Cognitive load and emotional processing in generalized anxiety disorder: electrocortical evidence for increased distractibility

Integrating dynamic psychophysiological indices across time and contexts: Elucidating mechanisms, risk markers, and intervention targets

Why should researchers measure psychophysiological processes repeatedly over time? The study of psychophysiology inherently involves sampling biological processes as they manifest over time. The most common approach is to use a brief sample to make conclusions about how individuals or groups differ. Although these types of between-subject comparisons have utility for understanding individual and group differences, many of the important conceptual questions in the field involve processes that are dynamic, varying within individuals over time. Using examples from the literature on affect regulation, this conceptual review contrasts three types of study designs: the classic single-observation design and the aggregated and temporally linked repeated observation designs, which have great promise for measuring variables that fluctuate dynamically over time. Importantly, these designs can be integrated to elucidate research questions about risk (when and for whom will the likelihood of an unwanted outcome occurring increase?), mechanisms (how and why does a change in psychophysiology contribute to a change in another process of interest?), and interventions (how and when should interventions take place to modify an outcome?). Researchers are encouraged to implement intensive sampling in their research, which can be conducted in traditional laboratory settings (e.g., fMRI, event-related brain potentials, and heart rate variability) and in ecologically valid contexts in everyday life using ambulatory assessment.

Positive emotion up-regulation is resistant to working memory load: An electrocortical investigation of reappraisal and savoring

Studies of emotion regulation to-date have mostly focused on negative emotion down-regulation, leaving positive emotion up-regulation poorly understood, particularly regarding factors that may modulate its success. While reappraisal and savoring have been shown to be effective at increasing electrocortical and subjective response to pictures in controlled laboratory settings, it remains unclear whether individuals can effectively enact these techniques to willfully increase positive emotions in everyday life when faced with other concurrent distractions/demands. Here, we used the late positive potential (LPP), an electrocortical measure that is larger for emotional compared to neutral stimuli, to assess the effect of working memory (WM) load on individuals' ability to reappraise or savor positive pictures. Seventy-six participants were randomly assigned to use either reappraisal or savoring to up-regulate positive emotion to pictures. Following training, participants engaged in a positive emotion up-regulation task interspersed with high and low WM load trials, while EEG was recorded. Frequentist and Bayesian statistics showed that although high WM load seemed to consume resources and reduced picture processing overall, it did not interfere with the enhancement of the LPP via positive emotion up-regulation. Nonetheless, WM performance (especially on high-load trials) was worse when participants were engaged in positive emotion up-regulation. Therefore, while both techniques appear to be effective under concurrent WM load, positive emotion up-regulation may interfere with other ongoing tasks.

Depressive states in healthy subjects lead to biased processing in frontal-parietal ERPs during emotional stimuli

Subthreshold depressive (sD) states and major depression are considered to occur on a continuum, and there are only quantitative and not qualitative differences between depressive states in healthy individuals and patients with depression. sD is showing a progressively increasing prevalence and has a lifelong impact, and the social and clinical impacts of sD are no less than those of major depressive disorder (MDD). Because depression leads to biased cognition, patients with depression and healthy individuals show different visual processing properties. However, it remains unclear whether there are significant differences in visual information recognition among healthy individuals with various depressive states. In this study, we investigated the event-related potentials (ERPs) and event-related spectrum perturbation (ERSP) of healthy individuals with various depressive states during the perception of emotional visual stimulation. We show that different neural activities can be detected even among healthy individuals. We divided healthy participants into high, middle, and low depressive state groups and found that participants in a high depressive state had a lower P300 amplitude and significant differences in fast and slow neural responses in the frontal and parietal lobes. We anticipate our study to provide useful parameters for assessing the evaluation of depressive states in healthy individuals.

The impacts of anxiety and depressive symptoms on emotional processing in children and their parents: an event-related potential study

BACKGROUND

Anxiety and depressive symptoms are associated with dysregulated emotional processing. However, less is known about the intra-personal and inter-personal impacts of anxiety and depressive symptoms on emotional processing in children and their parents.

METHODS

In a community sample of 36 parent-child dyads (total N = 72), the current study investigated the intra- and inter-personal effects of anxiety and depressive symptoms on the child's and the parent's neurophysiological responses to emotional (i.e., pleasant and unpleasant) stimuli, indexed by the late positive potential (LPP).

RESULTS

The results indicated that children's anxiety symptoms were correlated with their enhanced LPPs to pleasant versus neutral pictures. Additionally, children's depressive symptoms related to their increased LPPs to unpleasant stimuli. Importantly, children's anxiety symptoms were associated with their parents' increased LPPs to both unpleasant and pleasant information.

CONCLUSIONS

These findings suggest that anxiety symptoms in community children were related to their own as well as their parents' emotional processing. The findings contribute to cognitive and family models of anxiety and depression and further highlight the potential role of dyadic interventions for the alleviation of impairing symptoms in children and their caregivers.

Associations between the late positive potential and PTSD, anxiety, and depressive symptoms among trauma-exposed undergraduates

BACKGROUND

The late positive potential (LPP) is a neural marker of attention to emotional stimuli; dysregulations in those attentional processes might contribute to trauma-related psychopathology. Although higher LPP amplitudes to negative images have been found to be associated with anxiety symptoms, results have been mixed regarding depressive and PTSD symptoms, especially among trauma-exposed populations. Further, the relationships between the LPP to positive and neutral images and psychopathology symptoms have been underexamined. The purpose of the current study was to test the effects of image valence, and PTSD, anxiety, and depressive symptoms on LPP amplitude among trauma-exposed undergraduates.

METHOD

Seventy-three trauma-exposed undergraduates viewed a series of negative, positive, and neutral images while LPPs were recorded. Self-report measures were used to assess recent PTSD, anxiety, and depressive symptoms. Hierarchical linear modeling tested valence and symptom main effects, as well as Valence by Symptom interactions on LPP amplitude.

RESULTS

We found a main effect of valence such that individuals exhibited higher LPP amplitudes to negative images compared to neutral images. We also found a Valence by Depressive Symptoms interaction such that there was an inverse relationship between depressive symptoms and the LPP to neutral images but no associations between depressive symptoms and the LPP for positive or negative images. We found no main effects or interactions for anxiety and PTSD symptoms.

