Emotion processing deficits: A liability spectrum providing insight into comorbidity of mental disorders

Longitudinal Pathways from Parent Internalizing Symptoms to Parent and Youth Emotion Functioning

The current study utilized mediation analyses to examine how parental symptoms of depression and anxiety impact child emotion regulation (ER) and emotion stability (ES) through parent emotion functioning, parenting, and the coparent relationship. 564 parents of children between 3 and 17 years (Mage = 9.47; 54.4% male) were recruited via Amazon's Mechanical Turk across three time points: baseline (Wave 1), 4 months (Wave 2), 8 months (Wave 3). Mediation results demonstrated that symptoms of parent depression at Wave 1 predicted worse coparent relationships and decreases in parents' ability to identify their own emotions at Wave 2. Symptoms of parental anxiety at Wave 1 predicted decreases in positive parenting and an increased tendency to have negative secondary emotional responses, impulse-control difficulties, and difficulty accessing emotion-regulation strategies at Wave 2. Additionally, symptoms of parental anxiety at Wave 1 directly predicted lower child ER and ES at Wave 3. However, no significant indirect pathways were identified between parent symptoms and child ER and ES. Sensitivity analyses examined the effects of three youth developmental stages (i.e., early and middle childhood and adolescence), as well as parent gender (i.e., mother and father), and found no significant differences across groups. Thus, even at non-clinical levels, parental symptoms of anxiety and depression may negatively impact parenting, parent regulation, and the coparent relationship, while parental anxiety symptoms may contribute to lower child ER and ES.

Facial emotion recognition in children of parents with a mental illness

Objective

Facial emotion recognition (FER) is a fundamental social skill essential for adaptive social behaviors, emotional development, and overall well-being. FER impairments have been linked to various mental disorders, making it a critical transdiagnostic mechanism influencing the development and trajectory of mental disorders. FER has also been found to play a role in the transgenerational transmission of mental disorders, with the majority of research suggesting FER impairments in children of parents with a mental illness (COPMI). Previous research primarily concentrated on COPMI of parents with internalizing disorders, which does not cover the full spectrum of outpatient mental health service populations. Furthermore, research focuses on varying components of FER by using different assessment paradigms, making it challenging to compare study results. To address these gaps, we comprehensively investigated FER abilities in COPMI using multiple tasks varying in task characteristics.

Methods

We included 189 children, 77 COPMI and 112 children of parents without a diagnosed mental illness (COPWMI), aged 6 to 16 years. We assessed FER using three tasks with varying task demands: an emotional Go/NoGo task, a morphing task, and a task presenting short video sequences depicting different emotions. We fitted separate two-level hierarchical Bayesian models (to account for sibling pairs in our sample) for reaction times and accuracy rates for each task. Good model fit was assured by comparing models using varying priors.

Results

Contrary to our expectations, our results revealed no general FER deficit in COPMI compared to COPWMI. The Bayesian models fitted for accuracy in the morphing task and Go/NoGo task yielded small yet significant effects. However, Bayes factors fitted for the models suggested that these effects could be due to random variations or noise in the data.

Conclusions

Our study does not support FER impairments as a general feature of COPMI. Instead, individual factors, such as the type of parental disorder and the timing of its onset, may play a crucial role in influencing FER development. Future research should consider these factors, taking into account the diverse landscape of parental mental disorders.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth

Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.

Emotional state as a modulator of autonomic and somatic nervous system activity in postural control: a review

Advances in our understanding of postural control have highlighted the need to examine the influence of higher brain centers in the modulation of this complex function. There is strong evidence of a link between emotional state, autonomic nervous system (ANS) activity and somatic nervous system (somatic NS) activity in postural control. For example, relationships have been demonstrated between postural threat, anxiety, fear of falling, balance confidence, and physiological arousal. Behaviorally, increased arousal has been associated with changes in velocity and amplitude of postural sway during quiet standing. The potential links between ANS and somatic NS, observed in control of posture, are associated with shared neuroanatomical connections within the central nervous system (CNS). The influence of emotional state on postural control likely reflects the important influence the limbic system has on these ANS/somatic NS control networks. This narrative review will highlight several examples of behaviors which routinely require coordination between the ANS and somatic NS, highlighting the importance of the neurofunctional link between these systems. Furthermore, we will extend beyond the more historical focus on threat models and examine how disordered/altered emotional state and ANS processing may influence postural control and assessment. Finally, this paper will discuss studies that have been important in uncovering the modulatory effect of emotional state on postural control including links that may inform our understanding of disordered control, such as that observed in individuals living with Parkinson's disease and discuss methodological tools that have the potential to advance understanding of this complex relationship.

Negative emotion differentiation and white matter microstructure

BACKGROUND

Deficits in the differentiation of negative emotions - the ability to specifically identify one's negative emotions - are associated with poorer mental health outcomes. However, the processes that lead to individual differences in negative emotion differentiation are not well understood, hampering our understanding of why this process is related to poor mental health outcomes. Given that disruptions in some affective processes are associated with white matter microstructure, identifying the circuitry associated with different affective processes can inform our understanding of how disturbances in these networks may lead to psychopathology. Thus, examination of how white matter microstructure relates to individual differences in negative emotion differentiation (NED) may provide insights into (i) its component processes and (ii) its relationship to brain structure.

METHOD

The relationship between white matter microstructure and NED was examined.

RESULTS

NED was related to white matter microstructure in right anterior thalamic radiation and inferior fronto-occipital fasciculus and left peri-genual cingulum.

LIMITATIONS

Although participants self-reported psychiatric diagnoses and previous psychological treatment, psychopathology was not directly targeted, and thus, the extent to which microstructure related to NED could be examined in relation to maladaptive outcomes is limited.

CONCLUSIONS

Results indicate that NED is related to white matter microstructure and suggest that pathways subserving processes that facilitate memory, semantics, and affective experience are important for NED. Our findings provide insights into the mechanisms by which individual differences in NED arise, suggesting intervention targets that may disrupt the relationship between poor differentiation and psychopathology.

Attention Towards Pupil Size in Humans and Bonobos (Pan paniscus)

Previous work has established that humans have an attentional bias towards emotional signals, and there is some evidence that this phenomenon is shared with bonobos, our closest relatives. Although many emotional signals are explicit and overt, implicit cues such as pupil size also contain emotional information for observers. Pupil size can impact social judgment and foster trust and social support, and is automatically mimicked, suggesting a communicative role. While an attentional bias towards more obvious emotional expressions has been shown, it is unclear whether this also extends to a more subtle implicit cue, like changes in pupil size. Therefore, the current study investigated whether attention is biased towards pupils of differing sizes in humans and bonobos. A total of 150 human participants (141 female), with a mean age of 19.13 (ranging from 18 to 32 years old), completed an online dot-probe task. Four female bonobos (6 to 17 years old) completed the dot-probe task presented via a touch screen. We used linear mixed multilevel models to examine the effect of pupil size on reaction times. In humans, our analysis showed a small but significant attentional bias towards dilated pupils compared to intermediate-sized pupils and intermediate-sized pupils when compared to small pupils. Our analysis did not show a significant effect in bonobos. These results suggest that the attentional bias towards emotions in humans can be extended to a subtle unconsciously produced signal, namely changes in pupil size. Due to methodological differences between the two experiments, more research is needed before drawing a conclusion regarding bonobos.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00146-1.

