Disentangle the neural correlates of attachment style in healthy individuals

Drug development in psychopharmacology: Insights from evolutionary psychiatry

In the last decade, no other branch of clinical pharmacology has been subject to as much criticism of failed innovation and unsatisfactory effectiveness as psychopharmacology. Evolutionary psychiatry can offer original insights on the problems that complicate pharmacological research. Considering that invalid phenotyping is a major obstacle to drug development, an evolutionary perspective suggests targeting clinical phenotypes related to evolved behavior systems because they are more likely to map onto the underlying biology than constructs based on predetermined diagnostic criteria. Because of their emphasis on symptom remission, pharmacological studies of psychiatric populations rarely include functional capacities as the primary outcome measure and neglect the impact of social context on the effects of psychiatric drugs. Evolutionary psychiatry explains why it is appropriate to replace symptoms with functional capacities as the primary target of psychiatric therapies and why social context should be a major focus of studies assessing the effectiveness of drugs currently used and new drugs under development. When the focus of research shifts to those questions that go beyond the "disease-based" concept of drug action, evolutionary psychiatry clearly emerges as a reference framework to assess drug effectiveness and to optimize clinicians' decisions about prescribing, deprescribing, and non-prescribing.

Brain oscillations during emotion regulation and the two-dimensional model of adult attachment

Emotion Regulation (ER) refers to the processes by which individuals influence their own emotions. It is a crucial aspect of human behavior, affecting everything from interpersonal relationships to mental health. The relationship between ER and Attachment Theory (AT) is pivotal. AT suggests that early bonds with primary caregivers influence future relationship expectations and behaviors. These initial experiences shape internal models of self and others, affecting how individuals regulate their emotions. Understanding the interplay between ER and AT is essential for comprehending the human affective system. In this study, we explored the neural underpinnings of ER, focusing on two distinct strategies: cognitive reappraisal and expressive suppression. Using electroencephalography (EEG), we examined changes in neural oscillations from 52 adults during an ER task. Specifically, we observed increased frontal theta activity (3-6 Hz) during reappraisal compared to suppression strategies. This frontal theta activity suggests enhanced cognitive control engagement. Conversely, during suppression, we noted a decrease in beta frequency (15-30 Hz) activity from central electrodes, indicative of differing neural processes. Further integrating psychological theories, we explored the relationship between these neural markers and dimensions of human attachment. Employing the Experiences in Close Relationships-12 scale (ECR-12), we identified a negative correlation between attachment anxiety and frontal theta activity. Lower levels of attachment anxiety were associated with increased theta activity, reflecting potentially more effective emotion regulation. Additionally, we found that higher theta activity corresponded with fewer difficulties in emotional control measured by the Difficulties in Emotion Regulation Scale (DERS). Regarding central beta activity, our findings revealed an interesting correlation with Emotional Inattention, a concept tied to Attachment Avoidance. This suggests that central beta activity may serve as a neural marker for specific attachment-related ER processing. These results highlight the distinct neural pathways involved in different ER strategies and their relationship with the AT and neural responses during emotional processing.

Main Biological Models of Resilience

Objective

Resilience is a complex process of adaptation to new conditions that would permit a positive outcome after adversities, traumas or other sources of stress. However, despite the growing interest in this topic, there is no universally accepted definition and no comprehensive bio-behavioural model. This systematic review aims to provide an overview of the main biological models that have been theorized to date, with a focus on new alternative theories to improve our understanding of the mechanisms underlying the development and strengthening of resilience, with potential implications for the prevention of some psychopathological disorders.

Method

This review was conducted according to PRISMA guidelines and includes 185 studies published in English in PubMed and Embase up to December 2023.

Results

Most studies use the stress-related model, which conceptualizes resilience as the absence of symptoms after the stressful event and mainly deal with the differences between stress-prone and resilient phenotypes in animals exposed to stress. However, the results of this search seem to suggest that resilience might be an independent construct with biological bases rooted in the stress system and the social brain, and widely sculptured by individual and environmental factors, especially early life events and affiliation.