CONCLUSION

Depressive symptoms might be related to diminished attention to neutral stimuli among trauma-exposed undergraduates. Further investigation of the relationship between the LPP and psychopathology is needed.

Neural reactivity to affective stimuli and internalizing symptom dimensions in a transdiagnostic patient sample

BACKGROUND

Internalizing psychopathologies (IPs) are highly comorbid and exhibit substantial overlap, such as aberrant affective reactivity. Neural reactivity to emotional images, measured via the late positive potential (LPP) event-related potential (ERP) component, has been utilized to index affective reactivity in IPs. The LPP is often examined in isolation with a specific disorder, ignoring overlap between IPs. The current study examined how transdiagnostic IP symptom dimensions relate to neural affective reactivity in a highly comorbid patient sample.

METHODS

Participants (N = 99) completed a battery of IP symptom assessments as well as a target categorization task while viewing pleasant, unpleasant, and neutral images during electroencephalography recording. ERPs to each image valence were averaged from 400 to 1000 ms following picture onset at pooled centroparietal and occipital electrodes to calculate the LPP. A principal components analysis performed on the IP symptom measures resulted in two factors: affective distress/misery and fear-based anxiety.

RESULTS

Fear-based anxiety was associated with enhanced LPP reactivity to unpleasant, but not pleasant, images. Distress/misery was related to attenuated average LPP reactivity across images.

CONCLUSIONS

Results revealed a dissociable effect of IP symptom factors in a transdiagnostic sample such that enhanced reactivity to negative images was specific to enhanced fear-based anxiety symptoms while distress/misery symptoms predicted blunted affective reactivity. Neural affective reactivity may serve as an objective biological marker to elucidate the nature of psychological concerns in individuals with comorbid IPs.

Modulation of threat extinction by working memory load: An event-related potential study

Distraction is typically discouraged during exposure therapy for anxiety, because it is thought to interfere with extinction learning by diverting attention away from anxiety-provoking stimuli. Working memory load is one form of distraction that might interfere with extinction learning. Alternatively, working memory load might reduce threat responding and benefit extinction learning by engaging prefrontal brain regions that have a reciprocal relationship with brain circuits involved in threat detection and processing. Prior work examining the effect of working memory load on threat extinction has been limited and has found mixed results. Here, we used the late positive potential (LPP), an event-related potential that is larger for threatening compared to non-threatening stimuli to assess the effect of working memory load on threat extinction. After acquisition, 38 participants performed three blocks of an extinction task interspersed with low and high working memory load trials. Results showed that overall, the LPP was reduced under high compared to low working memory load, and that working memory load slowed extinction learning. Results provide empirical evidence in support of limiting distraction during exposure therapy in order to optimize extinction learning efficiency.

The Implicit Aesthetic Preference for Mobile Marketing Interface Layout-An ERP Study

Businesses and scholars have been trying to improve marketing effect by optimizing mobile marketing interfaces aesthetically as users browse freely and aimlessly through mobile marketing interfaces. Although the layout is an important design factor that affects interface aesthetics, whether it can trigger customer's aesthetic preferences in mobile marketing remains unexplored. To address this issue, we employ an empirical methodology of event-related potentials (EPR) in this study from the perspective of cognitive neuroscience and psychology. Subjects are presented with a series of mobile marketing interface images of different layouts with identical marketing content. Their EEG waves were recorded as they were required to distinguish a target stimulus from the others. After the experiment, each of the subjects chose five stimuli interfaces they like and five they dislike. By analyzing the ERP data derived from the EEG data and the behavioral data, we find significant differences between the disliked interfaces and the other interfaces in the ERP component of P2 from the frontal-central area in the 200–400 ms post-stimulus onset time window and LPP from both the frontal-central and parietal-occipital area in the 400–600 ms time window. The results support the hypothesis that humans do make rapid implicit aesthetic preferences for interface layouts and suggest that even under a free browsing context like the mobile marketing context, interface layouts that raise high emotional arousal can still attract more user attention and induce users' implicit aesthetic preference.

Neural mechanisms and predictors of SSRI and CBT treatment of anxiety: A randomized trial focused on emotion and cognitive processing

Anxiety disorders (ADs) are common and difficult to treat. While research suggests ADs are characterized by an imbalance between bottom-up and top-down attention processes and that effective treatments work by correcting this dysfunction, there is insufficient data to explain how and for whom treatments work. The late positive potential (LPP), an event-related potential reflecting elaborative processing of motivationally salient stimuli, is sensitive to both bottom-up and top-down processes. The present study examines the LPP in healthy controls (HC) and patients with ADs under low and high working memory (WM) load to assess its utility as a predictor and index of symptom reduction in patients who underwent cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The LPP when viewing negative and neutral distractor images and WM performance were assessed in 96 participants (40 HC, 32 CBT, 24 SSRI) during a letter recall task at Week 0 and in a subset of the study sample (23 CBT, 16 SSRI) at Week 12. Patients were randomly assigned to twelve weeks of CBT or SSRI treatment. Participants completed self-reported symptom measures at each time point. Greater Week 0 LPP to negative images under low WM load predicted greater symptom reduction in the SSRI, but not the CBT, group. Regression analyses examining the LPP to negative images as an index of symptom reduction revealed a smaller decrease in the LPP to negative images under low WM load was associated with less anxiety reduction across treatment modalities. Findings suggest the LPP during low WM load may serve as a cost-effective predictor and index of treatment outcome in ADs. Clinical Trials Registration: ClinicalTrials.gov (Identifier: NCT01903447).

