Enhanced anger superiority effect in generalized anxiety disorder and panic disorder

Emotion attribution in intermittent explosive disorder

BACKGROUND

Accurate recognition of the emotions of others is an important part of healthy neurological development and promotes positive psychosocial adaptation. Differences in emotional recognition may be associated with the presence of emotional biases and can alter one's perception, thus influencing their overall social cognition abilities. The present study aims to extend our collective understanding of emotion attribution abnormalities in individuals with Intermittent Explosive Disorder (IED).

METHODS

Two-hundred and forty-two adults participated, separated into groups of those diagnosed with IED according to DSM 5 criteria, Psychiatric Controls (PC), and Healthy Controls (HC). Participants completed a modified version of the Emotional Attribution Task wherein they attributed an emotion to the main character of a short vignette.

RESULTS

Participants with IED correctly identified anger stories and misattributed anger to non-anger stories significantly more often than PC and HC participants. They were also significantly less likely than HC participants to correctly identify "sad stories."

LIMITATIONS

We utilized self-report assessments in a community-recruited sample. Replication in a clinical is suggested.

CONCLUSIONS

Findings from this study support the validity of IED as a diagnostic entity and provide important information about how individuals with psychiatric disorders perceive and experience emotional cues.

Facial emotion recognition in panic disorder: a mini-review of behavioural studies

BACKGROUND

Panic Disorder (PD) is characterized by unexpected and repeated moments of intense fear or anxiety, which manifest themselves through strong cognitive and behavioural symptoms. However, a clear picture of how impairments in recognition and processing of facial emotions affect the everyday life of PD patients has yet to be delineated. This review attempts to provide an overview of behavioural studies of emotion detection from facial stimuli in PD patients.

METHODS

A bibliographic research on PubMed of all studies investigating the recognition and processing of facial emotion stimuli in patients with PD and in high-risk offspring was performed, and nine articles (yrs: 2000 to 2019) were discovered.

RESULTS

In several of the reviewed studies, PD patients showed significant deficits in detecting (particularly negative) emotions in facial stimuli. These impairments were also found in the offspring of parents with PD and high-risk individuals.

LIMITATIONS

Inferences are constrained by methodological heterogeneity, included but not limited to cross-study variability in the stimuli employed, and in the clinical characterization of PD patients.

CONCLUSIONS

In general, the results of this survey confirm that deficits in processing facially conveyed negative emotions should be considered a core impairment in PD. However, future larger and more homogenous studies are warranted to better highlight the connection between emotion recognition and PD.

The role of trait anxiety in attention and memory-related biases to threat: An event-related potential study

Threat-related information strongly competes for attentional selection, and can subsequently be more strongly represented within visual working memory. This is particularly the case for individuals reporting high trait anxious personality. The present study examined the role of anxiety in both attention and memory-related interactions with threat. We employed a hybrid working memory/visual search task, with participants preselected for low and high anxious personality traits. They selected and memorized an emotional face (angry or happy) appearing together with a neutral face in encode displays. Following a delay period, they matched the identity of the memorized face to a probe display item. Event-related markers of attentional selection (N2pc components) and memory maintenance during the delay period (i.e., CDA) were measured. Selection biases toward angry faces were observed within both encode and probe displays, evidenced by earlier and larger N2pcs. A similar threat-related bias was also found during working memory maintenance, with larger CDA components when angry faces were stored. High anxious individuals showed large selection biases for angry faces at encoding. For low anxious individuals, this bias was smaller but still significant. In contrast, only high anxious individuals showed larger CDA components for angry faces. These results suggest that threat biases in attentional selection are modulated by trait anxiety, and that threat biases within working memory may only be present for high anxious individuals. These findings highlight the key role of individual differences in trait anxiety on threat-related biases in visual processing, especially at the level of working memory maintenance.

A lack of differentiation in amygdala responses to fearful expression intensity in panic disorder patients

Patients with panic disorder show abnormalities in threat processing and regulation, both on a behavioural and neural level. Better understanding of the underlying mechanisms could help to develop new treatment strategies. In this study, we investigated brain region activation in 18 patients with untreated panic disorder (PD) and 17 healthy controls (HC) during the processing of emotional faces with fearful, happy and neutral expressions, using functional MRI. The intensity of the expressions was either prototypically high, medium or low. PD patients showed significantly increased activity in the dorso-medial prefrontal cortex (dmPFC) in response to faces in general and specifically for happy faces. While HC showed a decreased amygdala response to medium/low fearful versus high fearful faces, this effect was not present in PD: amygdala activation was stable across all fearful faces in this group. Psycho-physiological interaction analyses indicated more negative connectivity between the amygdala and prefrontal areas in the PD group during the task. Amygdala activation in panic patients appears to be less sensitive to decreasing intensities of fearful facial expressions and salience monitoring areas were less active during fearful faces in general in this group. This suggests PD patients might avoid more extensive processing of fearful faces.

