To what extent are emotional visual stimuli processed without attention and awareness?

"Does facial emotion recognition mediate the relationship between preterm birth and social skills? - A meta-analysis"

BACKGROUND

Preterm birth (PB) is prevalent and associated with structural and functional brain alterations which may affect cognitive and behavioural outcomes, including social development. Facial emotion recognition (FER) is one of the main components of social interaction. PB individuals face distinct FER challenges that may impact social skills. Furthermore, both FER and social skills have shown distinctive developmental trajectories in PB individuals compared to term born controls. This study investigates the association between FER and social skills in PB individuals compared to term-born controls.

OBJECTIVES

To systematically review and meta-analyse relevant literature on the association between FER and social skills and to summarize the reported differences in FER and social skills between PB individuals and term-born controls of similar age.

METHOD

a systematic search of peer-reviewed and English written studies was performed in MEDLINE, Web of Science and CINAHL, with an additional forward and backward citation search. Eligible studies included any observational study that had a term-born control sample of similar age with reported FER and social skills measures and/or correlations between them. Quality assessment and data extraction was carried out. Correlation coefficients and Hedges' g for FER and social skills were calculated as effect size indexes. Random effects model and subgroup analysis considering gestational age and age at assessment was performed. Results were summarized using forest plots. I2 statistics and Cochran's Q were used to test for heterogeneity.

RESULTS

8 studies were included (PB = 410, controls =337). Only 3 studies explored the correlation between FER and social skills. The review found a higher correlation between FER and social skills in the PB group (Z = 0.18, CI = -0.03, 0.39) compared to controls (Z = 0.11, CI = -0.03, 0.25). FER was significantly lower in PB individuals (overall g = -1.48; 95%IC = -2.46, -0-5), particularly in very preterm and adolescent subgroups.

DISCUSSION

FER might play a crucial role in the social development of PB individuals compared to those born at term, but existing research in this domain remains limited.

Cross-modal enhancement of defensive behavior via parabigemino-collicular projections

Effective detection and avoidance from environmental threats are crucial for animals' survival. Integration of sensory cues associated with threats across different modalities can significantly enhance animals' detection and behavioral responses. However, the neural circuit-level mechanisms underlying the modulation of defensive behavior or fear response under simultaneous multimodal sensory inputs remain poorly understood. Here, we report in mice that bimodal looming stimuli combining coherent visual and auditory signals elicit more robust defensive/fear reactions than unimodal stimuli. These include intensified escape and prolonged hiding, suggesting a heightened defensive/fear state. These various responses depend on the activity of the superior colliculus (SC), while its downstream nucleus, the parabigeminal nucleus (PBG), predominantly influences the duration of hiding behavior. PBG temporally integrates visual and auditory signals and enhances the salience of threat signals by amplifying SC sensory responses through its feedback projection to the visual layer of the SC. Our results suggest an evolutionarily conserved pathway in defense circuits for multisensory integration and cross-modality enhancement.

A premium for positive social interest and attractive voices in the acceptability of unfair offers? An ERP study

Although the attractiveness of voices plays an important role in social interactions, it is unclear how voice attractiveness and social interest influence social decision-making. Here, we combined the ultimatum game with recording event-related brain potentials (ERPs) and examined the effect of attractive versus unattractive voices of the proposers, expressing positive versus negative social interest ("I like you" vs. "I don't like you"), on the acceptance of the proposal. Overall, fair offers were accepted at significantly higher rates than unfair offers, and high voice attractiveness increased acceptance rates for all proposals. In ERPs in response to the voices, their attractiveness and expressed social interests yielded early additive effects in the N1 component, followed by interactions in the subsequent P2, P3 and N400 components. More importantly, unfair offers elicited a larger Medial Frontal Negativity (MFN) than fair offers but only when the proposer's voice was unattractive or when the voice carried positive social interest. These results suggest that both voice attractiveness and social interest moderate social decision-making and there is a similar "beauty premium" for voices as for faces.

Using virtual reality to induce multi-trial inattentional blindness despite trial-by-trial measures of awareness

Unconscious processing has been widely examined using diverse and well-controlled methodologies. However, the extent to which these findings are relevant to real-life instances of information processing without awareness is limited. Here, we present a novel inattentional blindness (IB) paradigm in virtual reality (VR). In three experiments, we managed to repeatedly induce IB while participants foveally viewed salient stimuli for prolonged durations. The effectiveness of this paradigm demonstrates the close relationship between top-down attention and subjective experience. Thus, this method provides an ecologically valid setup to examine processing without awareness.

Looming Angry Faces: Preliminary Evidence of Differential Electrophysiological Dynamics for Filtered Stimuli via Low and High Spatial Frequencies

Looming motion interacts with threatening emotional cues in the initial stages of visual processing. However, the underlying neural networks are unclear. The current study investigated if the interactive effect of threat elicited by angry and looming faces is favoured by rapid, magnocellular neural pathways and if exogenous or endogenous attention influences such processing. Here, EEG/ERP techniques were used to explore the early ERP responses to moving emotional faces filtered for high spatial frequencies (HSF) and low spatial frequencies (LSF). Experiment 1 applied a passive-viewing paradigm, presenting filtered angry and neutral faces in static, approaching, or receding motions on a depth-cued background. In the second experiment, broadband faces (BSF) were included, and endogenous attention was directed to the expression of faces. Our main results showed that regardless of attentional control, P1 was enhanced by BSF angry faces, but neither HSF nor LSF faces drove the effect of facial expressions. Such findings indicate that looming motion and threatening expressions are integrated rapidly at the P1 level but that this processing relies neither on LSF nor on HSF information in isolation. The N170 was enhanced for BSF angry faces regardless of attention but was enhanced for LSF angry faces during passive viewing. These results suggest the involvement of a neural pathway reliant on LSF information at the N170 level. Taken together with previous reports from the literature, this may indicate the involvement of multiple parallel neural pathways during early visual processing of approaching emotional faces.

