The emotional Stroop task and posttraumatic stress disorder: a meta-analysis

Effect of facial emotion recognition learning transfers across emotions

Introduction

Perceptual learning of facial expression is shown specific to the train expression, indicating separate encoding of the emotional contents in different expressions. However, little is known about the specificity of emotional recognition training with the visual search paradigm and the sensitivity of learning to near-threshold stimuli.

Methods

In the present study, we adopted a visual search paradigm to measure the recognition of facial expressions. In Experiment 1 (Exp1), Experiment 2 (Exp2), and Experiment 3 (Exp3), subjects were trained for 8 days to search for a target expression in an array of faces presented for 950 ms, 350 ms, and 50 ms, respectively. In Experiment 4 (Exp4), we trained subjects to search for a target of a triangle, and tested them with the task of facial expression search. Before and after the training, subjects were tested on the trained and untrained facial expressions which were presented for 950 ms, 650 ms, 350 ms, or 50 ms.

Results

The results showed that training led to large improvements in the recognition of facial emotions only if the faces were presented long enough (Exp1: 85.89%; Exp2: 46.05%). Furthermore, the training effect could transfer to the untrained expression. However, when the faces were presented briefly (Exp3), the training effect was small (6.38%). In Exp4, the results indicated that the training effect could not transfer across categories.

Discussion

Our findings revealed cross-emotion transfer for facial expression recognition training in a visual search task. In addition, learning hardly affects the recognition of near-threshold expressions.

Crisis-related stimuli do not increase the emotional attentional blink in a general university student population

Crises such as natural disasters or pandemics negatively impact the mental health of the affected community, increasing rates of depression, anxiety, or stress. It has been proposed that this stems in part from crisis-related stimuli triggering negative reactions that interrupt daily life. Given the frequency and prominence of crisis events, it is crucial to understand when crisis-related stimuli involuntarily capture attention and trigger increased stress and distraction from obligations. The emotional attentional blink (EAB) paradigm-in which emotional distractors hinder report of subsequent targets in streams of rapidly displayed stimuli-allows examination of such attentional capture in a rapidly changing dynamic environment. EABs are typically observed with generally disturbing stimuli, but stimuli related to personal traumas yield similar or greater effects, indicating strong attentional capture by stimuli related to individual trauma history. The current study investigated whether a similar comparable or increased crisis-related EAB exists within a community affected by large-scale crisis. Specifically, effects of conventional emotional distractors and distractors related to recent crises were compared using EABs in university students without a mental health diagnosis. Experiment 1 used images related to Hurricane Harvey, evaluating a crisis 4 years prior to data collection. Experiment 2 used words related to the COVID pandemic, evaluating an ongoing crisis at the time of data collection. In both experiments, the conventional EAB distractors yielded strong EABs, while the crisis-related distractors yielded absent or weak EABs in the same participants. This suggests that crisis-related stimuli do not have special potency for capturing attention in the general university student population. More generally, crises affecting communities do not necessarily yield widespread, strong reactivity to crisis-related stimuli.

An investigation of the mechanisms underlying the link between abstract reasoning and intrusive memories: A trauma analogue study

Potentially traumatic events elicit intrusive memories to which some individuals are more vulnerable than others. Lower abstract reasoning capacity has been related to more intrusive memories. A more perceptual processing style when encoding the event may mediate this link. Another potential mechanism is lower attentional control, resulting in greater attentional bias toward trauma-related content. We examined both of these possibilities using a trauma-analogue paradigm. One hundred and twenty participants completed abstract reasoning tasks. Then, 90 participants watched a negative video, and 30 participants watched a neutral video. The level of perceptual processing (P1) and attentional bias (RT) towards trauma-related stimuli were measured with a pictorial Stroop task while recording EEG. Intrusive memories were recorded for 5 days. Abstract reasoning was not associated with intrusive memories. However, lower abstract reasoning tended to be associated with more perceptual processing (greater P1 amplitude) following the negative video. More perceptual processing also tended to be related to more intrusive memories for younger participants. A more pronounced attentional bias was related to more intrusive memories, but only for women. Unexpectedly, also for women, better verbal reasoning was linked to a more pronounced attentional bias. Results are compared to existing studies and future implications are discussed.

Content specificity of attentional bias to COVID-19 threat-related information in trait anxiety

Introduction

Anxious individuals selectively attend to threatening information, but it remains unclear whether attentional bias can be generalized to traumatic events, such as the COVID-19 pandemic. Previous studies suggested that specific threats related to personal experiences can elicit stronger attentional bias than general threats. The current study aimed to investigate the relationship between content-specific attentional bias and trait anxiety during the COVID-19 pandemic.

Methods

Attentional bias was assessed using the dot-probe task with COVID-19-related, general threat-related, and neutral words at two exposure times, 200 and 500 ms.

Results

We found participants with high trait anxiety exhibited attentional bias toward COVID-19- related stimuli and attentional bias away from general threat-related stimuli, while participants with low trait anxiety showed attentional bias away from both types of stimuli.

Discussion

Results suggest that individuals with high trait anxiety show a content-specific attentional bias to COVID-19-related information during the COVID-19 pandemic. Apart from the innate attentional bias toward biological threats, individuals with high trait anxiety may also learn from trauma and develop trauma-specific attentional bias.

Biases in affective attention tasks in posttraumatic stress disorder patients: A systematic review of neuroimaging studies

INTRODUCTION

Posttraumatic stress disorder (PTSD) is characterized by alterations in emotional and cognitive processing. The current neurobiological model of PTSD posits that amygdala and prefrontal cortex functioning impairment underpins symptoms, such as altered emotional and cognitive processing. Additionally, these structures are key components of emotional and attention regulation.

AIM

This review sought to evaluate studies comparing PTSD group to non-PTSD controls performance in affective attention tasks during neuroimaging.

RESULTS

PTSD group behavioral performance when responding to affective stimuli differed from controls only in stroop-based tasks. However, neuroimaging techniques were able to identify brain activation differences even when behavioral differences were not present. Amygdala hyperactivation in PTSD patients was confirmed in most cases, but cortical networks results were not as consistent. More than a general reduction in activity, PTSD group data points out to impaired recruitment of ventral cortical structures and increased reliance on dorsal cortical structures during task performance.

CONCLUSION

Stroop-based tasks seem to be better at identifying differences in behavioral performance of PTSD individuals. PTSD individuals seems to present an altered brain activation pattern in affective attention tasks when compared to controls, where PTSD individuals seem to present enhanced amygdala activation and rely more on dorsal anterior cingulate cortex and posterior insula activation during tasks. The PROSPERO ID for this study is CRD42022355471.

P3a amplitude to trauma-related stimuli reduced after successful trauma-focused PTSD treatment

An elevated P3a amplitude to trauma-related stimuli is strongly associated with posttraumatic stress disorder (PTSD), yet little is known about whether this response to trauma-related stimuli is affected by treatment that decreases PTSD symptoms. As an analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the P3a in responses in a three-condition oddball visual task that included trauma-related (combat scenes) and trauma-unrelated (threatening animals) distractors. Fifty-five U.S. veterans diagnosed with combat-related PTSD were randomized to receive either active or sham repetitive transcranial magnetic stimulation (rTMS). All received cognitive processing therapy, CPT+A, which requires a written account of the index trauma. They were tested before and 6 months after protocol completion. P3a amplitude and response time decreases were driven largely by the changes in the responses to the trauma-related stimuli, and this decrease correlated to the decrease in PTSD symptoms. The amplitude changes were greater in those who received rTMS + CPT than in those who received sham rTMS + CPT, suggesting that rTMS plays beneficial role in reducing arousal and threat bias, which may allow for more effective engagement in trauma-focused PTSD treatment.