Emotion processing differences mediate the link between sex and autistic traits in young adulthood

Background

The male preponderance in autism diagnoses is widely reported, yet the psychological mechanisms (e.g., emotion processing) underlying this sex difference are poorly understood. Contributing to this gap in knowledge, most research has not been designed to investigate the intermediary (i.e., mediating) role of psychological processes in the relationship between sex and autism. Compounding this issue, concerns that autism measures are not reliably measuring the same constructs in males and females, and bias against females in clinical samples, make it difficult to investigate the psychological mechanisms underlying sex differences in autism.

Methods

Over two cross-sectional studies, 1656 young adults from the general population reported their sex (as assigned at birth) and completed questionnaires indexing their emotion processing differences, as well as a measure of autistic traits suggested to tap into the same psychometric construct in males and females.

Results

Emotion processing differences mediated the relationship between sex and autistic traits, whereby being male was associated with more emotion processing differences, which were subsequently linked with greater levels of autistic traits. There remained a direct effect of sex on autistic traits after accounting for emotion processing differences.

Conclusions

Emotion processing differences are a potential psychological mechanism underpinning higher prevalence of autism in males, which may serve a compensatory function in females; for example, females may seek out emotion-inducing experiences to help compensate for social-emotional difficulties. These findings inform our understanding of autism-related sex differences and have potential implications for clinical practice, where the need for sex-specific support and diagnostic processes is increasingly being recognised.

Acceptance and potential clinical added value of biocueing in forensic psychiatric patients with autism spectrum disorder and/or intellectual disability

Autism spectrum disorder (ASD) and intellectual disability (ID) are prevalent in forensic psychiatric samples. People with ASD and/or ID often experience difficulties in emotion processing which can lead to aggressive or self-harming behavior. The use of biocueing (using wearable technology to constantly monitor and provide feedback on bodily changes) shows promise for improving emotion processing and, thus, potentially reducing aggressive behavior in this population. Both qualitative and quantitative methods were used to examine the feasibility and acceptance of Sense-IT, a biocueing application, in a sample of forensic psychiatric patients with ASD and/or ID and their forensic psychiatric nurses. To our knowledge, the current study is the first to examine first-person experiences with biocueing in forensic psychiatric patients with ASD and/or ID. Results show that, in general, participants experienced the biocueing application as positive and are willing to use biocueing. This is an important finding since forensic patients are often unmotivated to engage with therapeutic techniques. An exploration of trends in aggression and self-harm prior to and during the use of biocueing showed no significant changes. Future research should focus on the way biocueing can be implemented in clinical practice.

The Nervous System as a Pathway for Exercise to Improve Social Cognition

The promotion of autonomic balance and social brain networks may explain the association of endurance exercise and social cognition.

Specific nervous system functions and the regulating roles of oxytocin have evolved because of the necessity to negotiate increasingly complex social systems. We hypothesize that acute and long-term physical activity and exercise have the potential to benefit social cognitive abilities, such as emotion recognition and regulation, by operating on these functions.

Impairments of Social Interaction in Depressive Disorder

OBJECTIVE

Despite the numerous findings on the altered emotion recognition and dysfunctional social interaction behavior of depressive patients, a lot of the relationships are not clearly clarified.

METHODS

In this pilot study, 20 depressive patients (mean±SD, 38.4±14.2) and 20 healthy subjects (mean±SD, 38.9±15.3) (each in dyads) were videographed. We then analyzed their social interaction behavior and emotion processing in terms of emotion recognition, their own emotional experience, and the expression of emotions under the conditions of a semi-structured experimental paradigm.

RESULTS

Patients showed more significant impairment regarding the dimensions of social interaction behavior (i.e., attention, interest, and activity) and their interaction behavior was characterized by neutral affectivity, silence, and avoidance of direct eye contact. This interactive behavioral style was statistically related to depressive psychopathology. There were no differences concerning emotion recognition.

CONCLUSION

Impairments of non-verbal and verbal social interaction behavior of depressive patients seem to be less associated with disturbances of basic skills of emotion recognition.

Reliability and Validity of the German Version of the Emotional Style Questionnaire

Until recently, emotional processes have played little role in personality psychology. Based on neuroscientific findings, Davidson and colleagues proposed a theory of emotional styles, postulating six dimensions of emotional life: outlook, resilience, social intuition, self-awareness, sensitivity to context, and attention. Recently, an English version of the Emotional Style Questionnaire (ESQ) was developed and tested for reliability and validity. The aim of the present work was to test the test-retest reliability, internal consistency, construct validity, and criterion validity of the German version of the ESQ. Two separate samples consisting of 365 and 344 subjects took part in an online survey. The results of the two studies indicated satisfactory test-retest reliability and internal consistency. Regarding the construct validity, the results from Study 1 to Study 2 indicate good model fit indices. Although there was a high correlation between the subscales outlook and resilience, the analyses supported the six-factor structure postulated by Davidson and colleagues. Substantial correlations were found between the dimensions of the ESQ and other validated scales, confirming the criterion validity of the questionnaire. Our results suggest that the German version of the ESQ is a reliable and valid measurement of emotional styles. It is a feasible and economical questionnaire that can be applied in various psychology disciplines, such as personality psychology, clinical psychology, industrial psychology or sport and exercise psychology.

Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use: an fMRI study

Insecure attachment, impaired personality structure and impaired emotion regulation figure prominently in substance use disorders. While negative emotions can trigger drug-use and relapse, cognitive reappraisal may reduce emotional strain by promoting changes in perspective. In the present study, we explored behavioral and neural correlates of cognitive reappraisal in poly-drug use disorder by testing individuals' capability to generate cognitive reappraisals for aversive events (Reappraisal Inventiveness Test). 18 inpatients with poly-drug use disorder and 16 controls completed the Adult Attachment Scale, the Emotion Regulation Questionnaire, the Brief Symptom Inventory, the Wonderlic Personnel Test, and the Operationalized Psychodynamic Diagnosis Structure Questionnaire, as well as two versions of the Reappraisal Inventiveness Test (during fMRI and outside the lab). Compared to controls, polydrug inpatients reported impaired personality structure, attachment and emotion regulation abilities. In the Reappraisal Inventiveness Test, poly-drug inpatients were less flexible and fluent in generating reappraisals for anger-eliciting situations. Corresponding to previous brain imaging evidence, cognitive reappraisal efforts of both groups were reflected in activation of left frontal regions, particularly left superior and middle frontal gyri and left supplemental motor areas. However, no group differences in neural activation patterns emerged. This suggests that despite cognitive reappraisal impairments on a behavioral level, neural reflections of these deficits in poly-drug use disorder might be more complex.