The Impact of Emotions on Habitual Inhibition

Emotional information prioritizes human behavior. How much emotions influence ongoing behavior critically depends on the extent of executive control functions in a given context. One form of executive control is based on stimulus-stop associations (i.e., habitual inhibition) that rapidly and effortlessly elicits control over the interruption of ongoing behavior. So far, no behavioral accounts have explored the emotional impact on habitual inhibition. We aimed to examine the emotional modulation on habitual inhibition and associated psycho-physiological changes. A go/no-go association task asked participants to learn stimulus-stop and stimulus-response associations during 10-day training to form habitual inhibition (without emotional interference). Probabilistic feedback guided learning with varying probabilities of congruent feedback, generating stronger versus weaker pairings. A reversal test measured habitual inhibition strength counteracted by emotional cues (high-arousal positive and negative stimuli compared with neutral ones). Our training protocol induced stable behavioral and psycho-physiological responses compatible with habitual behavior. At reversal, habitual inhibition was evident as marked by significant speed costs of reversed no-go trials for strongly associated stimuli. Positive and negative emotional cues produced larger impact on habitual inhibition. We report first evidence on a cognitive control mechanism that is vulnerable to emotional stimuli and suggest alternative explanations on how emotions may boost or counteract certain behavioral abnormalities mediated by habitual inhibition.

Learning emotional dialects: A British population study of cross-cultural communication

The aim of the current research was to explore whether we can improve the recognition of cross-cultural freely-expressed emotional faces in British participants. We tested several methods for improving the recognition of freely-expressed emotional faces, such as different methods for presenting other-culture expressions of emotion from individuals from Chile, New Zealand and Singapore in two experimental stages. In the first experimental stage, in phase one, participants were asked to identify the emotion of cross-cultural freely-expressed faces. In the second phase, different cohorts were presented with interactive side-by-side, back-to-back and dynamic morphing of cross-cultural freely-expressed emotional faces, and control conditions. In the final phase, we repeated phase one using novel stimuli. We found that all non-control conditions led to recognition improvements. Morphing was the most effective condition for improving the recognition of cross-cultural emotional faces. In the second experimental stage, we presented morphing to different cohorts including own-to-other and other-to-own freely-expressed cross-cultural emotional faces and neutral-to-emotional and emotional-to-neutral other-culture freely-expressed emotional faces. All conditions led to recognition improvements and the presentation of freely-expressed own-to-other cultural-emotional faces provided the most effective learning. These findings suggest that training can improve the recognition of cross-cultural freely-expressed emotional expressions.

Subliminal perception of others' physical pain induces personal distress rather than empathic concern

BACKGROUND

What is our immediate reaction when we witness someone experiencing pain? The empathy-altruism hypothesis predicts that observers would display empathy and a tendency to approach the person in pain. Alternatively, the threat value of pain hypothesis (TVPH) argues that others' pain serves as a signal of threat and should induce observers' avoidance response.

METHODS

To examine these two hypotheses, three experiments were conducted. The experiments aimed to investigate the impact of subliminal exposure to others' physical pain on participants' emotional and behavioural responses.

RESULTS

The results revealed that subliminal pain priming resulted in faster response and attentional bias to fearful faces compared to sad faces (Experiment 1), faster reaction times in recognizing fear-related words compared to anger-related words during a lexical decision task (Experiment 2), and faster avoidance responses towards anger-related words, as opposed to approaching responses towards positive words (Experiment 3).

CONCLUSIONS

The consistent findings across all experiments revealed that subliminal perception of pain scenes elicited fear emotion and immediate avoidance responses. Therefore, the outcomes of our study provide supportive evidence for the TVPH.

Identifying the duration of emotional stimulus presentation for conscious versus subconscious perception via hierarchical drift diffusion models

To investigate subliminal priming effects, different durations for stimulus presentation are applied ranging from 8 to 30 ms. This study aims to select an optimal presentation span whichleads to a subconscious processing. 40 healthy participants rated emotional faces (sad, neutral or happy expression) presented for 8.3 ms, 16.7 ms and 25 ms. Alongside subjective and objectivestimulus awareness, task performance was estimated via hierarchical drift diffusion models. Participants reported stimulus awareness in 65 % of the 25 ms trials,in 36 % of 16.7 ms trials, and in 2.5 % of 8.3 ms trials.Emotion-dependent responses were reflected in decreased performance (drift rates, accuracy)during sad trials. The detection rate (probability of making a correct response) during 8.3 ms was 12.2 % and slightly above chance level (33.333 % for three response options) during 16.7 ms trials (36.8 %). The experiments suggest a presentation time of 16.7 ms as optimal for subconscious priming. An emotion-specific response was detected during 16.7 ms while the performanceindicates a subconscious processing.

Non-conscious processing of fear faces: a function of the implicit self-concept of anxiety

BACKGROUND

Trait anxiety refers to a stable tendency to experience fears and worries across many situations. High trait anxiety is a vulnerability factor for the development of psychopathologies. Self-reported trait anxiety appears to be associated with an automatic processing advantage for threat-related information. Self-report measures assess aspects of the explicit self-concept of anxiety. Indirect measures can tap into the implicit self-concept of anxiety.

METHODS

We examined automatic brain responsiveness to non-conscious threat as a function of trait anxiety using functional magnetic resonance imaging. Besides a self-report instrument, we administered the Implicit Association Test (IAT) to assess anxiety. We used a gender-decision paradigm presenting brief (17 ms) and backward-masked facial expressions depicting disgust and fear.

RESULTS

Explicit trait anxiety was not associated with brain responsiveness to non-conscious threat. However, a relation of the implicit self-concept of anxiety with masked fear processing in the thalamus, precentral gyrus, and lateral prefrontal cortex was observed.

CONCLUSIONS

We provide evidence that a measure of the implicit self-concept of anxiety is a valuable predictor of automatic neural responses to threat in cortical and subcortical areas. Hence, implicit anxiety measures could be a useful addition to explicit instruments. Our data support the notion that the thalamus may constitute an important neural substrate in biased non-conscious processing in anxiety.