Suicide-related construct accessibility and attention disengagement bias in suicide ideation

Previous attempts to determine whether attention bias toward suicide-related stimuli is associated with risk for future suicide attempts have yielded mixed findings that have been difficult to replicate. Recent evidence suggests that methods used to assess attention bias toward suicide-specific stimuli have low reliability. The present study used a modified attention disengagement and construct accessibility task to examine suicide-specific disengagement biases, along with cognitive accessibility of suicide-related stimuli, among young adults with different histories of suicide ideation. Young adults (N = 125; 79% women), screened for moderate-to-high levels of anxiety or depressive symptoms completed an attention disengagement and lexical decision (cognitive accessibility) task, along with self-report measures of suicide ideation and clinical covariates. Findings using generalized linear mixed-effects modeling revealed that young adults with recent suicide ideation displayed a suicide-specific facilitated disengagement bias, compared to peers with lifetime ideation. In contrast, there was no evidence of a construct accessibility bias for suicide-specific stimuli, irrespective of suicide ideation history. These findings point to a suicide-specific disengagement bias that may depend on the recency of suicidal thoughts and suggests automatic processing of suicide-specific information. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Posttraumatic Stress Symptoms Increase the Efficiency of Memory Functioning for Trauma-Related Information

OBJECTIVE

The present study explored the resources reallocation explanation for memory biases in posttraumatic stress disorder (PTSD), whereby a preferential allocation of cognitive resources to the processing of threatening stimuli could result in both improvements in their memorization and deficits for other types of information.

METHOD

To this end, 25 participants presenting significant symptoms of PTSD (i.e., total PCL-5 score ≥33) and 32 participants presenting low levels of symptoms (i.e., total PCL-5 score <20) took part in a Remember/Know recognition procedure associated with a dual-task encoding of positive, neutral, negative, and trauma-related words. In order to manipulate the availability of cognitive resources, the encoding of each word was associated with a simultaneous encoding of series of letters and numbers.

RESULTS

Results replicated the increased production of Remember recognitions for trauma-related words in participants with significant PTSD symptoms. However, the dual-task load only impaired remember recognitions for non-trauma-related words.

CONCLUSIONS

Contrary to expectations, these findings suggest that the encoding of trauma-related information in PTSD is relatively independent from the availability of cognitive resources. Thus, rather than reflecting an increased allocation of cognitive resources to the processing of threatening information, memory biases in PTSD appeared to be supported by an enhanced efficiency of their processing.

Attentional bias in German Armed Forces veterans with and without posttraumatic stress symptoms - An eye-tracking investigation and group comparison

BACKGROUND AND OBJECTIVES

Most eye tracking based paradigms evidence patterns of sustained attention on threat coupled with low evidence for vigilance to or avoidance of threat in posttraumatic stress symptoms (PTSS). Still, eye tracking data on attention bias is particularly limited for military population. This eye tracking study investigated attentional bias in PTSS in a sample of German Armed Forces veterans.

METHODS

Veterans with deployment-related PTSS (N = 24), veterans with deployment-related traumatization without PTSS (N = 28), and never-deployed healthy veterans (N = 18) were presented with pairs of combat and neutral pictures, pairs of general threat and neutral pictures, and pairs of emotional and neutral faces. Their eye gazes were tracked during a free viewing task. 3 x 3 x 2 mixed general linear model analyses were conducted. Internal consistency of attention bias indicators was calculated for the entire sample and within groups.

RESULTS

Veterans with PTSS dwelled longer on general threat AOIs in contrast to non-exposed controls and shorter on general threat and combat associated neutral AOIs in contrast to both control groups. Veterans with PTSS entered faster to general threat AOIs than non-exposed controls. Veterans with PTSS showed circumscribed higher attention fluctuation in contrast to controls. Internal consistency varied across attention bias indicators.

LIMITATIONS

Statistical power was reduced due to recruitment difficulties.

CONCLUSIONS

Evidence is provided for the maintenance hypothesis in PTSS. No robust evidence is provided for hypervigilant behavior in PTSS. Findings on attention bias variability remain unclear, calling for more investigations in this field.

Cognitive processing of emotional information during menstrual phases in women with and without postpartum depression: differential sensitivity to changes in gonadal steroids

Gonadal steroids (GSs) have been repeatedly shown to play a central role in the onset of postpartum depression (PPD). The underlying mechanisms, however, are only partially understood. We investigated the relationship between cognitive processing of emotional information and naturally occurring hormonal fluctuations in women with and without previous PPD. Euthymic, parous women, with a history (hPPD, n=32) and without a history (nhPPD, n=43) of PPD, were assessed during late-follicular and late-luteal phases. Participants were administered cognitive tasks assessing attention (dot-probe; emotional Stroop), evaluation (self-referential encoding) and incidental recall, and self-report measures. Menstrual-phase-specific differences were found between late-follicular vs. late-luteal phases among hPPD only, with depression-associated patterns observed in the late-luteal phase on the self-referential encoding and incidental recall task and emotional Stroop task, but not on the dot-probe task. No main effect for menstrual phase was found on any of the tasks or questionnaires, apart from the brooding component of rumination. Women with hPPD demonstrate a differential bias in cognitive processing of emotional information that is menstrual phase dependent, and did not correspond to similar difference in mood symptoms. These biases may reflect sensitivity to gonadal steroid fluctuations that are associated with PPD.

Associations between changes in somatic and psychiatric symptoms and disability alterations in recent-era U.S. veterans

Cross-sectional work suggests that deployment-related posttraumatic sequelae are associated with increased disability in U.S. veterans deployed following the September 11, 2001 (9/11), terrorist attacks. However, few studies have examined the psychiatric and somatic variables associated with changes in functional disability over time. A total of 237 post-9/11 veterans completed comprehensive assessments of psychiatric and cognitive functioning, as well as a disability questionnaire, at baseline and 2-year follow-up. At baseline, higher levels of PTSD, depressive, and pain-related symptoms were associated with baseline global functional disability, semipartial r² = .036-.044. Changes in symptoms of PTSD, depression, pain, and sleep, but not anxiety or alcohol use, were independently associated with changes in functional disability, semipartial r² = .017-.068. Baseline symptoms of these conditions were unrelated to changes in disability, and cognitive performance was unrelated to disability at any assessment point. Together, this suggests that changes in psychiatric and somatic symptoms are tightly linked with changes in functional disability and should be frequently monitored, and even subclinical symptoms may be a target of intervention.

Age-Related Changes in the Perception of Emotions in Speech: Assessing Thresholds of Prosody and Semantics Recognition in Noise for Young and Older Adults

Older adults process emotions in speech differently than do young adults. However, it is unclear whether these age-related changes impact all speech channels to the same extent, and whether they originate from a sensory or a cognitive source. The current study adopted a psychophysical approach to directly compare young and older adults’ sensory thresholds for emotion recognition in two channels of spoken-emotions: prosody (tone) and semantics (words). A total of 29 young adults and 26 older adults listened to 50 spoken sentences presenting different combinations of emotions across prosody and semantics. They were asked to recognize the prosodic or semantic emotion, in separate tasks. Sentences were presented on the background of speech-spectrum noise ranging from SNR of −15 dB (difficult) to +5 dB (easy). Individual recognition thresholds were calculated (by fitting psychometric functions) separately for prosodic and semantic recognition. Results indicated that: (1). recognition thresholds were better for young over older adults, suggesting an age-related general decrease across channels; (2). recognition thresholds were better for prosody over semantics, suggesting a prosodic advantage; (3). importantly, the prosodic advantage in thresholds did not differ between age groups (thus a sensory source for age-related differences in spoken-emotions processing was not supported); and (4). larger failures of selective attention were found for older adults than for young adults, indicating that older adults experienced larger difficulties in inhibiting irrelevant information. Taken together, results do not support a sole sensory source, but rather an interplay of cognitive and sensory sources for age-related differences in spoken-emotions processing.

