high attachment avoidance, offering a possible target for treatment and prevention strategies.
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Affiliation(s)
| | - Andrew J Wrath
- Department of Psychiatry, University of Saskatchewan, Canada
| | - Thuy Le
- Department of Psychiatry, University of Saskatchewan, Canada
| | - G Camelia Adams
- Department of Psychiatry, University of Saskatchewan, Canada.
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Seo CL, Lee JH. Attentional Bias to High-Calorie Food in Binge Eaters With High Shape/Weight Concern. Front Psychiatry 2021; 12:606296. [PMID: 33762976 PMCID: PMC7982957 DOI: 10.3389/fpsyt.2021.606296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
Individuals with high shape/weight concern (SWC) place disproportionate emphasis on shape and weight in evaluating their self-worth, making them more vulnerable to body-related cues. Binge eaters (BE), who are obsessed with devouring high-calorie foods, would show severe symptomatology, especially when they have clinically high SWC. The present study attempted to elucidate how SWC influences binging based on attentional patterns toward high-calorie food cues. A total of 120 participants were selected and divided into four groups: (1) BE with high SWC, (2) BE with low SWC, (3) healthy controls (HC) with high SWC, and (4) HC with low SWC. BE and SWC status were respectively determined using the Eating Disorder Diagnostic Scale (DSM-5) and the Eating Disorder Examination Questionnaire. All participants completed the same free-viewing task, measuring initial fixation latency and total fixation duration. BE with high SWC showed attentional bias toward high-calorie food cues in terms of significantly faster initial fixation latency and longer total fixation duration, whereas BE with low SWC and the HC groups did not show any differences. The results revealed that SWC level makes unique contributions to BE's initial orienting bias toward and difficulty disengaging from high-calorie food cues. This may indicate that BE with high SWC merely worry about eating high-calorie food in a cognitive way, but not controlling actual binging behavior. The current study of attentional bias elucidated the role of SWC as a potential maintenance factor of being concerned and binging in BE.
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Affiliation(s)
- Chai Lee Seo
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, Seoul, South Korea
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Kishimoto T, Wen X, Li M, Zhang RY, Yao N, Huang Y, Qian M. Vigilance-Avoidance Toward Negative Faces in Social Anxiety With and Without Comorbid Depression. Front Psychiatry 2021; 12:636961. [PMID: 33868053 PMCID: PMC8044761 DOI: 10.3389/fpsyt.2021.636961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Despite the growing evidence for the attentional bias toward emotional related stimuli in patients with social anxiety disorder (SAD), it remains unclear how the attentional bias manifests in normal individuals with SAD and/or depressive traits. To address this question, we recruited three groups of normal participants with different psychiatric traits-individuals with comorbid SAD and depression (SADd, N = 19), individuals with only SAD (SAD, N = 15), and healthy control individuals (HC, N = 19). In a dot-probe paradigm, participants view angry, disgusted, and sad face stimuli with durations ranging from very brief (i.e., 14ms) that renders stimuli completely intangible, to relatively long (i.e., 2000ms) that guarantees image visibility. We find significant early vigilance (i.e., on brief stimuli) and later avoidance (i.e., on long stimuli) toward angry faces in the SADd group. We also find vigilance toward angry and disgusted faces in the SAD group. To our best knowledge, this is the first study to unify both vigilance and avoidance within the same experimental paradigm, providing direct evidence for the "vigilance-avoidance" theory of comorbid SAD and depression. In sum, these results provide evidence for the potential behavioral differences induced by anxiety-depression comorbidity and a single trait in non-clinical populations, but the lack of a depression-only group cannot reveal the effects of high levels of depression on the results. The limitations are discussed.
