The role of attentional deployment during distancing in adolescents with major depression

Regulation of negative emotions through directed attention in high-trait-anxious women: Evidence from event-related potentials and eye-tracking

Abnormal emotional responses in high-trait-anxious (HTA) individuals may be related to the use of emotion regulation strategies. Directed attention is a substrategy of attention deployment, which has been proven to be effective in regulating individual negative emotions. The present study investigated whether HTA women can effectively utilize directed attention to decrease negative emotions. Two studies were conducted using the same directed attention paradigm, with one focusing on event-related potentials (ERPs) and the other utilizing eye-tracking techniques. Participants viewed negative and neutral pictures and rated their negative emotions experienced during viewing. During directed attention, attention was directed towards highly arousing aspects, less arousing aspects of negative pictures, or less arousing aspects of neutral pictures. In study 1, late positive potentials (LPP) were recorded in 26 HTA and 24 low-trait-anxious (LTA) women. In study 2, the latency of first fixation, the proportion of gaze duration and fixations in the specific area were recorded in 27 HTA and 23 LTA women. Both the HTA and LTA groups revealed a decrease in negative emotional ratings and LPP amplitudes when their attention was directed towards the less arousing aspects of negative pictures. Furthermore, in this condition, the HTA group had a shorter latency of first fixation on highly arousing aspects and a higher proportion of gaze duration on less arousing aspects of negative pictures compared to the LTA group. These results indicate that when confronted with negative pictures, HTA women are able to regulate their emotional responses through directed attention, which may be accompanied by attentional vigilance and avoidance tendencies.

The deficit in cognitive reappraisal capacity in individuals with anxiety or depressive disorders: meta-analyses of behavioral and neuroimaging studies

BACKGROUND

The deficit in cognitive reappraisal capacity is a key factor in developing and maintaining emotional disorders such as anxiety disorders and depressive disorders. However, the results from both neuroimaging and behavioral studies are mixed. Therefore, we systematically conducted a series of meta-analyses based on behavioral and neuroimaging studies to clarify this issue.

METHODS

In behavioral meta-analyses, we used three-level random-effects models to summarize the overall effect sizes based on Hedges' g. In neuroimaging meta-analyses, we used SDM-PSI to summarize the brain activation patterns.

RESULTS

Behavioral meta-analyses found that individuals with anxiety disorders or depressive disorders could reduce negative reactivity through reappraisal; the reduction of negative emotions through reappraisal by individuals with anxiety disorders was similar to that by healthy individuals; the reduction by depressive disorders was lower than that of healthy individuals. Neuroimaging meta-analyses showed that individuals with anxiety disorders or depressive disorders activated regions of cognitive control during cognitive reappraisal; the activation in individuals with anxiety disorders was lower than in healthy individuals; while the activation in individuals with depressive disorders was similar to that in healthy individuals.

CONCLUSION

Individuals with anxiety and depressive disorders showed dissociation in behaviour and neuroimaging patterns of cognitive reappraisal capacity deficit.

Frontal alpha asymmetry during emotion regulation in adults with lifetime major depression

Emotion regulation (ER) often is impaired in current or remitted major depression (MD), although the extent of the deficits is not fully understood. Recent studies suggest that frontal alpha asymmetry (FAA) could be a promising electrophysiological measure to investigate ER. The purpose of this study was to investigate ER differences between participants with lifetime major depression (lifetime MD) and healthy controls (HC) for the first time in an experimental task by using FAA. We compared lifetime MD (n = 34) and HC (n = 25) participants aged 18-24 years in (a) an active ER condition, in which participants were instructed to reappraise negative images and (b) a condition in which they attended to the images while an EEG was recorded. We also report FAA results from an independent sample of adolescents with current MD (n = 36) and HC adolescents (n = 38). In the main sample, both groups were able to decrease self-reported negative affect in response to negative images through ER, without significant group differences. We found no differences between groups or conditions in FAA, which was replicated within the independent adolescent sample. The lifetime MD group also reported less adaptive ER in daily life and higher difficulty of ER during the task. The lack of differences between in self-reported affect and FAA between lifetime MD and HC groups in the active ER task indicates that lifetime MD participants show no impairments when instructed to apply an adaptive ER strategy. Implications for interventional aspects are discussed.

Emotion regulation in adolescents with major depression - Evidence from a combined EEG and eye-tracking study

BACKGROUND

Adolescent major depression (MD) is characterized by deficits in emotion regulation (ER). Little is known about the neurophysiological correlates that are associated with these deficits. Moreover, the additional examination of visual attention during ER would allow a more in-depth understanding of ER deficits but has not yet been applied simultaneously.

METHODS

N = 33 adolescents with MD and n = 35 healthy controls (HCs) aged 12-18 years performed an ER task during which they either a) down-regulated their negative affective response to negative images via cognitive reappraisal or b) attended the images without changing their affective response. During the task, the Late Positive Potential (LPP), gaze fixations on emotional image aspects, and self-reported affective responses were collected simultaneously.

RESULTS

Compared to HCs, adolescents with MD demonstrated reduced ER success based on self-report but did not differ in LPP amplitudes. Participants in both groups showed increased amplitudes in the middle LPP window when they reappraised negative pictures compared to when they attended them. Only in the HC group, increased LPP amplitudes during reappraisal were paralleled by more positive affective responses.

LIMITATION

The applied stimuli were part of picture databases and might therefore have limited self-relevance.

CONCLUSIONS

Increased LPP amplitude during ER in both groups might be specific to adolescence and might suggest that ER at this age is challenging and requires a high amount of cognitive resources. These findings provide an important starting point for future interventional studies in youth MD.