Dados normativos de um conjunto de faces do Karolinska Directed Emotional Faces em uma amostra brasileira

O objetivo desta pesquisa foi obter dados normativos de um conjunto de faces do Karolinska Directed Emotional Faces (KDEF) em uma amostra brasileira. Para isso foi utilizada uma amostra não probabilística (por conveniência) de 100 participantes da cidade de João Pessoa-PB. Esses tinham idades entre 18 e 62 anos (M=21,6; DP=6,2), a maioria do sexo feminino (76%). Os resultados mostraram que os participantes obtiveram um percentual de acerto médio de 76,2%, de modo que expressões de Alegria (94.7%) e Surpresa (90.3%) foram as emoções mais facilmente identificáveis e Medo (40.65%) a mais difícil. Em relação às medidas de intensidade e valência, Nojo seguida de Surpresa obtiveram classificações mais intensas, e Alegria foi a única emoção com valência positiva alta. Esses achados foram bastante similares com àqueles relatados em pesquisas anteriores, fornecendo normas subjetivas de classificação mais adequadas às características da população brasileira.

Responses to External Emotions or their Transitions at Central to Peripheral Nervous System Levels: A Methodological Contribution to Mental Health

Background:

Responses to external emotional-stimuli or their transitions might help to elucidate the scientific background and assist the clinical management of psychiatric problems, but pure emotional-materials and their utilization at different levels of neurophysiological processing are few.

Objective:

We aimed to describe the responses at central and peripheral levels in healthy volunteers and psychiatric patients when facing external emotions and their transitions.

Methods:

Using pictures and sounds with pure emotions of Disgust, Erotica, Fear, Happiness, Neutral, and Sadness or their transitions as stimuli, we have developed a series of non-invasive techniques, i.e., the event-related potentials, functional magnetic resonance imaging, excitatory and inhibitory brainstem reflexes, and polygraph, to assess different levels of neurophysiological responses in different populations.

Results:

Sample outcomes on various conditions were specific and distinguishable at cortical to peripheral levels in bipolar I and II disorder patients compared to healthy volunteers.

Conclusions:

Methodologically, designs with these pure emotions and their transitions are applicable, and results per se are specifically interpretable in patients with emotion-related problems.

Facial Expression Processing Across the Autism-Psychosis Spectra: A Review of Neural Findings and Associations With Adverse Childhood Events

Autism spectrum disorder (ASD) and primary psychosis are classified as distinct neurodevelopmental disorders, yet they display overlapping epidemiological, environmental, and genetic components as well as endophenotypic similarities. For instance, both disorders are characterized by impairments in facial expression processing, a crucial skill for effective social communication, and both disorders display an increased prevalence of adverse childhood events (ACE). This narrative review provides a brief summary of findings from neuroimaging studies investigating facial expression processing in ASD and primary psychosis with a focus on the commonalities and differences between these disorders. Individuals with ASD and primary psychosis activate the same brain regions as healthy controls during facial expression processing, albeit to a different extent. Overall, both groups display altered activation in the fusiform gyrus and amygdala as well as altered connectivity among the broader face processing network, probably indicating reduced facial expression processing abilities. Furthermore, delayed or reduced N170 responses have been reported in ASD and primary psychosis, but the significance of these findings is questioned, and alternative frequency-tagging electroencephalography (EEG) measures are currently explored to capture facial expression processing impairments more selectively. Face perception is an innate process, but it is also guided by visual learning and social experiences. Extreme environmental factors, such as adverse childhood events, can disrupt normative development and alter facial expression processing. ACE are hypothesized to induce altered neural facial expression processing, in particular a hyperactive amygdala response toward negative expressions. Future studies should account for the comorbidity among ASD, primary psychosis, and ACE when assessing facial expression processing in these clinical groups, as it may explain some of the inconsistencies and confound reported in the field.

Multisensory Integration of Emotion in Schizophrenic Patients

Multisensory integration (MSI) of emotion has been increasingly recognized as an essential element of schizophrenic patients' impairments, leading to the breakdown of their interpersonal functioning. The present review provides an updated synopsis of schizophrenics' MSI abilities in emotion processing by examining relevant behavioral and neurological research. Existing behavioral studies have adopted well-established experimental paradigms to investigate how participants understand multisensory emotion stimuli, and interpret their reciprocal interactions. Yet it remains controversial with regard to congruence-induced facilitation effects, modality dominance effects, and generalized vs specific impairment hypotheses. Such inconsistencies are likely due to differences and variations in experimental manipulations, participants' clinical symptomatology, and cognitive abilities. Recent electrophysiological and neuroimaging research has revealed aberrant indices in event-related potential (ERP) and brain activation patterns, further suggesting impaired temporal processing and dysfunctional brain regions, connectivity and circuities at different stages of MSI in emotion processing. The limitations of existing studies and implications for future MSI work are discussed in light of research designs and techniques, study samples and stimuli, and clinical applications.

[Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government]

Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government Children of parents with a mental illness (COPMI) are at an increased risk to develop (severe) mental disorders (SMI) themselves. Estimates for Germany result in about 25 % of COPMI. This is thus a large and high risk group. On the other hand, prevention programs for COPMI are still scarce, especially in Germany, and central features of the transgenerational transmission of mental disorders have not been studied in conjunction to shed light on potential transmission mechanisms. The current article presents two current research projects on COPMI focusing on preventive approaches. The BMBF funded project "Children of Parents with a Mental Illness At Risk Evaluation" (COMPARE) targets parents of children aged 1.5 to 16 years of age. Parents need to fulfil a current DSM-5 based diagnosis of a mental disorder and then receive either 25-45 sessions gold standard cognitive behavioural therapy (CBT) or CBT plus 10 sessions Positive Parenting Program (PPP) to test the effects of parental therapy on the children and whether an additional parent training results in incremental effects above and beyond CBT alone. The project "The Village" is a model project in the region Tyrol, Austria, targeting the improved identification and collaborative care of COPMI.

Emotional Intelligence as an Evolutive Factor on Adult With ADHD

Objective: ADHD adults exhibit deficits in emotion recognition, regulation, and expression. Emotional intelligence (EI) correlates with better life performance and is considered a skill that can be learned and developed. The aim of this study was to assess EI development as ability in ADHD adults, considering the effect of comorbid psychiatric disorders and previous diagnosis of ADHD. Method: Participants (n = 116) were distributed in four groups attending to current comorbidities and previous ADHD diagnosis, and administered the Mayer-Salovey-Caruso Emotional Intelligence Test version 2.0 to assess their EI level. Results: ADHD adults with comorbidity with no previous diagnosis had lower EI development than healthy controls and the rest of ADHD groups. In addition, ADHD severity in childhood or in adulthood did not influence the current EI level. Conclusion: EI development as a therapeutic approach could be of use in ADHD patients with comorbidities.

