Diagnostic and symptom-based predictors of emotional processing in generalized anxiety disorder and major depressive disorder: An event-related potential study

Blunted stimulus-preceding negativity during reward anticipation in major depressive disorder

BACKGROUND

Reward processing dysfunction is a core characteristic of major depressive disorder (MDD), yet event-related potential (ERP) research in MDD has predominantly focused on reward receipt as opposed to anticipation. The stimulus-preceding negativity (SPN) ERP reflects anticipatory brain processing. This study examines whether individuals with MDD exhibit deficits during reward anticipation as evidenced by altered SPN amplitude.

METHODS

We assessed prefeedback-SPN amplitudes during a monetary incentive delay (MID) task in individuals with MDD (n = 142, 99 with comorbid anxiety disorders [MDD + ANX]) compared to Controls (n = 37). A mixed analysis of variance was performed on prefeedback-SPN amplitude and behavioral measures, with group (MDD, MDD + ANX, Control) as the between-subjects factor, and feedback (gain, loss) and electrode (F3, F4, Fz, C3, C4, Cz, P3, P4, Pz) as within-subjects factors.

RESULTS

A group main effect revealed faster reaction times for the Control group than MDD and MDD + ANX groups. A group x feedback interaction indicated that the MDD subgroup had smaller prefeedback-SPN amplitudes than MDD + ANX and Control groups when anticipating gain feedback. Additionally, individuals with current MDD, irrespective of past MDD and comorbid anxiety, exhibited smaller SPN amplitudes than Controls prior to gain feedback.

LIMITATIONS

The MID paradigm, designed for functional magnetic resonance imaging (fMRI) data acquisition, lacks optimization for ERP analysis. Moreover, the clinical groups included more females than the Control group.

CONCLUSIONS

Reduced resource allocation to reward anticipation may differentiate MDD from MDD + ANX and Control groups. Further investigation of the neural mechanisms of distinct MDD phenotypes is warranted.

Electrocortical Reactivity During Self-Referential Processing Predicts the Development of Depression Across Adolescence

BACKGROUND

Negative attentional biases and self-schemas have been implicated in the development of depression. Research has indicated that a larger late positive potential (LPP) to negative self-referential words is associated with depression-as well as a maternal history of depression, an indicator of risk. However, it is unclear whether the LPP to self-referential words predicts the actual development of depression. In the current study, we examined whether electrocortical reactivity during self-referential processing predicted the development of depression across adolescence.

METHODS

The sample consisted of 165 8- to 14-year-old girls with no lifetime history of a depressive disorder who completed the self-referential encoding task while electroencephalography was recorded at a baseline assessment. Participants and their parent completed the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children at the baseline and 2-, 4-, and 6-year follow-up assessments.

RESULTS

Results indicated that a larger LPP to negative self-referential words at baseline predicted an increased likelihood of developing chronic-intermittent depression (i.e., persistent and/or recurrent), but not nonchronic, single-episode depression, across adolescence. In contrast, neither self-referential encoding task recall biases nor the LPP to positive self-referential words predicted the development of either type of depression.

CONCLUSIONS

The results of the current study suggest that electrocortical reactivity associated with a negative self-schema in late childhood predicts the development of a more pernicious subtype of depression across adolescence. Moreover, the current study highlights the importance of considering clinical course in the examination of biomarkers of risk for depression.

Beyond the RewP: The reward feedback-elicited LPP and its potential associations with perceived stress and internalizing symptoms in late childhood

Internalizing problems increase substantially during late childhood and early adolescence, which are known to be associated with elevated perceived stress as children transition into adolescence. One risk factor that may moderate the stress-symptom association is reward processing. While neurophysiological research in this field has focused on the reward positivity component (RewP) elicited during reward processing, little work has examined the reward feedback-elicited late positive potential (LPP) and its association with internalizing psychopathology. The present study examined the moderating roles of the RewP and feedback-elicited LPP in the relationship between perceived stress and internalizing symptoms in late childhood. A community sample of 115 nine-to-12-year-old children (66 girls, Mean age = 11.00 years, SD = 1.16) completed an EEG version of the reward feedback paradigm, the Doors task, and completed questionnaires on perceived stress and internalizing symptoms. A principal component analysis revealed three temporo-spatial factors that were temporally and spatially analogous to the RewP, anterior LPP, and posterior LPP, respectively. As expected, an enlarged RewP was found towards the win condition compared to the loss condition. We also observed a potentiated LPP towards loss relative to win feedback, which may reflect the evaluation and reappraisal processes following unsuccessful performance (i.e., loss). We did not, however, find significant moderating effects of any ERP components on the stress-symptom association. Our study was first to isolate the feedback-elicited LPP in a reward processing paradigm in children and provide initial evidence on the modulation of the ERP component by task conditions. Future research is warranted to further explore the functional significance of the reward feedback-elicited LPP in association with perceived stress and internalizing psychopathology in youths.

Neural reactivity to infant emotion cues during pregnancy: Associations with peripartum anxiety and depressive symptoms

BACKGROUND

Pregnancy is marked by physiological and psychosocial changes for women, and event-related potentials (ERP) are comfortable and safe for examining brain function across pregnancy. The late positive potential (LPP) ERP, a measure of allocated attention to emotional stimuli, may provide insight into associations between internalizing symptoms and neural processing of infant emotion cues, which may be particularly salient in this life stage.

METHODS

We developed a task to examine neural and behavioral responses to infant faces in pregnant women (N = 120, Mage=31.09, SD=4.81), the impact of auditory infant cries on the LPP to faces, and associations between the LPP and anxiety and depressive symptoms. Participants matched distressed, happy, and neutral infant faces and shapes as a comparison condition with interspersed auditory conditions (infant cry sounds vs. white noise) while electroencephalogram data were collected. Participants also completed self-report measures of anxiety and depressive symptoms.

RESULTS

Reaction time (RT) was faster for the infant cry vs. white noise condition and when matching shapes vs. infant faces. Depressive symptoms were associated with slower RTs to neutral infant faces. The LPP was enhanced overall to faces vs. shapes, but there was no main effect of auditory condition. Anxiety symptoms were associated with an enhanced LPP to infant distressed faces in the infant cry condition.

CONCLUSIONS

Results support these methods for measuring neural and behavioral responses to infant emotional cues in pregnancy and provide evidence that combinations of auditory and visual stimuli may be particularly useful for capturing emotional processes relevant to anxiety.

Triarchic psychopathy and affective picture processing: An event-related potential study

Psychopathy and its precursors appear to be associated with abnormal affective response. For example, individuals high in psychopathy show reduced psychophysiological response to unpleasant stimuli, which might explain low levels of empathy in psychopathic individuals, and their pursuit of individual goals without regard for others' wellbeing. In keeping with the notion that psychopathology is best represented on a continuum, the triarchic model suggests that psychopathy is characterized by elevations on three traits: boldness, meanness and disinhibition. Understanding how these traits relate to psychophysiological response to emotional stimuli would help validate the triarchic model, while also bridging to other psychopathological spectra (e.g., internalizing psychopathology, which is characterized by low boldness). Here, N = 123 young adults passively viewed unpleasant, pleasant and neutral pictures while subjective and electrocortical response were recorded. Controlling for the other triarchic traits, individuals with higher self-reported meanness had smaller late positive potentials (LPPs) to both pleasant and unpleasant pictures, whereas individuals higher in boldness had larger LPPs to unpleasant pictures. In addition, those higher in meanness rated unpleasant pictures as more pleasant and less emotionally arousing. Disinhibition was not associated with the LPP or ratings. Meanness appears to drive blunted response to unpleasant pictures that has previously been observed among those high on psychopathy, and may also be associated with reduced engagement with generic pleasant stimuli. Moreover, results converge with prior work on other traits of transdiagnostic relevance (e.g., extraversion), as well as internalizing symptoms, providing a bridge between psychopathy and other forms of psychopathology.

