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Lee SH, Lee KT. Attentional Processing of Unpleasant Stimuli in Alexithymia. Psychol Rep 2022:332941221146917. [PMID: 36527407 DOI: 10.1177/00332941221146917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Alexithymia is a multi-faceted personality trait defined by difficulties in identifying and describing emotions and is considered a risk factor for multiple psychiatric disorders. Current alexithymia research debates the type of attention bias involved in the processing of negative emotional information, especially in anxiety-evoking situations that are frequently associated with stress states. Relatedly, this study aims to examine the role of emotional influence on the attentional processing of Taiwanese alexithymic individuals. Using the Chinese version of the Toronto Alexithymia Scale-20 (TAS-20), individuals with high alexithymia (HA: TAS > 60, n = 26; Mage = 23.36) and individuals with low alexithymia (LA: TAS < 39, n = 26; Mage = 25.76) were recruited. Participants performed an emotional counting Stroop task preceded by anxiety-evoking (threatening and aversive pictures) or neutral pictures. Reaction times (RTs) of the emotional Stroop task were compared between HA and LA groups. Our results demonstrate that compared to individuals with LA, individuals with HA show early avoidance tendency (i.e., allocate less attentional resources to anxiety-evoking stimuli), and that negative affect therefore does not interfere with subsequent attention processing during the Stroop task, resulting in faster RT for unpleasant stimuli (Mthreatening = 683.87, Maversive = 685.87) than neutral stimuli (Mneutral = 695.64) (ps < .05). In addition, the attentional bias toward specific types of negative emotion was not differentiated in individuals with HA (p < .05), suggesting that alexithymic individuals' emotion schemas may be underdeveloped in terms of ability to specify exact emotions. This study provides evidence regarding early sensitization to negative stimuli during information processing, consistent with the notion that alexithymia is related to avoidant emotion regulation processes.
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Affiliation(s)
- Shu-Hui Lee
- Center for General Education, 34881National Tsing Hua University, Hsinchu, Taiwan
| | - Kuan-Te Lee
- Department of Educational Psychology and Counseling, 34881National Tsing Hua University, Hsinchu, Taiwan
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2
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Susta M, Bizik G, Yamamotova A, Petranek S, Kadochova M, Papezova H. The sight of one’s own body: Could qEEG help predict the treatment response in anorexia nervosa? Front Psychol 2022; 13:958501. [PMID: 36300071 PMCID: PMC9592122 DOI: 10.3389/fpsyg.2022.958501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Aims of the studyThe study aims to identify the differences in brain activity between participants with anorexia nervosa and healthy control using visual stimulus conditions combined with the quantitative dense-array EEG recording analysis method called Brain Activation Sequences (BAS).Materials and methods23 participants with anorexia nervosa and 21 healthy controls were presented with visual stimuli, including the subject’s facial expressions and body images. The 128-channel EEG data were processed using BAS and displayed as activity in up to 66 brain regions. Subsequent cluster analysis was used to identify groups of participants exhibiting area-specific activation patterns.ResultsCluster analysis identified three distinct groups: one including all healthy controls (HC) and two consisting of all participants with anorexia (AN-I with 19 participants and AN-II with four participants). The AN-I and AN-II groups differed in their response to treatment. Comparisons of HC vs. AN confirmed the dominance of the right cerebral hemisphere in participants with anorexia nervosa in two of the three reported conditions. The facial expressions condition, specifically the facial reaction expressing disgust, indicates the existence of a social attentional bias toward faces, whereas emotions remained undetected in participants. High limbic activity, medial frontal gyrus involvement, low fusiform cortex activity, and milder visual cortex activity in healthy controls compared to participants indicate that the facial expression stimulus is perceived by healthy subjects primarily as an emotion, not as the face itself. In the body image condition, participants showed higher activity in the fusiform gyrus and right insula, indicating activation of the brain’s “fear network.”ConclusionThe study describes a specific pattern of brain activation in response to facial expression of disgust and body images that likely contributes to social-cognitive and behavioral impairments in anorexia. In addition, the substantial difference in the pattern of brain activation within the participants with AN and its association with treatment resistance deserves special attention because of its potential to develop a clinically useful prediction tool and identify potential targets for, for example, neuromodulatory treatments and/or individualized psychotherapy.