Carga cognitiva y control atencional en puertorriqueños con trastorno obsesivocompulsivo

Trasfondo:El control ejecutivo de la atención media la resolución de problemas y la acción voluntaria y está implicado en la regulación de las emociones. Se ha reportado que el control atencional está afectado en personas con trastorno obsesivo-compulsivo (TOC). Sin embargo, no se ha considerado la influencia de la carga cognitiva y la distracción en la ejecución de tareas, lo que pudiera tener un impacto en el control atencional. En este estudio evaluamos si la carga cognitiva alta y baja influyen en el control atencional de personas con TOC, en comparación con un grupo control. Método:Quince adultos puertorriqueños con TOC (M=31.60, DE=10.70) y 26 saludables (M=28.42, DE=10.73) participaron en el estudio. Se administró el Attention Network Test y una tarea de carga cognitiva para evaluar el control atencional. Resultados:No se observaron diferencias significativas en las puntuaciones de alerta, orientación y control atencional entre los grupos en ambas condiciones de carga cognitiva (p>0.05). Solo se observó una diferencia significativa en el control atencional de los participantes con TOC (z=1.99, p=0.047) y del grupo control (z=-2.83, p=0.005) durante tareas con carga cognitiva baja y alta. Conclusiones:Ambos grupos experimentaron menor interferencia de distractores bajo alta carga cognitiva, lo que sugiere un mayor control de la atención durante esta condición. Es posible que el aumento de carga cognitiva pueda reducir la distracción en puertorriqueños saludables y aquellos con TOC. Tomar en cuenta la carga cognitiva puede facilitar el entrenamiento cognitivo para el control atencional y aumentar la flexibilidad cognitiva, mejorando la respuesta al tratamiento.  

Working memory load reduces the electrocortical processing of positive pictures

To date, the emotion regulation literature has focused primarily on the down-regulation of negative emotion, with far fewer studies interrogating the mechanisms at work in positive emotion regulation. This body of work has suggested that nonaffective mechanisms, such as cognitive load have a role to play in reducing emotional response. For example, the late positive potential (LPP), which tracks attention to salient stimuli, is reduced when task-irrelevant negative and neutral stimuli are presented under high compared with low working memory load. Using positive stimuli, working memory load has been shown to reduce the LPP elicited by positive words and faces but has not previously been shown to modulate the LPP elicited by positive scenes. Emotional scenes are the predominant type of stimuli used in the broader emotion regulation literature, are more arousing than faces, and have been shown to more strongly modulate the LPP. Here, 41 participants performed a working memory task interspersed with the presentation of positive and neutral scenes, while electroencephalography was recorded. Results showed that the LPP was increased for positive compared with neutral pictures and reduced on high-load compared to low-load trials. Working memory performance was worse on high-load compared with low-load trials, although it was not significantly correlated with the LPP, and picture type did not affect working memory performance. Results bridge to the willful emotion regulation literature to increase understanding of the mechanisms underlying positive emotion regulation, which has been relatively unexamined.

Investigating Principal Working Memory Features in Generalized, Panic, and Social Anxiety Spectrum Disorders

Anxiety spectrum disorders are characterized by excessive and uncontrollable worrying about potential negative events in the short- and long-term future. Various reports linked anxiety spectrum disorders with working memory (WM) deficits despite conflicting results stemming from different study approaches. It remains unclear, however, how different anxiety spectrum disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD), differ in WM function. In this study, we utilized verbal, numerical, and sequential evaluations of WM to cover most possible facets of the WM data space. We used principal component analysis to extract the uncorrelated/whitened components of WM based on these measures. We evaluated medication-free patients with GAD, SAD, and PD patients as well as matched healthy individuals using a battery that measures WM duration and load. We found that patients with GAD and SAD, but not PD, exhibited poor performance only in the WM principal component that represents maintenance. There were no other significant differences between the four groups. Further, different WM components significantly predicted the severity of anxiety symptoms in the groups. We explored the clinical utility of WM components for differentiating patients with anxiety spectrum disorders from healthy individuals. By only using the WM components that represent maintenance and encoding, we managed to differentiate patients from controls in 84% of cases. For the first time, we present multiple novel approaches to examine cognitive function and design cognitive screening, and potentially diagnostics, for psychiatric disorders.

Task and Non-task Brain Activation Differences for Assessment of Depression and Anxiety by fNIRS

Diagnosis and treatment of the patients with major depression (MD) or the combined anxiety and depression (A&D) depend on the questionnaire, sometimes accompanied by tasks such as verbal fluency task (VFT). Functional near infrared spectroscopy (fNIRS) is emerging as an auxiliary diagnostic tool to evaluate brain function, providing an objective criterion to judge psychoses. At present, the conclusions derived from VFT or rest (non-task) studies are controversial. The purpose of this study is to evaluate if task performs better than non-task in separating healthy people from psychiatric patients. In this study, healthy controls (HCs) as well as the patients with MD or A&D were recruited (n = 10 for each group) to participate in the non-task and VFT tasks, respectively, and the brain oxygenation was longitudinally evaluated by using fNIRS. An approach of spectral analysis is used to analyze cerebral hemoglobin parameters (i.e., Oxy and Deoxy), characterizing the physiological fluctuations in the non-task and task states with magnitude spectrum and average power. Moreover, the standard deviation of oxygenation responses during the non-task was compared with the peak amplitude during the task, with the aim to explore the sensitivity of the VFT task to brain activation. The results show that there is no significant difference (p > 0.05) among the three groups in average power during non-task. The VFT task greatly enhanced the magnitude spectrum, leading to significant difference (p < 0.05) in average power between any of two groups (HC, MD, and A&D). Moreover, 40% patients with A&D have an intermediate peak (around 0.05 Hz) in the magnitude spectrum when performing the VFT task, indicating its advantage in characterizing A&D. We defined a rate of the non-task standard variation to the task peak amplitude (namely, SD-to-peak rate) and found that this rate is larger than 20% in 90% of the MD subjects. By contrast, only 40% HC subjects have an SD-to-peak rate larger than 20%. These results indicate that the non-task may not be sufficient to separate MD or A&D from HC. The VFT task could enhance the characteristics of the magnitude spectrum, but its intensity needs to be elevated so as to properly explore brain functions related to psychoses.

Disgust face captures more attention in individuals with high social anxiety when cognitive resources are abundant: Evidence from N2pc

There is a debate about the relative contributions of top-down and bottom-up attention to the threat-related attentional bias. In this study we investigated the attentional bias in individuals with social anxiety under conditions of no, low and high visual working memory (WM) load. Event-related potential (ERP) and response time (RT) data were recorded while participants performed the dot-probe task and a concurrent change-detection task. The ERP results revealed that the maximum N2pc effect emerged in no visual WM load condition in individuals with social anxiety. The difference of N2pc effect between high socially anxious (HSA) and low socially anxious (LSA) groups was observed in no visual WM load condition, whereas this difference was eliminated under low and high load conditions. However, no significant main effects or interactions were observed in the behavioral index (reflected by Trial Level-Bias Score variability). Overall, the findings indicate the critical role of top-down attention on social anxiety-related attentional bias, which have important implication for attentional bias modification.