What we think about when we think about predictive processing

The predictive processing framework (PPF) attempts to tackle deep philosophical problems, including how the brain generates consciousness, how our bodies influence cognition, and how cognition alters perception. As such, it provides a zeitgeist that incorporates concepts from physics, computer science, mathematics, artificial intelligence, economics, psychology, and neuroscience, leveraging and, in turn, influencing recent advances in reinforcement learning and deep learning that underpin the artificial intelligence in many of the applications with which we interact daily. PPF purports to provide no less than a grand unifying theory of mind and brain function, underwriting an account of perception, cognition, and action and their dynamic relationships. While mindful of legitimate criticisms of the framework, to which we return below, an important test of PPF is its utility in accounting for individual differences such as psychopathology. These, then, are the central concern of this special section of the Journal of Abnormal Psychology: What is the state of the art with regards to applying the PPF to the symptoms of mental illness? How might we leverage its insights to elevate and systematize our explanations, and ideally treatments, of those symptoms? And, conversely, can we refine and refute aspects of the PPF by considering the particular challenges that our patients experience as departures from the parametric estimates of the PPF? (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Resting State Cortico-Limbic Functional Connectivity and Dispositional Use of Emotion Regulation Strategies: A Replication and Extension Study

Neuroimaging functional connectivity analyses have shown that the negative coupling between the amygdala and cortical regions is linked to better emotion regulation (ER) in experimental task settings. However, less is known about the neural correlates of ER traits or dispositions. The present study aimed to: (1) replicate the findings of differential cortico-limbic coupling during resting-state depending on the dispositional use of emotion regulation strategies. Furthermore, the study aimed to: (2) extend prior findings by examining whether differences in cortico-limbic coupling during resting-state predict experiential and neuronal ER success in a standard ER task. To this end, N = 107 healthy adults completed the Emotion Regulation Questionnaire (ERQ), underwent an 8-min resting-state fMRI acquisition, and completed a reappraisal task during fMRI. Functional connectivity maps of basolateral and centromedial amygdala nuclei were estimated with a seed-based approach regarding associations with regions of the prefrontal cortex and were then correlated with ERQ scores as well as experiential and neuronal ER success. All hypotheses and the analysis plan are preregistered at https://osf.io/8wsgu. Opposed to prior findings, we were not able to replicate a correlation of dispositional ER strategy use with functional connectivity between the amygdala and PFC regions (p > 0.05, FWE-corrected). Furthermore, there was no association of experiential and neuronal reappraisal success with functional connectivity between amygdala and insula as well as PFC (p > 0.05, FWE-corrected). The present preregistered study calls into question the reported association between individual differences in resting-state cortico-limbic connectivity and dispositional use of ER strategies. However, ongoing advances in functional brain imaging and distributed network approaches may leverage the identification of reliable functional connectivity patterns that underlie successful emotion regulation.

Facial Emotion Recognition Abilities in Women Experiencing Eating Disorders

OBJECTIVE

Impairments in facial emotion recognition are an underlying factor of deficits in emotion regulation and interpersonal difficulties in mental disorders and are evident in eating disorders (EDs).

METHODS

We used a computerized psychophysical paradigm to manipulate parametrically the quantity of signal in facial expressions of emotion (QUEST threshold seeking algorithm). This was used to measure emotion recognition in 308 adult women (anorexia nervosa [n = 61], bulimia nervosa [n = 58], healthy controls [n = 130], and mixed mental disorders [mixed, n = 59]). The M (SD) age was 22.84 (3.90) years. The aims were to establish recognition thresholds defining how much information a person needs to recognize a facial emotion expression and to identify deficits in EDs compared with healthy and clinical controls. The stimuli included six basic emotion expressions (fear, anger, disgust, happiness, sadness, surprise), plus a neutral expression.

RESULTS

Happiness was discriminated at the lowest, fear at the highest threshold by all groups. There were no differences regarding thresholds between groups, except for the mixed and the bulimia nervosa group with respect to the expression of disgust (F(3,302) = 5.97, p = .001, η = .056). Emotional clarity, ED pathology, and depressive symptoms did not predict performance (RChange ≤ .010, F(1,305) ≤ 5.74, p ≥ .079). The confusion matrix did not reveal specific biases in either group.

CONCLUSIONS

Overall, within-subject effects were as expected, whereas between-subject effects were marginal and psychopathology did not influence emotion recognition. Facial emotion recognition abilities in women experiencing EDs compared with women experiencing mixed mental disorders and healthy controls were similar. Although basic facial emotion recognition processes seems to be intact, dysfunctional aspects such as misinterpretation might be important in emotion regulation problems.

CLINICAL TRIAL REGISTRATION NUMBER

DRKS-ID: DRKS00005709.

Dissociating Profiles of Social Cognitive Disturbances Between Mixed Personality and Anxiety Disorder

BACKGROUND

An emerging body of research has begun to elucidate disturbances to social cognition in specific personality disorders (PDs). No research has been conducted on patients with Mixed Personality Disorder (MPD), however, who meet multiple diagnostic criteria. Further, very few studies have compared social cognition between patients with PD and those presenting with symptomatic diagnoses that co-occur with personality pathologies, such as anxiety disorder (AD). The aim of this study was to provide a detailed characterization of deficits to various aspects of social cognition in MPD and dissociate impairments specific to MPD from those exhibited by patients with AD who differ in the severity of personality pathology.

METHOD

Building on our previous research, we administered a large battery of self-report and performance-based measures of social cognition to age-, sex- and education-matched groups of patients with MPD or AD, and healthy control participants (HCs; n = 29, 23, and 54, respectively). This permitted a detailed profiling of these clinical groups according to impairments in emotion recognition and regulation, imitative control, low-level visual perspective taking, and empathic awareness and expression.

RESULTS

The MPD group demonstrated poorer emotion recognition for negative facial expressions relative to both HCs and AD. Compared with HCs, both clinical groups also performed significantly worse in visual perspective taking and interference resolution, and reported higher personal distress when empathizing and more state-oriented emotion regulation.

CONCLUSION

We interpret our results to reflect dysfunctional cognitive control that is common to patients with both MPD and AD. Given the patterns of affective dispositions that characterize these two diagnostic groups, we suggest that prolonged negative affectivity is associated with inflexible styles of emotion regulation and attribution. This might potentiate the interpersonal dysfunction exhibited in MPD, particularly in negatively valenced and challenging social situations.

Altered gray matter volumes in post-stroke depressive patients after subcortical stroke

Stroke survivors are known to suffer from post-stroke depression (PSD). However, the likelihood of structural changes in the brains of PSD patients has not been explored. This study aims to extract changes in the gray matter of these patients and test how these changes account for the PSD symptoms. High-resolution T1 weighted images were collected from 23 PSD patients diagnosed with subcortical stroke. Voxel-based morphometry and support vector machine analyses were used to analyze the data. The results were compared with those collected from 33 non-PSD patients. PSD group showed decreased gray matter volume (GMV) in the left middle frontal gyrus (MFG) when compared to the non-PSD patients. Together with the clinical and demographic variables, the MFG's GMV predictive model was able to distinguish PSD from the non-PSD patients (0•70 sensitivity and 0•88 specificity). The changes in the left inferior frontal gyrus (61%) and dorsolateral prefrontal cortex (39%) suggest that the somatic/affective symptoms in PSD is likely to be due to patients' problems with understanding and appraising negative emotional stimuli. The impact brought by the reduced prefrontal to limbic system connectivity needs further exploration. These findings indicate possible systemic involvement of the frontolimbic network resulting in PSD after brain lesions which is likely to be independent from the location of the lesion. The results inform specific clinical interventions to be provided for treating depressive symptoms in post-stroke patients.