Emotional induced attentional blink in trauma-exposed veterans: associations with trauma specific and nonspecific symptoms

Although theoretical models suggest that an attentional bias for threat contributes to the development of post-traumatic stress disorder (PTSD) symptoms, this bias has not been consistently observed in the literature. In the present study, trauma exposed veterans (N = 114) performed an emotional attentional blink task in which task-irrelevant combat-related, disgust, positive, or neutral distractor images appeared 200 ms, 400 ms, 600 ms, or 800 ms (i.e., lag 2, 4, 6, and 8, respectively) before the target. Relative to neutral distractors, impaired target detection was observed following combat distractors and disgust distractors, but not positive distractors. However, veterans were less accurate following disgust distractors compared to combat distractors. As predicted, combat distractors and disgust distractors were also associated with a stronger linear increase in trial accuracy reflecting task improvement with increasing lag before the target. However, the linear trend in trial accuracy for combat distractors and disgust distractors did not significantly differ from each other. Contrary to predictions, trauma specific (i.e., PTSD symptoms and diagnosis) and nonspecific processes (i.e., attentional control) were unrelated to trial accuracy. These data suggest that while initial attentional capture by cues of war is observed among trauma exposed veterans independent of individual differences in trauma specific and nonspecific symptoms, this attentional capture is less robust compared to attentional capture by disgust-eliciting stimuli. The implications of these findings for the theorized role of attentional biases for threat in the development and maintenance of PTSD are discussed.

Injured black men's perceptions of the recovery environment

BACKGROUND

Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated. These injured men are typically transported to a hospital where they are medically stabilized and soon after are returned to the community. Black men are less likely to be discharged to comprehensive rehabilitation facilities, magnifying disparities in recovery from injury. While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors.

PURPOSE

The purpose of this study was to describe Black men's perceptions of how characteristics of their environment affect their recovery following serious injury.

METHODS

This was a secondary analysis of an existing data set consisting of semi-structured, qualitative interviews of 43 injured Black men in a northeastern city. The interviews were conducted three months following discharge from a large urban trauma center, and were audiotaped, transcribed verbatim, and de-identified. Thematic analysis consistent with the qualitative paradigm was used to identify themes.

RESULTS

Four themes were identified in injured men's narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery.

CONCLUSIONS

Our findings emphasize the importance of the role of community resources that can support injured men's recovery within their neighborhoods. Additional resources should be directed to survivors who return to disadvantaged communities after injury in order to minimize adverse emotional experiences that detract from recovery.

The impact of aversive context on early threat detection in trauma exposed individuals and associations with post-traumatic stress symptoms

Introduction:

Prolonged attentional bias to threat (AB) is associated with posttraumatic stress symptoms (PTSS). However, it is unclear whether this relationship extends to early threat detection (elicited by masked stimuli) and/or varies if AB is measured during an aversive context.

Methods:

Two trauma-exposed samples of either intervention-seekers (N = 50) or community members (N = 98) completed a masked dot-probe task to measure early AB to angry faces in safe vs. aversive contexts (i.e., during threat of aversive noises).

Results:

Linear mixed effects models showed that an aversive context increased the orienting responses in both samples; however, PTSS did not moderate these effects in either sample.

Limitations:

Sample size and heterogeneity of trauma-type may have impacted effect of PTSS on AB.

Conclusion:

These results highlight the importance of assessing AB in varying contexts and examining generalizability across populations. Given prior research, the results also suggest that increased AB in PTSS may only be present for later attentional processes rather than early threat detection, at least with behavioral methods.

Alteration of early attentional processing after analogue trauma exposure: evidence from event-related potentials

The present study aimed to determine whether exposure to an analogue traumatic event affects attentional processing of emotional information. Two groups of non-clinical participants matched on anxiety level, depression symptoms and stressful life events viewed either a trauma or a neutral film. They then performed an emotional Stroop task during which both continuous electroencephalographic activity was recorded and intrusive memories were measured. Results revealed that the valence effect (measured by the difference between emotional and neutral conditions) for the P1 amplitude was significantly greater in participants who viewed the trauma film than in participants who viewed the neutral film. This interaction was specific to words semantically related to the analogue trauma event and did not extend to all negative words. Further analyses revealed a relationship between intrusions frequency, P1 amplitude and emotional Stroop interference, indicating a link between attention and intrusive memories. Our findings suggest that exposure to potentially traumatic events has an important impact on neurocognitive function, even in the absence of psychopathology, and that this impact occurs at an early, possibly automatic stage of processing.

Separate neural networks of implicit emotional processing between pictures and words: A coordinate-based meta-analysis of brain imaging studies

Both pictures and words are frequently employed as experimental stimuli to investigate the neurocognitive mechanisms of emotional processing. However, it remains unclear whether emotional picture processing and emotional word processing share neural underpinnings. To address this issue, we focus on neuroimaging studies examining the implicit processing of affective words and pictures, which require participants to meet cognitive task demands under the implicit influence of emotional pictorial or verbal stimuli. A coordinate-based activation likelihood estimation meta-analysis was conducted on these studies, which revealed no common activation maximum between the picture and word conditions. Specifically, implicit negative picture processing (35 experiments, 393 foci, and 932 subjects) engages the bilateral amygdala, left hippocampus, fusiform gyri, and right insula, which are mainly located in the subcortical network and visual network associated with bottom-up emotional responses. In contrast, implicit negative word processing (34 experiments, 316 foci, and 799 subjects) engages the default mode network and fronto-parietal network including the ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, and dorsomedial prefrontal cortex, indicating the involvement of top-down semantic processing and emotion regulation. Our findings indicate that affective pictures (that intrinsically have an affective valence) and affective words (that inherit the affective valence from their object) modulate implicit emotional processing in different ways, and therefore recruit distinct brain systems.

Perceptual processing of stimuli related to an analogue traumatic event: An ERP study

Previous research has suggested that exposure to potentially traumatic events can lead to increased perceptual processing specific to trauma-related stimuli. Moreover, conceptual processing strategies during encoding may reduce the effect of trauma exposure on perceptual processing. The current study investigated the effect of a trauma film on perceptual processing with visual evoked potentials. Participants were primed with perceptual or conceptual processing strategies, then viewed a trauma film and a control film. Participants then looked at emotionally negative and neutral images that were related or unrelated to the films. The amplitude of the P1 evoked potential was measured during image presentation. P1 amplitude was more positive specifically for negative film-related stimuli. Moreover, this effect was stronger in participants primed with perceptual processing. These results suggest that potentially traumatic events increase perceptual processing specifically for trauma-related stimuli, and that conceptual encoding strategies attenuate the effect of exposure to potentially traumatic events on perception.

