Emotional information processing in repressors: The vigilance–avoidance theory

Broad attention does not buffer the impact of emotionally salient stimuli on performance

It has been claimed that a broad attentional breadth buffers the impact of negative stimuli on human perception and cognition. Here we identify issues with the research on which this claim is based, and then rigorously test the claim. To induce narrow versus broad attentional breadth participants attended to the local versus global elements of Navon stimuli, and to investigate the impact of emotionally salient stimuli on performance we measured the effect of task-irrelevant stimuli of varying emotional salience (negative, neutral, or positive) on task performance. Across a series of experiments, we found that the Navon stimuli were effective in inducing different attentional breadths, and that both negative and positive task-irrelevant stimuli slowed responses relative to neutral stimuli, but that the magnitude of this emotion-induced slowing was invariant to whether attentional breadth was broad or narrow. This indicates that a broad attentional breadth did not buffer against the effect of either negative or positive emotionally salient stimuli. These results challenge the claim the broadening attentional breadth protects against the impact of emotionally salient stimuli.

Coping styles and the developmental trajectories of anxiety symptoms in children during transition into early adolescence

The study investigated how active and avoidant coping styles predicted the trajectory membership of anxiety symptoms during the transition into early adolescence. A total of 321 Chinese children aged 9 to 10 years were recruited from a primary school in mainland China. Self-reported trait anxiety, coping styles and anxiety symptoms were assessed at baseline. After 6 months, self-reported anxiety symptoms were measured at three follow-up assessments with an interval of 6 months. Latent class growth modelling revealed high (18.7%) and low (81.3%) trajectories of anxiety symptoms in children during the transition into early adolescence. After controlling for trait anxiety, depression and sex, high active coping style predicted the trajectory of high anxiety symptoms, which was not moderated by trait anxiety. Before controlling for these covariates, the relation between active coping style and anxiety symptoms was in the opposite direction. A high avoidant coping style showed a trend to predict the trajectory of high anxiety symptoms only for children with low trait anxiety. These findings add a developmental context to the relationships of active and avoidant coping styles to anxiety symptoms and suggest that trait anxiety may moderate these relationships.

Investigating attention toward pain-related cues in an Arabic-speaking population with and without chronic pain

There is some evidence for attentional biases in individuals with chronic pain (CP). Cultural and linguistic differences might affect the manifestation of these processes across populations. However, such attentional biases have not been explored in the Arabic-speaking population. The current study investigated these attentional biases and possible associations with resilience. Two matched groups of Arabic-speaking participants with (58) and without (58) CP were recruited from Jordan and the United Kingdom. They completed emotionally modified versions of the Posner cueing and Stroop tasks, alongside questionnaires. Significant group differences were found for the Posner task, with the CP group exhibiting disengagement revealed by the inhibition of return (IOR) effect for sensory pain-related cues compared to delayed disengagement for the other cue types. The control group showed IOR across cue types. No group differences were found on the Stroop task. The CP group had lower resilience scores than healthy controls, and resilience moderated performance on the Posner task. The study provides preliminary evidence about the attentional processes in the Arabic population; the speed of disengagement is affected in the CP group with early disengagement for sensory pain-related information compared to affect pain and neutral stimuli. Furthermore, resilience levels in the CP and control group moderated the performance on the Posner task, suggesting that it influences attentional allocation. This study can help in understanding how the phenomenon of attention bias intertwines with the cultural and linguistic factors. Future research should further explore attentional dynamics across different time points in this population and the modulatory effect of resilience.

Affective super-traits and/or individual patterns: a variable-centered and a person-centered approach of primary emotional aspects of personality

Theoretical approaches of personality structure are diverse. We examine the primary emotional aspects of personality as the correspondence of two mainstream constructs: the lexically-based Big Five (BIG5) and the biologically-based Affective Neuroscience Theory (ANT) within two approaches. In the variable-centered approach (VCA), our aim is to identify affective super-traits; while in the person-centered approach (PCA) to uncover latent profile patterns. 240 participants (177 women, 63 men) completed the 112-item affective neuroscience personality scales (ANPS), and the 44-item Big Five Inventory (BFI). We identified four super-traits: Negative emotions (FEAR, SADNESS, Emotional instability), Positive emotions and stimulation (SEEK, Extraversion), Affiliation and social bonds (reversed ANGER, CARE, Agreeableness), Self-regulation (PLAY, Conscientiousness. Based on the VCA, we conclude that the four super-traits represent two main affective tendencies (Positive emotions and approaching, Negative emotions and avoidance), interpersonal (Affiliation) and intrapersonal (Self-regulation) dynamics of personality. As a result of Latent Profile Analysis in the PCA, we explored three latent groups with different patterns of primary emotional traits based on their responsiveness (Highly emotional, Balanced, Low emotional). Our findings provide a holistic approach to emotional aspects of personality, and might have further implications for clinical psychology, neuroscience, and cross-cultural studies on emotions.