Emotion sensitivity and self-reported symptoms of generalized anxiety disorder across the lifespan: A population-based sample approach

BACKGROUND

Individuals with generalized anxiety disorder (GAD) symptoms show deficits in emotion processing, but results of prior studies have been conflicting, and little is known about developmental trajectories of emotion processing over time. We examined the association between GAD symptoms and sensitivity to recognizing emotional facial expressions (emotion sensitivity: ES) for three emotions (happiness, anger, fear) in a large, diverse, population-based sample. We hypothesized that higher anxiety scores would be associated with poorer performance, and expected that ES performance and anxiety scores would decline across the lifespan.

METHOD

Participants were 7,176 responders to a web-based ES study (age range = 10-96 years old).

RESULTS

Higher GAD-7 scores were associated with poorer ES performance for all emotion categories (happiness, anger, fear). The relationship between GAD-7 and ES scores remained significant after controlling for the effects of age and sex, and there was no significant interaction, indicating that the relationship does not change across age. Age significantly predicted ES and GAD-7 scores across emotions, with older ages showing lower ES scores and lower anxiety.

CONCLUSIONS

In the largest study of its kind, GAD symptoms were associated with impaired ES performance across three emotion types. Future research should explore the connection between anxiety symptoms, cognitive processing, and social processing to better characterize the mechanisms of how GAD is linked with both social and non-social information processing. Future work may also look at if ES is related over time to changes in anxiety, making it a promising target for intervention.

Generalized Anxiety Disorder, worry and attention to threat: A systematic review

Among anxious populations, attention has been demonstrated to be preferentially biased to threatening material compared to neutral or other valenced material. Individuals who have high levels of trait worry, such as those with Generalized Anxiety Disorder (GAD), may be biased to threat but research has produced equivocal findings. This review aimed to systematically review the extant experimental literature to establish the current evidence of attentional bias to threat among trait worriers compared to healthy controls and other clinical populations. Twenty-nine published articles were included in the final review. There was strong evidence of a bias to threat among GAD patients compared to other groups and this was found across most experimental paradigms. Few studies had investigated this bias in non-clinical trait worriers. Among GAD patients this bias to threat was most strongly evidenced when visual threat material was in a verbal-linguistic format (i.e., words) rather than when in pictorial form (i.e., images or faces). The bias was also found across several domains of negative material, supporting the general nature of worry. Further research should look to examine the specific components of the threat bias in GAD, as well as investigating the bias to threat in trait worriers.

Deficits in Response Inhibition in Patients with Attention-Deficit/Hyperactivity Disorder: The Impaired Self-Protection System Hypothesis

Problems in inhibitory control are regarded in Psychology as a key problem associated with attention-deficit/hyperactivity disorder (ADHD). They, however, might not be primary deficits, but instead a consequence of inattention. At least two components have been identified and dissociated in studies in regards to inhibitory control: interference suppression, responsible for controlling interference by resisting irrelevant or misleading information, and response inhibition, referring to withholding a response or overriding an ongoing behavior. Poor error awareness and self-monitoring undermine an individual's ability to inhibit inadequate responses and change course of action. In non-social contexts, an individual depends on his own cognition to regulate his mistakes. In social contexts, however, there are many social cues that should help that individual to perceive his mistakes and inhibit inadequate responses. The processes involved in perceiving and interpreting those social cues are arguably part of a self-protection system (SPS). Individuals with ADHD not only present impulsive behaviors in social contexts, but also have difficulty perceiving their inadequate responses and overriding ongoing actions toward more appropriate ones. In this paper, we discuss that those difficulties are arguably a consequence of an impaired SPS, due to visual attention deficits and subsequent failure in perceiving and recognizing accurately negative emotions in facial expressions, especially anger. We discuss evidence that children with ADHD exhibit problems in a series of components involved in the activation of that system and advocate that the inability to identify the anger expressed by others, and thus, not experiencing the fear response that should follow, is, ultimately, what prevents them from inhibiting the ongoing inappropriate behavior, since a potential threat is not registered. Getting involved in high-risk situations, such as reckless driving, could also be a consequence of not registering a threat and thus, not experiencing fear.

Hypervigilance-avoidance in children with anxiety disorders: magnetoencephalographic evidence

BACKGROUND

An altered pattern of threat processing is deemed critical for the development of anxiety disorders (AD). According to the hypervigilance-avoidance hypothesis, AD patients show hypervigilance to threat cues at early stages of processing but avoid threat cues at later stages of processing. Consistently, adults with AD show enhanced neurophysiological responses to threat in early time windows and reduced responses to threat in late time windows. The presence of such a hypervigilance-avoidance effect and its underlying neural sources remain to be determined in clinically anxious children.