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Affiliation(s)
- Tomoko Kishimoto
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Xu Wen
- Beijing Key Laboratory for Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Mingzhu Li
- George Warren Brown School of Social work, Washington University in St. Louis, Missouri, TX, United States
| | - Ru-Yuan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Nisha Yao
- State Key Laboratory of Brain and Cognitive Science, Chinese Academy of Sciences (CAS) Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yunzhen Huang
- Beijing Key Laboratory for Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Mingyi Qian
- Beijing Key Laboratory for Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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5
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Lin M, Wen X, Qian M, He D, Zlomuzica A. Self-focused attention vs. negative attentional bias during public speech task in socially anxious individuals. Behav Res Ther 2020; 136:103766. [PMID: 33253981 DOI: 10.1016/j.brat.2020.103766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/29/2020] [Accepted: 11/06/2020] [Indexed: 11/19/2022]
Abstract
Enhanced self-focused attention (SFA) and negative attentional bias (NAB) towards social cues are characteristic hallmarks of social anxiety. It is essential to investigate these two attentional phenomena under socially relevant situations using comparable stimuli. In the present study, individuals with high social anxiety (HSA, n = 32) and low social anxiety (LSA, n = 29) were compared according to their attention toward self-related stimuli and toward positive, neutral, and negative feedback related stimuli. Video stimuli of moving indicators of self-anxiety-status and positive, neutral, and negative feedback from an audience were presented during an impromptu speech task (high anxiety condition) and a re-watching phase (low anxiety condition). Eye movements in response to the different stimuli served as readouts for attentional preference. An interaction effect suggested that the HSA group directed more attention to self-related stimuli relative to other stimuli and the LSA group only during the high anxiety condition. The LSA group exhibited a general attentional preference toward positive feedback, especially during the low anxiety condition. Meanwhile, only the total duration of fixation on positive feedback negatively correlated with subjective anxiety rating. Our results point to increased SFA rather than NAB in HSA individuals under social threats.
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Affiliation(s)
- Muyu Lin
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China; Mental Health Research & Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Xu Wen
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China; Mental Health Research & Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany.
| | - Mingyi Qian
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China.
| | - Dongjun He
- Sichuan Research Center of Applied Psychology, Chengdu Medical College, 610500, Chengdu, China.
| | - Armin Zlomuzica
- Mental Health Research & Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany.
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Dissociated deficits in attentional networks in social anxiety and depression. SCIENCE CHINA. LIFE SCIENCES 2020; 63:1071-1078. [PMID: 32112270 DOI: 10.1007/s11427-019-1624-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/08/2020] [Indexed: 01/19/2023]
Abstract
A critical cognitive symptom that is commonly involved in social anxiety and depression is attentional deficit. However, the functional relationship between attentional deficit and these two disorders remains poorly understood. Here, we behaviorally disentangled the three key attentional components (alerting, orienting, and executive control) using the established attentional network task (ANT) to investigate how social anxiety and depression are related to deficits in these attention components. We identified a double dissociation between the symptoms of social anxiety and depression and the attentional component deficits when processing non-emotional stimuli. While individuals vulnerable to social anxiety exhibited deficits in the orienting component, individuals vulnerable to depression were impaired in the executive control component. Our findings showed that social anxiety and depression were associated with deficits in different attentional components, which are not specific to emotional information.
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7
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Lin M, Qian M, He D, Wen X, Li X. Avoidance of all feedback? Attention allocation during and after public speech in social anxiety. J Behav Ther Exp Psychiatry 2020; 66:101520. [PMID: 31675486 DOI: 10.1016/j.jbtep.2019.101520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 09/17/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Attention avoidance of feedback-related stimuli is proposed to be associated with and maintain social anxiety. However, previous research has mainly focused on comparing the attention bias between two types of stimuli, while little is known about attention distribution patterns among positive, neutral, and negative feedback and non-feedback stimuli in individuals with high trait social anxiety (HSA) or low trait social anxiety (LSA). METHODS The current study assessed eye movement pattern of participants with HSA or LSA during a speech task (high anxiety condition) or while solely watching audience feedback of the speech (low anxiety condition). A pre-recorded audience who displayed approving, neutral, or disapproving gestures was presented as feedback stimuli, while neutral facial photos were used as non-feedback stimuli. RESULTS Only in the high anxiety condition, participants with HSA exhibited longer total fixation on non-feedback stimuli compared to those with LSA; whereas in the low anxiety condition, both groups paid more attention to emotional feedback stimuli. LIMITATIONS The final sample size was modest due to a high suspicion rate of the reality of the audience. CONCLUSIONS These findings suggest that only in highly anxious social situations, socially anxious individuals lack the attentional preference toward positive feedback that individuals with low anxious have.
