Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children

The role of children's neural responses to emotional faces in the intergenerational transmission of anxiety symptomatology

Children's neural responses to emotions may play a role in the intergenerational transmission of anxiety. In a prospective longitudinal study of a community sample of N = 464 mother-child dyads, we examined relations among maternal anxiety symptoms when children were infants and age 5 years, child neural responses to emotional faces (angry, fearful, happy) at age 3 years, and child internalizing symptoms at age 5 years. Path analyses tested whether amplitudes of event-related potential (ERP) components selected a priori (N290, Nc, P400) (a) mediated associations between maternal anxiety symptoms in infancy and child internalizing symptoms at 5 years and/or (b) moderated associations between maternal anxiety symptoms at 5 years and child internalizing symptoms at 5 years. Mediating effects were not observed for any of the ERP measures. Nc and P400 amplitudes to angry faces and Nc amplitude to happy faces moderated the effect of maternal anxiety at 5 years on child internalizing symptoms at 5 years. Effects were not related to maternal depressive symptoms. Differential sex effects were not observed. The findings suggest that larger neural responses to emotional faces may represent a biological risk factor that amplifies vulnerability to the development of internalizing symptomatology in young children exposed to maternal anxiety.

Emotional reactivity and past self-injurious behavior moderate the association between trauma exposure and fearlessness about death

INTRODUCTION

As suicide remains a global public health concern, recent work has sought to characterize mechanisms underlying the transition from suicidal ideation to action. Acquired capability for suicide, or fearlessness about death, has been identified as one key factor underlying this transition; however, understanding how this capability emerges remains limited. This study sought to extend previous work on the correlates of fearlessness about death by examining its relationship with painful and provocative events and emotional reactivity.

METHODS

We tested the extent to which trait emotional reactivity and past self-injurious behavior moderated the relationship between assaultive trauma exposure and fearlessness about death in a diverse sample of 273 community adults (aged 18-55, M/SD = 32.77/10.78).

RESULTS

A three-way interaction emerged, such that among individuals with heightened emotional reactivity and a history of self-injurious behavior (suicide attempt or non-suicidal self-injury), assaultive trauma was associated with increased fearlessness about death. In contrast, among adults with low emotional reactivity and a history of self-injurious behavior, assaultive trauma was associated with reduced fearlessness about death.

CONCLUSIONS

Results suggest that emotional reactivity may be a key dispositional factor that influences how trauma exposure and self-injurious behavior impact fearlessness about death.

Interpersonal Trauma Effects on Adolescent Depression: The Moderating Role of Neurophysiological Responses to Positive Interpersonal Images

Trauma exposure is associated with a heightened risk for depression and such risk is thought to vary based on the type of traumatic events (e.g., interpersonal, including abuse and domestic violence, or non-interpersonal, including accidents or natural disasters). Depression is often accompanied by altered emotional reactivity, and the late positive potential (LPP) serves as a reliable neurophysiological measure of sustained attention towards emotional stimuli, raising questions regarding the role of the LPP in moderating trauma effects on depression. We conducted a cross-sectional study of 201 adolescents aged 14-17 years (61.2% female) who were oversampled for current depression and elevated risk of depression based on maternal history. Clinical interviews were conducted to assess diagnoses and lifetime trauma exposure, and participants reported on current depressive symptoms. Electroencephalogram (EEG) was continuously recorded while participants completed a previously validated interpersonal emotional images task. Cumulative trauma (CT) and interpersonal trauma (IPT) were both associated with greater depressive symptoms, but non-interpersonal trauma (NIPT) was not significantly related to depressive symptoms. The association between IPT and depressive symptoms was moderated by the LPP to positive interpersonal images, such that IPT-exposed adolescents with blunted neural responses to such images showed the greatest symptoms. This result was specific to IPT, and the LPP to threatening interpersonal images did not significantly moderate the effects of IPT on depressive symptoms. These findings highlight the unique effects of interpersonal trauma on depressive symptoms and elucidate a potential vulnerability linking trauma exposure to depression risk among adolescents.

The P300, the LPP, context updating, and memory: What is the functional significance of the emotion-related late positive potential?

The emotion-related late positive potential (LPP) of the event-related potential (ERP) has been the topic of many studies over the previous two decades, but the function of this component (the cognitive process that it reflects) is very much an open question. In this paper, I build on frameworks that suggest a close relationship between the LPP and the P300 component of the ERP to argue that the classic context updating account of the P300 may provide insights into the function of the LPP. I then review broader connections between the LPP and memory, and I connect the LPP to research and theory in the area of emotional memory. I argue that while a relationship between the LPP and attention has been widely noted in the literature, connections to memory have been overlooked and that a memory-related process should be considered as one candidate for the function of the LPP.

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.

Caregivers' positive emotion socialization tendencies are associated with positive affect in preschool age children

Longstanding theories of emotion socialization postulate that caregiver emotional and behavioral reactions to a child's emotions together shape the child's emotion displays over time. Despite the notable importance of positive valence system function, the majority of research on caregiver emotion socialization focuses on negative valence system emotions. In the current project, we leveraged a relatively large cross-sectional study of caregivers (N = 234; 93.59% White) of preschool aged children to investigate whether and to what degree, caregiver (1) emotional experiences, or (2) external behaviors, in the context of preschoolers' positive emotion displays in caregiver-child interactions, are associated with children's general positive affect tendencies. Results indicated that, in the context of everyday caregiver-child interactions, caregiver-reported positively valenced emotions but not approach behaviors were positively associated with child general positive affect tendencies. However, when examining specific caregiver behaviors in response to everyday child positive emotion displays, caregiver report of narrating the child's emotion and joining in the emotion with their child was positively associated with child general positive affect tendencies. Together, these results suggest that in everyday caregiver-child interactions, caregivers' emotional experiences and attunement with the child play a role in shaping preschoolers' overall tendencies toward positive affect.