Posttraumatic stress disorder symptoms and neurocognitive functioning in fire fighters: The mediating role of sleep problems and resilience

BACKGROUND

Firefighters are often exposed to terrible and dangerous scenes due to their duties, and thus have a high risk of developing posttraumatic stress disorder(PTSD). The purpose of the study is to examine the relationship between PTSD symptoms, sleep problems, resilience and neurocognitive functioning of firefighters, and to identify the sequential mediating effects of sleep problems and resilience on the relationship between PTSD symptoms and neurocognitive functioning (especially psychomotor speed and processing speed).

METHODS

Data were collected from 325 firefighters in eight fire departments in four regions of Korea. Subjects performed neurocognitive function tests and completed the following questionnaires: Primary Care PTSD Screening, Pittsburgh Sleep Quality Index-K and Connor-Davidson Resilience Scale-2. The correlation and dual mediation effects were analysed using SPSS 22.0 program and PROCESS macro 3.4 program.

RESULTS

PTSD symptoms, neurocognitive functioning, sleep problems and resilience were significantly correlated with each other. In the sequential mediation model, the relationship between PTSD and psychomotor speed/processing speed was sequentially mediated by sleep problems and resilience after adjusting for demographic variables.

CONCLUSIONS

The PTSD symptoms of firefighters were related to a sequential link between sleep problems, low resilience and decreased neurocognitive function. These findings could serve as a basis for more effective and integrated interventional strategies for facilitating better neurocognitive functioning in firefighters.

Eye-tracking exploration of inhibitory control in post-traumatic stress disorder: an emotional antisaccade paradigm

Background: Cognitive-behavioural studies among individuals suffering from post-traumatic stress disorder (PTSD) have highlighted attentional biases towards threats as a key factor in the maintenance of the disorder. Anxiety-related studies have hypothesized that attentional biases were due to attentional control difficulties in inhibition and flexibility of threatening information. Objective: Because it remains unclear how this theory could be applied to PTSD, this study aims to evaluate the inhibitory control and flexibility abilities of negative and threatening information in this population, using eye-tracking technology. Method: Fifteen adults with a history of physical assault and a current diagnosis of PTSD, and 15 healthy control participants, completed an original mixed antisaccade task. Results: We found enhanced overt attentional allocation towards every item of emotional information among PTSD participants, such as indexed by the latencies of the first saccade in prosaccade trials, followed by disengagement difficulties, such as indexed by increased reaction time to identify the target. Conclusion: Our results could represent empirical evidence of the general enhancement of attentional vigilance in people with PTSD in comparison with healthy controls, as well as specific inhibitory deficits. The results are interpreted through a fear-generalization hypothesis.

Semantic generalization of punishment-related attentional priority

The present study aimed to determine whether attentional prioritization of visual stimuli associated with punishment transfers across conceptual knowledge independently of physical features. Participants performed a Stroop task in which words were presented individually. These stimuli consisted of four pairs of synonyms selected such that the two words of each pair have both a strong semantic association and no perceptual similarity. In the learning phase, two words (from two different pairs) were associated with shock independently of performance; all the other words were never paired with shock. In the subsequent test phase, no shock was delivered. Results are consistent with semantic generalization of punishment-related attentional priority; synonyms of words paired with shock produced a Stroop interference effect (i.e., slower response times) in learning and test phases, relative to synonyms of words not paired with shock, suggesting they were prioritized by attention.

Performance Differences Between Native and Non-Native Speakers on a New Happy-Sad Executive Function Measure

OBJECTIVE

The happy-sad task adapts the classic day-night task by incorporating two early acquired emotional concepts ("happy" and "sad") and demonstrates elevated inhibitory demands for native speakers. The task holds promise as a new executive function measure for assessing inhibitory control across the lifespan, but no studies have examined the influence of language of test administration on performance.

METHOD

Seventy adult native English speakers and 50 non-native speakers completed the computerized day-night and the new happy-sad tasks administered in English. In two conditions, participants were categorized pictorial stimuli either in a congruent manner ("happy" for a happy face) or in a more challenging, incongruent manner ("sad" for a happy face). Lexical decision performance was obtained to estimate levels of English language proficiency.

RESULTS

Native speakers and non-native speakers performed comparably except for the critical incongruent condition of the happy-sad task, where native speakers responded more slowly. A greater congruency effect for the happy-sad task was found for native than for non-native speakers. Lexical decision performance was associated with performance on the challenging incongruent conditions.

CONCLUSION

This study reinforced the usefulness of the happy-sad task as a new measure in evaluating inhibitory control in adult native-speakers. However, the language of test administration needs to be considered in assessment because it may lead to performance differences between native and non-native speakers.

Emotion processing in depression and anxiety disorders in older adults: systematic review

BACKGROUND

Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a 'positivity effect', whereby older people attend more to positive than negative stimuli.

AIMS

This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing.

METHOD

We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included.

RESULTS

In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words.

CONCLUSIONS

How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.

Keeping Your Guard Up: Hypervigilance Among Urban Residents Affected By Community And Police Violence

Hypervigilance, a state of heightened awareness and watchfulness, is a consequence of violence that has been linked to adverse psychosocial outcomes. Although well documented in veteran populations, it remains poorly quantified in community populations that are exposed to high levels of neighborhood violence. In-person surveys of 504 adults were conducted in Chicago, Illinois, in 2018 to assess the relationships between hypervigilance and exposure to neighborhood violence, including community and police altercations. Exposure to police violence was associated with a 9.8-percentage-point increase in the hypervigilance score (on a 100-point scale)-nearly twice that associated with exposure to community violence (a 5.5-percentage-point increase). Among participants who reported having had a police stop, experiencing the stop as a traumatic event (defined as exposure to actual or threatened death or serious injury) was associated with a 20.0-percentage-point increase in the hypervigilance score. Scoring in the highest quartile of hypervigilance was associated with higher systolic blood pressure (an increase of 8.6 mmHg). Understanding hypervigilance and, importantly, its linkages with violence and health may help inform policing practices and health care responses to violence in urban communities.

A Pilot Adaptive Neurofeedback Investigation of the Neural Mechanisms of Implicit Emotion Regulation Among Women With PTSD

Posttraumatic stress disorder (PTSD) is widely associated with deficits in implicit emotion regulation. Recently, adaptive fMRI neurofeedback (A-NF) has been developed as a methodology that offers a unique probe of brain networks that mediate implicit emotion regulation and their impairment in PTSD. We designed an A-NF paradigm in which difficulty of an emotional conflict task (i.e., embedding trauma distractors onto a neutral target stimulus) was controlled by a whole-brain classifier trained to differentiate attention to the trauma distractor vs. target. We exploited this methodology to test whether PTSD was associated with: (1) an altered brain state that differentiates attention towards vs. away from trauma cues; and (2) an altered ability to use concurrent feedback about brain states during an implicit emotion regulation task. Adult women with a current diagnosis of PTSD (n = 10) and healthy control (n = 9) women participated in this task during 3T fMRI. During two initial non-feedback runs used to train a whole-brain classifier, we observed: (1) poorer attention performance in PTSD; and (2) a linear relationship between brain state discrimination and attention performance, which was significantly attenuated among the PTSD group when the task contained trauma cues. During the A-NF phase, the PTSD group demonstrated poorer ability to regulate brain states as per attention instructions, and this poorer ability was related to PTSD symptom severity. Further, PTSD was associated with the heightened encoding of feedback in the insula and hippocampus. These results suggest a novel understanding of whole-brain states and their regulation that underlie emotion regulation deficits in PTSD.