Attentional modulation as a mechanism for enhanced facial emotion discrimination: The case of action video game players

Action video game players (AVGPs) outperform nonvideo game players (NVGPs) on a wide variety of attentional tasks, mediating benefits to perceptual and cognitive decision processes. A key issue in the literature is the extent to which such benefits transfer beyond cognition. Using steady-state visual evoked potentials (SSVEP) as a neural measure of attentional resource allocation, we investigated whether the attentional benefit of AVGPs generalizes to the processing of rapidly presented facial emotions. AVGPs (n = 36) and NVGPs (n = 32) performed a novel, attention-demanding emotion discrimination task, requiring the identification of a target emotion in one of two laterally presented streams of emotional faces. The emotional faces flickered at either 2.0 Hz or 2.5 Hz. AVGPs outperformed NVGPs at detecting the target emotions regardless of the type of emotion. Correspondingly, attentional modulation of the SSVEP at parieto-occipital recording sites was larger in AVGPs compared with NVGPs. This difference appeared to be driven by a larger response to attended information, as opposed to a reduced response to irrelevant distractor information. Exploratory analyses confirmed that this novel paradigm elicited the expected pattern of event-related potentials associated with target detection and error processing. These components did not, however, differ between groups. Overall, the results indicate enhanced discrimination of facial emotions in AVGPs arising from enhanced attentional processing of emotional information. This presents evidence for the attentional advantage of AVGPs to extend beyond perceptual and cognitive processes.

Working memory modulates the anger superiority effect in central and peripheral visual fields

Angry faces have been shown to be detected more efficiently in a crowd of distractors compared to happy faces, known as the anger superiority effect (ASE). The present study investigated whether the ASE could be modified by top-down manipulation of working memory (WM), in central and peripheral visual fields. In central vision, participants held a colour in WM for a final memory test while simultaneously performing a visual search task that required them to determine whether a face showed a different expression from other coloured faces. The colour held in WM matched either the colour of the target face (target-matching), the colour of a distractor face (distractor-matching), or neither (non-matching). Results showed that the ASE was observed when the probability of target-matching trials was low. However, when the top-down WM effect was strengthened by raising the probability of target-matching trials, the ASE in the target-matching condition was completely eliminated. Intriguingly, when the visual search task was substituted by a peripheral crowding task, similar results to central vision were found in the target-matching condition. Taken together, our findings indicate that the ASE is subject to the top-down WM effect, regardless of the visual field.

Function without feeling: neural reactivity and intercommunication during flexible motor adjustments evoked by emotional and neutral stimuli

Motor conflicts arise when we need to quickly overwrite prepotent behavior. It has been proposed that affective stimuli modulate the neural processing of motor conflicts. However, previous studies have come to inconsistent conclusions regarding the neural impact of affective information on conflict processing. We employed functional magnetic resonance imaging during a Go/Change-Go task, where motor conflicts were either evoked by neutral or emotionally negative stimuli. Dynamic causal modeling was used to investigate how motor conflicts modulate the intercommunication between the anterior cingulate cortex (ACC) and the anterior insula (AI) as 2 central regions for cognitive control. Conflicts compared to standard actions were associated with increased BOLD activation in several brain areas, including the dorsal ACC and anterior insula. There were no differences in neural activity between emotional and non-emotional conflict stimuli. Conflicts compared to standard actions lowered neural self-inhibition of the ACC and AI and led to increased effective connectivity from the ACC to AI contralateral to the acting hand. Thus, our study indicates that neural conflict processing is primarily driven by the functional relevance of action-related stimuli, not their inherent affective meaning. Furthermore, it sheds light on the role of interconnectivity between ACC and AI for the implementation of flexible behavioral change.

Perceptual Awareness and Its Relationship with Consciousness: Hints from Perceptual Multistability

Many interesting theories of consciousness have been proposed, but so far, there is no "unified" theory capable of encompassing all aspects of this phenomenon. We are all aware of what it feels like to be conscious and what happens if there is an absence of consciousness. We are becoming more and more skilled in measuring consciousness states; nevertheless, we still "don't get it" in its deeper essence. How does all the processed information converge from different brain areas and structures to a common unity, giving us this very private "feeling of being conscious", despite the constantly changing flow of information between internal and external states? "Multistability" refers to a class of perceptual phenomena where subjective awareness spontaneously and continuously alternates between different percepts, although the objective stimuli do not change, supporting the idea that the brain "interprets" sensorial input in a "constructive" way. In this perspective paper, multistability and perceptual awareness are discussed as a methodological window for understanding the "local" states of consciousness, a privileged position from which it is possible to observe the brain dynamics and mechanisms producing the subjective phenomena of perceptual awareness in the very moment they are happening.

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

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

The attention-emotion interaction in healthy female participants on oral contraceptives during 1-week escitalopram intake

Previous findings in healthy humans suggest that selective serotonin reuptake inhibitors (SSRIs) modulate emotional processing via earlier changes in attention. However, many previous studies have provided inconsistent findings. One possible reason for such inconsistencies is that these studies did not control for the influence of either sex or sex hormone fluctuations. To address this inconsistency, we administered 20 mg escitalopram or placebo for seven consecutive days in a randomized, double-blind, placebo-controlled design to sixty healthy female participants with a minimum of 3 months oral contraceptive (OC) intake. Participants performed a modified version of an emotional flanker task before drug administration, after a single dose, after 1 week of SSRI intake, and after a 1-month wash-out period. Supported by Bayesian analyses, our results do not suggest a modulatory effect of escitalopram on behavioral measures of early attentional-emotional interaction in female individuals with regular OC use. While the specific conditions of our task may be a contributing factor, it is also possible that a practice effect in a healthy sample may mask the effects of escitalopram on the attentional-emotional interplay. Consequently, 1 week of escitalopram administration may not modulate attention toward negative emotional distractors outside the focus of attention in healthy female participants taking OCs. While further research in naturally cycling females and patient samples is needed, our results represent a valuable contribution toward the preclinical investigation of antidepressant treatment.

The Role of Emotional Information in Banner Blindness

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

Attention to affect 2.0: Multiple effects of emotion and attention on event-related potentials of visual word processing in a valence-detection task

Here we continue recent work on the specific mental processes engaged in a valence-detection task. Fifty-seven participants responded to one predefined target level of valence (negative, neutral, or positive), and ignored the remaining two levels. This enables more precise fine-tuning of neuronal pathways, compared to valence categorization where attention is divided between different levels of valence. Our group recently used valence detection with emotional words. Posterior P1 and N170 effects in the event-related potential (ERP) supported the idea of valent word forms that can be tuned by selective attention to valence. Here we report findings on three distinct posterior N2 components, P300, N400, and the late positive potential (LPP). Target but not nontarget words showed an arousal effect (emotional > neutral) on left-side early posterior negativity (180-280 ms). In contrast, an arousal effect on a sharp N2 deflection in left-minus-right difference ERPs (230-270 ms), suggesting facilitation of lexical access for emotional words, was independent of target status. This also applied to increased medial parieto-occipital N2 (260-300 ms) specific to negative words, indicating attentional capture. Medial-central N400 was specifically enhanced for negative nontarget words, further supporting attentional capture. The typical LPP arousal effect was observed, being stronger and more left-lateralized in target words. An exploratory finding concerned a broad component-overarching ERP valence effect (250-650 ms). Independent of target status, ERPs were more positive for positive than negative words. Combined with our previous results, data suggest multiple loci of emotion-attention interactions in valence detection.