Learning dynamics of electrophysiological brain signals during human fear conditioning

Electrophysiological studies in rodents allow recording neural activity during threats with high temporal and spatial precision. Although fMRI has helped translate insights about the anatomy of underlying brain circuits to humans, the temporal dynamics of neural fear processes remain opaque and require EEG. To date, studies on electrophysiological brain signals in humans have helped to elucidate underlying perceptual and attentional processes, but have widely ignored how fear memory traces evolve over time. The low signal-to-noise ratio of EEG demands aggregations across high numbers of trials, which will wash out transient neurobiological processes that are induced by learning and prone to habituation. Here, our goal was to unravel the plasticity and temporal emergence of EEG responses during fear conditioning. To this end, we developed a new sequential-set fear conditioning paradigm that comprises three successive acquisition and extinction phases, each with a novel CS+/CS- set. Each set consists of two different neutral faces on different background colors which serve as CS+ and CS-, respectively. Thereby, this design provides sufficient trials for EEG analyses while tripling the relative amount of trials that tap into more transient neurobiological processes. Consistent with prior studies on ERP components, data-driven topographic EEG analyses revealed that ERP amplitudes were potentiated during time periods from 33-60 ms, 108-200 ms, and 468-820 ms indicating that fear conditioning prioritizes early sensory processing in the brain, but also facilitates neural responding during later attentional and evaluative stages. Importantly, averaging across the three CS+/CS- sets allowed us to probe the temporal evolution of neural processes: Responses during each of the three time windows gradually increased from early to late fear conditioning, while long-latency (460-730 ms) electrocortical responses diminished throughout fear extinction. Our novel paradigm demonstrates how short-, mid-, and long-latency EEG responses change during fear conditioning and extinction, findings that enlighten the learning curve of neurophysiological responses to threat in humans.

Emotional distractors and attentional control in anxious youth: eye tracking and fMRI data

Attentional control theory suggests that high cognitive demands impair the flexible deployment of attention control in anxious adults, particularly when paired with external threats. Extending this work to pediatric anxiety, we report two studies utilising eye tracking (Study 1) and functional magnetic resonance imaging (Study 2). Both studies use a visual search paradigm to examine anxiety-related differences in the impact of threat on attentional control at varying levels of task difficulty. In Study 1, youth ages 8-18 years (N = 109), completed the paradigm during eye tracking. Results indicated that youth with more severe anxiety took longer to fixate on and identify the target, specifically on difficult trials, compared to youth with less anxiety. However, no anxiety-related effects of emotional distraction (faces) emerged. In Study 2, a separate cohort of 8-18-year-olds (N = 72) completed a similar paradigm during fMRI. Behaviourally, youth with more severe anxiety were slower to respond on searches following non-threatening, compared to threatening, distractors, but this effect did not vary by task difficulty. The same interaction emerged in the neuroimaging analysis in the superior parietal lobule and precentral gyrus-more severe anxiety was associated with greater brain response following non-threatening distractors. Theoretical implications of these inconsistent findings are discussed.

The Effect of Transcutaneous Auricular Vagal Nerve Stimulation (taVNS) on P3 Event-Related Potentials during a Bayesian Oddball Task

Transcutaneous auricular Vagal Nerve Stimulation (taVNS) is a non-invasive brain stimulation technique associated with possible modulation of norepinephrinergic (NE) activity. NE is suspected to contribute to generation of the P3 event-related potential. Recent evidence has produced equivocal evidence whether taVNS influences the P3 in healthy individuals during oddball tasks. We examined the effect of taVNS on P3 amplitudes using a novel visual Bayesian oddball task, which presented 200 sequences of three stimuli. The three consecutive stimuli in each sequence are labelled Draw 1, Draw 2 and Draw 3. In total, 47 Subjects completed this visual Bayesian oddball task under randomised sham and active taVNS stimulation in parallel with an electroencephalographic (EEG) recording. We conducted exploratory analyses of the effect of taVNS on P3 amplitudes separately for Draws. We found typical oddball effects on P3 amplitudes at Draws 1 and 2, but not Draw 3. At Draw 2, the oddball effect was enhanced during active compared to sham taVNS stimulation. These data provide evidence that taVNS influences parietal P3 amplitudes under specific circumstances. Only P3 amplitudes at Draw 2 were affected, which may relate to closure of Bayesian inference after Draw 2. Our findings seemingly support previously reported links between taVNS and the NE system.

Emotional conflict adaptation predicts intrusive memories

Why do some individuals experience intrusive emotional memories following stressful or traumatic events whereas others do not? Attentional control may contribute to the development of such memories by shielding attention to ongoing tasks from affective reactions to task-irrelevant emotional stimuli. The present study investigated whether individual differences in theability to exert cognitive control are associated with experiencing intrusive emotional memories after laboratory trauma. Sixty-one healthy women provided self-reported and experimentally derived measures of attentional control. They then viewed a trauma film in the laboratory and recorded intrusive memories for one week using a diary. Gaze avoidance during trauma film exposure was associated with more intrusive memories. Greater attentional control over emotion prior to film viewing, as assessed with the experimental task, predicted fewer intrusive memories while self-reported attentional control was unrelated to intrusive memories. Preexisting capacity to shield information processing from distraction may protect individuals from developing intrusive emotional memories following exposure to stress or trauma. These findings provide important clues for prevention and intervention science.

Reducing Amygdala Activity and Phobic Fear through Cognitive Top-Down Regulation

The amygdala is critically involved in emotional processing, including fear responses, and shows hyperactivity in anxiety disorders. Previous research in healthy participants has indicated that amygdala activity is down-regulated by cognitively demanding tasks that engage the PFC. It is unknown, however, if such an acute down-regulation of amygdala activity might correlate with reduced fear in anxious participants. In an fMRI study of 43 participants (11 men) with fear of snakes, we found reduced amygdala activity when visual stimuli were processed under high cognitive load, irrespective of whether the stimuli were of neutral or phobic content. Furthermore, dynamic causal modeling revealed that this general reduction in amygdala activity was partially mediated by a load-dependent increase in dorsolateral PFC activity. Importantly, high cognitive load also resulted in an acute decrease in perceived phobic fear while viewing the fearful stimuli. In conclusion, our data indicate that a cognitively demanding task results in a top-down regulation of amygdala activity and an acute reduction of fear in phobic participants. These findings may inspire the development of novel psychological intervention approaches aimed at reducing fear in anxiety disorders.