Conclusions

This work contributes to ongoing efforts to understand the intricate mechanisms of resilience, while highlighting the potential of improving social relationships since our birth to promote coping strategies towards stress and traumas, and even a peaceful world.

Practitioner Review: Neurobiological consequences of childhood maltreatment - clinical and therapeutic implications for practitioners

BACKGROUND

Childhood maltreatment is one of the most important preventable risk factors for a wide variety of psychiatric disorders. Further, when psychiatric disorders emerge in maltreated individuals they typically do so at younger ages, with greater severity, more psychiatric comorbid conditions, and poorer response to established treatments, resulting in a more pernicious course with an increased risk for suicide. Practitioners treating children, adolescents, and young adults with psychiatric disorders will likely encounter the highest prevalence of clients with early-onset maltreatment-associated psychiatric disorders. These may be some of their most challenging cases.

METHOD

In this report, we explore key validated alterations in brain structure, function, and connectivity associated with exposure to childhood maltreatment as potential mechanisms behind their patients' clinical presentations.

RESULTS

We then summarize key behavioral presentations likely associated with neurobiological alterations and propose a toolkit of established trauma and skills-based strategies that may help diminish symptoms and foster recovery. We also discuss how some of these alterations may serve as latent vulnerability factors for the possible development of future psychopathology.

CONCLUSIONS

Research on the neurobiological consequences of childhood adversity provides a vastly enriched biopsychosocial understanding of the developmental origins of health and pathology that will hopefully lead to fundamental advances in clinical psychology and psychiatry.

Resilience and Attachment in Patients with Major Depressive Disorder and Bipolar Disorder

BACKGROUND

Resilience represents one of the fundamental elements of attachment and has often been investigated in mood disorders. This study aims to investigate possible correlations between attachment and resilience in patients with major depressive disorder (MDD) and bipolar disorder (BD).

METHODS

106 patients (51 MDD, 55 BD) and 60 healthy controls (HCs) were administered the 21-item Hamilton Depression Rating Scale (HAM-D-21), the Hamilton Anxiety Rating Scale (HAM-A), the Young Mania Rating Scale (YMRS), the Snaith-Hamilton Pleasure Scale (SHAPS), the Barratt Impulsiveness Scale-11 (BIS-11), the Toronto Alexithymia Scale (TAS), the Connor-Davidson Resilience Scale (CD-RISC), and Experiences in Close Relationship (ECR).

RESULTS

MDD and BD patients did not significantly differ from each other according to the HAM-D-21, HAM-A, YMRS, SHAPS, and TAS, while they scored higher than HCs on all these scales. Patients in the clinical group scored significantly lower on CD-RISC resilience than HCs (p < 0.01). A lower proportion of secure attachment was found among patients with MDD (27.4%) and BD (18.2%) compared to HCs (90%). In both clinical groups, fearful attachment prevailed (39.2% patients with MDD; 60% BD).

CONCLUSIONS

Our results highlight the central role played by early life experiences and attachment in participants with mood disorders. Our study confirms the data from previous research showing a significant positive correlation between the quality of attachment and the development of resilience capacity, and supports the hypothesis that attachment constitutes a fundamental aspect of resilience capacity.

Affective Touch and Regulation of Stress Responses

Much has been documented on the association between stress and health. Both direct and indirect pathways have been identified and explored extensively, helping us understand trajectories from healthy individuals to reductions in well-being, and development of preclinical and disease states. Some of these pathways are well established within the field; physiology, affect regulation, and social relationships. The purpose of this review is to push beyond what is known separately about these pathways and provide a means to integrate them using one common mechanism. We propose that social touch, specifically affective touch, may be the missing active ingredient fundamental to our understanding of how close relationships contribute to stress and health. We provide empirical evidence detailing how affective touch is fundamental to the development of our stress systems, critical to the development of attachment bonds and subsequent social relationships across the life course. We will also explore how we can use this in applied contexts and incorporate it into existing interventions.