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.

Impact of a mindfulness-based school curriculum on emotion processing in Vietnamese pre-adolescents: An event-related potentials study

The neurocognitive mechanisms associated with mindfulness training in children are not well understood. This randomised controlled study with active and passive control groups examined the impact of an 18-week mindfulness curriculum delivered by schoolteachers on emotion processing in Vietnamese 7- to 11-year-olds. Event-related potential markers indexed emotion processing while children were completing emotional Go/No-Go tasks before and after mindfulness training, and at 6-month follow-up. In an oddball Go/No-Go task with Caucasian faces no changes in P3b and LPP components were detected, but in a Go/No-Go task with Caucasian and Japanese faces changes were observed in P3b latencies and LPP mean amplitudes. Specifically, the P3b in response to angry non-targets for Japanese faces peaked later in the mindfulness training group (TG) at 6-months follow-up in comparison to the non-intervention control group (NCG). The LPP mean amplitudes for averaged Caucasian and Japanese angry non-targets were also attenuated in the TG at 6-month follow-up. In contrast, no changes in the LPP mean amplitudes were observed for the NCG over time. Together, these findings may indicate that mindfulness training in pre-adolescents enhances emotional non-reactivity to negative distractors. A fluctuating pattern of LPP mean amplitude modulations for angry targets was observed in the active control group (ACG) receiving social-emotional learning (SEL) training. Overall, findings from this study suggest that mindfulness training in pre-adolescents enhances emotional non-reactivity to negative distractors and some of the effects are culturally sensitive.

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.

Neural markers of emotion regulation difficulties moderate effects of COVID-19 stressors on adolescent depression

BACKGROUND

Stressful events, such as those imposed by the COVID-19 pandemic, are associated with depression risk, raising questions about processes that make some people more susceptible to the effects of stress on mental health than others. Emotion regulation may be a key process, but methods for objectively measuring emotion regulation abilities in youth are limited. We leveraged event-related potential (ERP) measures and a longitudinal study of adolescents oversampled for depression and depression risk to examine emotion regulation difficulties as prospective predictors of depressive symptoms in response to pandemic-related stress.

METHODS

Before the pandemic, adolescents with (n = 28) and without (n = 34) clinical depression (N = 62 total) completed an explicit emotion regulation task while ERP data were recorded and measures of depressive symptoms. Adolescents were re-contacted during the pandemic to report on COVID-19 related stressful events and depressive symptoms (n = 48).

RESULTS

Adolescents who had never experienced a depressive episode showed an increase in depressive symptoms during the pandemic, but adolescents who were clinically depressed before the pandemic did not exhibit significant changes in symptoms. Neural markers of emotion regulation abilities interacted with pandemic-related stressful events to predict depressive symptoms during the pandemic, such that stressors predicted increases in depressive symptoms only for adolescents with greater difficulty modulating responses to negative images before the pandemic.

CONCLUSIONS

Results provide insight into adolescent mental health during the COVID-19 pandemic and highlight the role of emotion regulatory brain function in risk and resilience for depression.

Climate change impacts on the mental health and wellbeing of young people: A scoping review of risk and protective factors

BACKGROUND/RATIONALE

The impact of climate change on the mental health of young people is poorly understood. Emerging evidence suggests that exposure to climate change exerts a disproportionate mental health burden on young people. An understanding of the risk factors (RFs) and protective factors (PFs) that affect the likelihood of mental health impacts arising from exposure to climate change is required to support youth wellbeing.

AIMS/OBJECTIVES

This review scopes the current research on what and how RFs and PFs are related to the mental health impacts of both direct and indirect exposure to climate change for young people. RFs and PFs were reviewed through the lens of ecological system theory.

METHODS

We conducted systematic searches in four databases: PubMed, PsycInfo, Web of Science, and Scopus. Grey literature searches were conducted in ProQuest Dissertations, GreyLit.org, OpenGrey, and relevant organisations' websites. We included 92 empirical studies focused on the RFs and PFs of the mental wellbeing under the impact of climate change of young people (0-24). We extracted data on study characteristics, type of climate change event, mental health outcomes, RFs and PFs, and associated ecological system level.

RESULTS

The current evidence base focuses predominantly on young people's experience of PTSD (k = 59), depression (k = 26), or anxiety (k = 17) mainly following exposure to singular climate change-related natural disaster events. Only four studies explored the impacts of climate change in general. Majority of the studies investigated RFs and PFs at the individual level and at the micro-system level.

CONCLUSIONS

Several RFs and PFs were identified, such as coping strategies, family factors (e.g. parenting style), social support, community connection, and cultural identity. Positioning the mental health impacts of singular events within the broader context of ongoing and escalating climate change impacts will better inform the development of interventions that seek to build resilience among young people.

Emotional processing prospectively modulates the impact of anxiety on COVID-19 pandemic-related post-traumatic stress symptoms: an ERP study

BACKGROUND

Considering that the elevated distress caused by the COVID-19 pandemic, in some cases, led to post-traumatic stress symptoms (PTSS), it has been proposed as a specific traumatic event. The present longitudinal study investigated pre-pandemic motivated attention to emotional stimuli, as indexed by Late Positive Potential (LPP) amplitude, in relation with the potential differential role of anxiety and depressive symptoms in predicting PTSS severity related to the COVID-19 pandemic.

METHODS

A total of 79 university students initially completed self-report measures of depression and anxiety along with a passive viewing task of emotional (pleasant, unpleasant) and neutral pictures while electroencephaloghic activity was recorded. In December 2020, 57 participants completed a questionnaire assessing PTSS.