The Effect of Sleep Deprivation on Recognition of Ambiguous Emotional Facial Expressions in Individuals With ADHD

Objective: The present study sought to investigate whether young adults with ADHD have more difficulty recognizing emotional facial expressions compared with young adults without ADHD, and whether such a difference worsens following sleep deprivation. Method: Thirty-one young men (M = 25.6) with (n = 15) or without (n = 16) a diagnosis of ADHD were included in this study. The participants were instructed to sleep 7 hr or more each night for one week, and their sleep quality was monitored via actigraph. Subsequently, the participants were kept awake in a controlled environment for 30 hr. The participants completed a visual emotional morph task twice-at the beginning and at the end of this period. The task included presentation of interpolated face stimuli ranging from neutral facial expressions to fully emotional facial expressions of anger, sadness, or happiness, allowing for assessment of the intensity threshold for recognizing these facial emotional expressions. Results: Actigraphy data demonstrated that while the nightly sleep duration of the participants with ADHD was similar to that of participants without ADHD, their sleep efficiency was poorer. At the onset of the experiment, there were no differences in recognition thresholds between the participants with ADHD and those without ADHD. Following sleep deprivation, however, the ADHD group required clearer facial expressions to recognize the presence of angry, sad, and, to a lesser extent, happy faces. Conclusion: Among young adults with ADHD, sleep deprivation may hinder the processing of emotional facial stimuli.

Concurrent amygdalar and ventromedial prefrontal cortical responses during emotion processing: a meta-analysis of the effects of valence of emotion and passive exposure versus active regulation

Anatomically interconnected, the ventromedial prefrontal cortex (vmPFC) and amygdala interact in emotion processing. However, no meta-analyses have focused on studies that reported concurrent vmPFC and amygdala activities. With activation likelihood estimation (ALE) we examined 100 experiments that reported concurrent vmPFC and amygdala activities, and distinguished responses to positive vs. negative emotions and to passive exposure to vs. active regulation of emotions. We also investigated whole-brain experiments for other regional activities. ALE and contrast analyses identified convergent anterior and posterior vmPFC response to passive positive and negative emotions, respectively, and a subregion in between to mixed emotions. A smaller area in the posterior ventral vmPFC is specifically involved in regulation of negative emotion. Whereas bilateral amygdala was involved during emotional exposure, only the left amygdala showed convergent activities during active regulation of negative emotions. Whole-brain analysis showed convergent activity in left ventral striatum for passive exposure to positive emotions and downregulation of negative emotions, and in the posterior cingulate cortex and ventral precuneus for passive exposure to negative emotions. These findings highlight contrasting, valence-specific subregional vmPFC as well as other regional responses during passive exposure to emotions. The findings also suggest that hyperactivation of the vmPFC is associated with diminished right amygdala activities during regulation of negative emotions. Together, the findings extend the literature by specifying the roles of subregional vmPFC and amygdala activities in emotion processing.

The Role of Attachment in Poly-Drug Use Disorder: An Overview of the Literature, Recent Findings and Clinical Implications

Background: Substance use disorders (SUDs) represent a worldwide epidemic with extensive costs to the individual and to society. Occasionally described as an attachment disorder, they have been linked to various impairments in self-regulation and social functioning. However, while there have been significant advances in the development and validation of treatment strategies for SUD in recent years, the components of these treatment approaches have yet to be fully explored. The characteristics of polydrug use disorder (PUD) especially need to be addressed in more detail, as this diagnosis is highly common in individuals seeking treatment, while simultaneously being associated with poor treatment success. Aim and Scope: This review aims at further exploring the relevance of attachment in PUD and its treatment. To this end, this review provides a concise summary of relevant theories on the development and treatment of SUD in general, including related parameters of attachment, emotion regulation, and neuroscience. Furthermore, several studies focused specifically on PUD are described in more detail. These studies explored the connections between attachment, personality structure, primary and higher emotions (including spirituality), as well as structural and functional neural parameters in inpatients with PUD as well as in healthy controls. Most notably, the described studies highlight that insecure attachment and impairments in personality structure are present in inpatients with PUD. In addition, these characteristics are paralleled by extensive impairments in white matter integrity, especially in tracts connected to facets of emotion regulation. Conclusions: Based on our findings, we emphasize conceptualization of PUD as an Attachment Disorder, on a behavioral as well as on a neural level. Furthermore, we point out the importance of an integrated bio-psycho-social approach in this research area. Consequently, future studies might more closely focus on the influence of attachment-based interventions on emotion regulation abilities as well as a potentially related neuroplasticity. Neuroplastic changes, which are still rather unexplored, might represent important parameters for the assessment of treatment outcomes especially in long-term SUD treatment.

Testing Cold and Hot Cognitive Control as Moderators of a Network of Comorbid Psychopathology Symptoms in Adolescence

Comorbidity is pervasive across psychopathological symptoms, diagnoses, and domains. Network analysis is a method for investigating symptom-level associations that underlie comorbidity, particularly through bridge symptoms connecting diagnostic syndromes. We applied network analyses of comorbidity to data from a population-based sample of adolescents (n = 849). We implemented a method for assessing nonparametric moderation of psychopathology networks to evaluate differences in network structure across levels of intelligence and emotional control. Symptoms generally clustered by clinical diagnoses, but specific between-cluster bridge connections emerged. Internalizing symptoms demonstrated unique connections with aggression symptoms of interpersonal irritability, whereas externalizing symptoms showed more diffuse interconnections. Aggression symptoms identified as bridge nodes in the cross-sectional network were enriched for longitudinal associations with internalizing symptoms. Cross-domain connections did not significantly vary across intelligence but were weaker at lower emotional control. Our findings highlight transdiagnostic symptom relationships that may underlie co-occurrence of clinical diagnoses or higher-order factors of psychopathology.

Ecological micro-expression recognition characteristics of young adults with subthreshold depression

The micro-expression (ME) processing characteristics of patients with depression has been studied but has not been investigated in people with subthreshold depression. Based on this, by adopting the ecological MEs recognition paradigm, this study aimed to explore ME recognition in people with subthreshold depression. A 4 (background expression: happy, neutral, sad and fearful) × 4 (ME: happy, neutral, sad, and fearful) study was designed; two groups of participants (experimental group with subthreshold depression vs. healthy control group, 32 participants in each group) were asked to complete the ecological ME recognition task, and the corresponding accuracy (ACC) and reaction time (RT) were analyzed. Results: (1) Under different background conditions, recognizing happy MEs had the highest ACC and shortest RT. (2) There was no significant difference in the ACC and RT between experimental and control groups. (3)In different contexts, individuals with subthreshold depression tended to misjudge neutral, sad, and fearful MEs as happy, while neutral MEs were misjudged as sad and fearful. (4) The performance of individuals with subthreshold depression in the ecological ME recognition task were influenced by the type of ME; they showed highest ACC and shortest RT when recognizing happy MEs (vs. the other MEs). Conclusions: (1) The performance of individuals’ ecological ME recognition were influenced by the background expression, and this embodied the need for ecological ME recognition. (2) Individuals with subthreshold depression showed normal ecological ME recognition ability. (3) In terms of misjudgment, individuals with subthreshold depression showed both positive and negative bias, when completing the ecological ME recognition task. (4) Compared with the other MEs, happy MEs showed an advantage recognition effect for individuals with subthreshold depression who completed the ecological ME recognition task.