Influence of Attention Control on Implicit and Explicit Emotion Processing of Face and Body: Evidence From Flanker and Same-or-Different Paradigms

Many existing findings indicate that processing of emotional information is pre-attentive, largely immune from attentional control. Nevertheless, inconsistent evidence on the interference of emotional cues on cognitive processing suggests that this influence may be a highly conditional phenomenon. The aim of the present study was twofold: (1) to examine the modulation of attention control on emotion processing using facial expressions (2) explore the very same effect for emotional body expressions. In Experiment 1, participants performed a Flanker task in which they had to indicate either the emotion (happy/fearful) or the gender of the target stimulus while ignoring the distracting stimuli at the side. We found evidence for intrusion of the emotional dimension of a stimulus in both the emotion and gender discrimination performance, thus when either task-relevant or task-irrelevant. To further explore the influence of attention control mechanisms, in Experiment 2 participants performed a same-or-different judgment task in which they were asked to pay attention to both the central and lateral stimuli and indicated whether the central stimulus matched the lateral for emotion or gender. Results showed that emotional features exerted an influence at an implicit level (i.e., during gender judgments) for bodies only. Gender features did not affect emotional processing in either experiments. To rule out the possibility that this effect was driven by postural rather than emotional features of fearful vs. happy stimuli, a control experiment was conducted. In Experiment 3, bodies with an opening/up-ward or closing/down-ward posture but with no emotional valence were presented. Results revealed that the body posture did not influence gender discrimination. Findings suggest that the emotional valence of a face or body stimulus can overpass attention filtering mechanisms, independently from the level of attentional modulation (Experiment 1). However, broadening the focus of attention to include the lateral stimuli led emotional information to intrude on the main task, exerting an implicit, bottom–up influence on gender processing, only when conveyed by bodies (Experiment 2). Results point to different mechanisms for the implicit processing of face and body emotional expressions, with the latter likely having role on action preparation processes.

Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective

Generalized anxiety disorder (GAD), with uncontrollable worry at its core, is a common psychological disorder with considerable individual and societal costs. Cognitive behavior therapy (CBT) is recommended as the first-line treatment for GAD; however, further investigation into its effectiveness in routine clinical care is indicated and improvement is required in treatment outcomes for worry. Improvements to CBT need to be guided by experimental research that identifies key mechanisms maintaining core aspects of the disorder. This paper summarizes how theory-driven experimental research guided selection and refinements of CBT techniques originally developed by Borkovec and Costello, to target key cognitive processes that maintain worry in GAD. Hirsch and Mathews' model specifies three key research-supported processes that maintain uncontrollable worry in GAD: implicit cognitive biases such as negative interpretation bias and attention bias, generalized verbal thinking style, and impaired ability to re-direct attentional control away from worry. Specific CBT techniques outlined in this paper aim to target these key processes. Clinical data from clients treated using our refined CBT protocol for GAD in a routine clinical care service with a special interest in anxiety disorders were collected as part of service procedures. Large pre-to-posttreatment effect sizes were obtained for anxiety (GAD-7), depression (PHQ-9), and worry (PSWQ) (d=.90-2.54), and a moderate effect size was obtained for quality of life (WASA; d=.74). Recovery was indicated for 74% of cases for anxiety, 78% for depression, and 53% for worry. These findings exceeded most previous effectiveness studies in routine care and were in-line with GAD efficacy trials. This paper also outlines the application of specific clinical techniques selected, adapted or developed to target key cognitive mechanisms which maintain worry in GAD.

Examination of evaluative threat in worry: Insights from the Error-Related Negativity (ERN)

Recent research suggests atypical error-monitoring is important to understanding pathological anxiety. Because uncertainty is a transdiagnostic factor associated with anxiety and related disorders, recent research has begun to examine the influence of uncertainty in error-monitoring. Moreover, task irrelevant threat has been shown to influence cognitive performance in individuals with maladaptive anxiety. The current study aims to merge these literatures by examining the influence of task-irrelevant uncertain evaluative threat on error-monitoring using an event-related brain potential, the error-related negativity (ERN). Considering extensive literature indicating a relationship between worry and the ERN, worry was included as a continuous predictor in the analyses. Participants were randomly assigned to either a condition of negative or uncertain evaluative threat to determine their influence on error-monitoring in a Flankers task. Results for the ERN suggest that the ERN was significantly reduced only for the uncertain evaluative threat condition. The current study suggests that uncertain evaluative threat distractors result in a subsequent reduction in error-monitoring. This is consistent with literature suggesting that anxiety impairs inhibition of attentional processing of task irrelevant threatening information. This study adds to the burgeoning literature on the malleability of the ERN. Future research is needed to determine the mechanisms underlying this effect.

Executive function and other cognitive deficits are distal risk factors of generalized anxiety disorder 9 years later

OBJECTIVE

The cognitive model (Hirsch & Mathews, 2012) and attentional control theory (Eysenck & Derakshan, 2011) postulate that compromised executive function (EF) and other cognitive constructs are negatively linked to increased excessive and uncontrollable worry, the core symptom of generalized anxiety disorder (GAD). However, the prospective link between neuropsychological constructs and GAD are not well understood.

METHODS

A nationally representative sample of 2605 community-dwelling adults whose average age was 55.20 (s.d. = 11.41, range 33-84; 56.31% females) participated at baseline and 9-year follow-up. Baseline neuropsychological function and symptoms were measured using the Brief Test of Adult Cognition by Telephone and Composite International Diagnostic Interview - Short Form. Multivariate Poisson and negative binomial regression analyses were conducted with 11 baseline covariates entered simultaneously: age, gender, years of formal education, perceived control, hypertension/diabetes, body mass index, exercise status, as well as GAD severity, panic disorder severity, and depression severity. Those with baseline GAD were also removed.