Don't judge a book by its cover: Exploring low self-reported distress and repressive coping in a pediatric chronic pain population

Repression has been linked to greater illness, somatic symptoms, and poorer physical health, both in adult and pediatric populations. The current study examined psychological and pain profiles of children with chronic pain who may under-report levels of psychological distress at a first interdisciplinary chronic pain assessment. Children and their caregiver completed measures of psychopathology and pain intensity, while clinicians rated their levels of disability. Based on self-report measures, children were classified as "repressors" (low anxiety/high social desirability) or as "true low anxious" (low anxiety/low social desirability). Groups were then compared on psychological and pain characteristics. Compared to children with true low anxiety, repressors reported lower levels of depressive and somatic symptoms but provided higher ratings on pain intensity, pain-unpleasantness, and self-oriented perfectionism. Caregivers of repressors rated their children as having higher levels of adaptability compared to caregivers of children in the true low anxious group. Groups did not differ on clinician-rated level of disability. Children classified as repressors exhibited different profiles than children classified as having true low anxiety on both psychological outcomes and pain characteristics. Repression may be an important factor to consider for those assessing and treating children with chronic pain.

Repressive and vigilant coping styles in stress and relaxation: evidence for physiological and subjective differences at baseline, but not for differential stress or relaxation responses

Introduction

Previous research suggested differential stress reactivity depending on individuals' coping style, e.g., as classified by the model of coping modes. Specifically, stronger physiological reactivity and weaker subjective stress ratings were found for repressors than for sensitizers. However, it remains to be investigated (i) whether these findings, which are largely based on social stress induction protocols, also generalize to other stressors, (ii) whether repressors vs. sensitizers also exhibit differential stress recovery following the application of a relaxation method, and (iii) which stress reactivity and recovery patterns are seen for the two remaining coping styles, i.e., fluctuating, and non-defensive copers. The current study thus examines stress reactivity in physiology and subjective ratings to a non-social stressor and the subsequent ability to relax for the four coping groups of repressors, sensitizers, fluctuating, and non-defensive copers.

Methods

A total of 96 healthy participants took part in a stress induction (Mannheim Multicomponent Stress Test) and a subsequent relaxation intervention. Subjective ratings of stress and relaxation, heart rate (HR), heart rate variability (HRV), and blood pressure were assessed during the experiment. HR and blood pressure are markers of the sympathetic stress response that can be regulated by relaxation, while HRV should increase with relaxation. To investigate long-term relaxation effects, subjective ratings were also assessed on the evening of testing.

Results

Despite successful stress induction, no differential responses (baseline to stress, stress to relaxation) were observed between the different coping groups on any of the measures. In contrast, a strong baseline effect was observed that persisted throughout the experiment: In general, fluctuating copers showed lower HR and higher HRV than non-defensive copers, whereas repressors reported lower subjective stress levels and higher levels of relaxation during all study phases. No differences in subjective ratings were observed in the evening of testing.

Conclusion

Contrary to previous research, no differential stress reactivity pattern was observed between coping groups, which could be due to the non-social type of stressor employed in this study. The novel finding of physiological baseline differences between fluctuating and non-defensive individuals is of interest and should be further investigated in other stressor types in future research.

Eye movements and ERP biomarkers for face processing problems in avoidant attachment-style individuals

Background

Avoidant attachment poses a serious risk to intimate relationships and offspring. However, there are few studies on the face-processing characteristics and impairments of avoidant individuals based on basic emotion theory. Therefore, this study investigated the issues of emotional processing and deactivation strategies in individuals with avoidant attachment.

Methods

Avoidant and secure individuals were recruited to participate in an eye-tracking experiment and a two-choice oddball task in which they had to distinguish facial expressions of basic emotions (sadness, anger, fear, disgust, and neutral). Eye fixation durations to various parts of the face, including the eyes, nose, and mouth, were measured, and three event-related potentials (ERP) components (P100, N170, and P300) were monitored.

Results

Avoidant individuals could not process facial expressions as easily as secure individuals. Avoidant individuals focused less on the eyes of angry faces when compared to secure individuals. They also exhibited a more positive P100 component and a less negative N170 component when processing faces and a larger amplitude of the P300 component than secure individuals when processing emotional expressions.