Use of an estradiol-based combined oral contraceptives has no influence on attentional bias or depressive symptoms in healthy women

Combined oral contraceptive (COC) use is associated with small, albeit significant, increases in mental symptom scores, predominantly irritability, depressed mood, and anxiety. Yet, randomized prospective trials are needed to better characterize the women at risk for COC-induced negative mood change. Thus, the primary aim of this sub-study to a placebo-controlled randomized trial was to determine whether COC use influences emotional interference by negative and positive stimuli. Secondly, we wanted to evaluate what factors would predict depressive symptoms at the end of the trial, taking personality factors, history of mental disorders and other demographic factors into account. Sixty-nine women were included, randomized to three cycles of treatment with a COC (1.5 mg estradiol and 2.5 mg nomegestrolacetate) or placebo. An emotional verbal Stroop task was used to measure interference of emotional stimuli, in which participants were asked to only name the color of a presented word, while ignoring the meaning of the word. Four different word categories were used; neutral, positive, depression, and anxiety. For the second aim of the study, rating on the Montgomery-Åsberg Depression Rating Scale during the final days of the trial was used as outcome. We found no interaction between emotional verbal Stroop word category and treatment, indicating that COC treatment did not evoke any differences in emotional interference to the three word categories. Significant predictors for depressive symptoms at the end of the trial were trait anxiety at baseline and prior adverse mood effects by hormonal contraceptive use. Treatment (i.e. whether women had been treated with the COC or placebo) did not play a role in predicting depression scores at the end of the trial. In conclusion, we found no evidence that combined oral contraceptive use is associated with impaired cognitive-emotional processing. Instead, the main predictors of self-rated depression at the end of the trial were baseline trait anxiety and previous mental symptoms during hormonal contraceptive use.

The duality of human cognition: operations and intentionality in mental life and illness

What people think about, the intentional aspect of cognition, is distinguished from its operational aspect, or how proficiently they think. Many psychiatric disorders as well as social problems like racism, are defined largely by specified thought contents, whereas neurological disorders including dementia are defined by low proficiency. Intentionality contrasts with operational cognition in resisting objectification and in being expressed primarily in verbal narratives and subjective self-disclosure. This yields insecure data that have slowed progress in fields where intentional cognition plays a key role. The question is how to produce more secure knowledge and open the intentional domain itself to objective investigation. The use of operational methods to infer intentionality has provided only partial answers. However, the science of reconstructing mental events with neural data is providing a new horizon for the study of intentional cognition. Reconstruction science must address major challenges related to fidelity and validity. Nevertheless, this approach is showing the first steps on the road to accessing and revealing objectively the contents of thought.

Neurophysiology of threat processing bias in combat-related post-traumatic stress disorder

Post‐traumatic stress disorder (PTSD) is a debilitating condition that may develop after experiencing a traumatic event. Combat exposure increases an individual's chance of developing PTSD, making veterans especially susceptible to the disorder. PTSD is characterized by dysregulated emotional networks, memory deficits, and a hyperattentive response to perceived threatening stimuli. Recently, there have been a number of imaging studies that show structural and functional abnormalities associated with PTSD; however, there have been few studies utilizing electroencephalography (EEG). The goal of this study was to characterize **EEG brain dynamics in individuals with PTSD, in order to better understand the neurophysiological underpinnings of some of the salient features of PTSD, such as threat‐processing bias. Veterans of Operation Enduring Freedom/Iraqi Freedom completed an implicit visual threat semantic memory recognition task with stimuli that varied on both category (animals, items, nature, and people) and feature (threatening and nonthreatening) membership, including trauma‐related stimuli. Combat veterans with PTSD had slower reaction times for the threatening stimuli relative to the combat veterans without PTSD (VETC). There were trauma‐specific effects in frontal regions, with theta band EEG power reductions for the threatening combat scenes in the PTSD patients compared to the VETC group. Additionally, a moderate negative correlation was observed between trauma‐specific frontal theta power and hyperarousal symptoms as measured by clinically administered PTSD scale. These findings complement and extend current models of cortico‐limbic dysfunction in PTSD. The moderate negative correlation between frontal theta power and hyperarousal endorsements suggests the utility of these measures as therapeutic markers of symptomatology in PTSD patients.

Inhibitory control of threat remembering in PTSD

Intrusive traumatic recollections suggest an inability in Posttraumatic Stress Disorder (PTSD) to control and notably to inhibit memories for trauma-related information. Supported by inhibitory deficits found on experimental settings in PTSD, memory functioning and memory biases in the disorder were usually explained through inhibitory and control deficits in the processing of trauma-related information. The present study aimed to directly assess this hypothesis by investigating memory control abilities for emotional information in PTSD. For this purpose, 34 patients diagnosed with PTSD were compared to 37 non-PTSD controls on an item-cued directed forgetting paradigm for emotional words combined with a Remember/Know recognition procedure. Results revealed enhanced amounts of Remember recognitions for trauma-related words in PTSD. Moreover, we replicated findings of memory control impairments in the disorder. However, such impairments only occurred for non-trauma-related words. Accordingly, it appeared that PTSD patients presented preserved memory control abilities for trauma-related words, at the expenses of other emotional valences. Surprisingly, PTSD patients presented a preserved ability to control and notably to inhibit their memory functioning for trauma-related material. In addition to potential theoretical and clinical relevance, these results are discussed in the light of resource reallocation hypotheses and vigilant-avoidant theories of information processing in PTSD.

The Role in Road Traffic Accident and Anxiety as Moderators Attention Biases in Modified Emotional Stroop Test

Introduction

According to the World Health Organisation, road accidents will be the most common cause of premature death by 2020. According to research, one in every five victims of accidents suffers from acute stress disorder and one in every four suffers from psychological problems up to 1 year after the event, including post-traumatic stress disorder. It was assumed that one of the mechanisms responsible for maintaining excessive arousal or anxiety is a dysfunction in cognitive processes occurring under the guise of selective attention disorders or a deficit in executive control.

Materials and Methods

The research encompassed 157 individuals (a group of victims and perpetrators N = 90; M = 34.1, SD = 10.77; control group N = 67; M = 34.20, SD = 11.16). The participants, tested after road traffic accidents, were patients of Traumatology and Orthopedic wards in Warsaw who had been involved in a road traffic accident up to a month prior to the research. The state of their physical injuries and administered drugs were monitored so that this did not interfere with the tests the participants undertook on computer. In each situation, the decision was made by the doctor responsible for the patient in the hospital ward. The control group comprised people who drive regularly and in 5 years had not been involved in any road traffic incidents. The participants from both groups completed the State–Trait Anxiety Inventory questionnaire on anxiety as a state and as a trait, as well as a modified computerized emotional Stroop test. This new version of the test enables a study of the process of the depth of coding of the stimuli associated with trauma.

Results

The hypotheses were tested with the use of a series of correlation analyses, regression analyses with a stepwise method of entering predictors into the model, and mediation analyses with the use of the A. F. Hayes PROCESS macro. Differences were observed in the declarative level of anxiety as a state and the size of the interference effect depending on the person’s status in the accident. It was discovered that in the group of perpetrators, the longer the interference effect, the lower the declared level of anxiety as a state and they were significantly worse at remembering the stimuli associated with trauma.

Conclusion

Anxiety symptoms in victims and perpetrators of road traffic accidents measured by self-report questionnaires are consistent only among victims. In the case of perpetrators, an accurate measure of disorders is a study with the use of methods enabling the tracking of the functioning of unconscious processes.