Weathering the storm of emotions: immediate and lasting effects of reinterpretation and distancing on event-related potentials and their association with habitual use of cognitive reappraisal

Reinterpretation and distancing, two cognitive reappraisal tactics, are known to effectively reduce negative feelings and event-related potentials (ERPs), such as the P300 and the late positive potential (LPP), in the short-term. Less is known about differential and lasting effects on ERPs as well as their association with habitual reappraisal. Fifty-seven participants were instructed to passively view or reappraise (reinterpretation, distancing) pictures that were repeatedly presented with the same instruction (active regulation phase). Thirty minutes later, these pictures were shown again without instruction for the assessment of lasting effects (re-exposure phase). ERPs were recorded and participants rated the intensity of negative feelings following picture presentation. Reappraisal led to an attenuation of the LPP, and both tactics decreased negative feelings during active regulation, whereby reinterpretation had a stronger impact on the subjective level. Passive re-exposure resulted in reduced negative feelings for previously reappraised pictures but had no lasting effects on ERPs. Higher habitual reappraisal was associated with higher P300 and early LPP amplitudes for emotional reactivity during the active regulation phase. During the re-exposure phase, higher habitual reappraisal was not related to ERPs. The current findings emphasize the effectiveness of both tactics in the short-term and lasting effects on the subjective experience of negative feelings. Enhanced emotional reactivity on the electrocortical level in individuals with a more frequent habitual use of reappraisal might indicate a higher preparedness to regulate.

Catch the drift: Depressive symptoms track neural response during more efficient decision-making for negative self-referents

Background

Adolescence is a time of heightened risk for developing depression and also a critical period for the development and integration of self-identity. Despite this, the relation between the neurophysiological correlates of self-referential processing and major depressive symptoms in youth is not well understood. Here, we leverage computational modeling of the self-referential encoding task (SRET) to identify behavioral moderators of the association between the posterior late positive potential (LPP), an event-related potential associated with emotion regulation, and youth self-reported symptoms of depression. Specifically, within a drift-diffusion framework, we evaluated whether the association between the posterior LPP and youth symptoms of major depression was moderated by drift rate, a parameter reflecting processing efficiency during self-evaluative decisions.

Methods

A sample of 106 adolescents, aged 12 to 17 (53% male; Mage = 14.49, SD = 1.70), completed the SRET with concurrent high-density electroencephalography and self-report measures of depression and anxiety.

Results

Findings indicated a significant moderation: for youth showing greater processing efficiency (drift rate) when responding to negative compared to positive words, larger posterior LPPs predicted greater depressive symptom severity.

Limitations

We relied on a community sample and our study was cross-sectional in nature. Future longitudinal work with clinically depressed youth would be beneficial.

Conclusions

Our results suggest a neurobehavioral model of adolescent depression wherein efficient processing of negative information co-occurs with increased demands on affective self-regulation. Our findings also have clinical relevance; youth's neurophysiological response (posterior LPP) and performance during the SRET may serve as a novel target for tracking treatment-related changes in one's self-identity.

Chronic stress in peer relationships moderates the association between pubertal development and neural response to emotional faces in adolescence

Adolescence is a period of heightened risk for multiple forms of psychopathology, partly due to greater exposure to interpersonal stress. One way that interpersonal stress may increase risk for psychopathology is by altering the normative development of neural systems that support socio-affective processing. The late positive potential (LPP) is an event-related potential component that reflects sustained attention to motivationally-salient information and is a promising marker of risk for stress-related psychopathology. However, it is not clear how the LPP to socio-affective information changes across adolescence, nor whether exposure to stress with peers interferes with normative developmental differences in the LPP to socio-affective content during this period. In 92 adolescent girls (10-19 years old), we assessed the LPP to task-irrelevant emotional and neutral faces, as well as behavioural measures of interference following the presentation of these faces. Adolescents at more advanced stages of puberty showed a smaller LPP to emotional faces, but adolescents exposed to greater peer stress exhibited a larger LPP to these stimuli. Additionally, for girls exposed to lower levels of peer stress, more advanced pubertal development was associated with a smaller LPP to emotional faces, whereas for girls exposed to higher levels of peer stress, the association between pubertal development and the LPP to emotional faces was not significant. Neither stress nor pubertal stage was significantly associated with behavioural measures. Combined, these data suggest that one pathway through which stress exposure increases risk for psychopathology during adolescence is by interfering with the normative development of socio-affective processing.

The impacts of anxiety and depressive symptoms on emotional processing in children and their parents: an event-related potential study

BACKGROUND

Anxiety and depressive symptoms are associated with dysregulated emotional processing. However, less is known about the intra-personal and inter-personal impacts of anxiety and depressive symptoms on emotional processing in children and their parents.

METHODS

In a community sample of 36 parent-child dyads (total N = 72), the current study investigated the intra- and inter-personal effects of anxiety and depressive symptoms on the child's and the parent's neurophysiological responses to emotional (i.e., pleasant and unpleasant) stimuli, indexed by the late positive potential (LPP).

RESULTS

The results indicated that children's anxiety symptoms were correlated with their enhanced LPPs to pleasant versus neutral pictures. Additionally, children's depressive symptoms related to their increased LPPs to unpleasant stimuli. Importantly, children's anxiety symptoms were associated with their parents' increased LPPs to both unpleasant and pleasant information.

CONCLUSIONS

These findings suggest that anxiety symptoms in community children were related to their own as well as their parents' emotional processing. The findings contribute to cognitive and family models of anxiety and depression and further highlight the potential role of dyadic interventions for the alleviation of impairing symptoms in children and their caregivers.

Familial risk for depression is associated with reduced P300 and late positive potential to affective stimuli and prolonged cardiac deceleration to unpleasant stimuli

Despite evidence of abnormal affective processing as a key correlate of depression, specific attentional mechanisms underlying processing of emotions in familial risk for depression have yet to be investigated in a single study. To this end, the amplitude of the P300 and late positive potential (LPP) complex and cardiac deceleration were assessed during the passive viewing of affective pictures in 32 individuals who had family history of depression (without depressive symptoms) and in 30 controls (without depressive symptoms and family history of depression). Individuals with familial risk for depression revealed reduced P300-LPP amplitudes in response to pleasant and unpleasant stimuli relative to controls, and comparable P300-LPP amplitudes in response to pleasant and neutral stimuli. Controls, but not individuals with familial risk for depression, reported cardiac deceleration during the viewing of pleasant vs. neutral and unpleasant stimuli in the 0-3 s time window. Also, only individuals with familial risk for depression showed a prolonged cardiac deceleration in response to unpleasant vs. neutral stimuli. Overall, the present study provides new insights into the characterization of emotion-related attentional processes in familial risk for depression as potential vulnerability factors for the development of the disorder.

The mediating effect of stress reactivity in the 18-year bidirectional relationship between generalized anxiety and depression severity

BACKGROUND

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Heightened stress reactivity may be a mediation mechanism underlying the long-term connections between GAD and MDD. However, cross-sectional studies on this topic have hindered directional inferences.

METHOD

The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults (M age = 45.6, range = 20-74). Participants completed three waves of measurement (T1, T2, and T3) spaced nine years apart. GAD and MDD symptom severity were assessed at T1, T2, and T3 (Composite International Diagnostic Interview-Short Form). Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2.

RESULTS

Structural equation mediation modeling demonstrated that higher T1 GAD symptoms positively predicted more severe T3 MDD symptoms via T2 stress reactivity, controlling for T1 MDD (d = 0.45-0.50). However, T2 stress reactivity was not a significant mediator in the relationship between T1 MDD severity and T3 GAD symptoms after controlling for T1 GAD. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later and vice versa (d = 1.29-1.65).

LIMITATIONS

Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. physiologically indexed) stress reactivity.

CONCLUSIONS

These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.