Is aberrant affective cognition an endophenotype for affective disorders? - A monozygotic twin study

BACKGROUND

Identification of endophenotypes can improve prevention, detection and development of new treatments. We therefore investigated whether aberrant affective cognition constitutes an endophenotype for affective disorders by being present in monozygotic (MZ) twins with unipolar or bipolar disorder in partial remission (i.e. affected) and their unaffected co-twins (i.e. high-risk) relative to twins with no family history of affective disorder (i.e. low-risk).

METHODS

We conducted an assessor blind cross-sectional study from 2014 to 2017 of MZ twins using Danish population-based registers in recruitment. Twins attended one test session involving neurocognitive testing, clinical ratings and questionnaires. Main outcomes were attention to and recognition of emotional facial expressions, the memory of emotional self-referential words, emotion regulation and coping strategies.

RESULTS

Participants were 103 affected, 44 high-risk and 36 low-risk MZ twins. Groups were demographically well-balanced and showed comparable non-affective cognitive performance. We observed no aberrant affective cognition in affected and high-risk relative to low-risk twins. However, high-risk twins displayed attentional avoidance of emotional faces (ps ⩽ 0.009) and more use of task-oriented coping strategies (p = 0.01) compared with affected twins. In contrast did affected twins show more emotion-oriented coping than high- and low-risk twins (ps ⩽ 0.004).

CONCLUSIONS

Our findings provide no support of aberrant affective cognition as an endophenotype for affective disorders. High-risk twins' attentional avoidance of emotional faces and greater use of task-oriented coping strategies may reflect compensatory mechanisms.

Impact of FAAH genetic variation on fronto-amygdala function during emotional processing

Recent translational studies identified a common endocannabinoid polymorphism, FAAH C385A, in the gene for the fatty acid amide hydrolase (FAAH). This polymorphism alters endocannabinoid anandamide levels, which are known to be involved in the fronto-amygdala circuitry implicated in mood regulation and anxiety-like behaviors. While it has been shown that the variant that selectively enhances fronto-amygdala connectivity at rest is associated with decreased anxiety-like behaviors, no study so far has investigated whether this finding of FAAH-related differential plasticity extends to task-related differential functional expression and regulation during negative emotional processing. Using an imaging genetics approach, this study aimed to replicate and extend prior findings by examining functional activity and task-related connectivity in fronto-amygdala regions during emotion reactivity and emotional down-regulation of negative affect. Therefore, 48 healthy young adults underwent a functional MRI resting state measurement, completed an emotion regulation paradigm and provided self-reports on anxiety and use of emotion regulation strategies. In line with previous studies, preliminary evidence suggests that A-allele carriers demonstrate stronger fronto-amygdala connectivity during rest. In addition, exploratory whole-brain analyses indicate differential functional activity of A-allele carriers during emotion reactivity and emotion regulation. There were no associations with anxiety-related self-reports and use of emotional regulation strategies. Further research using larger samples and polygenic approaches is indicated to clarify the precise role and its underlying mechanisms in emotion processing.

Children of Mentally III Parents at Risk Evaluation (COMPARE): Design and Methods of a Randomized Controlled Multicenter Study-Part I

Objectives: Mental disorders are frequent, associated with disability-adjusted life years, societal, and economic costs. Children of parents with a mental illness (COPMI) are at an increased risk to develop disorders themselves. The transgenerational transmission of mental disorders has been conceptualized in a model that takes parental and family factors, the social environment (i.e., school, work, and social support), parent-child-interaction and possible child outcomes into account. The goal of the "Children of Mentally Ill Parents At Risk Evaluation" (COMPARE) study will thus be twofold: (1) to establish the efficacy and cost-effectiveness of a high-quality randomized controlled trial (RCT) with the aim of interrupting the intergenerational transmission of mental disorders in COPMI, (2) to test the components of the trans-generational transmission model of mental disorders. Methods: To implement a randomized controlled trial (RCT: comparison of parental cognitive behavioral therapy/CBT with CBT + Positive Parenting Program) that is flanked by four add-on projects that apply behavioral, psychophysiological, and neuro-imaging methods to examine potential moderators and mediators of risk transmission (projects COMPARE-emotion/-interaction/-work/-school). COMPARE-emotion targets emotion processing and regulation and its impact on the transgenerational disorder transmission; COMPARE-interaction focuses especially on the impact of maternal comorbid diagnoses of depression and anxiety disorders and will concentrate on different pathways of the impact of maternal disorders on socio-emotional and cognitive infant development, such as parent-infant interaction and the infant's stress regulation skills. COMPARE-work analyzes the transmission of strains a person experiences in one area of life to another (i.e., from family to work; spill-over), and how stress and strain are transmitted between individuals (i.e., from parent to child; cross-over). COMPARE-school focuses on the psychosocial adjustment, school performance, and subjective well-being in COPMI compared to an adequate control group of healthy children. Results: This study protocol reports on the interdisciplinary approach of COMPARE testing the model of the transgenerational transmission of mental disorders. Conclusion: The combination of applied basic with clinical research will facilitate the examination of specific risk transmission mechanisms, promotion, dissemination and implementation of results into a highly important but largely neglected field. Clinical Trial Registration: DRKS-ID: DRKS00013516 (German Clinical Trials Register, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013516).

Relationship Between Attachment Style in Adulthood, Alexithymia, and Dissociation in Alcohol Use Disorder Inpatients. Mediational Model

Background: Attachment theory is a widely used framework for understanding emotion regulation as well as alexithymia, and dissociation and this perspective has also been applied to understand alcohol use disorders. Apart from these theoretical suggestions, there has been scarce empirical research on this subject-matter. Therefore, the objective of the present study was to investigate potential associations between attachment style in adulthood, alexithymia, and dissociation in alcohol use disorder inpatients. Methods: The Revised Adult Attachment Scale (RAAS), the Toronto Alexithymia Scale-20 (TAS-20), the Michigan Alcoholism Screening Test (MAST), and the Curious Experiences Survey (CES) were administered to a sample of 97 alcohol use disorder inpatients recruited from drug and alcohol treatment centers in Warsaw, and 104 persons in control groups, Poland. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: alexithymia, dissociation, and attachment styles. The analysis of models related to the impact of attachment styles on the level of alcohol addiction with regard to a mediatory role of alexithymia and dissociation showed that all models are well fitted to data and statistically significant: intimacy F(3.197) = 34.41; p < 0.001 and explains 34% (R ² = 0.3438); depend F(3.197) = 36.55; p < 0.001, and explains 36% (R ² = 0.3576); anxiety F(3.197) = 34.71; p < 0.001, and explains 35% (R ² = 0.3458) of the variability of alcohol addiction scores. Mediation analysis found that alexithymia and dissociation enhance the fear of intimacy and rejection in a romantic relationship. Conclusion: These findings support the broad attachment theory suggesting that attachment is associated with and predicts alexithymia and dissociation in the sample of substance use disorder inpatients. Alexithymia and dissociation, by inhibiting the processes of emotions' identification and verbalization, cause that language does not serve for the purpose of changing self or others, as the communication is distorted. Absent are common meanings and accurate mutual understanding in a relationship.