In Trauma-Exposed Individuals, Self-reported Hyperarousal and Sleep Architecture Predict Resting-State Functional Connectivity in Frontocortical and Paralimbic Regions

BACKGROUND

Symptoms of posttraumatic stress disorder (PTSD) reflect abnormalities in large-scale brain networks. In individuals with recent trauma exposure, we examined associations of seed-based resting-state functional connectivity (rs-FC) with posttraumatic symptoms and sleep. We hypothesized that more severe PTSD symptoms and poorer sleep quality would predict 1) greater rs-FC between fear-related seeds and other fear-related regions and 2) lesser rs-FC between fear-related seeds and emotion-regulatory regions.

METHODS

Seventy-four participants who had experienced a DSM-5 criterion A stressor within the past 2 years and ranged from asymptomatic to fully meeting criteria for PTSD diagnosis underwent 14 days of actigraphy and sleep diaries, a night of ambulatory polysomnography, and a functional magnetic resonance imaging resting-state scan at 3T. rs-FC measures of 5 fear-related seeds and 1 emotion regulatory seed with regions of the anterior cerebrum were correlated with PTSD symptoms, objective and subjective habitual sleep quality, and sleep architecture.

RESULTS

Longer objective habitual sleep onset latency was associated with greater connectivity between fear-related seeds and other regions of the salience network. Greater PTSD symptoms were associated with less connectivity between fear-related seeds and anterior emotion regulatory regions, whereas greater percent slow wave sleep was associated with more connectivity between these regions. However, other objective and subjective measures reflecting better habitual sleep quality were associated with less rs-FC between these regions.

CONCLUSIONS

Longer sleep onset latency predicted greater rs-FC among fear-related areas. More severe PTSD symptoms predicted less rs-FC between fear and fear regulatory regions reflecting putatively reduced top-down fear regulation. Some (e.g., percent slow wave sleep), but not all sleep indices predicted greater top-down fear regulation.

Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates

BACKGROUND

Attentional disruptions are common in PTSD, but findings across neuropsychological and neuroimaging studies have been variable. Few PTSD studies have investigated abnormalities in attention networks using a multi-modal imaging approach and attentional tasks that include emotionally-salient images. This study combined a behavioral task that included these images (emotional Stroop) with functional and structural neuroimaging (fMRI and diffusion tensor imaging; DTI) methods to comprehensively investigate attentional control abnormalities in a highly-traumatized civilian sample.

METHODS

48 traumatized women with and without PTSD received clinical assessments, fMRI and DTI. During fMRI, the Affective Stroop (AS), an attentional control task that includes emotionally-salient distractor images (trauma-relevant, positive, neutral) and variable task demands, was administered.

RESULTS

In response to more difficult AS trials, participants with PTSD demonstrated lower activation in the dorsal and rostral anterior cingulate cortex and greater activation in the insula. This group also showed comparatively poorer performance on positive AS distractor trials, even after adjusting for trauma exposure. Performance on these trials inversely correlated with structural integrity of the cingulum bundle and uncinate fasciculus.

CONCLUSIONS

Even after adjusting for trauma exposure, participants with PTSD showed worse performance on an attentional control task in the context of emotional stimuli. They also showed relatively lower cognitive control network activation and greater salience network activation. Fronto-parietal and fronto-limbic white matter connectivity corresponded with AS performance. Our findings indicate that attentional control impairments in PTSD are most evident in the context of emotional cues, and are related to decrements in function and structure of cognitive control and salience networks.

Is it dangerous? The role of an emotional visual search strategy and threat-relevant training in the detection of guns and knives

Counter-terrorism strategies rely on the assumption that it is possible to increase threat detection by providing explicit verbal instructions to orient people's attention to dangerous objects and hostile behaviours in their environment. Nevertheless, whether verbal cues can be used to enhance threat detection performance under laboratory conditions is currently unclear. In Experiment 1, student participants were required to detect a picture of a dangerous or neutral object embedded within a visual search display on the basis of an emotional strategy 'is it dangerous?' or a semantic strategy 'is it an object?'. The results showed a threat superiority effect that was enhanced by the emotional visual search strategy. In Experiment 2, whilst trainee police officers displayed a greater threat superiority effect than student controls, both groups benefitted from performing the task under the emotional than semantic visual search strategy. Manipulating situational threat levels (high vs. low) in the experimental instructions had no effect on visual search performance. The current findings provide new support for the language-as-context hypothesis. They are also consistent with a dual-processing account of threat detection involving a verbally mediated route in working memory and the deployment of a visual template developed as a function of training.

Sack A, Fecteau S. Characterizing emotional Stroop interference in posttraumatic stress disorder, major depression and anxiety disorders: A systematic review and meta-analysis

BACKGROUND

Posttraumatic stress disorder is a debilitating psychiatric disorder characterized by symptoms of intrusive re-experiencing of trauma, avoidance and hyper-arousal. Diagnosis and treatment of PTSD is further complicated by concurrently occurring disorders, the most frequent being major depressive disorder and anxiety disorders. Previous research highlights that attentional processing in posttraumatic stress disorder is associated with substantial interference by emotional stimuli, a phenomenon also observed in these concurrently occurring psychiatric disorders. However, the diagnosis-relevance of this interference remains elusive. Here, we investigated the emotional Stroop interference for diagnosis-related stimuli, generally negative stimuli, and generally positive stimuli in posttraumatic stress disorder, major depressive disorder and anxiety disorders.

METHODS

We performed a systematic database search in PubMed (Medline), Cochrane Library and PsycINFO on emotional Stroop performance in individuals with a diagnosis of posttraumatic stress disorder, major depressive disorder or anxiety disorders separately. Mean effect sizes, standard errors and confidence intervals were estimated for each clinical group and healthy control group comparison using random effect models.

RESULTS

As compared to healthy control group, the posttraumatic stress disorder group displayed greater interference by diagnosis-related stimuli and positive stimuli but not for generally negative stimuli. The major depressive disorder and anxiety disorders groups showed greater interference by diagnosis-related and negative stimuli, but not by positive stimuli. The age and sex had no significant impact on interference.

CONCLUSIONS

These findings highlight the importance of diagnosis-relevant information on attentional processing in all three clinical populations, posttraumatic stress disorder, major depressive disorder and anxiety disorders. Further, the impact of generally negative stimuli but not generally positive stimuli in major depressive disorder and anxiety disorders indicate impaired attentional bias for mood-congruent stimuli but not for general stimuli. Finally, it remains to be studied whether the influence of generally positive stimuli in posttraumatic stress disorder indicate that positive stimuli are perceived as PTSD related.

Attention to threat in posttraumatic stress disorder as indexed by eye-tracking indices: a systematic review

BACKGROUND

Cognitive models of posttraumatic stress disorder (PTSD) implicate threat-related attentional biases in the etiology and phenomenology of the disorder. However, extant attentional research using reaction time (RT)-based paradigms and measures has yielded mixed results. Eye-tracking methodology has emerged in recent years to overcome several inherent drawbacks of RT-based tasks, striving to better delineate attentional processes.

METHODS

A systematic review of experimental studies examining threat-related attention biases in PTSD, using eye-tracking methodology and group-comparison designs, was conducted conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were selected following a systematic search for publications between 1980 and December 2017 in PsycINFO, MEDLINE and the National Center for PTSD Research's Published International Literature on Traumatic Stress (PILOTS) database. Additional records were identified by employing the Similar Articles feature in PubMed, and the Cited Reference Search in ISI Web of Science. Reference sections of review articles, book chapters and studies selected for inclusion were searched for further studies. Ongoing studies were also sought through Clinicaltrials.gov.