RESULTS

Lower Time 1 composite global cognition z-score independently predicted higher Time 2 GAD severity and diagnosis [odds ratio (OR) 0.60, 95% confidence interval (CI) 0.40-0.89, p = 0.01]. Poor inhibition, set-shifting, working memory (WM) updating, inductive reasoning, and global cognition sequentially forecasted heightened GAD. However, processing speed, verbal WM, verbal fluency, and episodic memory did not predict future GAD.

CONCLUSION

Global cognition, inductive reasoning, inhibition, set-shifting, and WM updating EF impairments may be distal risk factors for elevated GAD nearly a decade later.

Verbal Memory Deficits in OEF/OIF/OND Veterans Exposed to Blasts at Close Range

OBJECTIVES

This study investigated the relationship between close proximity to detonated blast munitions and cognitive functioning in OEF/OIF/OND Veterans.

METHODS

A total of 333 participants completed a comprehensive evaluation that included assessment of neuropsychological functions, psychiatric diagnoses and history of military and non-military brain injury. Participants were assigned to a Close-Range Blast Exposure (CBE) or Non-Close-Range Blast Exposure (nonCBE) group based on whether they had reported being exposed to at least one blast within 10 meters.

RESULTS

Groups were compared on principal component scores representing the domains of memory, verbal fluency, and complex attention (empirically derived from a battery of standardized cognitive tests), after adjusting for age, education, PTSD diagnosis, sleep quality, substance abuse disorder, and pain. The CBE group showed poorer performance on the memory component. Rates of clinical impairment were significantly higher in the CBE group on select CVLT-II indices. Exploratory analyses examined the effects of concussion and multiple blasts on test performance and revealed that number of lifetime concussions did not contribute to memory performance. However, accumulating blast exposures at distances greater than 10 meters did contribute to poorer performance.

CONCLUSIONS

Close proximity to detonated blast munitions may impact memory, and Veterans exposed to close-range blast are more likely to demonstrate clinically meaningful deficits. These findings were observed after statistically adjusting for comorbid factors. Results suggest that proximity to blast should be considered when assessing for memory deficits in returning Veterans. Comorbid psychiatric factors may not entirely account for cognitive difficulties. (JINS, 2018, 24, 466-475).

Working Memory Load and Negative Picture Processing: Neural and Behavioral Associations With Panic, Social Anxiety, and Positive Affect

BACKGROUND

Internalizing disorders such as anxiety may be characterized by an imbalance between bottom-up (stimulus-driven) and top-down (goal-directed) attention. The late positive potential (LPP) can be used to assess these processes when task-irrelevant negative and neutral pictures are presented within a working memory paradigm. Prior work using this paradigm has found that working memory load reduces the picture-elicited LPP across participants; however, anxious individuals showed a reduced effect of working memory load on the LPP, suggesting increased distractibility.

METHODS

The current study assessed transdiagnostic associations between specific symptom dimensions of anxiety, the LPP, and behavior in a clinically representative, heterogeneous group of 76 treatment-seeking patients with internalizing disorders, who performed a working memory task interspersed with negative and neutral pictures.

RESULTS

As expected, negative pictures enhanced the LPP, and working memory load reduced the LPP. Participants with higher social anxiety showed increased LPPs to negative stimuli during early and late portions of picture presentation. Panic symptoms were associated with reduced LPPs to negative pictures compared with neutral pictures as well as a reduced effect of working memory load on the LPP during the late time window. Reduced positive affect was associated with greater behavioral interference from negative pictures.

CONCLUSIONS

Hypervigilance for negative stimuli was uniquely explained by social anxiety symptoms, whereas panic symptoms were associated with the opposing effect-blunted processing/avoidance of these stimuli. Panic symptoms were uniquely associated with reduced top-down control. Results reveal distinct associations between neural reactivity and anxiety symptom dimensions that transcend traditional diagnostic boundaries.

Emotion Regulating Attentional Control Abnormalities In Major Depressive Disorder: An Event-Related Potential Study

Major depressive disorders (MDD) exhibit cognitive dysfunction with respect to attention. The deficiencies in cognitive control of emotional information are associated with MDD as compared to healthy controls (HC). However, the brain mechanism underlying emotion that influences the attentional control in MDD necessitates further research. The present study explores the emotion-regulated cognitive competence in MDD at a dynamic attentional stage. Event-Related Potentials (ERPs) were recorded from 35 clinical MDD outpatients and matched HCs by applying a modified affective priming dot-probe paradigm, which consisted of various emotional facial expression pairs. From a dynamic perspective, ERPs combined with sLORETA results showed significant differences among the groups. In compared to HC, 100 ms MDD group exhibited a greater interior-prefrontal N100, sensitive to negative-neutral faces. 200 ms MDD showed an activated parietal-occipital P200 linked to sad face, suggesting that the attentional control ability concentrated on sad mood-congruent cognition. 300 ms, a distinct P300 was observed at dorsolateral parietal cortex, representing a sustained attentional control. Our findings suggested that a negatively sad emotion influenced cognitive attentional control in MDD in the early and late attentional stages of cognition. P200 and P300 might be predictors of potential neurocognitive mechanism underlying the dysregulated attentional control of MDD.

Distinct Associations Between Low Positive Affect, Panic, and Neural Responses to Reward and Threat During Late Stages of Affective Picture Processing

BACKGROUND

Abnormal patterns of attention to threat and reward have been proposed as potential mechanisms of dysfunction in anxiety and mood disorders. However, research on this topic has been inconsistent, perhaps because of both clinical heterogeneity in the samples assessed and measurement of attentional biases that is temporally imprecise.

METHODS

The present study measured transdiagnostic symptoms of anxiety and depression in 205 young adults and recorded affect-modulated event-related potentials in response to task-irrelevant pictures in a speeded response task.

RESULTS

Low positive affect was uniquely associated with reduced modulation of later event-related potentials (i.e., the P300 and the late positive potential) by rewarding images, suggesting deficits in sustained attention to reward. Low positive affect was also associated with a blunted threat-elicited late positive potential. Symptoms of panic were associated with an increased N1 to rewarding images, as well as an increased late positive potential to all picture types.