RESULTS

Significant interactions between anxiety and LPP emerged in predicting pandemic-related PTSS, where greater anxiety symptoms predicted PTSS only in individuals with greater LPP to unpleasant or with reduced LPP to pleasant stimuli.

LIMITATIONS

The prevalence of the female sex, the relatively young age of the participants, as well as the fact that they were all enrolled in a University course might not allow the generalization of the findings.

CONCLUSIONS

Taken together, the present longitudinal study provided novel evidence on EEG predictors of pandemic-related PTSS that might be useful for the prevention and treatment of PTSS. Indeed, assessing anxiety symptoms and pre-trauma LPP to emotional stimuli might be a useful target for identifying individuals that are more vulnerable to the development of PTSS during times of crisis.

Neural vulnerability and hurricane-related media are associated with post-traumatic stress in youth

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm's way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue using data from nearly 400 9- to 11-year-old children collected before and after Hurricane Irma, evaluating whether pre-existing neural patterns moderate associations between hurricane experiences and later PTS. The 'dose' of both self-reported objective exposure and media exposure predicted PTS, the latter even among children far from the hurricane. Furthermore, neural responses in brain regions associated with anxiety and stress conferred particular vulnerability. For example, heightened amygdala reactivity to fearful stimuli moderated the association between self-reported media exposure and PTS. Collectively, these findings show that for some youth with measurable vulnerability, consuming extensive disaster-related media may offer an alternative pathway to disaster exposure that transcends geography and objective risk.

The interplay among interparental conflict, children's emotional insecurity, neurophysiological correlates of processing interparental conflict cues, and externalizing symptoms

Exposure to destructive interparental conflict consistently predicts children's externalizing symptoms. Research has identified children's emotional security as an explanatory mechanism underpinning this association, but little is known about the role of children's neurophysiology in this pathway. We aimed to address that gap using event-related potential (ERP) data from a sample of 86 children, ages 9-11 years. The P3 ERP was measured during an emotion categorization task involving photographs of a couple exhibiting facial expressions of emotion toward one another. Angry images were target stimuli, and happy and neutral images were nontarget stimuli. Children reported interparental conflict, and their mothers reported children's emotional security. Mothers also reported children's externalizing symptoms at two time points 1 year apart. Results indicated elevated interparental conflict predicted more behavioral dysregulation (an aspect of emotional insecurity), which predicted a smaller P3 on angry trials, which, in turn, predicted greater externalizing symptoms 1 year later, controlling for initial externalizing. Greater involvement in interparental conflict, another aspect of emotional insecurity, predicted a larger P3 on neutral trials. Further, both greater involvement and a larger P3 on happy trials predicted increases in externalizing. The results suggest differing associations between different elements of emotional insecurity and the P3.

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.

Mother Nature's Fury: Antagonist Metaphors for Natural Disasters Increase Forecasts of Their Severity and Encourage Evacuation

Natural disasters are often described as having antagonistic qualities (e.g., wildfires ravage). The information deficit model presumes that when people assess the risk of weather hazards, they ignore irrelevant metaphoric descriptors. However, metaphoric frames affect reasoning. The current research assessed whether antagonist metaphors for natural disasters affect perceptions of the risk they pose. Three studies (N = 1,936) demonstrated that participants forecasted an antagonist-framed natural hazard as being more severe, and intended to evacuate more often, than a literal-framed natural hazard. Thus, the metaphorical language used to discuss natural disasters deserves consideration in the development of effective risk communication.

The Relationship Between Childhood Emotional Abuse and Processing of Emotional Facial Expressions in Healthy Young Men: Event-Related Potential and Behavioral Evidence

Background: Individuals exposed to childhood maltreatment present with a deficiency in emotional processing in later life. Most studies have focused mainly on childhood physical or sexual abuse; however, childhood emotional abuse, a core issue underlying different forms of childhood maltreatment, has received relatively little attention. The current study explored whether childhood emotional abuse is related to the impaired processing of emotional facial expressions in healthy young men. Methods: The emotional facial processing was investigated in a classical gender discrimination task while the event-related potentials (ERPs) data were collected. Childhood emotional abuse was assessed by a Childhood Trauma Questionnaire (CTQ) among 60 healthy young men. The relationship between the score of emotional abuse and the behavioral and the ERP index of emotional facial expression (angry, disgust, and happy) were explored. Results: Participants with a higher score of childhood emotional abuse responded faster on the behavioral level and had a smaller P2 amplitude on the neural level when processing disgust faces compared to neutral faces. Discussion: Individuals with a higher level of childhood emotional abuse may quickly identify negative faces with less cognitive resources consumed, suggesting altered processing of emotional facial expressions in young men with a higher level of childhood emotional abuse.

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.

Protective Predictors Associated With Posttraumatic Stress and Psychological Distress in Chinese Nurses During the Outbreak of COVID-19

Background: The novel coronavirus disease 2019 (COVID-19) posed an unprecedented threat to Chinese healthcare professionals. Nevertheless, few studies notably focused on the mental health conditions of nurses and explored protective factors to prevent posttraumatic stress and psychological distress. This study aimed to explore the prevalence and the predictive factors especially defensive predictors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic.

Methods: In this online study, 1,728 nurses (~77.5% came from the COVID-19 pandemic frontline) were included in the final analysis. Posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5) and Self-Reporting Questionnaire (SRQ) was used to assess posttraumatic stress and psychological distress.