METHODS

Twenty-three children diagnosed with an AD and 23 healthy control children aged 8-14 years saw faces with angry and neutral expressions while whole-head magnetoencephalography (MEG) was recorded. Neural sources were estimated based on L2-Minimum Norm inverse source modeling and analyzed in early, midlatency, and late time windows.

RESULTS

In visual cortical regions, early threat processing was relatively enhanced in patients compared to controls, whereas this relation was inverted in a late interval. Consistent with the idea of affective regulation, the right dorsolateral prefrontal cortex revealed relatively reduced inhibition of early threat processing but revealed enhanced inhibition at a late interval in patients. Both visual-sensory and prefrontal effects were correlated with individual trait anxiety.

CONCLUSIONS

These results support the hypothesis of early sensory hypervigilance followed by later avoidance of threat in anxiety disordered children, presumably modulated by early reduced and later enhanced prefrontal inhibition. This neuronal hypervigilance-avoidance pattern unfolds gradually with increasing trait anxiety, reflecting a progressively biased allocation of attention to threat.

Exploring factors related to the anger superiority effect in children with Autism Spectrum Disorder

Despite face and emotion recognition deficits, individuals with Autism Spectrum Disorder (ASD) appear to experience the anger superiority effect, where an angry face in a crowd is detected faster than a neutral face. This study extended past research to examine the impacts of ecologically valid photographic stimuli, gender and anxiety symptoms on the anger superiority effect in children with and without ASD. Participants were 81, 7-12year old children, 42 with ASD matched on age, gender and perceptual IQ to 39 typically developing (TYP) children. The photographic stimuli did not impact on task performance in ASD with both groups exhibiting the anger superiority effect. There were no gender differences and no associations with anxiety. Age was associated with the effect in the TYP but not ASD group. These findings confirm a robust effect of speeded detection of threat in ASD which does not appear to be confounded by gender or anxiety, but may have different underlying age-associated mechanisms.

Visual working memory representations guide the detection of emotional faces: An ERP study

We investigated the correlates of the influences exerted by visual working memory (VWM) on attentional selection of emotional faces using electrophysiological method. Participants performed a search task to detect happy or angry faces among groups of neutral faces while simultaneously keeping in VWM a colour cue presented initially. A visual working memory test was required at last to ensure that the cue had been maintained in VWM. Happy faces elicited a larger amplitude N2pc ERP component when VWM features matched the target face (valid condition) and a smaller amplitude when VWM features matched a distractor face (invalid condition), compared with the neutral condition (wherein VWM features did not match any face in the search array). Additionally, angry faces elicited a greater N2pc amplitude in valid trials than in neutral and invalid trials. Although VWM could guide the attentional deployment of angry and happy faces, the guidance was subject to an anger superiority effect.

Mechanisms of Selective Attention in Generalized Anxiety Disorder

A well-established literature has identified different selective attentional orienting mechanisms underlying anxiety-related attentional bias, such as engagement and disengagement of attention. These mechanisms are thought to contribute to the onset and maintenance of anxiety disorders. However, conclusions to date have relied heavily on experimental work from subclinical samples. We therefore investigated individuals with diagnosed generalized anxiety disorder (GAD), healthy volunteers, and individuals with high trait anxiety (but not meeting GAD diagnostic criteria). Across two experiments we found faster disengagement from negative (angry and fearful) faces in GAD groups, an effect opposite to that expected on the basis of the subclinical literature. Together these data challenge current assumptions that we can generalize, to those with GAD, the pattern of selective attentional orienting to threat found in subclinical groups. We suggest a decisive two-stage experiment identifying stimuli of primary salience in GAD, then using these to reexamine orienting mechanisms across groups.

Orienting and maintenance of attention to threatening facial expressions in anxiety--an eye movement study

Cognitive models posit that anxiety disorders stem in part from underlying attentional biases to threat. Consistent with this, studies have found that the attentional bias to threat-related stimuli is greater in high vs. low anxious individuals. Nevertheless, it is not clear if similar biases exist for different threatening emotions or for any facial emotional stimulus. In the present study, we used eye-tracking to measure orienting and maintenance of attention to faces displaying anger, fear and disgust as threats, and faces displaying happiness and sadness. Using a free viewing task, we examined differences between low and high trait anxious (HTA) individuals in the attention they paid to each of these emotional faces (paired with a neutral face). We found that initial orienting was faster for angry and happy faces, and high trait anxious participants were more vigilant to fearful and disgust faces. Our results for attentional maintenance were not consistent. The results of the present study suggest that attentional processes may be more emotion-specific than previously believed. Our results suggest that attentional processes for different threatening emotions may not be the same and that attentional processes for some negative and some positive emotions may be similar.