Case-by-case: neural markers of emotion and task stimulus significance

The present study assessed the hypothesis that electrophysiological markers of emotional and task stimulus significance can be demonstrated in concert at the level of the individual case. Participants (n = 18, 9 females) viewed low and high-arousing pictures selected from behavior systems of sexual reproduction, disease avoidance, and predator fear. Furthermore, to concurrently manipulate task relevance, participants performed an explicit emotion categorization task with either low or high-arousing pictures alternating as target stimuli in separate experimental blocks. Pooled across behavior systems, event-related components sensitive to emotional significance reached statistical significance in 100% of the tests for the early posterior negativity and in 96% of the tests for the late positive potential. Regarding explicit task relevance, the target P3 effect was significant in 96% of the tests. These findings demonstrate that neural markers of stimulus significance driven by emotional picture content and explicit task demands can be assessed at the individual level. Replicating an effect case-after-case provides strong support for an effect common-to-all and may support individual inferences. Contributions of the case-by-case approach to reveal reproducible effects and implications for the development of neural biomarkers for specific affective and cognitive component processes are discussed.

Effects of depressive symptoms on regulating emotional goals: preferences for distinct facial emotions

BACKGROUND

Although many studies of emotion regulation in depression have focused on regulatory strategies, few have explored the goals of regulation. Regulatory strategies refer to methods of adjusting emotions, while regulatory goals refer to the desired states of emotion. According to situational selection strategy, individuals choose situations to regulate their emotions, and also selectively approach or avoid certain people.

METHODS

We used the Beck Depression Inventory-II scale to classify healthy individuals into two groups: those with either high or low levels of depressive symptoms. We then explored the influence of these symptoms on individual goals for emotion regulation. Event-related potentials in the brain were recorded as participants viewed and selected images of happy, neutral, sad, and fearful faces. Participants also provided subjective emotional preferences. Results Late positive potential (LPP) amplitudes for all faces were smaller in the high depressive-symptom group than those in the low depressive-symptom group. Additionally, participants in the high depressive-symptom group chose to look at sad and fearful faces more often than they chose to view happy or neutral faces, and showed a stronger preference for sad and fearful emotions and a weaker preference for happy emotions.

CONCLUSION

The results suggest that the more individuals exhibit depressive symptoms, the less likely that they will be motivated to approach happy faces and avoid sad and fearful faces. The result of this emotional regulation goal is an increase in the experience of negative emotions, which likely contributes to their depressive state.

A Neurobiological Profile Underlying Comorbidity Load and Prospective Increases in Dysphoria in a Focal Fear Sample

BACKGROUND

Knowledge of the neural mechanisms underlying increased disease burden in anxiety disorders that is unaccounted for by individual categorical diagnoses could lead to improved clinical care. Here, we tested the utility of a joint functional magnetic resonance imaging-electroencephalography neurobiological profile characterized by overvaluation of negative stimuli (amygdala) in combination with blunted elaborated processing of these same stimuli (the late positive potential [LPP], an event-related potential) in predicting increased psychopathology across a 2-year period in people with anxiety disorders.

METHODS

One hundred ten participants (64 female, 45 male, 1 other) including 78 participants with phobias who varied in the extent of their internalizing comorbidity and 32 participants who were free from psychopathology viewed negative and neutral pictures during separate functional magnetic resonance imaging blood oxygen level-dependent and electroencephalogram recordings. Dysphoria was assessed at baseline and 2 years later.

RESULTS

Participants with both heightened amygdala activation and blunted LPPs to negative pictures showed the greatest increases in dysphoria 2 years later. Cross-sectionally, participants with higher comorbidity load (≥2 additional diagnoses, n = 34) showed increased amygdala activation to negative pictures compared with participants with lower comorbidity load (≤1 additional diagnosis, n = 44) and compared with participants free from psychopathology. In addition, high comorbid participants showed reduced LPPs to negative pictures compared with low comorbid participants.

CONCLUSIONS

Heightened amygdala in response to negative stimuli in combination with blunted LPPs could indicate overvaluation of threatening stimuli in the absence of elaborated processing that might otherwise help regulate threat responding. This brain profile could underlie the worsening and maintenance of internalizing psychopathology over time.

Rethinking the risk for depression using the RDoC: A psychophysiological perspective

Considering that the classical categorical approach to mental disorders does not allow a clear identification of at-risk conditions, the dimensional approach provided by the Research Domain Criteria (RDoC) is useful in the exploration of vulnerability to psychopathology. In the RDoC era, psychophysiological models have an important role in the reconceptualization of mental disorders. Indeed, progress in the study of depression vulnerability has increasingly been informed by psychophysiological models. By adopting an RDoC lens, this narrative review focuses on how psychophysiological models can be used to advance our knowledge of the pathophysiological mechanisms underlying depression vulnerability. Findings from psychophysiological research that explored multiple RDoC domains in populations at-risk for depression are reviewed and discussed. Future directions for the application of psychophysiological research in reaching a more complete understanding of depression vulnerability and, ultimately, improving clinical utility, are presented.

Deactivating attachment strategies associate with early processing of facial emotion and familiarity in middle childhood: an ERP study

Neurophysiological evidence suggests associations between attachment and the neural processing of emotion expressions. This study asks whether this relationship is also evident in middle childhood, and how it is affected by facial familiarity. Attachment strategies (deactivation, hyperactivation) were assessed in 51 children (9 - 11 years)  using a story stem completion task. Event-related potentials (ERPs) were recorded during children's passive viewing of mother and stranger emotional faces (angry/happy). At the stage of facial information encoding (N250), attachment deactivation was associated with a pattern pointing to increased vigilance towards angry faces. Further, the attention-driven LPP was increased to happy mother faces as highly salient stimuli overall, but not in children scoring high on deactivation. These children did not discriminate between mothers' facial emotions and showed a general attentional withdrawal from facial stimuli. While our results on attachment deactivation support a two-stage processing model, no effect of hyperactivation was found.

Associations between the late positive potential and PTSD, anxiety, and depressive symptoms among trauma-exposed undergraduates

BACKGROUND

The late positive potential (LPP) is a neural marker of attention to emotional stimuli; dysregulations in those attentional processes might contribute to trauma-related psychopathology. Although higher LPP amplitudes to negative images have been found to be associated with anxiety symptoms, results have been mixed regarding depressive and PTSD symptoms, especially among trauma-exposed populations. Further, the relationships between the LPP to positive and neutral images and psychopathology symptoms have been underexamined. The purpose of the current study was to test the effects of image valence, and PTSD, anxiety, and depressive symptoms on LPP amplitude among trauma-exposed undergraduates.

METHOD

Seventy-three trauma-exposed undergraduates viewed a series of negative, positive, and neutral images while LPPs were recorded. Self-report measures were used to assess recent PTSD, anxiety, and depressive symptoms. Hierarchical linear modeling tested valence and symptom main effects, as well as Valence by Symptom interactions on LPP amplitude.

RESULTS

We found a main effect of valence such that individuals exhibited higher LPP amplitudes to negative images compared to neutral images. We also found a Valence by Depressive Symptoms interaction such that there was an inverse relationship between depressive symptoms and the LPP to neutral images but no associations between depressive symptoms and the LPP for positive or negative images. We found no main effects or interactions for anxiety and PTSD symptoms.

CONCLUSION

Depressive symptoms might be related to diminished attention to neutral stimuli among trauma-exposed undergraduates. Further investigation of the relationship between the LPP and psychopathology is needed.