EXPRESS: Task demands moderate the effect of emotion on attentional capture

The current experiment examined the effect of task demands on attention to emotional images. Eighty participants viewed pairs of images, with each pair consisting of an emotional (negative or positive) and a neutral image, or two neutral images. Participants' eye movements were recorded during picture viewing, and participants were either asked 1) which picture contains more colour? (colour task), 2) are the images equally pleasant? (pleasantness task), 3) which picture do you prefer? (preference task), or 4) were given no task instructions (control task). Although the results did not suggest that emotional images strongly captured attention, emotional images were looked at earlier than neutral images. Importantly, the pattern of results were dependent upon the task instructions; whilst the preference and colour task conditions showed early attentional biases to emotional images, only positive images were looked at earlier in the pleasantness task condition, and no early attentional biases were observed in the control task. Moreover, total fixation duration was increased for positive images in the preference task condition, but not in the other task conditions. It was concluded that attention to emotional stimuli can be modified by the demands of the task during viewing. However, further research should consider additional factors, such as the cognitive load of the viewing tasks, and the content of the images used.

Confusion Effects of Facial Expression Recognition in Patients With Major Depressive Disorder and Healthy Controls

Facial expression recognition plays a crucial role in understanding the emotion of people, as well as in social interaction. Patients with major depressive disorder (MDD) have been repeatedly reported to be impaired in recognizing facial expressions. This study aimed to investigate the confusion effects between two facial expressions that presented different emotions and to compare the difference of confusion effect for each emotion pair between patients with MDD and healthy controls. Participants were asked to judge the emotion category of each facial expression in a two-alternative forced choice paradigm. Six basic emotions (i.e., happiness, fear, sadness, anger, surprise, and disgust) were examined in pairs, resulting in 15 emotion combinations. Results showed that patients with MDD were impaired in the recognition of all basic facial expressions except for the happy expression. Moreover, patients with MDD were more inclined to confuse a negative emotion (i.e., anger and disgust) with another emotion as compared to healthy controls. These findings highlight the importance that patients with MDD show a deficit of sensitivity in distinguishing specific two facial expressions.

Fatigue, Emotion, and Cognitive Performance in Simulated Long-Duration, Single-Piloted Flight Missions

BACKGROUND: Fatigue of air force pilots has become an increasing concern due to changes in mission characteristics. In the current study we investigated fatigue, emotions, and cognitive performance in a simulated 11-h mission in the 39 Gripen fighter aircraft. METHODS: A total of 12 subjects were evaluated in a high-fidelity dynamic flight simulator for 12 consecutive hours. Perceived fatigue was measured by the Samn-Perelli Fatigue Index (SPFI). Emotions were assessed with the Circumplex Affect Space. Cognitive performance was assessed by five cognitive tasks. RESULTS: Significant increase in self-reported fatigue, general decrease in two positive emotional states, as well increase of one negative emotional state occurred after approximately 7 h into the mission. Self-reported fatigue negatively correlated with enthusiasm and cheerfulness (r 0.75; 0.49, respectively) and positively correlated with boredom and gloominess (r 0.61; r 0.30, respectively). Response time in the low-order task negatively correlated with enthusiasm, cheerfulness and calmness (r 0.44; r 0.41; r 0.37, respectively) and positively correlated with boredom and anxiousness (r 0.37; r 0.28, respectively). Mission duration had an adverse impact on emotions in these environmental conditions, particularly after 7 h. DISCUSSION: These results contribute to the understanding of fatigue development in general and of emotion-cognition relationships. These findings emphasize that both emotional states and the type of cognitive tasks to be performed should be considered for planning long-duration missions in single-piloted fighter aircrafts as to increase the probability of missions success. Rosa E, Gronkvist M, Kolegard R, Dahlstrom N, Knez I, Ljung R, Willander J. Fatigue, emotion, and cognitive performance in simulated long-duration, single-piloted flight missions. Aerosp Med Hum Perform. 2021; 92(9):710719.

Improving motor and cognitive recovery following severe traumatic brain injury using advanced emotional audio-video stimulation: Lessons from a case report

RATIONALE

It is estimated that about 6 million people suffer from severe traumatic brain injury (TBI) each year (73 cases per 100,000 people). TBI may affect emotional, sensory-motor, cognitive, and psychological functions with a consequent worsening of both patient and his/her caregiver's quality of life. In recent years, technological innovations allowed the development of new, advanced sensory stimulation systems, such as Neurowave, to further stimulate residual cognitive abilities and, at the same time, evaluate residual cognition.

PATIENT CONCERN

An 69-year-old Italian man entered our neurorehabilitation unit with a diagnosis of minimally conscious state following severe TBI. He breathed spontaneously via tracheostomy and was fed via percutaneous gastrostomy. At the neurological examination, the patient showed severe tetraparesis as he showed fluctuating alertness and responsiveness to external stimuli and opened the eyes without stimulation.

DIAGNOSIS

Patient was affected by subarachnoid hemorrhage and frontotemporal bilateral hematoma, which were surgically treated with decompressive craniotomy and subsequent cranioplasty about 6 months before.

INTERVENTIONS

The patient underwent a neuropsychological and clinical evaluation before (T0) and after a conventional rehabilitation cycle (T1), and after a Neurowave emotional stimulation-supported rehabilitative cycle (T2).

OUTCOMES

Following conventional rehabilitation (T1), the patient achieved a partial improvement in behavioral responsiveness; there was also a mild improvement in the caregiver's distress. Conversely, Neurowave emotional stimulation session determined (at T2) a significant improvement of the patient's behavioral responsiveness, cognition, and in the caregiver's distress. The P300 recording in response to the NES showed a significant change of P300 magnitude and latency.