Decoupling between hub-connected functional connectivity of the social brain network and real-world social network in individuals with social anhedonia

Altered hub regions in brain network have been consistently reported in patients with schizophrenia. However, it is unclear whether similar altered hub regions of the brain would be exhibited in individuals with subclinical features of schizophrenia such as social anhedonia (SA). In this study, we examined the hub regions of resting-state social brain network (SBN) of 35 participants with SA and 50 healthy controls (HC). We further examined the prediction effect of hub-connected FCs with SBN on the real-life social network characteristics. Our findings showed that the right amygdala, left temporal lobe and right media superior frontal gyrus were the hub regions of SBN both in SA and HC groups. In the SA group, the left temporal lobe connected functional connectivity (FC) did not predict social network characteristics, while the other FCs strengthened the association with social network characteristics. These findings were replicated in an independent sample of 33 SA and 32 HC. These findings suggested that the left temporal lobe as one of the hub regions of SBN exhibited the abnormality of their connected FCs in the association with social network characteristics in individuals with SA.

Cerebellar engagement in the attachment behavioral system

Brain structural bases of individual differences in attachment are not yet fully clarified. Given the evidence of relevant cerebellar contribution to cognitive, affective, and social functions, the present research was aimed at investigating potential associations between attachment dimensions (through the Attachment Style Questionnaire, ASQ) and cerebellar macro- and micro-structural measures (Volumetric and Diffusion Tensor Imaging data). In a sample of 79 healthy subjects, cerebellar and neocortical volumetric data were correlated with ASQ scores at the voxel level within specific Regions Of Interest. Also, correlations between ASQ scores and age, years of education, anxiety and depression levels were performed to control for the effects of sociodemographic and psychological variables on neuroimaging results. Positive associations between scores of the Preoccupation with Relationships (ASQ subscale associated to insecure/anxious attachment) and cortical volume were found in the cerebellum (right lobule VI and left Crus 2) and neocortex (right medial OrbitoFrontal Cortex, OFC) regions. Cerebellar contribution to the attachment behavioral system reflects the more general cerebellar engagement in the regulation of emotional and social behaviors. Cerebellar properties of timing, prediction, and learning well integrate with OFC processing, supporting the regulation of attachment experiences. Cerebellar areas might be rightfully included in the attachment behavioral system.

Sleepy Psychotherapists: How Clinicians' Biological Factors May Affect the Conduct of Psychotherapy

OBJECTIVE

Numerous therapist variables and cognitive biases can affect the quality of the therapeutic alliance and the conduct and outcomes of psychotherapy. This article aims to examine factors that potentially affect clinician performance, including chronobiological variables of clinicians and patients.

METHODS

The author reviewed literature pertaining to biological influences on human cognitive performance and considered how these factors may apply to the practice of psychotherapy.

RESULTS

Biological factors potentially affecting the conduct and quality of psychotherapy were identified. These factors include decision fatigue, hunger, sleep deficit, shift work, and several chronobiological issues related to circadian rhythms and episodic ultradian rhythms. In addition, misaligned scheduling of psychotherapy sessions in relation to therapist and patient evening-morning chronotypes may impede the effectiveness of psychotherapy.

CONCLUSIONS

The practice of psychotherapy is cognitively demanding, requiring that clinicians remain constantly alert and in command of their executive functions. Decreases in clinician alertness resulting from homeostatic depletion, chronobiologically misaligned schedules, and illness-associated factors may reduce the quality and benefit of psychotherapy sessions. Mitigation strategies are available. Investigations of these factors are needed.