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Affiliation(s)
- Muyu Lin
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China.
| | - Mingyi Qian
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China.
| | - Dongjun He
- Sichuan Research Center of Applied Psychology, Chengdu Medical College, 610500, Chengdu, China.
| | - Xu Wen
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China.
| | - Xiang Li
- School of Psychological and Cognitive Sciences and Key Laboratory of Behavior and Mental Health, Peking University, 100871, Beijing, China.
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Langer JK, Tonge NA, Piccirillo M, Rodebaugh TL, Thompson RJ, Gotlib IH. Symptoms of social anxiety disorder and major depressive disorder: A network perspective. J Affect Disord 2019; 243:531-538. [PMID: 30292147 PMCID: PMC6202058 DOI: 10.1016/j.jad.2018.09.078] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/05/2018] [Accepted: 09/21/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND We used network analyses to examine symptoms that may play a role in the co-occurrence of social anxiety disorder (SAD) and major depressive disorder (MDD). Whereas latent variable models examine relations among latent constructs, network analyses have the advantage of characterizing direct relations among the symptoms themselves. METHOD We conducted network modeling on symptoms of social anxiety and depression in a clinical sample of 130 women who met criteria for SAD, MDD, both disorders, or had no lifetime history of mental illness. RESULTS In the resulting network, the core symptoms of social fear and depressed mood appeared at opposite ends of the network and were weakly related; so-called "bridges" between these symptoms appeared to occur via intervening variables. In particular, the worthless variable appeared to play a central role in the network. LIMITATIONS Because our data were cross-sectional, we are unable to draw conclusions about the direction of these effects or whether these variables are related to each other prospectively. CONCLUSIONS Continued testing of these pathways using longitudinal data will help facilitate the development of more effective clinical interventions for these disorders.
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Affiliation(s)
- Julia K. Langer
- Minneapolis Veterans Affairs Health Care System, Washington University in St. Louis
| | - Natasha A. Tonge
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Marilyn Piccirillo
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Thomas L. Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Renee J. Thompson
- Department of Psychological and Brain Sciences, Washington University in St. Louis
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Haller SPW, Mills KL, Hartwright CE, David AS, Cohen Kadosh K. When change is the only constant: The promise of longitudinal neuroimaging in understanding social anxiety disorder. Dev Cogn Neurosci 2018; 33:73-82. [PMID: 29960860 PMCID: PMC6969264 DOI: 10.1016/j.dcn.2018.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/27/2022] Open
Abstract
Longitudinal studies offer a unique window into developmental change. Yet, most of what we know about the pathophysiology of psychiatric disorders is based on cross-sectional work. Here, we highlight the importance of adopting a longitudinal approach in order to make progress towards identifying the neurobiological mechanisms of social anxiety disorder (SAD). Using examples, we illustrate how longitudinal data can uniquely inform SAD etiology and timing of interventions. The brain's inherently adaptive quality requires that we model risk correlates of disorders as dynamic in their expression. Developmental theories regarding timing of environmental events, cascading effects and (mal)adaptations of the developing brain will be crucial components of comprehensive, integrative models of SAD. We close by discussing analytical considerations when working with longitudinal, developmental data.
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Affiliation(s)
| | | | - Charlotte E Hartwright
- Department of Experimental Psychology, University of Oxford, UK; Aston Brain Center, Aston University, UK
| | - Anthony S David
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kathrin Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, UK; School of Psychology, University of Surrey, UK.