Associations between parental conflict and social and monetary reward responsiveness in adolescents with clinical depression

Increased rates of depression beginning in adolescence are thought to be attributed in part to marked developmental changes in reward systems and interpersonal relationships. Blunted reward response has been observed in depression and this may be shaped in part by social experiences, raising questions about the combined associations of parental conflict, depression, and reward response in both social and monetary domains. The present study used the reward positivity (RewP), an event-related potential that indexes both monetary and social reward processing, to examine the unique and combined associations of parental conflict and depressive symptoms on reward responsiveness in adolescents with clinical depression (N = 70) 14-18 years of age (M = 15.81, SD = 1.46; 65.7% female). Results indicated that depressive symptoms interacted with maternal conflict in characterizing the RewP to social, but not monetary, rewards. Specifically, higher levels of current depressive symptoms and potentiated maternal conflict together were associated with an attenuated RewP to social rewards in this clinical sample. We found no significant effects of paternal conflict. This investigation highlights maternal conflict as an important environmental factor for reward responsiveness and also emphasizes the utility of examining social reward responsiveness in depression in order to better understand the impacts of contextual factors.

Neural reactivity to affective stimuli and internalizing symptom dimensions in a transdiagnostic patient sample

BACKGROUND

Internalizing psychopathologies (IPs) are highly comorbid and exhibit substantial overlap, such as aberrant affective reactivity. Neural reactivity to emotional images, measured via the late positive potential (LPP) event-related potential (ERP) component, has been utilized to index affective reactivity in IPs. The LPP is often examined in isolation with a specific disorder, ignoring overlap between IPs. The current study examined how transdiagnostic IP symptom dimensions relate to neural affective reactivity in a highly comorbid patient sample.

METHODS

Participants (N = 99) completed a battery of IP symptom assessments as well as a target categorization task while viewing pleasant, unpleasant, and neutral images during electroencephalography recording. ERPs to each image valence were averaged from 400 to 1000 ms following picture onset at pooled centroparietal and occipital electrodes to calculate the LPP. A principal components analysis performed on the IP symptom measures resulted in two factors: affective distress/misery and fear-based anxiety.

RESULTS

Fear-based anxiety was associated with enhanced LPP reactivity to unpleasant, but not pleasant, images. Distress/misery was related to attenuated average LPP reactivity across images.

CONCLUSIONS

Results revealed a dissociable effect of IP symptom factors in a transdiagnostic sample such that enhanced reactivity to negative images was specific to enhanced fear-based anxiety symptoms while distress/misery symptoms predicted blunted affective reactivity. Neural affective reactivity may serve as an objective biological marker to elucidate the nature of psychological concerns in individuals with comorbid IPs.

The P300 and late positive potential in pregnancy prospectively predict increases in depressive and anxious symptoms in the early postpartum period

Postnatal depression and anxiety disorders pose a major burden on maternal mental health. While psychosocial risk factors for perinatal depression and anxiety are well-researched, there is a dearth of research examining neural biomarkers of risk for postnatal increases in depression and anxiety. Previous studies suggest two different event-related potentials, the P300 and the late positive potential (LPP), may predict the course of depressive and anxious symptoms in non-perinatal populations. In a sample of 221 perinatal women, the present study utilized an emotional interrupt task administered in pregnancy to examine whether antenatal P300 and LPP amplitudes may predict change in depressive and anxious symptoms from pregnancy to the early postpartum period. Zero-order correlations and linear regressions revealed that a reduced antenatal P300 to target stimuli and an enhanced LPP to positive infant images were uniquely associated with postnatal depressive and anxiety symptoms, respectively, and that these ERPs were independent predictors beyond antenatal self-report measures of psychological symptoms. Furthermore, individuals with increased depressive symptoms in pregnancy exhibited a stronger negative association between antenatal P300 amplitude and postnatal depressive symptoms. The present findings underscore the possibility that the measurement of ERPs during pregnancy could serve as a screening tool for risk for perinatal depression and anxiety, and thereby assist with identifying at-risk individuals who might benefit from prevention efforts.

Application of unified protocol as a transdiagnostic treatment for emotional disorders during COVID-19: An internet-delivered randomized controlled trial

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has been an emotionally challenging time, especially for young adults. It is associated with a substantial increase in the prevalence of mental health problems, negative symptoms, and stressful experiences that compromise well-being. In low-income countries, internet-delivered psychological services could have a remarkable impact on the population’s mental health, given the lack of mental health professionals.

AIM

To investigate the efficacy of internet-delivered cognitive-behavior therapy (CBT)-transdiagnostic intervention for adults with emotional disorders.

METHODS

In this internet-delivered randomized controlled trial, 102 students with an emotional disorder (mean age = 28.20 years, standard deviation = 5.07) were randomly allocated to receive unified protocol (UP) (n = 51) or treatment as the usual intervention. Following a semi-structured clinical interview, participants completed an online survey including the Overall Anxiety Severity and Impairment Scale, Overall Depression Severity and Impairment Scale, Difficulties in Emotion Regulation Scale, Positive and Negative Affect Schedule, and Emotional Style Questionnaire.

RESULTS

The participants showed a high degree of adherence. In total, 78% (n = 40) of the experimental group participants completed the UP treatment. Considering the intention to treat procedure, the results of the analysis of covariance indicated that participants who received UP showed statistically significant changes in depression symptoms [Cohen’s d = -1.50 with 95% confidence interval (CI): -1.90 to -1.10], anxiety (Cohen’s d = -1.06 with 95%CI: -1.48 to -0.65), difficulties with emotion regulation (Cohen’s d = -0.33 with 95%CI: -0.7 to -0.06), positive affect (Cohen's d = 1.27 with 95%CI: 0.85 to 1.68), negative affect (Cohen’s d= -1.04 with 95%CI: -1.46 to -0.63), and healthy emotionality (Cohen’s d = 0.53 with 95%CI: 0.09 to 0.13) compared with the control group.

CONCLUSION

This study’s findings highlight the potential value of transdiagnostic internet-delivered programs for young adults with an emotional disorder during the COVID-19 pandemic, and expand the research examining emotional well-being improvements resulting from CBT-transdiagnostic interventions. The findings suggest that UP, which generally concentrates on reducing negative effects, can increase positive effects.

Emotion regulation and the late positive potential (LPP) in older adults

Emotion regulation (ER) processes in older adults may be important for successful aging. Neural correlates of ER processes have been examined using event-related brain potentials (ERPs), such as the late-positive potential (LPP) during cognitive reappraisal paradigms. The current study sought to extend this research by examining the LPP from an ER task in a sample of 47 community-dwelling older adults between the ages of 60 and 84 years, scoring either high on emotional well-being (as measured by habitual ER use and resiliency; high WB group, n = 20) or low on emotional well-being (as measured by habitual ER use, resiliency, and depression; low WB group, n = 27). Participants viewed unpleasant and neutral images and were instructed to simply react to the images or reappraise their emotional response. Both pre- and post-instruction LPP amplitudes were scored, in addition to self-reported ratings of negative emotion collected during the task. We found greater LPP amplitude to emotionally salient compared to neutral stimuli, reduced LPP amplitude following instructions to reappraise emotional response to stimuli across groups, and a blunted LPP overall for individuals with higher depressive symptoms. Additionally, we demonstrated that older adults with low emotional well-being were less successful at reappraisal according to self-reported ratings of negative emotion, although this was not reflected in the LPP. Collectively, these data suggest that laboratory-based ER tasks might be used to understand abnormal ER use-though the LPP may be more sensitive to depression than individual differences in ER ability.

Neural correlates of emotional reactivity predict response to cognitive-behavioral therapy in obsessive-compulsive disorder

BACKGROUND

Examining predictive biomarkers to identify individuals who will likely benefit from a specific treatment is important for the development of targeted interventions. The late positive potential (LPP) is a neural marker of attention and elaborated stimulus processing, and increased LPP responses to negative stimuli are characteristic of pathological anxiety. The present study investigated whether LPP reactivity would prospectively predict response to cognitive-behavioral therapy (CBT), the first-line treatment for obsessive-compulsive disorder (OCD).

METHODS

To this end, the LPP in response to negative as compared to neutral pictures was examined in 45 patients with OCD, who underwent CBT in a naturalistic outpatient setting. LPP amplitudes were used as predictors of symptom reduction after CBT.