Results: The results demonstrated that the prevalence of posttraumatic stress and psychological distress in nurses throughout China between February 1, 2020 and February 13, 2020 was 39.12 and 24.36%, respectively. Multivariate logistic regression indicated that insomnia, high panic intensity, and high impact of the COVID-19 pandemic were risk predictors of posttraumatic stress and psychological distress in nurses. Married participants had a 1.58 times increased risk of having posttraumatic stress when compared with the single participants. Frontline medical staff were more likely to suffer from psychological distress. The adequate exercise was a protective predictor of psychological distress [adjusted odds ratio (AOR) = 0.655, 95% CI = 0.486–0.883], but not with posttraumatic stress. High-quality diet was a protective predictor of posttraumatic stress (AOR = 0.112, 95% CI = 0.037–0.336) and psychological distress (AOR = 0.083, 95% CI = 0.028–0.247).

Conclusions: Our study revealed the prevalence and factors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic. Low panic intensity, low level of impact, satisfactory sleep, adequate exercise, and better diet were protective factors of posttraumatic stress and psychological distress. It indicated that the psychological status of nurses (particularly those from the COVID-19 pandemic frontline) should be monitored, and protective factors associated with posttraumatic stress and psychological distress should be increased.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effects of Autonomic Nervous System Functioning and Tornado Exposure on Long-Term Outcomes of Aggressive Children

This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9-13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts. Parent-rated externalizing and internalizing problems were assessed prior to the tornado (Wave 1; W1), and at 4-12 months (W2), 16-24 months (W3), 42-28 months (W4) and 56-60 months (W5) post-tornado. Children's pre-tornado Skin Conductance Level (SCL) reactivity and Respiratory Sinus Arrhythmia (RSA) withdrawal were assessed at W1 using SCL and RSA measured during resting baseline and during the first 5 min of the Iowa Gambling Task (IGT). Children and parents reported their exposure to tornado-related trauma and disruptions at Wave 3. Children displayed less reduction in externalizing problems if there had been higher child- or parent-reported tornado exposure and less RSA withdrawal, or if they had lower parent-reported TORTE and less SCL reactivity or lower SCL baseline. Highlighting the importance of children's pre-disaster arousal, higher levels of disaster exposure negatively affected children's level of improvement in externalizing problems when children had less vagal withdrawal, and when tornado exposure disrupted the protective effects of higher SCL reactivity and higher SCL baseline.

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.

Exposure to COVID-19 pandemic stress: Associations with depression and anxiety in emerging adults in the United States

BACKGROUND

Stressful events due to the coronavirus disease-2019 (COVID-19) pandemic are likely to have profound effects on mental health, and validated methods for assessing these experiences and associations with psychopathology are needed. We developed the Pandemic Stress Questionnaire (PSQ) and tested its psychometric properties, characterized experiences in emerging adults, and examined associations with internalizing symptoms.

METHODS

Emerging adults (N = 450) completed the PSQ and measures of internalizing symptoms and perceived stress through an online platform in May 2020. One month later, 288 participants completed a follow-up questionnaire to assess reliability of the PSQ and longitudinal associations between stress and internalizing symptoms.

RESULTS

Results supported the validity/reliability of PSQ total scores and indicated that stressful events were highly prevalent in May, particularly among younger, female, and Black emerging adults. Symptoms of depression and anxiety were high overall, but decreased at the follow-up assessment. Pandemic-related stress was moderately associated with both depression and anxiety at each assessment, but baseline stress did not predict change in symptoms when controlling for baseline symptoms.

CONCLUSIONS

Results provide empirical evidence that emerging adults are at high risk for depression and anxiety related to the psychosocial effects of the COVID-19 pandemic, and highlight specific types of experiences associated with greatest risk. Further, this study provides support for a questionnaire measure of experiences related to the COVID-19 pandemic that can be applied in future work to advance understanding of risk and resilience in response to stressful events.

Parental Presence Impacts a Neural Correlate of Anxiety (the Late Positive Potential) in 5-7 Year Old Children: Interactions with Parental Sensitivity to Child Anxiety

Anxiety disorders tend to onset early in development and often result in chronic impairment across the lifespan. Thus, there is substantial interest in identifying early neural markers of anxiety and leveraging these markers to better understand processes leading to anxiety. The late positive potential (i.e., LPP) indexes sustained attention to motivationally relevant stimuli; and the LPP to negative images is increased in individuals with anxiety. In the current study, we examined how parental presence impacts the LPP to threatening images in children (52.6% male) between 5 and 7 years-old (N = 78). Moreover, we explored interactions with parental sensitivity to child anxiety symptoms. Results suggest that when children are in the presence of their parent (compared to the presence of an experimenter), they displayed a larger LPP to threatening images. LPP activity was modulated by parental response to their child's anxiety symptoms, such that children with parents who were overly reactive to their children's anxiety symptoms had the greatest LPP response when viewing threatening stimuli in their parent's presence. Additionally, exploratory analyses indicated that children with clinical and subclinical anxiety were characterized by an increased LPP to negative images, but only when the LPP was measured with parents in the room. Findings are novel and extend previous work by suggesting that parents who react strongly when observing their children's anxiety symptoms in turn increase their child's engagement with threatening stimuli, thereby placing them at greater risk for anxiety.

Developmental trajectories to reduced activation of positive valence systems: A review of biological and environmental contributions

Reduced activation of positive valence systems (PVS), including blunted neural and physiological responses to pleasant stimuli and rewards, has been shown to prospectively predict the development of psychopathology. Yet, little is known about how reduced PVS activation emerges across development or what implications it has for prevention. We review genetic, temperament, parenting, and naturalistic and laboratory stress research on neural measures of PVS and outline developmentally-informed models of trajectories of PVS activation. PVS function is partly heritable and appears to reflect individual differences in early-emerging temperament traits. Although lab-induced stressors blunt PVS activation, effects of parenting and naturalistic stress on PVS are mixed and depend on the type of stressor, developmental timing, and interactions amongst risk factors. We propose that there may be multiple, dynamic developmental trajectories to reduced PVS activation in which combinations of genes, temperament, and exposure to severe, prolonged, or uncontrollable stress may exert direct and interactive effects on PVS function. Critically, these risk factors may alter PVS developmental trajectories and/or PVS sensitivity to proximal stressors. Distinct factors may converge such that PVS activation proceeds along a typical, accelerated, chronically low, or stress-reactive trajectory. Finally, we present directions for future research with translational implications.