DISCUSSION

Our data suggest that emotional-integrated sensory stimulation using adequate visual stimuli represents a beneficial, complementary rehabilitative treatment for patients in minimally conscious state following a severe TBI. This may occur because stimuli with emotional salience can provide a reliable motivational resource to stimulate motor and cognitive recovery following severe TBI.

Holistic face processing is influenced by non-conscious visual information

Holistic face processing has been widely implicated in conscious face perception. Yet, little is known about whether holistic face processing occurs when faces are processed unconsciously. The present study used the composite face task and continuous flash suppression (CFS) to inspect whether the processing of target facial information (the top half of a face) is influenced by irrelevant information (the bottom half) that is presented unconsciously. Results of multiple experiments showed that the composite effect was observed in both monocular and CFS conditions, providing the first evidence that the processing of top facial halves is influenced by the aligned bottom halves no matter whether they are presented consciously or unconsciously. However, much of the composite effect for faces without masking was disrupted when bottom facial parts were rendered with CFS. These results suggest that holistic face processing can occur unconsciously, but also highlight the significance of holistic processing of consciously presented faces.

Emotional content overrides spatial attention

Spatial attention is our capacity to attend to or ignore particular regions of our spatial environment. However, some classes of stimuli may be able to override our efforts to ignore them. Here we assessed the relationship between involuntary attentional capture with emotional images and spatial attention at early stages of perceptual processing. Multiple scenes of unpleasant and neutral content were displayed in rapid serial visual presentation (RSVP) streams that elicited the steady-state visual evoked potential (SSVEP), a neural marker of selective attention at early visual areas. In a spatial cueing task, participants were cued to covertly attend to RSVP streams presented at 4 and 6 Hz presentation rates in the left and right visual hemifields. The task was to detect square targets occasionally displayed within the image streams, responding only to those appearing on the cued side. The RSVP streams were always neutral pictures in one visual hemifield but would unpredictably switch from neutral to aversive content in the other visual hemifield. We found that SSVEP amplitude was consistently modulated by a change in emotional valence of image streams, regardless of whether the change in content occurred in the attended or unattended spatial location, reflecting an automatic sensory amplification for affective stimuli. The present data provide further evidence in support that emotional images can attract visual processing resources independently of spatial attention allocation, and are consistent with sustained sensory facilitation of early visual areas through re-entrant feedback projections from higher-order cortical areas involved in the extraction of affective information.

The early processing of fearful and happy facial expressions is independent of task demands - Support from mass univariate analyses

Most ERP studies on facial expressions of emotion have yielded inconsistent results regarding the time course of emotion effects and their possible modulation by task demands. Most studies have used classical statistical methods with a high likelihood of type I and type II errors, which can be limited with Mass Univariate statistics. FMUT and LIMO are currently the only two available toolboxes for Mass Univariate analysis of ERP data and use different fundamental statistics. Yet, no direct comparison of their output has been performed on the same dataset. Given the current push to transition to robust statistics to increase results replicability, here we compared the output of these toolboxes on data previously analyzed using classic approaches (Itier & Neath-Tavares, 2017). The early (0-352 ms) processing of fearful, happy, and neutral faces was investigated under three tasks in a within-subject design that also controlled gaze fixation location. Both toolboxes revealed main effects of emotion and task but neither yielded an interaction between the two, confirming the early processing of fear and happy expressions is largely independent of task demands. Both toolboxes found virtually no difference between neutral and happy expressions, while fearful (compared to neutral and happy) expressions modulated the N170 and EPN but elicited maximum effects after the N170 peak, around 190 ms. Similarities and differences in the spatial and temporal extent of these effects are discussed in comparison to the published classical analysis and the rest of the ERP literature.

Divided attention at encoding or retrieval interferes with emotionally enhanced memory for words

Emotional information is typically better remembered than neutral information. We asked whether emotional, compared to neutral, words were less vulnerable to the detrimental effects of divided attention. In two experiments, undergraduate students intentionally encoded words of intermixed valence (neutral, negative, or positive) and arousal (neutral, high, or low). Following a filled delay, memory was assessed with a free recall test. In Experiment 1, participants encoded visually-presented words under either full attention (FA; no distracting task) or divided attention (DA; concurrently making animacy decisions to auditorily-presented distractor words) in a counterbalanced, within-subjects design. As expected following FA at encoding, recall was significantly enhanced for negative compared to neutral words. Following DA at encoding, recall was significantly impaired across all valences. Critically, DA at encoding also eliminated the memory benefit for negative information: recall of negative words was no longer significantly different from neutral or positive words. In Experiment 2, we manipulated attention at retrieval rather than encoding. Remarkably, results from Experiment 1 were replicated: DA eliminated the well-known emotionality boost for negative words. In both experiments, memory for positive words did not significantly differ from neutral. Findings suggest that DA during either encoding or retrieval can interfere with the specific mechanisms by which negative emotion typically improves memory.

"Speak of the Devil… and he Shall Appear": Religiosity, Unconsciousness, and the Effects of Explicit Priming in the Misperception of Immorality

Psychological theory and research suggest that religious individuals could have differences in the appraisal of immoral behaviours and cognitions compared to non-religious individuals. This effect could occur due to adherence to prescriptive and inviolate deontic religious-moral rules and socio-evolutionary factors, such as increased autonomic nervous system responsivity to indirect threat. The latter thesis has been used to suggest that immoral elicitors could be processed subliminally by religious individuals. In this manuscript, we employed masking to test this hypothesis. We rated and pre-selected IAPS images for moral impropriety. We presented these images masked with and without negatively manipulating a pre-image moral label. We measured detection, moral appraisal and discrimination, and physiological responses. We found that religious individuals experienced higher responsivity to masked immoral images. Bayesian and hit-versus-miss response analyses revealed that the differences in appraisal and physiological responses were reported only for consciously perceived immoral images. Our analysis showed that when a negative moral label was presented, religious individuals experienced the interval following the label as more physiologically arousing and responded with lower specificity for moral discrimination. We propose that religiosity involves higher conscious perceptual and physiological responsivity for discerning moral impropriety but also higher susceptibility for the misperception of immorality.