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10
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Bauer A, Schneider S, Waldorf M, Cordes M, Huber TJ, Braks K, Vocks S. Visual processing of one's own body over the course of time: Evidence for the vigilance-avoidance theory in adolescents with anorexia nervosa? Int J Eat Disord 2017; 50:1205-1213. [PMID: 28851058 DOI: 10.1002/eat.22771] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 07/12/2017] [Accepted: 08/09/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The vigilance-avoidance theory postulates a specific threat-related pattern of attention deployment, characterized by initial orientation towards fear-evoking stimuli and subsequent directing of attention away from them. The current eye-tracking study was the first to examine the applicability of the theory for patients with eating disorders, who perceive their own body as a highly aversive, threat-evoking stimulus. METHOD N = 56 female adolescents with anorexia nervosa (AN) and n = 43 healthy controls (HC) aged 13-18 viewed own-body pictures while their eye movements were recorded. Relative fixation times on self-defined unattractive body areas were compared between the groups by sequencing the overall presentation time of 6,000 ms into six intervals à 1,000 ms. RESULTS Participants with AN showed a significantly stronger attentional bias for unattractive body areas than HC within the time intervals 1, 2, and 3. However, for intervals 4, 5, and 6, no significant group differences occurred. Within the AN group, the bias for unattractive body areas was significantly stronger in interval 1 compared to intervals 4, 5, and 6; whereas within the HC group, a stable pattern of attention deployment emerged. In AN, early attention deployment was positively correlated with the negative affect reported after photo presentation. DISCUSSION The early vigilance in AN and the subsequent decrease in attention to unattractive body parts is in line with our assumptions. However, no indication of attentional avoidance was found. The current findings partially support the vigilance-avoidance theory for the exposure to one's own body in adolescents with AN.
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Affiliation(s)
- Anika Bauer
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Silvia Schneider
- Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Manuel Waldorf
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Martin Cordes
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | | | | | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
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11
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Colich NL, Ho TC, Foland-Ross LC, Eggleston C, Ordaz SJ, Singh MK, Gotlib IH. Hyperactivation in Cognitive Control and Visual Attention Brain Regions During Emotional Interference in Adolescent Depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:388-395. [PMID: 28890942 DOI: 10.1016/j.bpsc.2016.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Individuals with Major Depressive Disorder (MDD) are characterized by biases in attention to negative emotional material. While there is evidence that anomalous functioning in frontocingulate regions may underlie these biases, we know little about the neural correlates of negative emotional biases in depressed adolescents. METHODS Eighteen adolescents diagnosed with MDD and 21 matched healthy control (CTL) adolescents underwent fMRI while performing an emotional distractor task. On each trial participants were presented with task-relevant house pairs and task-irrelevant face pairs. Participants indicated whether the house pairs were identical while ignoring the face pairs, which were either fearful, sad, or neutral. RESULTS Despite equivalent behavioral performance (response time and accuracy) between groups, adolescents with MDD exhibited greater activation in frontocingulate regions, including dorsal anterior cingulate cortex (dACC) and inferior frontal gyrus/middle frontal gyrus (IFG/MFG), and occipitoparietal regions, including lateral occipital cortex and superior parietal lobule when ignoring fearful versus neutral faces. Response times to these trial conditions also correlated negatively with activation in IFG/MFG and lateral occipital cortex suggesting these regions are recruited in order to effectively ignore emotional distractors. Groups did not differ when ignoring sad versus neutral faces or fearful versus sad faces. CONCLUSIONS Adolescents with MDD recruit both cognitive control and visual attention regions to a greater degree than do CTL adolescents, reflecting greater cognitive demand when downregulating threat-related stimuli.
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Affiliation(s)
| | | | - Lara C Foland-Ross
- Department of Psychiatry and Behavioral Sciences, Stanford University, Berkeley
| | | | - Sarah J Ordaz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Berkeley
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Berkeley
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Tseng HH, Huang YL, Chen JT, Liang KY, Lin CC, Chen SH. Facial and prosodic emotion recognition in social anxiety disorder. Cogn Neuropsychiatry 2017; 22:331-345. [PMID: 28537109 DOI: 10.1080/13546805.2017.1330190] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Patients with social anxiety disorder (SAD) have a cognitive preference to negatively evaluate emotional information. In particular, the preferential biases in prosodic emotion recognition in SAD have been much less explored. The present study aims to investigate whether SAD patients retain negative evaluation biases across visual and auditory modalities when given sufficient response time to recognise emotions. METHODS Thirty-one SAD patients and 31 age- and gender-matched healthy participants completed a culturally suitable non-verbal emotion recognition task and received clinical assessments for social anxiety and depressive symptoms. A repeated measures analysis of variance was conducted to examine group differences in emotion recognition. RESULTS Compared to healthy participants, SAD patients were significantly less accurate at recognising facial and prosodic emotions, and spent more time on emotion recognition. The differences were mainly driven by the lower accuracy and longer reaction times for recognising fearful emotions in SAD patients. Within the SAD patients, lower accuracy of sad face recognition was associated with higher severity of depressive and social anxiety symptoms, particularly with avoidance symptoms. CONCLUSION These findings may represent a cross-modality pattern of avoidance in the later stage of identifying negative emotions in SAD. This pattern may be linked to clinical symptom severity.