RESULTS

We found that higher LPP amplitudes to negative relative to neutral stimuli were predictive of lower self-reported OCD symptoms after completion of CBT, controlling for pre-treatment symptoms. Further, LPP reactivity was negatively correlated with self-reported habitual use of suppression in everyday life.

LIMITATIONS

Some participants had already begun treatment at the time of study participation. Overall, results need further replication in larger samples and standardized therapy settings.

CONCLUSIONS

The current findings suggest that patients with increased emotional reactivity benefit more from CBT, possibly through less avoidance of anxiety-provoking stimuli during exposure with response prevention, a crucial component in CBT for OCD. Although its clinical utility still needs to be evaluated further, the LPP constitutes a promising candidate as a prognostic marker for CBT response in OCD.

Evaluating the Modulation of the Acoustic Startle Reflex in Children and Adolescents via Vertical EOG and EEG: Sex, Age, and Behavioral Effects

Acoustic startle reflex (ASR) constitutes a reliable, cross-species indicator of sensorimotor and inhibitory mechanisms, showing distinct signature in cognitive aging, sex, and psychopathological characterization. ASR can be modulated by the prepulse inhibition (PPI) paradigm, which comprises the suppression of reactivity to a startling stimulus (pulse) following a weak prepulse (30- to 500-ms time difference), being widely linked to inhibitory capabilities of the sensorimotor system. If the prepulse–pulse tones are more clearly separated (500–2,000 ms), ASR amplitude is enhanced, termed as prepulse facilitation (PPF), reflecting sustained or selective attention. Our study aimed to investigate early-life sensorimotor sex/age differences using Electroencephalographic recordings to measure muscular and neural ASR in a healthy young population. Sixty-three children and adolescents aged 6.2–16.7 years (31 females) took part in the experiment. Neural ASR was assessed by two different analyses, namely, event-related potentials (ERPs) and first-derivative potentials (FDPs). As expected, PPF showed enhanced responses compared with PPI, as indicated by eyeblink, ERP and FDP measures, confirming the gating effect hypothesis. Sex-related differences were reflected in FDPs, with females showing higher ASR than males, suggesting increased levels of poststartle excitability. Intragroup age effects were evaluated via multipredictor regression models, noticing positive correlation between age versus eyeblink and ERP responses. Attention-related ERPs (N100 and P200) showed distinct patterns in PPI versus PPF, potentially indicative for alternative attentional allocation and block-out of sensory overload. Screening measures of participants’ neurodevelopmental (assessed by Wechsler Intelligence Scale for Children) and behavioral (assessed by Child Behavior Checklist) markers were also associated with increased N100/P200 responses, presumably indexing synergy between perceptual consistency, personality profiling, and inhibitory performance. Conclusively, modulation of ASR by PPI and PPF is associated with biological sex and internal/external personality traits in childhood and adolescence, potentially useful to guide symptomatology and prevention of psychopathology.

Event-related potentials to acoustic startle probes during unpredictable threat are associated with individual differences in intolerance of uncertainty

Individual differences in sensitivity to unpredictable threat may be a critical mechanism for internalizing psychopathology phenotypes. The present study examined whether the startle probe-elicited N100 and P300 during unpredictable threat - two event-related potentials indexing early and elaborative attentional processing of unpredictable threat - may be endophenotypes for internalizing psychopathology, including fear and distress/misery disorders and intolerance of uncertainty (IU), a clinical trait that is transdiagnostically associated with internalizing disorders. A large sample of adult siblings (N = 375) completed the no, predictable, and unpredictable threat task, during which the N100 and P300 were recorded. Relative to the no threat condition, N100 was more strongly enhanced in anticipation of unpredictable than predictable threat while P300 was suppressed to both predictable and unpredictable threat. While neither N100 enhancement nor P300 suppression to unpredictable threat was associated with fear or distress/misery disorders, they were negatively linked to inhibitory IU (a facet of IU). Thus, individuals high in inhibitory IU showed reduced attentional engagement with the threatening context when it was unpredictable. Further, N100 enhancement and, to a lesser degree, P300 suppression to unpredictable threat showed familial aggregation - a key criterion for determining whether a biomarker is an endophenotype. In sum, N100 enhancement and P300 suppression to unpredictable threat may be endophenotypes for dimensional measures of internalizing psychopathology.

P300 amplitude during a monetary incentive delay task predicts future therapy completion in individuals with major depressive disorder

INTRODUCTION

Treatment effectiveness for major depressive disorder (MDD) is often affected by client non-adherence, dropout, and non-response. Identification of client characteristics predicting successful treatment completion and/or response (i.e., symptom reduction) may be an important tool to increase intervention effectiveness. It is unclear whether neural attenuations in reward processing associated with MDD predict behavioral treatment outcome.

METHODS

This study aimed to determine whether blunted neural responses to reward at baseline differentiate MDD (n = 60; 41 with comorbid anxiety) and healthy control (HC; n = 40) groups; and predict MDD completion of and response to 7-10 sessions of behavior therapy. Participants completed a monetary incentive delay (MID) task. The N200, P300, contingent negative variation (CNV) event related potentials (ERPs) and behavioral responses (reaction time [RT], correct hits) were quantified and extracted for cross-sectional group analyses. ERPs and behavioral responses demonstrating group differences were then used to predict therapy completion and response within MDD.

RESULTS

MDD exhibited faster RT and smaller P300 amplitudes than HC across conditions. Within the MDD group, treatment completers (n = 37) exhibited larger P300 amplitudes than non-completers (n = 21).

LIMITATIONS

This study comprises secondary analyses of EEG data; thus task parameters are not optimized to examine feedback ERPs from the paradigm. We did not examine heterogenous presentations of MDD; however, severity and comorbidity did not influence findings.

CONCLUSIONS

Previous studies suggest that P300 is an index of motivational salience and stimulus resource allocation. In sum, individuals who deploy greater neural resources to task demands are more likely to persevere in behavioral therapy.

Development of emotion processing and regulation: Insights from event-related potentials and implications for internalizing disorders

Emotionally-salient stimuli receive selective attention and elicit complex neural responses that evolve considerably across development. Event-related potentials (ERPs) optimally capture the dynamics of emotion processing and regulation, with sensitivity to detect changes in magnitude, latency, and maximal location across development. In this selective qualitative review, we summarize evidence of developmental changes in neural reactivity to emotional stimuli and modulation of neural responses during emotion regulation indexed by ERPs across infancy, childhood, and adolescence. The cumulative ERP literature suggests the transition from childhood to adulthood is characterized by a gradual decrease in neural reactivity to emotional stimuli and increased efficiency in attentional allocation towards emotional stimuli. Some studies show sensitivity to emotional stimuli peaks in adolescence, but the evidence is mixed. While both early (<300 ms) and late (>300 ms) ERPs demonstrate sensitivity to emotional stimuli, emotional modulation is more consistently observed in relatively later ERPs across development. The literature additionally shows improvements in regulation abilities across development, though ERP research on developmental changes in emotion regulation is still relatively limited, highlighting a critical direction for future research. Finally, we briefly discuss changes in emotion-related ERPs relevant to the emergence of depression and anxiety. Findings from this review indicate that ERPs provide abundant information about the development of emotion processing and regulation, with potential clinical utility for detecting early-emerging vulnerabilities for internalizing forms of psychopathology.

Disentangling emotional processing in dysphoria: An ERP and cardiac deceleration study

The present study aimed to investigate emotional processing in dysphoria. To this end, the amplitude of the Late Positive Potential (LPP) and cardiac deceleration were assessed during the passive viewing of affective (pleasant, neutral, and unpleasant) pictures in 26 individuals with dysphoria and in 25 non-depressed controls. The group with dysphoria revealed a smaller LPP amplitude than the group without dysphoria in response to pleasant and neutral, but not unpleasant, stimuli at centro-parieto-occipital sites. Interestingly, whereas both groups showed cardiac deceleration when viewing pleasant compared to neutral pictures (3-6 s time window), only individuals with dysphoria showed a prolonged cardiac deceleration in response to unpleasant stimuli as compared with neutral ones. This study suggests that dysphoria is characterized by reduced motivated attentional allocation to positive information and by sustained intake of unpleasant information. Overall, the present findings provide novel insights into the characterization of valence-specific attentional processes in dysphoria as potential vulnerability factors for clinically significant depression.