Developmental trajectory of the late positive potential: Using temporal-spatial PCA to characterize within-subject developmental changes in emotional processing

The late positive potential (LPP) is characterized by temporal and spatial changes across development-though existing work has primarily relied on visual or statistical comparisons of relatively few electrodes and averaged activity over time. The current study used an empirically based approach to characterize temporal and spatial changes in ERPs over time. Data were utilized from a large longitudinal study (N = 380) in which the LPP was recorded to pleasant, neutral, and unpleasant pictures around age 9 and again around age 12. Age 9 ERPs were subtracted from age 12 ERPs for all three image types; the resulting ERPs for each subject at each electrode site were then submitted to a temporospatial principal component analysis (PCA). A PCA factor was greater in amplitude for emotional pictures compared to neutral pictures between ages 9 and 12, evident as an occipital negativity and frontocentral positivity that peaked approximately 850 ms following picture presentation. Furthermore, the factor scores to emotional pictures for this component increased as a function of age 12 pubertal development, consistent with the notion that the LPP shifts from occipital to more frontocentral sites in relation to developmental changes from childhood to adolescence. A similar factor was observed when PCA was applied to all ERPs from both ages 9 and 12. Using temporospatial PCA on ERPs collected from the same subjects over time-especially within-subject subtraction-based ERPs-provides a concise way of characterizing and quantifying within-subject developmental changes in both the timing and scalp distribution of ERPs.

Blunted Social Reward Responsiveness Moderates the Effect of Lifetime Social Stress Exposure on Depressive Symptoms

Exposure to social stress is a well-established risk factor for the development and recurrence of depression. Reduced neural responsiveness to monetary reward has been associated with greater symptoms following stress exposure. However, it remains unclear whether reduced reward responsiveness serves as a mediator or moderator of the effects of stress on internalizing symptoms or whether similar patterns emerge with responses to social reward. We addressed this issue by measuring lifetime stress exposure and event-related potentials (ERPs) to social reward in 231 emerging adults (M = 18.16, SD = 0.41 years old). Participants completed the Stress and Adversity Inventory (STRAIN) to assess severity of lifetime stressors and self-report measures of current internalizing symptoms. In addition, participants completed the Island Getaway task in which the reward positivity (RewP) ERP was recorded in response to social acceptance, adjusting for responses to rejection (RewP residual). In this task, participants vote to accept or reject peers and receive reward/acceptance and rejection feedback. Stressors were divided into social and non-social stress severity scores. Analyses were conducted to test social reward responsiveness as a mediator or moderator of the effects of social and non-social stress on internalizing symptoms. Both social and non-social stress exposure over the life course predicted symptoms of depression (ps < 0.001) and social anxiety (ps < 0.002). The effect of social stress on depression was moderated by the residual RewP to social reward, adjusting for responses to social rejection (p =0.024), such that greater lifetime social stress exposure and a relatively blunted RewP to social reward were associated with greater depressive symptoms. Social reward responsiveness did not mediate effects of stress on internalizing symptoms. Reduced processing of social reward may be a vulnerability for depression that increases risk for symptoms following exposure to social stress. Blunted social reward responsiveness appears to be a relatively unique vulnerability for depression, rather than social anxiety. Results support the utility of ERP measures in measuring individual differences in social reward processing that can be applied to better understand neural processes involved in the development of depression, and highlight the importance of considering specific dimensions of stressful life experiences.

Stability and change in emotional processing across development: A 6-year longitudinal investigation using event-related potentials

ERPs reveal the temporal dynamics of emotional processing and are easily assessed in children. Yet, little longitudinal research has examined ERPs sensitive to emotion across development. We aimed to systematically identify timing and spatial distributions of ERPs sensitive to emotion in a longitudinal sample of youth (N = 62) using principal component analysis (PCA) and evaluate stability and change in emotional responses across development. Participants completed an emotional interrupt paradigm in childhood (M_age  = 9.38, SD = 0.42), early adolescence (M_age  = 13.03, SD = 0.24), and midadolescence (M_age  = 15.16, SD = 0.17). ERPs were recorded to unpleasant, pleasant, and neutral images. Participants were instructed to respond to a target while viewing images. Two components sensitive to emotion emerged across development: P300/early late positive potential (LPP) and late LPP. The P300/early LPP component was characterized by an enhanced positivity for unpleasant compared to pleasant and neutral images. The late LPP was enhanced for both unpleasant and pleasant compared to neutral images, and more positive for unpleasant compared to pleasant images. The components showed moderate to strong stability. Overall LPP magnitude decreased from childhood into adolescence. There was a developmental shift in distributions from occipital sites in childhood to centroparietal sites in midadolescence. Results support use of PCA to inform scoring windows and electrode selection. The shift in distribution may reflect developmental focalization in underlying neural circuitry. Future work is needed using multimodal approaches to further understand the relationship between ERPs and changes in neural circuitry across development.