Neurophysiological Processing of Emotion in Children of Mothers with a History of Depression: the Moderating Role of Preschool Persistent Irritability

Research on emotion-processing biases in offspring of depressed parents has produced a variety of findings. Child persistent irritability may be a useful clinical feature that demarcates subgroups of offspring with distinct patterns of emotion processing. The present study examined whether early persistent irritability moderated the relationship between maternal lifetime history of a depressive disorder and appetitive- and aversive-emotion processing in 338 never-depressed pre-adolescent children (43.8% female). When children were 3, mothers were interviewed about children's persistent irritability. Six years later, EEG was recorded while children completed a task in which the late positive potential (LPP), a neural index of emotional reactivity, was measured in response to appetitive, aversive, and neutral images. At both assessments, mothers were interviewed about their own psychopathology. Among offspring of depressed mothers, children characterized by high levels of early persistent irritability showed an enhanced LPP to appetitive and aversive compared to neutral images (i.e., ΔLPP), whereas children with low levels of early irritability showed attenuated ΔLPPs. In offspring of mothers with no history of depression, there was no association between irritability and emotion processing. Findings suggest that persistent irritability influences the pattern of emotion-processing aberrations in offspring of depressed mothers.

The dot-probe task to measure emotional attention: A suitable measure in comparative studies?

For social animals, attending to and recognizing the emotional expressions of other individuals is of crucial importance for their survival and likely has a deep evolutionary origin. Gaining insight into how emotional expressions evolved as adaptations over the course of evolution can be achieved by making direct cross-species comparisons. To that extent, experimental paradigms that are suitable for investigating emotional processing across species need to be developed and evaluated. The emotional dot-probe task, which measures attention allocation toward emotional stimuli, has this potential. The task is implicit, and subjects need minimal training to perform the task successfully. Findings in nonhuman primates, although scarce, show that they, like humans, have an attentional bias toward emotional stimuli. However, the wide literature on human studies has shown that different factors can have important moderating effects on the results. Due to the large heterogeneity of this literature, these moderating effects often remain unnoticed. We here review this literature and show that subject characteristics and differences in experimental designs affect the results of the dot-probe task. We conclude with specific recommendations regarding these issues that are particularly relevant to take into consideration when applying this paradigm to study animals.

Recognition of emotional facial expressions in adolescents with anorexia nervosa and adolescents with major depression

Anorexia nervosa (AN) has been suggested to be associated with abnormalities in facial emotion recognition. Most prior studies on facial emotion recognition in AN have investigated adult samples, despite the onset of AN being particularly often during adolescence. In addition, few studies have examined whether impairments in facial emotion recognition are specific to AN or might be explained by frequent comorbid conditions that are also associated with deficits in emotion recognition, such as depression. The present study addressed these gaps by investigating recognition of emotional facial expressions in adolescent girls with AN (n = 26) compared to girls with major depression (MD; n = 26) and healthy girls (HC; n = 37). Participants completed one task requiring identification of emotions (happy, sad, afraid, angry, neutral) in faces and two control tasks. Neither of the clinical groups showed impairments. The AN group was more accurate than the HC group in recognising afraid facial expressions and more accurate than the MD group in recognising happy, sad, and afraid expressions. Misclassification analyses identified subtle group differences in the types of errors made. The results suggest that the deficits in facial emotion recognition found in adult AN samples are not present in adolescent patients.

The Emotion Mapping Activity: Preliminary evaluation of a mindfulness-informed exercise to improve emotion labeling in alexithymic persons

Alexithymia is a psychoemotional trait associated with many treatment-resistant psychological and social difficulties. Research suggests that these difficulties stem primarily from an inability to appropriately apply linguistic labels to emotional experiences and content. The present research introduces and preliminarily evaluates a novel mindfulness-informed exercise to improve emotion-labeling ability in alexithymic persons. Based in culturally universal patterns of somatic experience, the Emotion Mapping Activity (EMA) directs alexithymic persons to reflect on their internal, somatic experiences as a source of information for interpreting and labeling emotional experiences. In the present study, 67 alexithymic persons completed a series of emotion-labeling tasks either with or without assistance of the EMA. Results suggest that completion of the EMA may improve ability to label emotions that would be otherwise misinterpreted - without interfering with labeling that is already intact. Though further research is necessary, the present study suggests that the EMA may hold the potential to be incorporated into psychotherapy protocols as an exercise for improving emotion-labeling ability in alexithymic clients.

Emotion recognition from faces with in- and out-group features in patients with depression

BACKGROUND

Previous research has shown that context (e.g. culture) can have an impact on speed and accuracy when identifying facial expressions of emotion. Patients with a major depressive disorder (MDD) are known to have deficits in the identification of facial expressions, tending to give rather stereotypical judgments. While healthy individuals perceive situations which conflict with their own cultural values more negatively, this pattern would be even stronger in MDD patients, as their altered mood results in stronger biases. In this study we investigate the effect of cultural contextual cues on emotion identification in depression.

METHODS

Emotional faces were presented for 100ms to 34 patients with an MDD and matched controls. Stimulus faces were either covered by a cap and scarf (in-group condition) or by an Islamic headdress (niqab; out-group condition). Speed and accuracy were evaluated.

RESULTS

Results showed that across groups, fearful faces were identified faster and with higher accuracy in the out-group than in the in-group condition. Sadness was also identified more accurately in the out-group condition. In comparison, happy faces were more accurately (and tended to be faster) identified in the in-group condition. Furthermore, MDD patients were slower, yet not more accurate in identifying expressions of emotion compared to controls.

LIMITATIONS

All patients were on pharmacological treatment. Participants' political orientation was not included. The experiment differs from real life situations.

CONCLUSION

While our results underline findings that cultural context has a general impact on emotion identification, this effect was not found to be more prominent in patients with MDD.

Pupil mimicry and trust - Implication for depression

Individuals suffering from depression often have difficulty trusting others. Previous research has shown a relationship between trust formation and pupil mimicry - the synchronization of pupil sizes between individuals. The current study therefore examined whether pupil mimicry is weaker in depressed individuals and an underlying factor of their low levels of trust. Forty-two patients with major depressive disorder (MDD) and 40 healthy control subjects played trust games with virtual partners. Images of these partners' eye regions were presented to participants before they had to make a monetary investment decision. Partners' pupils either dilated, constricted, or remained static over the course of 4-s interactions. During the task, participants' pupil sizes were recorded with eye-tracking equipment to assess mimicry. The results confirm that patients with MDD were somewhat less trusting than controls and used another's pupillary cues differently when deciding to trust. Specifically, whereas healthy controls trusted partners with dilating pupils more than partners with constricting pupils, patients with MDD particularly trusted partners whose pupils changed in size less, regardless of whether partners' pupils were dilating or constricting. This difference in investment behavior was unrelated to differences in pupil mimicry, which was equally apparent in both groups and fostered trust to the same extent. Whereas lower levels of trust observed in patients with MDD could not be explained by differences in pupil mimicry, our data show that pupil dilation mimicry might help people to trust. These findings provide further evidence for the important role of pupil size and pupil mimicry in interpersonal trust formation and shed light on the pathophysiology of clinically low trust in patients with MDD.