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Affiliation(s)
- Huai-Hsuan Tseng
- a Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,b Department of Psychosis Studies , Institute of Psychiatry, King's College London , London , UK
| | - Yu-Lien Huang
- c Department of Psychology , Fo Gung University , Yilan , Taiwan
| | - Jian-Ting Chen
- d Department of General Psychiatry , Bali Psychiatric Center , New Taipei , Taiwan
| | - Kuei-Yu Liang
- e Department of Psychiatry , Wei Gong Memorial Hospital , Miaoli City , Taiwan
| | - Chao-Cheng Lin
- f Department of Psychiatry , National Taiwan University Hospital College of Medicine , Taipei , Taiwan.,g Yujie Clinic , Taipei , Taiwan
| | - Sue-Huei Chen
- h Department of Psychology , National Taiwan University , Taipei , Taiwan
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13
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Abstract
Background: The mechanisms and triggers of the attentional bias in social anxiety are not yet fully determined, and the modulating role of personality traits is being increasingly acknowledged. Aims: Our main purpose was to test whether social anxiety is associated with mechanisms of hypervigilance, avoidance (static biases), vigilance-avoidance or the maintenance of attention (dynamic biases). Our secondary goal was to explore the role of personality structure in shaping the attention bias. Method: Participants with high vs low social anxiety and different personality structures viewed pairs of faces (free-viewing eye-tracking task) representing different emotions (anger, happiness and neutrality). Their eye movements were registered and analysed for both whole-trial (static) and time-dependent (dynamic) measures. Results: Comparisons between participants with high and low social anxiety levels did not yield evidence of differences in eye-tracking measures for the whole trial (latency of first fixation, first fixation direction, total dwell time), but the two groups differed in the time course of overt attention during the trial (dwell time across three successive time segments): participants with high social anxiety were slower in disengaging their attention from happy faces. Similar results were obtained using a full-sample, regression-based analysis. Conclusion: Our results speak in favour of a maintenance bias in social anxiety. Preliminary results indicated that personality structure may not affect the maintenance (dynamic) bias of socially anxious individuals, although depressive personality structures may favour manifestations of a (static) hypervigilance bias.
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14
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Leppanen J, Cardi V, Paloyelis Y, Simmons A, Tchanturia K, Treasure J. FMRI Study of Neural Responses to Implicit Infant Emotion in Anorexia Nervosa. Front Psychol 2017; 8:780. [PMID: 28567026 PMCID: PMC5434152 DOI: 10.3389/fpsyg.2017.00780] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/26/2017] [Indexed: 12/29/2022] Open
Abstract
Difficulties in social–emotional processing have been proposed to play an important role in the development and maintenance of anorexia nervosa (AN). Few studies, thus far, have investigated neural processes that underlie these difficulties, including processing emotional facial expressions. However, the majority of these studies have investigated neural responses to adult emotional display, which may be confounded by elevated sensitivity to social rank and threat in AN. Therefore, the aim of this study was to investigate the neural processes underlying implicit processing of positively and negatively valenced infant emotional display in AN. Twenty-one adult women with AN and twenty-six healthy comparison (HC) women were presented with images of positively valenced, negatively valenced, and neutral infant faces during a fMRI scan. Significant differences between the groups in positive > neutral and negative > neutral contrasts were investigated in a priori regions of interest, including the bilateral amygdala, insula, and lateral prefrontal cortex (PFC). The findings revealed that the AN participants showed relatively increased recruitment while the HC participants showed relatively reduced recruitment of the bilateral amygdala and the right dorsolateral PFC in the positive > neutral contrast. In the negative > neutral contrast, the AN group showed relatively increased recruitment of the left posterior insula while the HC groups showed relatively reduced recruitment of this region. These findings suggest that people with AN may engage in implicit prefrontal down-regulation of elevated limbic reactivity to positively social–emotional stimuli.