Neural Response to Pleasant Pictures Moderates Prospective Relationship Between Stress and Depressive Symptoms in Adolescent Girls

Adolescent girls are at increased risk for depression, which is thought to result from the interaction of biological vulnerabilities and life stressors common to adolescent girls. A blunted late positive potential (LPP) to emotional stimuli (i.e., pleasant and unpleasant) has been associated with depressive symptoms and risk. The current study of adolescent girls examines the moderating effects of the LPP, a candidate biomarker of depression, of the link between life stress and increases in depressive symptoms over 1 year. We measured LPP to pleasant and unpleasant pictures from the International Affective Picture Set among 143 predominantly Caucasian adolescent girls ages 8 to 14, who also reported on the frequency of common life stressors. Self-reported depressive symptoms were assessed both at baseline and 1 year after the initial lab visit. The LPP to pleasant pictures moderated the relationship between baseline life stressors and the change in depressive symptoms. Specifically, life stress was associated with increases in depressive symptoms when the LPP to pleasant pictures was blunted, whereas life stress was associated with decreases in depressive symptoms when the LPP to pleasant pictures was potentiated. These effects showed some specificity to family and school-related stressors and to anhedonic and efficacy-related depressive symptoms. A similar pattern, though not statistically significant, was found for the LPP to unpleasant pictures. Together, these findings suggest that the LPP to pleasant pictures may represent a useful biomarker in identifying individuals at greatest risk of experiencing depressive symptoms following stress.

Children's sustained attention to emotional facial expressions and their autonomic nervous system reactivity during parent-child interactions

The way individuals process socio-affective information is thought to impact their responses to social interactions, but research testing the relation between these processes is scarce, particularly among children. This study examined if children's attention to socio-affective stimuli was associated with their autonomic nervous system (ANS) reactivity during parent-child interactions. Children's sustained attention to facial expressions of emotion (afraid, happy, sad) was indexed using the late positive potential (LPP) event-related potential (ERP) component during a computer-based task. To measure ANS reactivity, children's respiratory sinus arrhythmia (RSA) was assessed at baseline and during positive and negative parent-child discussions. Enhanced LPP amplitudes in response to all emotional facial expressions, reflecting greater sustained attention to socio-affective stimuli, were associated with increased RSA reactivity during parent-child discussions. These results show correspondence between two psychophysiological substrates of emotion processing in healthy children and highlight how these systems may be synergistic forces contributing to emotion reactivity.

The Electrical Aftermath: Brain Signals of Posttraumatic Stress Disorder Filtered Through a Clinical Lens

This review aims to identify patterns of electrical signals identified using electroencephalography (EEG) linked to posttraumatic stress disorder (PTSD) diagnosis and symptom dimensions. We filter EEG findings through a clinical lens, evaluating nuances in findings according to study criteria and participant characteristics. Within the EEG frequency domain, greater right than left parietal asymmetry in alpha band power is the most promising marker of PTSD symptoms and is linked to exaggerated physiological arousal that may impair filtering of environmental distractors. The most consistent findings within the EEG time domain focused on event related potentials (ERPs) include: 1) exaggerated frontocentral responses (contingent negative variation, mismatch negativity, and P3a amplitudes) to task-irrelevant distractors, and 2) attenuated parietal responses (P3b amplitudes) to task-relevant target stimuli. These findings suggest that some individuals with PTSD suffer from attention dysregulation, which could contribute to problems concentrating on daily tasks and goals in lieu of threatening distractors. Future research investigating the utility of alpha asymmetry and frontoparietal ERPs as diagnostic and predictive biomarkers or intervention targets are recommended.

Neurophysiological Response to Olfactory Stimuli in Combat Veterans With Posttraumatic Stress Disorder

There is a need for a better understanding of underlying pathology in posttraumatic stress disorder (PTSD) to develop more effective treatments. The late positive potential (LPP) amplitude from electroencephalogram has been used to assess individual differences in emotional reactivity. There is evidence that olfaction is particularly important in emotional processing in PTSD. The current study examined LPP amplitudes in response to olfactory stimuli in 24 combat veterans with PTSD and 24 nonmilitary/non-PTSD controls. An olfactometer delivered three negatively valenced odorants, with 12 trials of each delivered in a random order. The groups did not differ in LPP amplitude across odorants. However, within the PTSD group, higher Clinician-Administered PTSD Scale scores related to an increased LPP amplitude after diesel fuel and rotten egg, but not n_butanol, odorants. Results provide specific targets and theory for further research into clinical applications such as selection of idiographic odorants for use in virtual-reality exposure therapy.

Parental Expressed Emotion-Criticism and Neural Markers of Sustained Attention to Emotional Faces in Children

There is growing evidence for the role of environmental influences on children's information-processing biases for affectively salient stimuli. The goal of this study was to extend this research by examining the relation between parental criticism (expressed emotion-criticism, or EE-Crit) and children's processing of facial displays of emotion. Specifically, we examined the relation between EE-Crit and children's sensitivity in detecting facial displays of emotion. We also examined a neural marker of sustained attention, the late positive potential (LPP) event-related potential component (ERP). Participants were 87 children (ages 7-11 years; 53.3% female, 77.8% Caucasian) and their parents (ages 24-71; 90% female, 88.9% Caucasian). Parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child. Children completed a morphed faces task during which behavioral and ERP responses were assessed. Although there were no group differences in sensitivity in detecting facial displays of emotion, we found that children of parents exhibiting high, compared to low, EE-Crit displayed less attention (smaller LPP magnitudes) to all facial displays of emotion (fearful, happy, sad). These results suggest that children of critical parents may exhibit an avoidant pattern of attention to affectively-salient interpersonal stimuli.