The impact of a single session of aerobic exercise on positive emotional reactivity in depression: Insight into individual differences from the late positive potential

Depression has been characterized by a broad disengagement from the environment, as reflected by dampened positive and negative emotional reactivity. Research has shown that acute exercise may enhance positive emotional reactivity in healthy adults. It is unknown whether it can alter positive emotional reactivity in depression. In the present study, positive emotional reactivity was assessed using the late positive potential (LPP) event-related potential before and after 30 min of moderate-intensity aerobic exercise in 43 adults with current or a lifetime history of depression (Mage = 32.74 years; Min/Max = 18/59) and 18 never-depressed healthy adults (Mage = 37.94 years; Min/Max = 21/61). Acute exercise increased the LPP for healthy adults; the LPP did not change among those with current or a lifetime history of depression. A secondary aim was to identify moderators of change in positive emotional reactivity among subgroups of adults with current depression. Compared to adults with impaired mood reactivity, those with intact mood reactivity had a pre-to-post increase in the LPP. The current study provides preliminary support for the LPP as a neural indicator of exercise efficacy and highlights individual differences in response to acute exercise in depression.

Psychometric Validation of the Indonesian Version of the Fear of COVID-19 Scale: Personality Traits Predict the Fear of COVID-19

The coronavirus disease-2019 (COVID-19) pandemic is a global health crisis that has generated fear and negative psychological consequences. The present study evaluated the validity and factor structure of Fear of COVID-19 Scale (FCV-19S) among a sample from the general Indonesian population. The English version of the FCV-19S was translated and back-translated into Indonesian language, followed by a pilot study. Using convenience sampling method, a total of 728 participants completed an online survey distributed on various social media platforms. The survey included the FCV-19S, personality traits (neuroticism and extraversion), Positive and Negative Affect Scale (PANAS), Generalized Anxiety Disorder Scale (GAD-7), and the nine-item Patient Health Questionnaire (PHQ-9). The Indonesian FCV-19S had very good internal consistency (Cronbach's alpha and McDonald's omega) and composite reliability (alpha = 0.88, omega = .86, composite reliability = .87). Maximum likelihood confirmatory factor analysis (CFA) was conducted to test construct validity (χ 2/df = 2.51, CFI = .984, SRMR = .028, PCLOSE = .15 > .05, RMSEA = .06, 90% CI [.03, .09]). As for criterion-related validity, the FCV-19S score positively correlated with the score on PHQ-9, GAD-7, negative affect, and neuroticism and negatively correlated with extraversion. Negative affect was identified as the most important predictor of the fear of COVID-19. Personality traits also predicted the fear of COVID-19. The findings provide evidence that the FCV-19S is a reliable and valid instrument for assessing fear generated by COVID-19 among a healthy Indonesian-speaking population.

Optimal well-being in the aftermath of anxiety disorders: A 10-year longitudinal investigation

BACKGROUND

Although preliminary research has explored the possibility of optimal well-being after depression, it is unclear how rates compare to anxiety. Using Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) as exemplars of anxiety, we tested the rates of optimal well-being one decade after being diagnosed with an anxiety disorder. Based on reward deficits in depression, we pre-registered our primary hypothesis that optimal well-being would be more prevalent after anxiety than depression as well as tested two exploratory hypotheses.

METHOD

We used data from the Midlife in the United States (MIDUS) study, which contains a nationally representative sample across two waves, 10 years apart. To reach optimal well-being, participants needed to have no symptoms of GAD, PD, or major depressive disorder (MDD) at the 10 year follow-up and exceed cut-offs across nine dimensions of well-being.

RESULTS

The results failed to support our primary hypothesis. Follow-up optimal well-being rates were highest for adults previously diagnosed with MDD (8.7%), then PD (6.1%), and finally GAD (0%). Exploratory analyses revealed optimal well-being was approximately twice as prevalent in people without anxiety or depression at baseline and provided partial support for baseline well-being predicting optimal well-being after anxiety. Results were largely replicated across different classifications of optimal well-being.

LIMITATIONS

Findings are limited by the somewhat unique measurement of anxiety in the MIDUS sample as well as the relatively high rate of missing data.

CONCLUSIONS

We discuss possible explanations for less prevalent optimal well-being after anxiety vs. depression and the long-term positivity deficits from GAD.

Neural mechanisms and predictors of SSRI and CBT treatment of anxiety: A randomized trial focused on emotion and cognitive processing

Anxiety disorders (ADs) are common and difficult to treat. While research suggests ADs are characterized by an imbalance between bottom-up and top-down attention processes and that effective treatments work by correcting this dysfunction, there is insufficient data to explain how and for whom treatments work. The late positive potential (LPP), an event-related potential reflecting elaborative processing of motivationally salient stimuli, is sensitive to both bottom-up and top-down processes. The present study examines the LPP in healthy controls (HC) and patients with ADs under low and high working memory (WM) load to assess its utility as a predictor and index of symptom reduction in patients who underwent cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The LPP when viewing negative and neutral distractor images and WM performance were assessed in 96 participants (40 HC, 32 CBT, 24 SSRI) during a letter recall task at Week 0 and in a subset of the study sample (23 CBT, 16 SSRI) at Week 12. Patients were randomly assigned to twelve weeks of CBT or SSRI treatment. Participants completed self-reported symptom measures at each time point. Greater Week 0 LPP to negative images under low WM load predicted greater symptom reduction in the SSRI, but not the CBT, group. Regression analyses examining the LPP to negative images as an index of symptom reduction revealed a smaller decrease in the LPP to negative images under low WM load was associated with less anxiety reduction across treatment modalities. Findings suggest the LPP during low WM load may serve as a cost-effective predictor and index of treatment outcome in ADs. Clinical Trials Registration: ClinicalTrials.gov (Identifier: NCT01903447).

The emotion-elicited late positive potential is stable across five testing sessions

Many studies have examined associations between neural and behavioral markers of attention to emotion and individual differences in affective functioning. However, the majority of these studies are cross-sectional, and examine associations between brain, behavior, and individual differences at one or two time-points, limiting our understanding of the extent to which these neural responses reflect trait-like patterns of attention. The present study used the Emotional Interrupt paradigm, and examined the stability and trajectory of behavioral (i.e., reaction time to targets following task-irrelevant appetitive, neutral, and aversive images), and neural responses to images (i.e., the late positive potential or LPP), across five sessions separated by one week in 86 individuals. Additionally, we examined the extent to which the LPP and behavioral measures were sensitive to naturally occurring daily fluctuations in positive and negative affect. Results indicate that, though the magnitude of the conditional LPP waveforms decreased over time, the degree of emotional modulation (i.e., differentiation of emotional from neutral) did not; in fact, differentiation of appetitive from neutral increased over time. Behavioral responses were similarly stable across sessions. Additionally, we largely did not observe significant effects of state positive and negative affect on the LPP or behavior over time. Finally, the LPP elicited by appetitive images significantly predicted reaction time to targets following these images. These data suggest that neural and behavioral markers of attention to motivationally salient cues may be trait-like in nature, and may be helpful in future studies seeking to identify markers of vulnerability for diverse forms of psychopathology.