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Affiliation(s)
- Marek Susta
- Department of Public Health, St. Elisabeth University, Bratislava, Slovakia
| | - Gustav Bizik
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- *Correspondence: Gustav Bizik,
| | - Anna Yamamotova
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Svojmil Petranek
- Health Care Facility, Department of the Interior, Prague, Czechia
| | - Marie Kadochova
- Department of Public Health, St. Elisabeth University, Bratislava, Slovakia
| | - Hana Papezova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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3
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Wallis DJ, Ridout N. Direct and indirect effects of alexithymia on disordered eating in a non-clinical female sample: Determining the role of negative affect. Front Psychiatry 2022; 13:994024. [PMID: 36506454 PMCID: PMC9729352 DOI: 10.3389/fpsyt.2022.994024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Alexithymia is an independent predictor of symptoms of eating disorders, but also influences disordered eating in clinical samples indirectly via negative affect (depression and anxiety). The aim of the current work was to establish if alexithymia predicts disordered eating in a non-clinical sample directly and indirectly (via negative affect). METHODS A sample of healthy females (n = 248) completed measures of depression, anxiety, alexithymia, and disordered eating (drive for thinness, bulimia, and body dissatisfaction). Bias-corrected bootstrapping was used to conduct parallel mediation analyses to determine if negative affect (depression and anxiety) mediated the influence of alexithymia on disordered eating. RESULTS The relationship between alexithymia (difficulty identifying feelings) and drive for thinness was mediated by depression but not anxiety. The link between difficulty identifying feelings and bulimia was mediated by anxiety but not depression. The correlation between alexithymia (difficulty describing feelings) and body dissatisfaction was mediated by both depression and anxiety. However, after controlling for negative affect, difficulty identifying feelings remained an independent predictor of drive for thinness, and difficulty describing feelings remained an independent predictor of body dissatisfaction. CONCLUSION Facets of alexithymia (DIF and DDF) directly predict disordered eating in healthy participants as well as indirectly via depression and anxiety. These findings suggest that targeted interventions to improve the ability of individuals to identify and describe their feelings could be beneficial in reducing disordered eating, particularly in those "at risk" of developing eating disorders.
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Affiliation(s)
- Deborah J Wallis
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom
| | - Nathan Ridout
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Early vigilance and improved processing efficiency to the test-related target in test anxiety: Evidence from the visual search task and eye-movements. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02454-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Luminet O, Nielson KA, Ridout N. Cognitive-emotional processing in alexithymia: an integrative review. Cogn Emot 2021; 35:449-487. [PMID: 33787442 DOI: 10.1080/02699931.2021.1908231] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Alexithymia is a multifaceted personality construct characterised by difficulties identifying one's feelings and distinguishing them from bodily sensations, difficulties describing one's feelings to others, and an externally oriented cognitive style. Over the past 25 years, a burgeoning body of research has examined how alexithymia moderates processing at the cognition-emotion interface. We review the findings in five domains: attention, appraisals, memory, language, and behaviours. The preponderance of studies linked alexithymia with deficits in emotion processing, which was apparent across all domains, except behaviours. All studies on behaviours and a proportion of studies in other domains demonstrated emotional over-responding. Analysis at the facet level revealed deficits in memory and language that are primarily associated with externally oriented thinking, while over-responding was most often linked to difficulty identifying feelings and difficulty describing feelings. The review also found evidence for contextual modulation: The pattern of deficits and over-responding was not restricted to emotional contexts but also occurred in neutral contexts, and in some circumstances, emotional over-responding in alexithymia was beneficial. Taken together, this review highlights alexithymia as a central personality dimension in the interplay between cognition and emotion.
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Affiliation(s)
- Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain, Louvain-la-Neuve, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| | - Kristy A Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, USA.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
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Abstract
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.
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Ridout N, Smith J, Hawkins H. The influence of alexithymia on memory for emotional faces and realistic social interactions. Cogn Emot 2020; 35:540-558. [PMID: 32268841 DOI: 10.1080/02699931.2020.1747991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
High levels of alexithymia are typically associated with impaired memory for emotional, but not neutral words. We conducted two experimental studies to establish if this effect generalises to non-verbal socially relevant stimuli. Thirty-nine female undergraduates (Study 1) viewed faces with different expressions (neutral, angry, happy or sad) and 38 female students (Study 2) viewed videos of realistic social interactions (featuring anger, happiness, sadness or neutral affect). Participants were asked to identify the emotion portrayed and were subsequently given an intentional recognition memory test for the stimuli. They also completed self-report measures of alexithymia and mood (depression & anxiety). In Study 1, memory for emotional (especially angry), but not neutral faces was negatively related to the "difficulty describing feelings" facet of alexithymia. In Study 2, memory for emotional (particularly those featuring anger), but not neutral videos was negatively related to the "difficulty identifying feelings" and "externally oriented thinking" facets of alexithymia. In both studies, these memory deficits were independent of the effects of age and mood. Furthermore, the deficits appear to be most evident in the conscious recollection of the emotional stimuli. Our findings confirm that the memory deficit for emotional words in alexithymia generalises to important non-verbal socially relevant stimuli.