Neural indices of emotional reactivity and regulation predict course of PTSD symptoms in combat-exposed veterans

After diagnosis, veterans with posttraumatic stress disorder (PTSD) display significant variability in the natural course of illness (Bonanno et al., 2012)). Cross-sectional work reveals that abnormal neural response during emotion reactivity-measured using the late positive potential (LPP)-correlates with PTSD symptom severity; however, whether the LPP during emotional reactivity and regulation predicts symptoms over time is unknown. The current study examined the LPP during emotion reactivity and regulation as predictors of PTSD symptoms over one year in OEF/OIF/OND combat-exposed veterans. At baseline, participants completed an Emotion Regulation Task (ERT) during electroencephalogram recording. The Clinician Administered PTSD Scale (CAPS) was completed at baseline (N=86), 6-months (N=54) and 1-year (N=49) later. During ERT, participants viewed negative pictures; partway through they were instructed to "reappraise" (i.e., reduce negative affect/regulate) or "look" (i.e., passively react). Change in LPP during emotional reactivity (ΔLPP-E) and reappraisal (ΔLPP-R) were calculated and used in multilevel mixed modeling to predict CAPS over time. Findings demonstrated that deficiency in reappraisal (ΔLPP-R) predicted more overall symptoms over time, while greater neural responses to emotion (ΔLPP-E) and greater change in neural response as a function of reappraisal (ΔLPP-R) predicted a decline in avoidance symptoms over time. Together, results support the utility of neural markers of emotional reactivity and regulation as predictors of PTSD symptoms-and change in symptoms-across one year.

Social processing in early adolescence: Associations between neurophysiological, self-report, and behavioral measures

Peer relationships play a major role in adolescent development, but few methods exist for measuring social processing at the neurophysiological level. This study extends our pilot study of Island Getaway, a task for eliciting event-related potentials (ERPs) to peer feedback. We differentiated ERPs using principal components analysis (PCA) and examined associations with behavioral and self-report measures in young adolescents (N=412). PCA revealed an early negativity in the ERP enhanced for rejection feedback, followed by a series of positivities (consistent with reward positivity [RewP], P300, and late positive potential) that were enhanced for acceptance feedback. Greater self-reported task engagement correlated with a larger RewP to acceptance and lower rates of rejecting peers. Youth higher in depressive symptoms exhibited a blunted RewP to social acceptance and reported lower engagement. Results highlight ERP components sensitive to peer feedback that may inform understanding of social processes relevant to typical and atypical development.

Emotion regulation in adolescents: An ERP study

AIMS

The use of emotion regulation strategies can reduce the intensity of negative emotional experiences. Event related potentials (ERPs), specifically the late positive potential (LPP), are known to be sensitive to this modulation in adults. This is the first study to explore the neural correlates of expressive suppression in adolescents. We sought to replicate previous findings from emotion regulation studies with adult populations, show that the LPP can be modulated by expressive suppression in healthy adolescents, and examine the influence of age on LPP changes.

METHOD

ERPs of 53 healthy adolescents (12-17 years old) performing an emotion regulation task (expressive suppression) were recorded.

RESULTS

Expressive suppression altered the LPP in adolescents with both increases and decreases noted depending on time window and recording site. The LPP during expressive suppression was decreased with increasing age.

CONCLUSIONS

The findings suggest that 1) the LPP is an effective tool to study processes associated with emotion regulation in adolescents, and 2) expressive suppression, in terms of its neural indicators, seems to become more effective with age. The nature and utility of expressive suppression as a specific form of emotion regulation in adolescents are discussed.

The Impact of Natural Disasters on Youth: A Focus on Emerging Research beyond Internalizing Disorders

PURPOSE OF REVIEW

This paper reviews youth outcomes following exposure to natural disaster, with a focus on three relatively understudied outcomes: externalizing behavior problems, physical health, and posttraumatic growth. Recent, high-impact studies focusing on each outcome are summarized.

RECENT FINDINGS

Studies highlighted in this review utilize innovative and comprehensive approaches to improve our current understanding of youth broad-based physical and mental health outcomes beyond PTSD. The review concludes with recommendations to advance the field of youth disaster research by exploring how disasters may impact children across multiple domains, as well as using cutting edge ecobiological approaches and advanced modeling strategies to better understand how youth adjust and thrive following natural disaster.

The Stony Brook Temperament Study: Early Antecedents and Pathways to Emotional Disorders

In this article, we summarize findings from the Stony Brook Temperament Study, which seeks to elucidate the early antecedents and pathways to later depressive and anxiety disorders. The study focuses on parents' internalizing disorders and children's early temperament as distal risk factors that operate, in part, through biobehavioral reward and threat systems. We summarize findings linking parents' emotional disorders and observations of children's early temperament to subsequent neural measures of children's affective processing. Next, we review findings showing that children's temperament and affective processing predict subsequent depression and anxiety. We also show that many of these associations are moderated by environmental factors, such as parenting and stress. Finally, we relate our findings to literature on the relationships of early temperament and affective processing to anxiety and depression in youth.

Behavioral observations of positive and negative valence systems in early childhood predict physiological measures of emotional processing three years later

BACKGROUND

The Research Domain Criteria (RDoC) constructs of Positive Valence Systems (PVS) and Negative Valence Systems (NVS) are presumed to manifest behaviorally through early-emerging temperamental negative affectivity (NA) and positive affectivity (PA). The late positive potential (LPP) is a physiological measure of attention towards both negative and positive emotional stimuli; however, its associations with behavioral aspects of PVS and NVS have yet to be examined.

METHODS

In a community sample of children (N = 340), we examined longitudinal relationships between observational measures of temperamental PA and NA assessed at age 6, and the LPP to both pleasant and unpleasant images assessed at age 9.

RESULTS

Lower PA at age 6 predicted reduced LPP amplitudes to pleasant, but not unpleasant, images. NA as a composite measure was not related to the LPP, but specific associations were observed with facets of NA: greater fear predicted an enhanced LPP to unpleasant images, whereas greater sadness predicted a reduced LPP to unpleasant images.