CONCLUSIONS

These data suggest that dysfunction in neural markers of sustained attention to threat and reward relate in specific ways to transdiagnostic symptom dimensions of anxiety and depression. Moreover, event-related potentials are likely to be useful in investigations of the time course of attentional abnormalities associated with these symptom dimensions.

Cognitive conflict increases processing of negative, task-irrelevant stimuli

The detection of cognitive conflict is thought to trigger adjustments in executive control. It has been recently shown that cognitive conflict increases processing of stimuli that are relevant to the ongoing task and that these modulations are exerted by the dorsolateral prefrontal cortex (DLPFC). However, it is still unclear whether such control influences are unspecific and might also affect the processing of task-irrelevant stimuli. The aim of the study was to examine if cognitive conflict affects processing of neutral and negative, task-irrelevant pictures. Participants responded to congruent (non-conflict) or to incongruent (conflict-eliciting) trials of a modified flanker task. Each response was followed by a presentation of a neutral or negative picture. The late positive potential (LPP) in response to picture presentation was used to assess the level of picture processing after conflict vs non-conflict trials. Connectivity between the DLPFC and attentional and perceptual areas during picture presentation was analysed to check if the DLPFC might be a source of these modulations. ERP results showed an effect of cognitive conflict only on processing of negative pictures: LPP in response to negative pictures was increased after conflict trials, whereas LPP in response to neutral pictures remained unchanged. Cortical connectivity analysis showed that conflict trials intensified information flow from the DLPFC towards attentional and perceptual regions. Results suggest that cognitive conflict increases processing of task-irrelevant stimuli; however, they must display high biological salience. Increase in cognitive control exerted by the DLPFC over attentional and perceptual regions is a probable mechanism of the effect.

The sound and the fury: Late positive potential is sensitive to sound affect

Emotion is an emergent construct of multiple distinct neural processes. EEG is uniquely sensitive to real-time neural computations, and thus is a promising tool to study the construction of emotion. This series of studies aimed to probe the mechanistic contribution of the late positive potential (LPP) to multimodal emotion perception. Experiment 1 revealed that LPP amplitudes for visual images, sounds, and visual images paired with sounds were larger for negatively rated stimuli than for neutrally rated stimuli. Experiment 2 manipulated this audiovisual enhancement by altering the valence pairings with congruent (e.g., positive audio + positive visual) or conflicting emotional pairs (e.g., positive audio + negative visual). Negative visual stimuli evoked larger early LPP amplitudes than positive visual stimuli, regardless of sound pairing. However, time frequency analyses revealed significant midfrontal theta-band power differences for conflicting over congruent stimuli pairs, suggesting very early (∼500 ms) realization of thematic fidelity violations. Interestingly, late LPP modulations were reflective of the opposite pattern of congruency, whereby congruent over conflicting pairs had larger LPP amplitudes. Together, these findings suggest that enhanced parietal activity for affective valence is modality independent and sensitive to complex affective processes. Furthermore, these findings suggest that altered neural activities for affective visual stimuli are enhanced by concurrent affective sounds, paving the way toward an understanding of the construction of multimodal affective experience.

Brain-behavioral adaptability predicts response to cognitive behavioral therapy for emotional disorders: A person-centered event-related potential study

Single-trial-level analyses afford the ability to link neural indices of elaborative attention (such as the late positive potential [LPP], an event-related potential) with downstream markers of attentional processing (such as reaction time [RT]). This approach can provide useful information about individual differences in information processing, such as the ability to adapt behavior based on attentional demands ("brain-behavioral adaptability"). Anxiety and depression are associated with maladaptive information processing implicating aberrant cognition-emotion interactions, but whether brain-behavioral adaptability predicts response to psychotherapy is not known. We used a novel person-centered, trial-level analysis approach to link neural indices of stimulus processing to behavioral responses and to predict treatment outcome. Thirty-nine patients with anxiety and/or depression received 12 weeks of cognitive behavioral therapy (CBT). Prior to treatment, patients performed a speeded reaction-time task involving briefly-presented pairs of aversive and neutral pictures while electroencephalography was recorded. Multilevel modeling demonstrated that larger LPPs predicted slower responses on subsequent trials, suggesting that increased attention to the task-irrelevant nature of pictures interfered with reaction time on subsequent trials. Whereas using LPP and RT averages did not distinguish CBT responders from nonresponders, in trial-level analyses individuals who demonstrated greater ability to benefit behaviorally (i.e., faster RT) from smaller LPPs on the previous trial (greater brain-behavioral adaptability) were more likely to respond to treatment and showed greater improvements in depressive symptoms. These results highlight the utility of trial-level analyses to elucidate variability in within-subjects, brain-behavioral attentional coupling in the context of emotion processing, in predicting response to CBT for emotional disorders.

AN EFFECTIVE NEUROFEEDBACK TRAINING, WITH CORTISOL CORRELATES, IN A CLINICAL CASE OF ANXIETY

Background and objectives: Neurofeedback treatments have shown successful results in anxiety disorders. Thus, the effectiveness of a beta1 Neurofeedback protocol was tested in a longitudinal clinical case study. Design and methods: A participant suffering from an anxiety syndrome was treated with 10 sessions of Neurofeedback, which protocol consisted in uptraining beta1 rhythm (16-21 Hz) while downtraining theta (4-8 Hz) band. For each of the 10 sessions the state anxiety and salivary cortisol levels were measured in a pre/post design. Initial and final examinations of anxiety symptoms and sustained attention performance were taken in addition. Results: The final evaluation showed that levels of anxiety fell within normative range and sustained attention improved. A t-test for related samples disclosed a significant improvement of beta1 amplitude across sessions, without modifications in untrained bands. A significant inverse correlation between beta1 amplitude and salivary cortisol appeared, suggesting that brain activity could be considered a marker of anxiety. The validation of the beta1 Neurofeedback protocol was assessed by independence, trainability and interpretability criteria. Conclusions: We showed an effective Neurofeedback protocol on anxiety and sustained attention, the success of which could consist on the reestablishment of an optimal cortical arousal capable of inhibiting the elevated amygdalar activity. (English)

Electrocortical consequences of image processing: The influence of working memory load and worry

Research suggests that worry precludes emotional processing as well as biases attentional processes. Although there is burgeoning evidence for the relationship between executive functioning and worry, more research in this area is needed. A recent theory suggests one mechanism for the negative effects of worry on neural indicators of attention may be working memory load, however few studies have examined this directly. The goal of the current study was to document the influence of both visual and verbal working memory load and worry on attention allocation during processing of emotional images in a cued image paradigm. It was hypothesized that working memory load will decrease attention allocation during processing of emotional images. This was tested among 38 participants using a modified S1-S2 paradigm. Results indicated that both the visual and verbal working memory tasks resulted in a reduction of attention allocation to the processing of images across stimulus types compared to the baseline task, although only for individuals low in worry. These data extend the literature by documenting decreased neural responding (i.e., LPP amplitude) to imagery both the visual and verbal working memory load, particularly among individuals low in worry.