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Affiliation(s)
- Jenni Leppanen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Valentina Cardi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Andy Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK.,Department of Psychology, Ilia State UniversityTbilisi, Georgia
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
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15
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Stange JP, MacNamara A, Barnas O, Kennedy AE, Hajcak G, Phan KL, Klumpp H. Neural markers of attention to aversive pictures predict response to cognitive behavioral therapy in anxiety and depression. Biol Psychol 2016; 123:269-277. [PMID: 27784617 DOI: 10.1016/j.biopsycho.2016.10.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 12/26/2022]
Abstract
Excessive attention toward aversive information may be a core mechanism underlying emotional disorders, but little is known about whether this is predictive of response to treatments. We evaluated whether enhanced attention toward aversive stimuli, as indexed by an event-related potential component, the late positive potential (LPP), would predict response to cognitive behavioral therapy (CBT) in patients with social anxiety disorder and/or major depressive disorder. Thirty-two patients receiving 12 weeks of CBT responded to briefly-presented pairs of aversive and neutral pictures that served as targets or distracters while electroencephaolography was recorded. Patients with larger pre-treatment LPPs to aversive relative to neutral distracters (when targets were aversive) were more likely to respond to CBT, and demonstrated larger reductions in symptoms of depression and anxiety following treatment. Increased attention toward irrelevant aversive stimuli may signal attenuated top-down control, so treatments like CBT that improve this control could be beneficial for these individuals.
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Affiliation(s)
- Jonathan P Stange
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
| | - Annmarie MacNamara
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station, TX 77840, USA
| | - Olga Barnas
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA
| | - Amy E Kennedy
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA; Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA
| | - Greg Hajcak
- Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY 11794, USA
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA; Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA; Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St., Chicago, IL 60607, USA; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, 808 S. Wood St., Chicago, IL 60612, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA; Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St., Chicago, IL 60607, USA.
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16
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Washburn D, Wilson G, Roes M, Rnic K, Harkness KL. Theory of mind in social anxiety disorder, depression, and comorbid conditions. J Anxiety Disord 2016; 37:71-7. [PMID: 26658117 DOI: 10.1016/j.janxdis.2015.11.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 11/04/2015] [Accepted: 11/07/2015] [Indexed: 11/16/2022]
Abstract
Social anxiety disorder is characterized by marked interpersonal impairment, particularly when presenting with comorbid major depression. However, the foundational social-cognitive skills that underlie interpersonal impairment in comorbid and non-comorbid manifestations of SAD has to date received very little empirical investigation. In a sample of 119 young adults, the current study examined differences in theory of mind (ToM), defined as the ability to decode and reason about others' mental states, across four groups: (a) non-comorbid SAD; (b) non-comorbid Lifetime MDD; (c) comorbid SAD and Lifetime MDD; and (d) healthy control. The non-comorbid SAD group was significantly less accurate at decoding mental states than the non-comorbid MDD and control groups. Further, both the comorbid and non-comorbid SAD groups made significantly more 'excessive' ToM reasoning errors than the non-comorbid MDD group, suggesting a pattern of over-mentalizing. Findings are discussed in terms of their implications for understanding the social cognitive foundations of social anxiety.
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Affiliation(s)
- Dustin Washburn
- Department of Psychology, Queen's University, Kingston, ON K7L3N6, Canada.
| | - Gillian Wilson
- Department of Psychology, Queen's University, Kingston, ON K7L3N6, Canada
| | - Meighen Roes
- Department of Psychology, Queen's University, Kingston, ON K7L3N6, Canada
| | - Katerina Rnic
- Department of Psychology, Queen's University, Kingston, ON K7L3N6, Canada
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