Neurophysiological Responses to Interpersonal Emotional Images: Associations with Symptoms of Depression and Social Anxiety

Affective neuroscience research using electrocortical event-related potentials has provided valuable insights on alterations in emotion processing in internalizing disorders. However, internalizing disorders are accompanied by additional impairments in social cognition and functioning, and most extant research examines neural responses to broad categories of emotional scenes or faces presented irrespective of context. Examining neural reactivity specifically to interpersonal emotional scenes may more precisely capture and disentangle processes involved in depression and social anxiety, two highly comorbid forms of psychopathology. The current study validated a novel set of positive and threatening interpersonal emotional stimuli in a sample of emerging adults (N = 114) who completed a modified emotional interrupt paradigm while electroencephalogram and behavioral data were recorded. Participant ratings of valence and arousal supported the validity of the emotional images. Consistent with prior research, sustained neurophysiological processing indexed by the late positive potential (LPP) was observed for interpersonal emotional images, especially positive, compared with neutral images. Elevated LPP reactivity to both positive and threatening interpersonal images moderated the effects of chronic interpersonal stress on social anxiety symptoms, such that enhanced LPP reactivity in conjunction with higher levels of chronic interpersonal stress was associated with elevated social anxiety symptoms. These results were unique to social anxiety symptoms and not symptoms of depression, suggesting sustained neural processing of interpersonal stimuli may differentiate social anxiety from depression. Future research on emotional reactivity specifically within the interpersonal domain is needed to inform our understanding of developmental pathways to internalizing psychopathology.

Comorbid anxiety and depression: Opposing effects on the electrocortical processing of negative imagery in a focal fear sample

BACKGROUND

Anxiety and depression are highly comorbid and share clinical characteristics, such as high levels of negative emotion. Attention toward negative stimuli in anxiety and depression has been studied primarily using negative pictures. Yet, negative mental imagery-that is, mental representations of imagined negative events or stimuli-might more closely mirror patient experience.

METHODS

The current study presents the first examination of neural response to negative imagery in 57 adults (39 female) who all shared a common "focal fear" diagnosis (i.e., specific phobia or performance-only social anxiety disorder), but varied in levels of comorbid anxiety and depression. After listening to standardized descriptions of negative and neutral scenes, participants imagined these scenes as vividly as possible. Associations between categorical and continuous measures of depression, generalized anxiety disorder (GAD), and social anxiety disorder with electrocortical and subjective responses to negative imagery were assessed.

RESULTS

Individuals who were more depressed showed reduced electrocortical processing of negative imagery, whereas those with GAD showed increased electrocortical processing of negative imagery-but only when controlling for depression. Furthermore, participants with higher levels of depression rated negative imagery as less negative and those with greater social anxiety symptoms rated negative imagery more negatively.

CONCLUSIONS

Depression and GAD are characterized by opposing electrocortical response to negative imagery; moreover, depression may suppress GAD-related increases in the electrocortical processing of negative imagery. Results highlight distinctions between different dimensions of distress-based psychopathology, and reveal the unique and complex contribution of comorbid depression to affective response in anxiety.

Reduced neural response to reward and pleasant pictures independently relate to depression

BACKGROUND

Multiple studies have found a reduced reward positivity (RewP) among individuals with major depressive disorder (MDD). Event-related potential studies have also reported blunted neural responses to pleasant pictures in MDD as reflected by the late positive potential (LPP). These deficits have been interpreted broadly in terms of anhedonia and decreased emotional engagement characteristic of depression.

METHODS

In the current study, a community-based sample of 83 participants with current MDD and 45 healthy individuals performed both a guessing task and a picture viewing paradigm with neutral and pleasant pictures to assess the RewP and the LPP, respectively.

RESULTS

We found that both RewP and LPP to pleasant pictures were reduced in the MDD group; moreover, RewP and LPP were both independent predictors of MDD status. Within the MDD group, a smaller RewP predicted impaired mood reactivity in younger but not older participants. Smaller LPP amplitudes were associated with increased anhedonia severity in the MDD group.

CONCLUSIONS

These data replicate and merge separate previous lines of research, and suggest that a blunted RewP and LPP reflect independent neural deficits in MDD - which could be used in conjunction to improve the classification of depression.

"She finds you abhorrent" - The impact of emotional context information on the cortical processing of neutral faces in depression

Depression is associated with abnormalities in patterns of information processing, particularly in the context of processing of interpersonal information. The present study was designed to investigate the differences in depressive individuals in cortical processing of facial stimuli when neutral faces were presented in a context that involved information about emotional valence as well as self-reference. In 21 depressive patients and 20 healthy controls, event-related potentials (ERPs) were recorded during the presentation of neutral facial expressions, which were accompanied by affective context information that was either self- or other-related. Across conditions, depressive patients showed larger mean P100 amplitudes than healthy controls. Furthermore, mean late positive potential (LPP) amplitudes of depressive patients were larger in response to faces in self-related than in other-related context. In addition, irrespective of self-reference, mean LPP responses of depressive patients to faces presented after socially threatening sentences were larger compared with faces presented after neutral sentences. Results regarding self-reference supported results of previous studies indicating larger mean amplitudes in self-related conditions. Findings suggest a general heightened initial responsiveness to emotional cues and a sustained emotion processing of socially threatening information in depressive patients.

Neurophysiological Responses to Interpersonal Emotional Images Prospectively Predict the Impact of COVID-19 Pandemic-Related Stress on Internalizing Symptoms

BACKGROUND

Exposure to stressful events related to the COVID-19 coronavirus pandemic has been associated with increases in the prevalence of depression and anxiety, raising questions about vulnerabilities that make some individuals more susceptible to internalizing symptoms following stress exposure.

METHODS

This prospective study examined the effects of neurophysiological reactivity to positive and threatening interpersonal stimuli, indexed by the late positive potential (LPP) event-related potential, in conjunction with exposure to interpersonal pandemic-related stressors in the prediction of internalizing symptom changes from before to during the pandemic. Emerging adults (n= 75) initially completed measures of internalizing symptoms and an interpersonal emotional images task while an electroencephalogram was recorded pre-pandemic and were recontacted during the COVID-19 pandemic in May 2020 to complete measures of exposure to pandemic-related stressful events and current internalizing symptoms.

RESULTS

Results indicated that emerging adults experienced numerous stressful events associated with the pandemic, as well as overall increases in symptoms of depression and traumatic intrusions during the pandemic. Furthermore, significant interactions between LPP reactivity to positive and threatening interpersonal stimuli and interpersonal stress exposure emerged in the prediction of internalizing symptoms, controlling for baseline symptoms. Under high exposure to interpersonal stressors, reduced positive LPPs predicted increases in depressive symptoms while enhanced threatening LPPs predicted increases in traumatic intrusions.

CONCLUSIONS

These findings highlight the mental health impacts of the COVID-19 pandemic on emerging adults, and the role of individual differences in neurophysiological reactivity to emotional stimuli in vulnerability for depression and traumatic intrusions following stress exposure.

Dissociating disorders of depression, anxiety, and their comorbidity with measures of emotional processing: A joint analysis of visual brain potentials and auditory perceptual asymmetries

In a multigenerational study of families at risk for depression, individuals with a lifetime history of depression had: 1) abnormal perceptual asymmetry (PA; smaller left ear/right hemisphere [RH] advantage) in a dichotic emotion recognition task, and 2) reduced RH late positive potential (P3_RH) during an emotional hemifield task. We used standardized difference scores for processing auditory (PA sad-neutral) and visual (P3_RH negative-neutral) stimuli for 112 participants (52 men) in a logistic regression to predict history of depression, anxiety or comorbidity of both. Whereas comorbidity was separately predicted by reduced PA (OR = 0.527, p = .042) or P3_RH (OR = 0.457, p = .013) alone, an interaction between PA and P3_RH (OR = 2.499, p = .011) predicted depressive disorder. Follow-up analyses revealed increased probability of depression at low (lack of emotional differentiation) and high (heightened reactivity to negative stimuli) levels of both predictors. Findings suggest that reduced or heightened right-lateralized emotional responsivity to negative stimuli may be uniquely associated with depression.