Changes in Emotion Processing following Brief Augmented Psychodynamic Interpersonal Therapy for Functional Neurological Symptoms

Background: Functional neurological symptoms (FNS) are considered non-volitional and often very disabling, but are not explainable by neurological disease or structural abnormalities. Brief Augmented Psychodynamic Interpersonal Therapy (BAPIT) was adapted to treat the putative emotion processing deficits thought to be central to FNS aetiology and maintenance. BAPIT for FNS has previously been shown to improve levels of distress and functioning, but it is unknown whether improvements on such measures correlate with changes in emotion processing ‒ which this treatment focuses on. Aim: To determine (a) whether the recently developed Emotional Processing Scale-25 can be used to demonstrate BAPIT-associated changes in patients with FNS, and (b) whether changes in the EPS-25 are associated with changes in previously validated outcome measures. Method: 44 patients with FNS completed questionnaires including the EPS-25 and measures of clinical symptomology (health-related quality of life (SF-36), somatic symptoms (PHQ-15), psychological distress (CORE-10) and illness understanding (BIPQ)) pre- and post-therapy. Results: At group level, emotion processing improved following therapy (p = .049). Some measures of clinical symptomology also improved, namely health-related quality of life (p = .02) and illness understanding (p = .01). Improvements in the EPS-25 correlated with improvements in mental health-related quality of life and psychological distress. Conclusions: Emotion processing and some measures of clinical symptomology improved in patients with FNS following BAPIT. The EPS-25 demonstrated changes that correlated with previously validated outcome measures. The EPS-25 is a suitable measure of psychotherapy-associated change in the FNS patient population.

Neural substrates of the ability to recognize facial expressions: a voxel-based morphometry study

The recognition of facial expressions of emotion is adaptive for human social interaction, but the ability to do this and the manner in which it is achieved differs among individuals. Previous functional neuroimaging studies have demonstrated that some brain regions, such as the inferior frontal gyrus (IFG), are active during the response to emotional facial expressions in healthy participants, and lesion studies have demonstrated that damage to these structures impairs the recognition of facial expressions. However, it remains to be established whether individual differences in the structure of these regions could be associated with differences in the ability to recognize facial expressions. We investigated this issue using acquired structural magnetic resonance imaging, and assessed the performance of healthy adults with respect to recognition of the facial expressions of six basic emotions. The gray matter volume of the right IFG positively correlated with the total accuracy of facial expression recognition. This suggests that individual differences in the ability to recognize facial expressions are associated with differences in the structure of the right IFG. Furthermore, the mirror neuron activity of the IFG may be important for establishing efficient facial mimicry to facilitate emotion recognition.

Differences in neural and cognitive response to emotional faces in middle-aged dizygotic twins at familial risk of depression

BACKGROUND

Negative bias and aberrant neural processing of emotional faces are trait-marks of depression but findings in healthy high-risk groups are conflicting.

METHODS

Healthy middle-aged dizygotic twins (N = 42) underwent functional magnetic resonance imaging (fMRI): 22 twins had a co-twin history of depression (high-risk) and 20 were without co-twin history of depression (low-risk). During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task and questionnaires assessing mood, personality traits and coping.

RESULTS

Unexpectedly, high-risk twins showed reduced fear vigilance and lower recognition of fear and happiness relative to low-risk twins. During face processing in the scanner, high-risk twins displayed distinct negative functional coupling between the amygdala and ventral prefrontal cortex and pregenual anterior cingulate. This was accompanied by greater fear-specific fronto-temporal response and reduced fronto-occipital response to all emotional faces relative to baseline. The risk groups showed no differences in mood, subjective state or coping.

CONCLUSIONS

Less susceptibility to fearful faces and negative cortico-limbic coupling during emotional face processing may reflect neurocognitive compensatory mechanisms in middle-aged dizygotic twins who remain healthy despite their familial risk of depression.

Confirmatory Factor Analytic Structure and Measurement Invariance of the Emotion Regulation Questionnaire for Children and Adolescents in a Longitudinal Sample of Adolescents

While adolescence is a critical stage of development marked by heightened bottom-up emotional reactivity and immature top-down regulatory control, research on emotion regulation has relatively neglected middle childhood to adolescence years. This may be attributed to the limited number and scope of age-appropriate, reliable, and valid measures of emotion regulation. This study examines the confirmatory factor analytic structure and measurement invariance of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), a 10-item self-report measure designed to measure habitual use of cognitive reappraisal and expressive suppression, across a 1-year time interval in school samples of adolescents. Results indicate low test–retest reliability but high to acceptable internal consistency over a 1-year time period. The two-factor model has an approximate but close fit to the data collected, which is consistent with underlying theoretical framework and prior empirical findings. Tests of measurement equivalence support strong invariance, indicating that there were no statistically significant differences in factor means, variances, and correlations over a 1-year interval.

Visual Attention to Ambiguous Emotional Faces in Eating Disorders: Role of Alexithymia

Eating disorders (EDs) are often accompanied by social-emotional problems. Recently, alexithymia has been suggested to explain objective emotion processing deficits in EDs. We tested if elevated levels of alexithymia may explain emotional face-processing problems in a mixed ED group (N = 24, 19 with anorexia and five with bulimia), comparing them with high-alexithymic (N = 25) and low-alexithymic healthy controls (N = 25). Participants judged the mixture ratio of clear and ambiguous facial emotion blends while eye movements were recorded. The ED group was less accurate judging ambiguous blends containing anger or disgust and attended less to the faces compared with low-alexithymic controls. Reduced attention to faces, in particular the eye region, was linked to confusion with ambiguous anger and disgust in the ED group only. Although significant group differences only emerged compared with low-alexithymic controls, the visual attention patterns underlying the ED group's problems with subtle anger and disgust expressions were not driven by alexithymia. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Attachment style moderates theory of mind abilities in depression

INTRODUCTION

Being able to understand other people's emotions and intentions is crucial for social interactions and well-being. Deficits in theory of mind (ToM) functioning hamper this ability and have been observed in depression and other neuropsychiatric disorders. However, results of previous research in depression have been inconclusive, possibly due to the presence of comorbid disorders and the disregarding of other modulating factors.

METHODS

Thirty-eight patients with a major depressive disorder (MDD) and forty healthy matched controls were assessed with a ToM task using animated triangles. Results were correlated with attachment styles, empathy abilities and neurocognitive performance.

RESULTS

Our findings show that 1) healthy female controls performed significantly stronger on the ToM task than female MDD patients, 2) these performance differences were driven by attachment styles and 3) depression severity did not impact task performance.

LIMITATIONS

The pharmacological treatment of the majority of patients might limit the generalizability of this study.

DISCUSSION

Results indicate a gender-specific impact of attachment styles on ToM performance. Future studies should investigate whether impairments in social cognitive tasks pose a risk factor for depression and/or interactional styles or vice versa. Moreover, with regard to remediation programs gender-specific needs should be taken into account.