Reward history modulates perceptual load effects

The reward history of a stimulus can yield strong attentional selection biases. Indeed, attentional capture can be triggered by previously rewarded items which are neither salient nor relevant for the ongoing task, even when selection is clearly counter-productive to actually obtain the reward outcome. Therefore, value-driven attentional capture (VDAC) has been argued to be an automatic attention mechanism. Our study aimed at putting the VDAC automaticity directly to the test. For this purpose, the Load Theory offers a comprehensive framework where distraction is observed under low but not high perceptual load condition. Nevertheless, if VDAC is indeed automatic, distraction by reward-stimuli should be observed on both perceptual load conditions. We used a feature vs. conjunction discrimination of a go/no-go cue to manipulate perceptual load. As expected, our results revealed that perceptual load decreased interference produced by low-reward distractor. However, this effect was not significant for high-reward distractor, giving support to VDAC automaticity. We discussed our results in light of the Load Theory literature and we strongly encourage to consider reward history along with perceptual load in determining attentional capture.

Where does fear originate in the brain? A coordinate-based meta-analysis of explicit and implicit fear processing

Processing of fear is of crucial importance for human survival and it can generally occur at explicit and implicit conditions. It is worth noting that explicit and implicit fear processing produces different behavioral and neurophysiological outcomes. The present study capitalizes on the Activation Likelihood Estimation (ALE) method of meta-analysis to identify: (a) the "core" network of fear processing in healthy individuals; (b) common and specific neural activations associated with explicit and implicit processing of fear. Following PRISMA guidelines, a total of 92 fMRI and PET studies were included in the meta-analysis. The overall analysis show that the core fear network comprises the amygdala, pulvinar, and fronto-occipital regions. Both implicit and explicit fear processing activated amygdala, declive, fusiform gyrus, and middle frontal gyrus, suggesting that these two types of fear processing share a common neural substrate. Explicit fear processing elicited more activations at the pulvinar and parahippocampal gyrus, suggesting visual attention/orientation and contextual association play important roles during explicit fear processing. In contrast, implicit fear processing elicited more activations at the cerebellum-amygdala-cortical pathway, indicating an 'alarm' system underlying implicit fear processing. These findings have shed light on the neural mechanism underlying fear processing at different levels of awareness.

The interaction between reward and the task-irrelevant emotional context in memory

Reward improves task performance while the emotional contexts irrelevant to the task impair task performance. An interaction between reward and the task-irrelevant emotional context has been discovered by some studies using perceptual tasks. However, it is unclear that how memory performance would be affected by both variables. This study aimed to answer this question and explore the role of arousal induced by emotional stimuli, to which was seldomly paid attention by previous studies. We conducted two experiments with the study-test paradigm. The first difference between the experiments was the way that the emotional stimuli were presented. They were presented with the words (Experiment 1) or separately (Experiment 2). The second difference was that the manipulation of the emotional arousal was phasic (Experiment 1) or tonic (Experiment 2). Both experiments showed that the reward effect was greater in emotional context compared to the neutral context, which is not only due to the poorer memory of no reward-associated words but also the better memory of reward-associated words in emotional contexts especially in negative one. These results supported the view that emotional arousal enhanced the memory of high priority stimuli (reward-associated words) and impaired the memory of low priority stimuli (no reward-associated words).

Time will tell: Object categorization and emotional engagement during processing of degraded natural scenes

The aim of the present study was to examine the relationship between object categorization in natural scenes and the engagement of cortico-limbic appetitive and defensive systems (emotional engagement) by manipulating both the bottom-up information and the top-down context. Concerning the bottom-up information, we manipulated the computational load by scrambling the phase of the spatial frequency spectrum, and asked participants to classify natural scenes as containing an animal or a person. The role of the top-down context was assessed by comparing an incremental condition, in which pictures were progressively revealed, to a condition in which no probabilistic relationship existed between each stimulus and the following one. In two experiments, the categorization and response to emotional and neutral scenes were similarly modulated by the computational load. The Late Positive Potential (LPP) was affected by the emotional content of the scenes, and by categorization accuracy. When the phase of the spatial frequency spectrum was scrambled by a large amount (>58%), chance categorization resulted, and affective LPP modulation was eliminated. With less degraded scenes, categorization accuracy was higher (.82 in Experiment 1, .86 in Experiment 2) and affective modulation of the LPP was observed at a late window (>800 ms), indicating that it is possible to delay the time of engagement of the motivational systems which are responsible for the LPP affective modulation. The present data strongly support the view that semantic analysis of visual scenes, operationalized here as object categorization, is a necessary condition for emotional engagement at the electrocortical level (LPP).

Individual differences in anxiety and automatic amygdala response to fearful faces: A replication and extension of Etkin et al. (2004)

Trait anxiety refers to the stable tendency to attend to threats and experience fears and worries across many situations. According to the widely noticed, pioneering investigation by Etkin et al. (2004) trait anxiety is strongly associated with reactivity in the right basolateral amygdala to non-conscious threat. Although this observation was based on a sample of only 17 individuals, no replication effort has been reported yet. We reexamined automatic amygdala responsiveness as a function of anxiety in a large sample of 107 participants. Besides self-report instruments, we administered an indirect test to assess implicit anxiety. To assess early, automatic stages of emotion processing, we used a color-decision paradigm presenting brief (33 ms) and backward-masked fearful facial expressions. N = 56 participants were unaware of the presence of masked faces. In this subset of unaware participants, the relationship between trait anxiety and basolateral amygdala activation by fearful faces was successfully replicated in region of interest analyses. Additionally, a relation of implicit anxiety with masked fear processing in the amygdala and temporal gyrus was observed. We provide evidence that implicit measures of affect can be valuable predictors of automatic brain responsiveness and may represent useful additions to explicit measures. Our findings support a central role of amygdala reactivity to non-consciously perceived threat in understanding and predicting dispositional anxiety, i.e. the frequency of spontaneously occurring anxiety in everyday life.