Crossmodal Audiovisual Emotional Integration in Depression: An Event-Related Potential Study

Depression is related to the defect of emotion processing, and people's emotional processing is crossmodal. This article aims to investigate whether there is a difference in audiovisual emotional integration between the depression group and the normal group using a high-resolution event-related potential (ERP) technique. We designed a visual and/or auditory detection task. The behavioral results showed that the responses to bimodal audiovisual stimuli were faster than those to unimodal auditory or visual stimuli, indicating that crossmodal integration of emotional information occurred in both the depression and normal groups. The ERP results showed that the N2 amplitude induced by sadness was significantly higher than that induced by happiness. The participants in the depression group showed larger amplitudes of N1 and P2, and the average amplitude of LPP evoked in the frontocentral lobe in the depression group was significantly lower than that in the normal group. The results indicated that there are different audiovisual emotional processing mechanisms between depressed and non-depressed college students.

Transdiagnostic treatment of emotional disorders in people with multiple sclerosis: randomized controlled trial

BACKGROUND

Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. MS is significantly associated with a high rate of psychological, behavioral, and emotional consequences. Despite the frequent mental disorders, high rate of psychological comorbidities, and emotional problems in people with MS (PwMS), these conditions are often underdiagnosed and undertreated. This study aimed to examine the efficacy of a group format of the unified protocol for the transdiagnostic treatment of emotional disorders in adult PwMS associated with an emotional disorder.

METHODS

Seventy adult PwMS were randomized using an internet-based computer system to either the unified protocol (n = 35) or treatment as usual condition. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional dysregulation, and affectivity.

RESULTS

The parametric test of analysis of covariance, followed the intent to treat analyses, revealed the unified protocol significantly changed depression symptoms (Cohen's d = 1.9), anxiety symptoms (Cohen's d = 2.16), worry symptoms (Cohen's d = 1.27), emotion dysregulation (Cohen's d = 0.44), positive affect (Cohen's d = 1.51), and negative affect (Cohen's d = 1.89) compared with the control group. The unified protocol also significantly improved outcome scores at the end of treatment relative to baseline (p < .001).

CONCLUSION

The findings support that the unified protocol could be an additional efficient psychological treatment for PwMS. Trial registration IRCT, number: IRCT20190711044173N1. Registered 31october 2019, https://en.irct.ir/user/trial/40779/view .

Transdiagnostic treatment of emotional disorders for women with multiple sclerosis: a randomized controlled trial

BACKGROUND

Multiple sclerosis (MS) is a chronic, unpredictable, neurodegenerative disease, significantly associated with psychological, behavioral, cognitive, and emotional consequences. MS is more common in females than males and frequently affects women during their reproductive years. Despite the frequent mental disorders, comorbidities, and emotional problems in People with MS (PwMS), these conditions are too often underdiagnosed and undertreated.

OBJECTIVE

This study aimed to examine the efficacy of a group format of the Unified Protocol (UP) for the Transdiagnostic treatment of depression and anxiety disorders in females with MS.

METHODS

In the present study, Sixty-four adult females diagnosed with MS were randomized to either the UP (n = 32) or treatment-as-usual conditions. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional regulation, and affectivity.

RESULTS

Repeated measure analysis of variance (ANOVA) revealed that the UP significantly improved depression scores [Cohen's d = - 2.11, 95% CI (- 2.72, - 1.50)], anxiety scores [Cohen's d = - 3.34, 95% CI (- 4.01, - 2.58)], positive and negative affect scale (PANAS)-positive affect scores [Cohen's d = 1.46, 95% CI (1.46, 2.01)], PANAS-negative affect scores [Coen's d = - 2.21, 95% CI (- 2.84, - 1.60)], difficulties emotion regulation scale scores [Cohen's d = 1.40, 95% CI (- 0.87, - 0.03)], and Worry scale scores [Cohen's d = - 0.45, 95% CI (- 0.95, - 0.04)] at the end of treatment relative to compared to the control condition. Also, treatment gains were maintained at the three-month follow-up (p < 0.001).

CONCLUSION

The findings provide the support that the UP could be an additional efficient psychological treatment for females with MS. ISRCTN Number: ISRCTN95459505.

Transdiagnostic treatment of emotional disorders in people with multiple sclerosis: randomized controlled trial

Background

Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. MS is significantly associated with a high rate of psychological, behavioral, and emotional consequences. Despite the frequent mental disorders, high rate of psychological comorbidities, and emotional problems in people with MS (PwMS), these conditions are often underdiagnosed and undertreated. This study aimed to examine the efficacy of a group format of the unified protocol for the transdiagnostic treatment of emotional disorders in adult PwMS associated with an emotional disorder.

Methods

Seventy adult PwMS were randomized using an internet-based computer system to either the unified protocol (n = 35) or treatment as usual condition. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional dysregulation, and affectivity.

Results

The parametric test of analysis of covariance, followed the intent to treat analyses, revealed the unified protocol significantly changed depression symptoms (Cohen’s d = 1.9), anxiety symptoms (Cohen’s d = 2.16), worry symptoms (Cohen’s d = 1.27), emotion dysregulation (Cohen’s d = 0.44), positive affect (Cohen’s d = 1.51), and negative affect (Cohen’s d = 1.89) compared with the control group. The unified protocol also significantly improved outcome scores at the end of treatment relative to baseline (p < .001).

Conclusion

The findings support that the unified protocol could be an additional efficient psychological treatment for PwMS.

Trial registration IRCT, number: IRCT20190711044173N1. Registered 31october 2019, https://en.irct.ir/user/trial/40779/view.

Abnormalities of the late positive potential during emotional processing in individuals with psychopathic traits: a meta-analysis

BACKGROUND

Individuals with psychopathic traits display deficits in emotional processing. A key event-related potential component involved in emotional processing is the late positive potential (LPP). In healthy controls, LPP amplitude is greater in response to negative stimuli than to positive or neutral stimuli. In the current study, we aimed to compare LPP amplitudes between individuals with psychopathic traits and control subjects when presented with negative, positive or neutral stimuli. We hypothesized that LPP amplitude evoked by emotional stimuli would be reduced in individuals with psychopathic traits compared to healthy controls.

METHODS

After a systematic review of the literature, we conducted a meta-analysis to compare LPP amplitude elicited by emotional stimuli in individuals with psychopathic traits and healthy controls.

RESULTS

Individuals with psychopathic traits showed significantly reduced LPP amplitude evoked by negative stimuli (mean effect size = -0.47; 95% CI -0.60 to -0.33; p < 0.005) compared to healthy controls. No significant differences between groups were observed for the processing of positive (mean effect size = -0.15; 95% CI -0.42 to 0.12; p = 0.28) and neutral stimuli (mean effect size = -0.12; 95% CI 0.31 to 0.07; p = 0.21).

CONCLUSIONS

Measured by LPP amplitude, individuals with psychopathic traits displayed abnormalities in the processing of emotional stimuli with negative valence whereas processing of stimuli with positive and neutral valence was unchanged as compared with healthy controls.

Divergences among Three Higher-Order Self-Report Psychopathology Factors in Normal-Range Personality and Emotional Late Positive Potential Reactivity

Personality is related to psychopathology and its higher-order structures, but there is little research regarding neurobiological associations of higher-order psychopathology factors. This study examined the factor structure of a wide range of psychopathology and its associations with both personality and emotional reactivity revealed through the late positive potential (LPP) in a sample of 275 undergraduates. A three-factor structure of psychopathology emerged comprising Internalizing (INT), Externalizing (EXT), and Aberrant Experiences (ABX). EXT predicted aggressive disconstraint, whereas both INT and ABX predicted Alienation and Stress Reaction. INT uniquely predicted low Well-Being, and ABX predicted a rigid absorption combined with interpersonal detachment. ABX correlated with reduced parietal emotional LPP reactivity, whereas INT correlated with stronger frontal LPP reactivity to emotional versus neutral pictures.