Neural basis underlying the trait of attachment anxiety and avoidance revealed by the amplitude of low-frequency fluctuations and resting-state functional connectivity

Background

Attachment theory demonstrates that early attachment experience shapes internal working models with mental representations of self and close relationships, which affects personality traits and interpersonal relationships in adulthood. Although research has focused on brain structural and functional underpinnings to disentangle attachment styles in healthy individuals, little is known about the spontaneous brain activity associated with self-reported attachment anxiety and avoidance during the resting state.

Methods

One hundred and nineteen individuals participated in the study, completing the Experience in Close Relationship scale immediately after an 8-min fMRI scanning. We used the resting-state functional magnetic resonance imaging (rs-fMRI) signal of the amplitude of low-frequency fluctuation and resting-state functional connectivity to identify attachment-related regions and networks.

Results

Consequently, attachment anxiety is closely associated with the amplitude of low-frequency fluctuations in the right posterior cingulate cortex, over-estimating emotional intensity and exaggerating outcomes. Moreover, the functional connectivity between the posterior cingulate cortex and fusiform gyrus increases detection ability for potential threat or separation information, facilitating behavior motivation. The attachment avoidance is positively correlated with the amplitude of low-frequency fluctuation in the bilateral lingual gyrus and right postcentral and negatively correlated with the bilateral orbital frontal cortex and inferior temporal gyrus. Functional connection with attachment avoidance contains critical nodes in the medial temporal lobe memory system, frontal-parietal network, social cognition, and default mode network necessary to deactivate the attachment system and inhibit attachment-related behavior.

Conclusion and implications

These findings clarify the amplitude of low-frequency fluctuation and resting-state functional connectivity neural signature of attachment style, associated with attachment strategies in attachment anxiety and attachment avoidance individuals. These findings may improve our understanding of the pathophysiology of the attachment-related disorder.

Attachment security and striatal functional connectivity in typically developing children

Attachment security is formed through interactions with a main caregiver during the first three years of life and reflects inter-individual differences in mental representations for the relationship. The striatum is known to be a key structure to initiate attachment behaviours and maintain attachment relationships as well as to modulate reward-related processing as part of the approach module in current neurobiological models of human attachment. Although findings have suggested critical roles of the striatum in inter-individual differences in attachment, most studies were based on a wide variety of tasks and very few have investigated these associations in intrinsic brain connectivity in typically developing children. In the present study, using resting-state functional magnetic resonance imaging, we examined the striatal functional connectivity according to children’s attachment security in 68 nine-year-olds (Secure attachment = 39, Insecure attachment = 29, mean age/SD = 9.62/0.69). Children with secure attachment demonstrated increased functional connectivity in the tempro-limbic region, compared to children with insecure attachment. In addition, the child-reported attachment security scores were negatively associated with the caudate-prefrontal connectivity, but positively with the putamen-visual area connectivity. These data demonstrate that inter-individual differences in attachment can be captured in striatal functional connectivity organization in the typical brain.

Xlr4 as a new candidate gene underlying vulnerability to cocaine effects

Although several studies have been performed in rodents, non-human primates and humans, the biological basis of vulnerability to develop cocaine addiction remains largely unknown. Exposure to critical early events (as Repeated Cross Fostering (RCF)) has been reported to increase sensitivity to cocaine effects in adult C57BL/6J female mice. Using a microarray approach, here we report data showing a strong engagement of X-linked lymphocyte-regulated 4a and 4b (Xlr4) genes in cocaine effects. The expression of Xlr4, a gene involved in chromatin remodeling and dendritic spine morphology, was reduced into the Nucleus Accumbens (NAc) of adult RCF C57BL/6J female. We used virally mediated accumbal Xlr4 down-modulation (AAVXlr4-KD) to investigate the role of this gene in vulnerability to cocaine effects. AAVXlr4-KD animals show a potentiated behavioral and neurochemical response to cocaine, reinstatement following cocaine withdrawal and cocaine-induced spine density alterations in the Medium-Sized Spiny Neurons of NAc. We propose Xlr4 as a new candidate gene mediating the cocaine effects.