A crowd of emotional voices influences the perception of emotional faces: Using adaptation, stimulus salience, and attention to probe audio-visual interactions for emotional stimuli

Correctly assessing the emotional state of others is a crucial part of social interaction. While facial expressions provide much information, faces are often not viewed in isolation, but occur with concurrent sounds, usually voices, which also provide information about the emotion being portrayed. Many studies have examined the crossmodal processing of faces and sounds, but results have been mixed, with different paradigms yielding different results. Using a psychophysical adaptation paradigm, we carried out a series of four experiments to determine whether there is a perceptual advantage when faces and voices match in emotion (congruent), versus when they do not match (incongruent). We presented a single face and a crowd of voices, a crowd of faces and a crowd of voices, a single face of reduced salience and a crowd of voices, and tested this last condition with and without attention directed to the emotion in the face. While we observed aftereffects in the hypothesized direction (adaptation to faces conveying positive emotion yielded negative, contrastive, perceptual aftereffects), we only found a congruent advantage (stronger adaptation effects) when faces were attended and of reduced salience, in line with the theory of inverse effectiveness.

Acquired Visual Deficits Independent of Lesion Site in Acute Stroke

Most clinical diagnoses of stroke are based on the persistence of symptoms relating to consciousness, language, visual-field loss, extraocular movement, neglect (visual), motor strength, and sensory loss following acute cerebral infarction. Yet despite the fact that most motor actions and cognition are driven by vision, functional vision per se is seldom tested rigorously during hospitalization. Hence we set out to determine the effects of acute stroke on functional vision, using an iPad application (Melbourne Rapid Field-Neural) that can be used to assess vision (visual acuity and visual field sensitivity) at the bedside or in the emergency ward in about 6 min per eye. Our convenience sample comprised 60 (29–88 years, 65 ± 14 years, 33 males) of 160 sequentially presenting first episode, acute (<7 days) ischemic stroke patients at Sunshine Hospital, Melbourne. One hundred patients were excluded due to existing eye disease, inadequate radiological confirmation, inability to comply with English directions or too ill to participate. Stroke cases were compared with 37 (29–85 years, 64 ± 12 years,14 males) similar-aged controls using a Mann-Whitney U-test. A significant loss in visual field sensitivity was measured in 68% of stroke cases (41/60, Mean Deviation: Stroke: −5.39 ± 6.26 dB, Control: 0.30 ± 0.60 dB, MWU = 246, p < 0.0001). Surprisingly, 44% (18/41) of these patients were unaware of their field loss. Although high contrast visual acuity was unaffected in most (55/60) patients, visual acuity-in-noise was reduced in 62% (37/60, Stroke: mean 6/12−2, log MAR 0.34 ± 0.21 vs. Control: mean 6/7·5–2, log MAR 0.14 ± 0.10; MWU = 470, p < 0.0001). Visual field defects were associated with all occipital, parietal and posterior cerebellar artery strokes while 9/15 middle cerebral artery lesions and 11 lesions in other brain regions were also associated with visual field defects. Our findings demonstrate that ~2/3 of acute first episode ischemic stroke patients experience acquired vision deficits, often unrelated to the confirmed lesion site. Our results also imply that visual dysfunction may be associated with a more generalized cerebral dysfunction while highlighting the need for bedside testing of vision for every stroke patient and demonstrating the translational clinical value of the “Melbourne Rapid Field- Neural” iPad application.

Clinical Trial:http://www.ANZCTR.org.au/ACTRN12618001111268.aspx.

Facial expressions recognition and discrimination in Parkinson's disease

Emotion processing impairment is a common non-motor symptom in Parkinson's Disease (PD). Previous literature reported conflicting results concerning, in particular, the performance for different emotions, the relation with cognitive and neuropsychiatric symptoms and the affected stage of processing. This study aims at assessing emotion recognition and discrimination in PD. Recognition of six facial expressions was studied in order to clarify its relationship with motor, cognitive and neuropsychiatric symptoms. Sensitivity in discriminating happy and fearful faces was investigated to address controversial findings on impairment in early stages of emotion processing. To do so, seventy PD patients were tested with the Ekman 60 Faces test and compared with 46 neurologically unimpaired participants. Patients' performances were correlated with clinical scales and neuropsychological tests. A subsample of 25 PD patients and 25 control participants were also tested with a backward masking paradigm for sensitivity in happiness and fear discrimination. Results showed that PD patients were impaired in facial emotion recognition, especially for fearful expressions. The performance correlated with perceptual, executive and general cognitive abilities, but facial expression recognition deficits were present even in cognitively unimpaired patients. In contrast, patients' sensitivity in backward masking tasks was not reduced as compared to controls. Taken together our data demonstrate that facial emotion recognition, and fear expression in particular, is critically affected by neurodegeneration in PD and related to cognitive abilities; however, it appears before other cognitive impairments. Preserved performances in discriminating shortly presented facial expressions, suggest unimpaired early stages of emotion processing.

Uncovering electrophysiological and vascular signatures of implicit emotional prosody

The capability of differentiating between various emotional states in speech displays a crucial prerequisite for successful social interactions. The aim of the present study was to investigate neural processes underlying this differentiating ability by applying a simultaneous neuroscientific approach in order to gain both electrophysiological (via electroencephalography, EEG) and vascular (via functional near-infrared-spectroscopy, fNIRS) responses. Pseudowords conforming to angry, happy, and neutral prosody were presented acoustically to participants using a passive listening paradigm in order to capture implicit mechanisms of emotional prosody processing. Event-related brain potentials (ERPs) revealed a larger P200 and an increased late positive potential (LPP) for happy prosody as well as larger negativities for angry and neutral prosody compared to happy prosody around 500 ms. FNIRS results showed increased activations for angry prosody at right fronto-temporal areas. Correlation between negativity in the EEG and activation in fNIRS for angry prosody suggests analogous underlying processes resembling a negativity bias. Overall, results indicate that mechanisms of emotional and phonological encoding (P200), emotional evaluation (increased negativities) as well as emotional arousal and relevance (LPP) are present during implicit processing of emotional prosody.