Neural markers of attention to aversive pictures predict response to cognitive behavioral therapy in anxiety and depression

Excessive attention toward aversive information may be a core mechanism underlying emotional disorders, but little is known about whether this is predictive of response to treatments. We evaluated whether enhanced attention toward aversive stimuli, as indexed by an event-related potential component, the late positive potential (LPP), would predict response to cognitive behavioral therapy (CBT) in patients with social anxiety disorder and/or major depressive disorder. Thirty-two patients receiving 12 weeks of CBT responded to briefly-presented pairs of aversive and neutral pictures that served as targets or distracters while electroencephaolography was recorded. Patients with larger pre-treatment LPPs to aversive relative to neutral distracters (when targets were aversive) were more likely to respond to CBT, and demonstrated larger reductions in symptoms of depression and anxiety following treatment. Increased attention toward irrelevant aversive stimuli may signal attenuated top-down control, so treatments like CBT that improve this control could be beneficial for these individuals.

Alpha oscillations and their impairment in affective and post-traumatic stress disorders

Affective and anxiety disorders are debilitating conditions characterized by impairments in cognitive and social functioning. Elucidating their neural underpinnings may assist in improving diagnosis and developing targeted interventions. Neural oscillations are fundamental for brain functioning. Specifically, oscillations in the alpha frequency range (alpha rhythms) are prevalent in the awake, conscious brain and play an important role in supporting perceptual, cognitive, and social processes. We review studies utilizing various alpha power measurements to assess abnormalities in brain functioning in affective and anxiety disorders as well as obsessive compulsive and post-traumatic stress disorders. Despite some inconsistencies, studies demonstrate associations between aberrant alpha patterns and these disorders both in response to specific cognitive and emotional tasks and during a resting state. We conclude by discussing methodological considerations and future directions, and underscore the need for much further research on the role of alpha functionality in social contexts. As social dysfunction accompanies most psychiatric conditions, research on alpha's involvement in social processes may provide a unique window into the neural mechanisms underlying these disorders.

Computer-mediated communication preferences predict biobehavioral measures of social-emotional functioning

The use of computer-mediated communication (CMC) as a form of social interaction has become increasingly prevalent, yet few studies examine individual differences that may shed light on implications of CMC for adjustment. The current study examined neurocognitive individual differences associated with preferences to use technology in relation to social-emotional outcomes. In Study 1 (N = 91), a self-report measure, the Social Media Communication Questionnaire (SMCQ), was evaluated as an assessment of preferences for communicating positive and negative emotions on a scale ranging from purely via CMC to purely face-to-face. In Study 2, SMCQ preferences were examined in relation to event-related potentials (ERPs) associated with early emotional attention capture and reactivity (the frontal N1) and later sustained emotional processing and regulation (the late positive potential (LPP)). Electroencephalography (EEG) was recorded while 22 participants passively viewed emotional and neutral pictures and completed an emotion regulation task with instructions to increase, decrease, or maintain their emotional responses. A greater preference for CMC was associated with reduced size of and satisfaction with social support, greater early (N1) attention capture by emotional stimuli, and reduced LPP amplitudes to unpleasant stimuli in the increase emotion regulatory task. These findings are discussed in the context of possible emotion- and social-regulatory functions of CMC.

Diagnostic and symptom-based predictors of emotional processing in generalized anxiety disorder and major depressive disorder: An event-related potential study

The delineation of specific versus overlapping mechanisms in GAD and MDD could shed light on the integrity of these diagnostic categories. For example, negative emotion generation is one mechanism that may be especially relevant to both disorders. Emotional processing abnormalities were examined among 97 outpatients with generalized anxiety disorder (GAD) or major depressive disorder (MDD) and 25 healthy adults, using the late positive potential (LPP), an event-related potential that is larger for emotional versus neutral stimuli. GAD and MDD were also assessed dimensionally across all participants. Both MDD diagnosis and dimensional depression scores were associated with reduced ΔLPP. When controlling for MDD diagnosis/dimension, both the diagnosis and dimension of GAD were associated with increased ΔLPP. Both MDD and GAD dimensions, but not diagnoses, were associated with increased ΔRT to targets that followed emotional pictures. Therefore, MDD and GAD have distinguishable and opposing features evident in neural measures of emotion processing.

Error-related brain activity in the age of RDoC: A review of the literature

The ability to detect and respond to errors is critical to successful adaptation to a changing environment. The error-related negativity (ERN), an event-related potential (ERP) component, is a well-validated neural response to errors and reflects the error monitoring activity of the anterior cingulate cortex (ACC). Additionally, the ERN is implicated in several processes key to adaptive functioning. Abnormalities in error-related brain activity have been linked to multiple forms of psychopathology and individual differences. As such, the component is likely to be useful in NIMH's Research Domain Criteria (RDoC) initiative to establish biologically-meaningful dimensions of psychological dysfunction, and currently appears as a unit of measurement in three RDoC domains: Positive Valence Systems, Negative Valence Systems, and Cognitive Systems. In this review paper, we introduce the ERN and discuss evidence related to its psychometric properties, as well as important task differences. Following this, we discuss evidence linking the ERN to clinically diverse forms of psychopathology, as well as the implications of one unit of measurement appearing in multiple RDoC dimensions. And finally, we discuss important future directions, as well as research pathways by which the ERN might be leveraged to track the ways in which dysfunctions in multiple neural systems interact to influence psychological well-being.