RESULTS

A total of 11 studies (n = 456 participants in total) were included in the final review. Results indicated little support for enhanced threat detection, hypervigilance and attentional avoidance. However, consistent evidence emerged for sustained attention on threat (i.e. attention maintenance) in PTSD.

CONCLUSIONS

This review is the first to systematically evaluate extant findings in PTSD emanating from eye-tracking studies employing group-comparison designs. Results suggest that sustained attention on threat might serve as a potential target for therapeutic intervention.

Increased recruitment of cognitive control in the presence of traumatic stimuli in complex PTSD

A neurocircuitry model of post-traumatic stress disorder (PTSD) suggests increased amygdala responses to emotional stimuli, coupled with hypoactivation of prefrontal regions associated with cognitive control. However, results are heterogenous across different subsamples of PTSD as well as different paradigms. We investigated cognitive control in a classic and emotional Stroop task in 28 female patients with complex PTSD (cPTSD), 28 female trauma-exposed healthy controls (TCs) and 28 female non-trauma-exposed healthy controls (HCs) using functional neuroimaging. Afterwards, we assessed memory function in a spontaneous free recall and recognition task. Patients with cPTSD displayed significantly greater Stroop interference with trauma-related words (as reflected in slower reaction times and increased errors) compared to the other conditions and compared to the TC and HC groups. Moreover, patients with cPTSD showed increased activation in the context of trauma-related words in brain regions associated with cognitive control (dlPFC, vmPFC, dACC) compared to both control groups, and a trend for increased activation in the insula compared to the HC group. Increased recruitment of regions contributing to cognitive control in patients with cPTSD, together with a lack of amygdala response may point to efforts to compensate for emotional distraction caused by the trauma-related words.

Depressive Symptoms in Late Pregnancy Disrupt Attentional Processing of Negative-Positive Emotion: An Eye-Movement Study

This study investigated biases for negative-positive information in component processes of visual attention (initial shift vs. maintenance of gaze) among women in late pregnancy with or without depressive symptoms. Eye movements were recorded while participants viewed a series of picture pairs depicting negative, positive, and neutral scenes. Initial orienting (latency and percentage of first fixation) and gaze duration were computed. Compared with neutral pictures, the group with major depressive symptoms (MDS) were less able to sense the positive emotion-related pictures and were over-responsive to negative emotion-related pictures. The group with suspicious depressive symptoms (SDS) had an attention bias toward both positive and negative emotion-related pictures. The group with no depressive symptoms (NDS) had an attention bias toward positive emotion-related pictures and had an initial attention avoidance tendency for negative emotion-related pictures. The initial gaze direction bias score for negative emotion-related pictures was positively correlated with the severity of depressive symptoms. Therefore, women with a risk of perinatal depression have a significant bias toward negative stimuli. Hypervigilant emotion processing during pregnancy may increase a woman's susceptibility to depression during late pregnancy. Attention away from negative information or attention toward positive information may provide a way of buffering emotional responses.

Altered neural encoding of prediction errors in assault-related posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is widely associated with deficits in extinguishing learned fear responses, which relies on mechanisms of reinforcement learning (e.g., updating expectations based on prediction errors). However, the degree to which PTSD is associated with impairments in general reinforcement learning (i.e., outside of the context of fear stimuli) remains poorly understood. Here, we investigate brain and behavioral differences in general reinforcement learning between adult women with and without a current diagnosis of PTSD. 29 adult females (15 PTSD with exposure to assaultive violence, 14 controls) underwent a neutral reinforcement-learning task (i.e., two arm bandit task) during fMRI. We modeled participant behavior using different adaptations of the Rescorla-Wagner (RW) model and used Independent Component Analysis to identify timecourses for large-scale a priori brain networks. We found that an anticorrelated and risk sensitive RW model best fit participant behavior, with no differences in computational parameters between groups. Women in the PTSD group demonstrated significantly less neural encoding of prediction errors in both a ventral striatum/mPFC and anterior insula network compared to healthy controls. Weakened encoding of prediction errors in the ventral striatum/mPFC and anterior insula during a general reinforcement learning task, outside of the context of fear stimuli, suggests the possibility of a broader conceptualization of learning differences in PTSD than currently proposed in current neurocircuitry models of PTSD.

Attentional biases and trauma status: Do psychotic-like experiences matter?

OBJECTIVE

In a large undergraduate sample, we explored whether attentional biases were similar between individuals reporting positive psychotic-like experiences (PLEs) with a history of traumatic life events (TLEs) compared with individuals with a TLE history alone.

METHOD

Participants completed the Emotional Stroop Task, and self-report questionnaires of TLEs and PLEs.

RESULTS

Although reaction time (RT) to physical, sexual, emotional, and overall trauma words was associated with TLEs, only RT to physical abuse and overall trauma words remained significantly associated with TLE status after controlling for age, race, and neutral word RT. Contrary to our hypotheses, PLEs were not associated with RT to TLE words and there were no significant interactions between TLE history and PLEs on RT to TLE-salient stimuli.

CONCLUSION

Findings suggest that psychosis risk alone does not appear to exacerbate attentional biases and that TLE history may exert similar influence on attention regardless of psychosis risk. In conclusion, phenotypes associated with TLEs may be similar in populations potentially at risk for psychosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Animacy and attentional processes: Evidence from the Stroop task

In visual perception, evidence has shown that attention is captured earlier and held longer by animate than inanimate stimuli. The former are also remembered better than the latter. Thus, as far as attentional processes are concerned, animate entities have a privileged status over inanimate entities. We tested this hypothesis further using an adaptation of the Stroop paradigm. Adults had to categorise the colours of words that referred to either animate or inanimate concepts. In two experiments, we found that it took longer to process the ink colour of animate than inanimate words. Indeed, this effect was found when the words were presented in an oral animacy Stroop task (Experiment 1) and in a manual animacy Stroop task (Experiment 2). Using ex-Gaussian analyses and examining the distribution of RTs as a function of vincentiles per animacy condition, we did not find a specific localisation of the animacy effect. The findings are interpreted as providing further evidence that animates are prioritised in processing because their fitness value is higher than that of inanimates.

Implicit emotion regulation in adolescent girls: An exploratory investigation of Hidden Markov Modeling and its neural correlates

Numerous data demonstrate that distracting emotional stimuli cause behavioral slowing (i.e. emotional conflict) and that behavior dynamically adapts to such distractors. However, the cognitive and neural mechanisms that mediate these behavioral findings are poorly understood. Several theoretical models have been developed that attempt to explain these phenomena, but these models have not been directly tested on human behavior nor compared. A potential tool to overcome this limitation is Hidden Markov Modeling (HMM), which is a computational approach to modeling indirectly observed systems. Here, we administered an emotional Stroop task to a sample of healthy adolescent girls (N = 24) during fMRI and used HMM to implement theoretical behavioral models. We then compared the model fits and tested for neural representations of the hidden states of the most supported model. We found that a modified variant of the model posited by Mathews et al. (1998) was most concordant with observed behavior and that brain activity was related to the model-based hidden states. Particularly, while the valences of the stimuli themselves were encoded primarily in the ventral visual cortex, the model-based detection of threatening targets was associated with increased activity in the bilateral anterior insula, while task effort (i.e. adaptation) was associated with reduction in the activity of these areas. These findings suggest that emotional target detection and adaptation are accomplished partly through increases and decreases, respectively, in the perceived immediate relevance of threatening cues and also demonstrate the efficacy of using HMM to apply theoretical models to human behavior.