The impact of novelty and emotion on attention-related neuronal and pupil responses in children

Focusing on relevant and ignoring irrelevant information is essential for many learning processes. The present study investigated attention-related brain activity and pupil dilation responses, evoked by task-irrelevant emotional novel sounds. In the framework of current theories about the relation between attention and the locus coeruleus-norepinephrine (LC-NE) system, we simultaneously registered event-related potentials (ERPs) in the EEG and changes in pupil diameter (PDR). Unexpected emotional negative and neutral environmental novel sounds were presented within a sequence of repeated standard sounds to 7-10-year-old children and to adults, while participants focused on a visual task. Novel sounds evoked distinctive ERP components, reflecting attention processes and a biphasic PDR in both age groups. Amplitudes of the novel-minus-standard ERPs were increased in children compared to adults, indicating immature neuronal basis of auditory attention in middle childhood. Emotional versus neutral novel sounds evoked increased responses in the ERPs and in the PDR in both age groups. This demonstrates the increased impact of emotional sounds on attention mechanisms and indicates an advanced level of emotional information processing in children. The similar pattern of novel-related PDR and ERPs is conforming to recent theories, emphasizing the role of the LC-NE system in attention processes adding a developmental perspective.

Common neural value representations of hedonic and utilitarian products in the ventral stratum: An fMRI study

Hedonic goods are goods that people buy to obtain emotional experiences, such as joy or excitement, while utilitarian goods are bought to meet functional or instrumental needs. Although research in neuroscience suggests that the values of hedonic and utilitarian goods are similarly represented, it remains largely unknown how these values are mapped during purchasing decisions or task-irrelevant judgments. It has been suggested that people rely more on hedonic (vs. utilitarian) factors when making task-irrelevant judgments, and that this is amplified by trait-reward seeking. Functional magnetic resonance imaging (fMRI) can directly measure the mental processes involved in explicit or task-irrelevant value judgments. Using fMRI, we found that the explicit value of hedonic and utilitarian goods was commonly processed in the ventral striatum. In contrast, no significant results were obtained in common neural processing of task-irrelevant hedonic and utilitarian value. Additionally, we did not find any evidence that trait-reward seeking modulates task-irrelevant hedonic (vs. utilitarian) value processing. Our findings show that the value of both hedonic and utilitarian goods is commonly represented in the ventral striatum, and indicate that the value construct underlying consumer purchases is unidimensional.

Mid-Frontal Theta Modulates Response Inhibition and Decision Making Processes in Emotional Contexts

Inhibitory control is an integral part of executive functions. In this study, we report event-related spectral perturbation (ERSP) results from 15 healthy adults performing an emotional stop-signal task with the use of happy, disgusted, and neutral emotional faces. Our ERSP results at the group level suggest that changes in low frequency oscillatory power for emotional and neutral conditions start at as early as 200 ms after stimulus onset and 300 ms before button press for successful go trials. To quantify the dynamics of trial-by-trial theta power, we applied the hierarchical drift diffusion model to single-trial ERSP at the mid-frontal electrode site for the go condition. Hierarchical drift diffusion modeling (HDDM) assigned higher frontal low-frequency oscillatory power for evidence accumulation in emotional contexts as compared to a neutral setting. Our results provide new evidence for dynamic modulation of sensory processing of go stimuli in inhibition and extend our knowledge for processing of response inhibition in emotional contexts.

Rapid sensory gain with emotional distracters precedes attentional deployment from a foreground task

The steady-state visual evoked potential (SSVEP), an electrophysiological marker of attentional resource allocation, has recently been demonstrated to serve as a neural signature of emotional content extraction from a rapid serial visual presentation (RSVP). SSVEP amplitude was reduced for streams of emotional relative to neutral scenes passively viewed at 6 Hz (~167 ms per image), but it was enhanced for emotional relative to neutral scenes when viewed as 4 Hz RSVP (250 ms per image). Here, we investigated whether these seemingly contradictory observations may be related to different dynamics in the allocation of attentional resources as a consequence of stimulation frequency. To this end, we advanced our distraction paradigm by presenting a visual foreground task consisting of randomly moving squares flickering at 15 Hz superimposed on task-irrelevant RSVP streams shown at 6 or 4 Hz, which could unpredictably switch from neutral to unpleasant content during the trial or remained neutral. Critically, our findings demonstrate that affective distractors captured attentional resources more strongly than their neutral counterparts, irrespective of whether they were presented at 6 or 4 Hz rate. Moreover, the emotion-dependent attentional deployment from the foreground task was temporally preceded by sustained sensory facilitation in response to emotional background images. Together, present findings provide evidence for rapid sustained visual facilitation but a rather slow attentional bias in favor of emotional distractors in early visual areas.

Affective distraction along the flexibility-stability continuum

This study explored whether conditions that promote flexibility in task processing enhance the detrimental impact of irrelevant negative stimulation on performance. We approached this flexibility from a transient and a sustained perspective, by manipulating whether participants repeated or switched between two tasks in consecutive trials and whether they performed the tasks in separate blocks or randomly mixed. Participants categorised either a letter or the colour of a bar, which were presented close to an irrelevant negative or neutral picture. Performance was worse in the presence of negative rather than neutral pictures. Repeating or switching tasks transiently did not modulate this detrimental impact of affective distraction in three experiments (n_Exp1 = 32, n_Exp2 = 32, n_Exp3 = 64). Attentional capture by negative content did decline in single compared to mixed task contexts, but only when these sustained task contexts also differed in the frequency of affective stimulation. When affective stimulation was the same in mixed and single task contexts, this modulation vanished. Overall, these results suggest that the influence of task-irrelevant negative stimulation on performance is surprisingly independent of cognitive states that favour either flexible or stable processing of task-relevant information.

What drives prioritized visual processing? A motivational relevance account

Emotion is fundamental to our being, and an essential aspect guiding behavior when rapid responding is required. This includes whether we approach or avoid a stimulus, and the accompanying physiological responses. A common tenet is that threat-related content drives stimulus processing and biases visual attention, so that rapid responding can be initiated. In this paper, it will be argued instead that prioritization of threatening stimuli should be encompassed within a motivational relevance framework. To more fully understand what is, or is not, prioritized for visual processing one must, however, additionally consider: (i) stimulus ambiguity and perceptual saliency; (ii) task demands, including both perceptual load and cognitive load; and (iii) endogenous/affective states of the individual. Combined with motivational relevance, this then leads to a multifactorial approach to understanding the drivers of prioritized visual processing. This accords with current recognition that the brain basis allowing for visual prioritization is also multifactorial, including transient, dynamic and overlapping networks. Taken together, the paper provides a reconceptualization of how "emotional" information prioritizes visual processing.