LIMITATIONS

We were unable to evaluate concurrent associations between behavioral observations of temperament and the LPP, and effect sizes were modest.

CONCLUSIONS

Results support correspondence between behavioral and physiological measures of emotional processing across development, and provide evidence of discriminant validity in that PA was specifically related to the LPP to pleasant images, while facets of NA were specifically linked to the LPP to unpleasant images. Distinct associations of temperamental sadness and fear with the LPP highlight the importance of further evaluating subconstructs of NVS.

Temperamental Effortful Control Modulates Gender Differences in Late Positive Potentials Evoked by Affective Pictures in Adolescents

We investigated whether effort control (EC) modulates gender differences in late positive potential (LPP) evoked by affective pictures. We collected EEG data from 46 healthy adolescents while they viewed 90 affective pictures. Relative to neutral pictures, boys showed larger LPP amplitudes for positive pictures compared to girls while girls showed larger LPP amplitudes for negative pictures compared to boys. Temperamental EC in boys negatively predicted LPP amplitudes for positive pictures, whereas EC in girls negatively predicted LPP amplitudes for negative pictures. These observations increase our understanding of the relationship between EC and gender difference in electrocortical maturation.

Neural responses to negative outcomes predict success in community-based substance use treatment

BACKGROUND AND AIMS

Patterns of brain activation have demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but have not yet been explored in SDIs typical of community-based treatment settings.

DESIGN

Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3-month substance use treatment outcomes.

SETTING

Community-based substance use programs in Bloomington, Indiana, USA.

PARTICIPANTS

Twenty-three SDIs (17 male, aged 18-43 years) in an intensive outpatient or residential treatment program; abstinent 1-4 weeks at baseline.

MEASUREMENTS

Event-related brain response, BART performance and self-report scores at treatment onset, substance use outcome measure (based on days of use).

FINDINGS

Using voxel-level predictive modeling and leave-one-out cross-validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use during the 3-month study interval (P ≤ 0.006, cluster-corrected). This effect was robust to inclusion of significant non-brain-based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward-seeking responses after negative feedback (r₍₂₃₎  = -0.544, P = 0.007; r₍₂₃₎  = -0.588, P = 0.003). A model including Amyg/aHipp activation, faster reward-seeking after negative feedback and significant self-report scores accounted for 45% of the variance in substance use outcomes in our sample.

CONCLUSIONS

An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community-based treatment.

Neural Biomarker and Early Temperament Predict Increased Internalizing Symptoms After a Natural Disaster

OBJECTIVE

Although most people will experience a traumatic event at some point in their life, only some will develop significant psychological symptoms in the aftermath. In the current study, we use a preexisting longitudinal study located in Long Island to examine the impact of Hurricane Sandy on internalizing symptoms in a large sample of children. We focused on temperamental fear and a biomarker of risk for anxiety, the error-related negativity (ERN). The ERN is a negative deflection in the event-related potential (ERP) occurring when individuals make mistakes and is increased in anxious individuals.

METHOD

The final sample consisted of 223 children who had undergone an observational assessment of fear at age 3 years and an electroencephalogram assessment of the ERN at age 6 years. At the age 9 year assessment, internalizing symptoms were assessed, and then again after the hurricane (∼65 weeks later).

RESULTS

A significant three-way interaction among fearfulness, hurricane stressors, and the ERN in predicting posthurricane increases in internalizing symptoms suggested that children who were high in fear at age 3 years and experienced elevated hurricane stressors were characterized by subsequent increases in internalizing symptoms, but only when they were also characterized by an increased ERN at age 6 years.

CONCLUSION

These findings support a diathesis-stress model, suggesting that early temperament and prestressor biological markers confer risk for increased psychological symptoms following environmental stressors.

Genome-wide association study of positive emotion identifies a genetic variant and a role for microRNAs

Positive affect denotes a state of pleasurable engagement with the environment eliciting positive emotion such as contentment, enthusiasm or happiness. Positive affect is associated with favorable psychological, physical and economic outcomes in many longitudinal studies. With a heritability of ⩽64%, positive affect is substantially influenced by genetic factors; however, our understanding of genetic pathways underlying individual differences in positive affect is still limited. Here, through a genome-wide association study of positive affect in African-American participants, we identify a single-nucleotide polymorphism, rs322931, significantly associated with positive affect at P<5 × 10-8, and replicate this association in another cohort. Furthermore, we show that the minor allele of rs322931 predicts expression of microRNAs miR-181a and miR-181b in human brain and blood, greater nucleus accumbens reactivity to positive emotional stimuli and enhanced fear inhibition. Prior studies have suggested that miR-181a is part of the reward neurocircuitry. Taken together, we identify a novel genetic variant for further elucidation of genetic underpinning of positive affect that mediates positive emotionality potentially via the nucleus accumbens and miR-181.

Hurricane Sandy Exposure Alters the Development of Neural Reactivity to Negative Stimuli in Children

This study examined whether exposure to Hurricane Sandy-related stressors altered children's brain response to emotional information. An average of 8 months (M_age  = 9.19) before and 9 months after (M_age  = 10.95) Hurricane Sandy, 77 children experiencing high (n = 37) and low (n = 40) levels of hurricane-related stress exposure completed a task in which the late positive potential, a neural index of emotional reactivity, was measured in response to pleasant and unpleasant, compared to neutral, images. From pre- to post-Hurricane Sandy, children with high stress exposure failed to show the same decrease in emotional reactivity to unpleasant versus neutral stimuli as those with low stress exposure. Results provide compelling evidence that exposure to natural disaster-related stressors alters neural emotional reactivity to negatively valenced information.