Attention training modulates resting-state neurophysiological abnormalities in posttraumatic stress disorder

Recent research indicates the relative benefits of computerized attention control treatment (ACT) and attention bias modification treatment (ABMT) for posttraumatic stress disorder (PTSD); however, neural changes underlying these therapeutic effects remain unknown. This study examines how these two types of attention training modulate neurological dysfunction in veterans with PTSD. A community sample of 46 combat veterans with PTSD participated in a randomized double-blinded clinical trial of ACT versus ABMT and 32 of those veterans also agreed to undergo resting-state magnetoencephalography (MEG) recordings. Twenty-four veterans completed psychological and MEG assessments at pre- and post-training to evaluate treatment effects. MEG data were imaged using an advanced Bayesian reconstruction method and examined using statistical parametric mapping. In this report, we focus on the neural correlates and the differential treatment effects observed using MEG; the results of the full clinical trial have been described elsewhere. Our results indicated that ACT modulated occipital and ABMT modulated medial temporal activity more strongly than the comparative treatment. PTSD symptoms decreased significantly from pre- to post-test. These initial neurophysiological outcome data suggest that ACT modulates visual pathways, while ABMT modulates threat-processing regions, but that both are associated with normalizing aberrant neural activity in veterans with PTSD.

Sexual Abuse Exposure Alters Early Processing of Emotional Words: Evidence from Event-Related Potentials

This study aimed to compare the time course of emotional information processing between trauma-exposed and control participants, using electrophysiological measures. We conceived an emotional Stroop task with two types of words: trauma-related emotional words and neutral words. We assessed the evoked cerebral responses of sexual abuse victims without post-traumatic stress disorder (PTSD) and no abuse participants. We focused particularly on an early wave (C1/P1), the N2pc, and the P3b. Our main result indicated an early effect (55–165 ms) of emotionality, which varied between non-exposed participants and sexual abuse victims. This suggests that potentially traumatic experiences modulate early processing of emotional information. Our findings showing neurobiological alterations in sexual abuse victims (without PTSD) suggest that exposure to highly emotional events has an important impact on neurocognitive function even in the absence of psychopathology.

Different patterns of attentional bias in antenatal and postpartum depression

BACKGROUND

Biased information processing in attention, memory, and interpretation is proposed to be central cognitive alterations in patients with major depressive disorder, but studies in women with peripartum depression are scarce. Because of the many similarities with depression in nonperipartum states as regards symptom profile and risk factors, we hypothesized that women with antenatal and postpartum depression would display attentional bias to negatively and positively valenced words.

METHODS

One hundred and seventy-seven pregnant and 157 postpartum women were included. Among these, 40 suffered from antenatal depressive disorder and 33 from postpartum depressive disorder. An emotional Stroop task with neutral, positive, negative, and negatively valenced obstetric words was used.

RESULTS

No significant difference in emotional interference scores was noted between women with antenatal depression and nondepressed pregnant women. In contrast, women with postpartum depression displayed shorter reaction times to both positive (p = .028) and negative (p = .022) stimuli, compared with neutral words. Pregnant women on antidepressant treatment displayed longer reaction times to negatively valenced obstetric words in comparison with untreated depressed women (p = .012), and a trend toward greater interference in comparison with controls (p = .061).

CONCLUSIONS

In contrast with the hypothesis, we found no evidence of attentional bias to emotionally valenced stimuli in women with untreated peripartum depression. However, the shorter reaction times to emotional stimuli in women with postpartum depression may indicate emotional numbing, which in turn, is a functional impairment that may have repercussions for child development and well-being. Our findings emphasize the need to identify and treat women with postpartum depression at the earliest possible time point to ensure swift recovery and support for the family.

Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD)

Emotional Stroop task (EST) has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD). Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3) were included in the analysis, out of which 136 (70.1%) were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented). Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs) related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

Associations Among Posttraumatic Stress Disorder Symptoms, Substance Use, and Affective Attentional Processing in OEF/OIF/OND Veterans

The majority of research examining affective attentional bias in posttraumatic stress disorder (PTSD) has not examined the influence of co-occurring psychiatric disorders. This study examined the individual and interactive effects of PTSD symptoms and substance use disorders (SUDs) on affective attentional processing among 323 veterans deployed to Iraq or Afghanistan. Participants were divided into those with SUD (SUD+, n = 46) and those without (SUD-, n = 277). Substance use disorder was determined using the Structured Clinical Interview for DSM-IV. Posttraumatic stress disorder was measured using the Clinician Administered PTSD Scale. A computerized go/no-go task (Robbins et al., 1994, Robbins et al.,1998) assessed affective attentional processing. Relative to those without SUD, those with SUD showed a significant association between PTSD symptoms and increased omission and commission accuracy rates and decreased d prime. No effects of valence were found. Findings suggest the need to consider co-occurring SUD when investigating the effects of PTSD on attentional control.

Veterans with post-traumatic stress disorder exhibit altered emotional processing and attentional control during an emotional Stroop task

BACKGROUND

Post-traumatic stress disorder (PTSD) is often associated with attention allocation and emotional regulation difficulties, but the brain dynamics underlying these deficits are unknown. The emotional Stroop task (EST) is an ideal means to monitor these difficulties, because participants are asked to attend to non-emotional aspects of the stimuli. In this study, we used magnetoencephalography (MEG) and the EST to monitor attention allocation and emotional regulation during the processing of emotionally charged stimuli in combat veterans with and without PTSD.

METHOD

A total of 31 veterans with PTSD and 20 without PTSD performed the EST during MEG. Three categories of stimuli were used, including combat-related, generally threatening and neutral words. MEG data were imaged in the time-frequency domain and the network dynamics were probed for differences in processing threatening and non-threatening words.

RESULTS

Behaviorally, veterans with PTSD were significantly slower in responding to combat-related relative to neutral and generally threatening words. Veterans without PTSD exhibited no significant differences in responding to the three different word types. Neurophysiologically, we found a significant three-way interaction between group, word type and time period across multiple brain regions. Follow-up testing indicated stronger theta-frequency (4-8 Hz) responses in the right ventral prefrontal (0.4-0.8 s) and superior temporal cortices (0.6-0.8 s) of veterans without PTSD compared with those with PTSD during the processing of combat-related words.

CONCLUSIONS

Our data indicated that veterans with PTSD exhibited deficits in attention allocation and emotional regulation when processing trauma cues, while those without PTSD were able to regulate emotion by directing attention away from threat.

Modification of cognitive biases related to posttraumatic stress: A systematic review and research agenda

Cognitive models of Posttraumatic Stress Disorder (PTSD) postulate that cognitive biases in attention, interpretation, and memory represent key factors involved in the onset and maintenance of PTSD. Developments in experimental research demonstrate that it may be possible to manipulate such biases by means of Cognitive Bias Modification (CBM). In the present paper, we summarize studies assessing cognitive biases in posttraumatic stress to serve as a theoretical and methodological background. However, our main aim was to provide an overview of the scientific literature on CBM in (analogue) posttraumatic stress. Results of our systematic literature review showed that most CBM studies targeted attentional and interpretation biases (attention: five studies; interpretation: three studies), and one study modified memory biases. Overall, results showed that CBM can indeed modify cognitive biases and affect (analog) trauma symptoms in a training congruent manner. Interpretation bias procedures seemed effective in analog samples, and memory bias training proved preliminary success in a clinical PTSD sample. Studies of attention bias modification provided more mixed results. This heterogeneous picture may be explained by differences in the type of population or variations in the CBM procedure. Therefore, we sketched a detailed research agenda targeting the challenges for CBM in posttraumatic stress.