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Affiliation(s)
- Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Jade Smith
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Holly Hawkins
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
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Wambach L, Schmidt J. „Attention bias“ für sozial-bedrohliche Reize bei körperbezogenen Sorgen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00406-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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9
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Kerr-Gaffney J, Harrison A, Tchanturia K. Eye-tracking research in eating disorders: A systematic review. Int J Eat Disord 2018; 52:3-27. [PMID: 30582199 DOI: 10.1002/eat.22998] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/18/2018] [Accepted: 11/11/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Those with eating disorders (EDs) show attentional biases to disorder-relevant stimuli, such as food and body shape information. However, attentional bias research in EDs largely relies on reaction time based measures, which are limited in their ability to assess different components and the time course of attention. Eye-tracking paradigms have therefore been utilized to provide greater ecological validity, and directly capture the detailed sequence of processes in perception and attention. While numerous studies have examined eye movements in the mood, anxiety, and psychotic disorders, there has been a lack of studies in EDs. The purpose of this qualitative review is to provide a summary of eye-tracking studies in clinical ED populations. METHOD The review was conducted using the PRISMA guidelines. Electronic databases were systematically searched to identify studies examining gaze parameters in ED compared to healthy controls (HCs). Thirty-one studies met inclusion criteria. RESULTS Across ED diagnoses, there was evidence of attentional biases towards food and body stimuli. In addition, differential patterns of attention to social information, and differences in smooth pursuit and saccadic eye movements were found in anorexia nervosa (AN). DISCUSSION Findings are discussed in relation to research in other psychiatric disorders, and recommendations for future studies using eye-tracking in EDs are given. The findings add to the wider literature on attentional biases in EDs, and provide potential avenues for treatment. IJED-18-0331.R1. Investigación de seguimiento ocular en trastornos de la conducta alimentaria: una revisión sistemática.
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Affiliation(s)
- Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, UK
| | - Amy Harrison
- Department of Psychology and Human Development, University College London, London, UK
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, UK
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, UK
- Institute of Psychology, Ilia State University, Tbilisi, Georgia
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10
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Attentional avoidance of emotional information in emotional eating. Psychiatry Res 2018; 269:172-177. [PMID: 30149274 DOI: 10.1016/j.psychres.2018.08.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 11/21/2022]
Abstract
We investigated an attention bias (AB) for emotional faces in emotional eating (EM). A group obtaining a low score (n = 18) on the Emotional eating scale of the Dutch Eating Behavior Questionnaire and a high scoring group (n = 23) completed the Exogenous Cueing Task (ECT). The ECT experiment measured their reaction times to the location of a target dot preceded by a happy, sad, angry or neutral face cue. The Coping Inventory for Stressful Situations was administrated to collect information on participants' coping strategies. Compared to the group with a low degree of EM, the high EM group showed significant attentional avoidance of emotional faces, particularly negative faces, in the ECT. The coping questionnaire indicated that the high EM group displayed higher levels of avoidance coping compared to the low EM group. General levels of EM and avoidance coping were also positively correlated, and avoidance coping significantly predicted the level of EM. The findings of the present study indicate that attentional avoidance of emotional content, which has previously been observed in clinical studies of eating disorders (Cardi et al., 2015a; Davies et al., 2011), is also present in subclinical samples of EM.
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Wallis DJ, Ridout N, Sharpe E. The influence of non-clinical eating-related psychopathology on the recognition of emotion from static faces and realistic social interactions. Eat Behav 2018; 29:19-24. [PMID: 29413820 DOI: 10.1016/j.eatbeh.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 11/28/2022]
Abstract
Emotion recognition deficits have consistently been reported in clinical and sub-clinical disordered eating. However, most studies have used static faces, despite the dynamic nature of everyday social interactions. The current aims were to confirm previous findings of emotion recognition deficits in non-clinical disordered eating and to determine if these deficits would be more evident in response to static as compared to dynamic emotional stimuli. We also aimed to establish if these emotion recognition deficits could be explained by comorbid psychopathology (depression, anxiety or alexithymia). Eighty-nine females were assigned to groups based on scores on the Eating Disorders Inventory (EDI); high (n = 45) and low (n = 44). Participants were presented with emotional faces and video clips portraying fear, anger, disgust, sadness, happiness, surprise and neutral affect. As predicted, the high EDI group correctly recognised fewer emotional displays than did the low EDI group. However, this deficit was not more evident for negative as opposed to positive emotions. Furthermore, the deficit was not larger for static stimuli in comparison to dynamic. Overall emotion recognition accuracy was negatively associated with Drive for Thinness, but not Bulimia or Body Dissatisfaction. Importantly, the emotion recognition deficits observed in the high EDI group and that were associated with eating disorder symptoms were independent of depression, anxiety and alexithymia. Findings confirm that even minor elevations in disordered eating are associated with poorer emotion recognition. This is important, as problems in recognition of the emotional displays of others are thought to be a risk factor for clinical eating disorders.
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Affiliation(s)
- Deborah J Wallis
- Centre for Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
| | - Nathan Ridout
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK
| | - Emma Sharpe
- Centre for Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
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Fujiwara E, Kube VL, Rochman D, Macrae-Korobkov AK, Peynenburg V. Visual Attention to Ambiguous Emotional Faces in Eating Disorders: Role of Alexithymia. EUROPEAN EATING DISORDERS REVIEW 2017; 25:451-460. [PMID: 28762613 DOI: 10.1002/erv.2535] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/20/2017] [Accepted: 06/25/2017] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- Esther Fujiwara
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Veronica L Kube
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Daniel Rochman
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Alberta Health Services, Edmonton, Canada
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