Automatic emotion regulation prompts response inhibition to angry faces in sub-clinical depression: An ERP study

The neurocognitive mechanism by which automatic emotion regulation (AER) affects emotion processing remains understudied in the context of psychopathology, such as depression. Participants with sub-clinical depression and healthy controls were randomly assigned to an emotion regulation priming group or a neutral priming group. All participants completed an emotional Go/No-go task by judging the gender of angry or happy faces. During the Go/No-go task, each trial was preceded by subliminal presentation of words describing emotion regulation goals or neutral goals as a manipulation of priming. The behavioral results showed that compared with neutral priming, subliminal priming of regulation goals increased the accuracy in No-go trials with angry faces only for sub-clinically depressed participants. In the ERP results, the main effect of regulation priming was significant in sub-clinically depressed participants, such that showing subliminal priming of regulation goals decreased the amplitude of N2 compared to the neutral priming. Similarly, for the sub-clinically depressed participants, regulation goal priming evoked smaller P3 in response to angry faces than to happy faces. No such pattern was found in neutral goal priming condition or for healthy controls. According to the automotive model of emotion regulation, once goals or norms related to emotion regulations are formed in the mind, a related regulation response could be activated without awareness. Our results suggest that subliminal priming of regulation goals could change the response inhibition to angry faces in sub-clinically depressed participants.

The Effects of Attentional Deployment on Reinterpretation in Depressed Adolescents: Evidence from an Eye-Tracking Study

Background

Individuals with major depression have difficulties employing cognitive reappraisal. Most prior studies have not accounted for attentional deployment, which seems to be involved in this process.

Methods

We investigated the cognitive reappraisal tactic reinterpretation in 20 depressed and 28 healthy youths and assessed regulation success in response to negative pictures via self-report. To investigate attentional deployment during reinterpretation, we applied eye-tracking and manipulated gaze focus by instructing participants to direct their attention towards/away from emotional picture aspects.

Results

Depressed adolescents, compared with healthy youths, had a diminished regulation success when their gaze was focused on emotional aspects. Both depressed and healthy adolescents spent less time fixating on emotional facets of negative pictures when using reinterpretation as compared with simply attending to the pictures.

Conclusions

Results from this study suggest that adolescents with major depression have emotion regulation deficits when being confronted with negative emotional facets, while showing intact overt attentional processes. The findings provide important starting points for future research investigating the role of other factors which might impact on emotion regulation processes in this patient group, such as cognitive control deficits.

Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report

Decentering is a ubiquitous therapeutic concept featuring in multiple schools of psychological intervention and science. It describes an ability to notice to day-to-day psychological stressors (negative thoughts, feelings, and memories) from an objective self-perspective and without perseverating on the themes they represent. Thus, decentering dampens the impact and distress associated with psychological stressors that can otherwise increase mental ill health in vulnerable individuals. Importantly, the strengthening of decentering-related abilities has been flagged as a core component of psychological interventions that treat and prevent anxiety and depression. We provide an in-depth review evidence of the salutary effects of decentering with a special focus on youth mental health. This is because adolescence is a critical window for the development of psychopathology but is often under-represented in this research line. A narrative synthesis is presented that integrates and summarizes findings on a range of decentering-related abilities. Section 1 reviews extant conceptualizations of decentering and data-driven approaches to characterize its characteristic. A novel definition is then offered to guide future empirical research. Section 2 overviews laboratory-based research into the development of decentering as well as its relationship with anxiety and depression. Section 3 examines the role decentering-related skills play in psychological interventions for anxiety and depression. Critically, we review evidence that treatment-related increases in decentering predict latter reductions in anxiety and depression severity. Each section highlights important areas for future research. The report concludes by addressing the vital questions of whether, how, why and when decentering alleviates youth anxiety and depression.

Study protocol for a randomised-controlled study on emotion regulation training for adolescents with major depression: the KONNI study

INTRODUCTION

Major depression (MD) often has its onset during adolescence and is associated with significant morbidity and mortality. One important factor for the development and maintenance of adolescent MD are disturbances in emotion regulation and the underlying neural processes. Cognitive reappraisal (CR) is a particular adaptive emotion regulation strategy. Previously, it has been shown in healthy adults that a task-based training in CR is efficient to reduce negative affect, and that these effects translate into everyday life.This randomised controlled trial examines for the first time whether a task-based training in CR proves effective in MD adolescents. Specifically, we will investigate whether the CR training improves the ability to downregulate negative affect in MD individuals as assessed by behavioural and neurobiological indices, and whether training effects generalise outside the laboratory.

METHODS AND ANALYSIS

Adolescents with MD will be randomly allocated to a group that either receives a task-based training in CR or a control training. Both involve four training sessions over a time period of 2 weeks. In the CR training, participants will be instructed to downregulate negative affective responses to negative pictures via CR, while the control training involves picture viewing. During the training sessions, the Late Positive Potential, gaze fixations on negative picture aspects and affective responses to pictures will be collected. Before and after the training programmes, and at a 2-week follow-up, overall negative and positive affect, rumination and perceived stress will be assessed as primary outcomes. Analyses of variance will be conducted to test the effectiveness of the CR training with regard to both primary outcomes and task-based behavioural and neurobiological parameters.

ETHICS AND DISSEMINATION

The study was approved by the Ethics Committee of the Medical Faculty of the LMU Munich, Germany. The results will be published in peer-reviewed journals and disseminated through conferences, social media and public events.

TRIAL REGISTRATION DETAILS

ClinicalTrials.gov NCT03957850, registered 21^st May 2019; URL: https://clinicaltrials.gov/ct2/show/NCT03957850.