Conclusion

Avoidant individuals use deactivating strategies and exhibit specific characteristics at different stages, which are of great significance in social interaction.

Deactivating attachment strategies associate with early processing of facial emotion and familiarity in middle childhood: an ERP study

Neurophysiological evidence suggests associations between attachment and the neural processing of emotion expressions. This study asks whether this relationship is also evident in middle childhood, and how it is affected by facial familiarity. Attachment strategies (deactivation, hyperactivation) were assessed in 51 children (9 - 11 years)  using a story stem completion task. Event-related potentials (ERPs) were recorded during children's passive viewing of mother and stranger emotional faces (angry/happy). At the stage of facial information encoding (N250), attachment deactivation was associated with a pattern pointing to increased vigilance towards angry faces. Further, the attention-driven LPP was increased to happy mother faces as highly salient stimuli overall, but not in children scoring high on deactivation. These children did not discriminate between mothers' facial emotions and showed a general attentional withdrawal from facial stimuli. While our results on attachment deactivation support a two-stage processing model, no effect of hyperactivation was found.

Adult Avoidant Attachment, Attention Bias, and Emotional Regulation Patterns: An Eye-Tracking Study

Proximity-seeking in distress situations is one of attachment theory's primary strategies; insecure individuals often also develop secondary strategies. The mechanisms implied in attachment deactivation constitute a key issue in the current debate related to their role in support-seeking. The main aim of this study is to investigate the attachment deactivation strategy and the processes of proximity/support-seeking under distress conditions by analyzing the attentional processes (i.e., an essential emotion-regulation strategy), using eye-tracking techniques. Seventy-two participants (45 female; M_age 23.9 ± 3.97) responded to the ECR-R questionnaire in order to identify their attachment style. They participated in an experimental situation in which they had to choose between pictures of care or pictures of food, following the presentation of threatening or neutral prime conditions (via the pictures' stimuli). Results showed that a care-consistency response pattern was the most frequent pattern of response, particularly under a threatening condition; on the contrary, only avoidant individuals showed a lower care-consistency response pattern by choosing food pictures. The overall findings demonstrate that avoidant individuals used the deactivation strategy to process comfort-related attachment pictures, suggesting that they considered these stimuli to be threatening. The implications for attachment theory and particularly for avoidant strategies are discussed.

Biased information processing and anxiety coping: differences in attentional and approach patterns towards positive cues in repressors

Individual differences in emotional coping styles are likely to affect information processing on different stages. Repressive coping is assumed to be related to an attentional bias away from threatening information. Possible links to biases in later stages of information processing have not been investigated to date. In the current study, 82 participants completed the visual dot-probe task as a measure of attentional bias and the Approach-Avoidance Task (AAT) as a measure of approach/avoidance bias and classified into coping groups via the Mainz Coping Inventory (MCI). Prevalence of attention bias and approach/avoidance bias were compared between groups. Main results revealed a strong approach tendency toward positive stimuli for repressors and a strong avoidance tendency for sensitizers. No group differences were found for approach bias to negative stimuli or for attention bias. The present findings of strong preferential processing of positive stimuli in repressors may be part of broader information processing alterations, which may also be linked to alterations in emotion processing.

Psychoanalysis and Neuropsychological Explanations

Psychoanalysis is an explanatory science, and if our aim is to develop accurate theories of the mind, psychoanalysis would benefit from integrating explanations developed by psychology and neuroscience. The main part of the essay shows how psychoanalysis can be integrated with neuroscience and psychology. The concept of integration is defined in terms of six criteria, and the author argues that no matter how tight the integration is, it does not entail that neuropsychological explanations can replace psychoanalytic theory.

Don't look now! Emotion-induced blindness: The interplay between emotion and attention

Scientists have long been interested in understanding the influence of emotionally salient stimuli on attention and perception. One experimental paradigm that has shown great promise in demonstrating the effect of such stimuli is emotion-induced blindness. That is, when emotionally salient stimuli are presented in a rapid stream of stimuli, they produce impairments in the perception of task-relevant stimuli, even though they themselves are task irrelevant. This is known as emotion-induced blindness, and it is a profound and robust form of attentional bias. Here, we review the literature on emotion-induced blindness, such as identifying the types of stimuli that elicit it, and its temporal dynamics. We discuss the role of dimensional versus categorical approaches to emotion in relation to emotion-induced blindness. We also synthesize the work examining whether certain individuals, such as those high in anxiety versus psychopathy, succumb to emotion-induced blindness to different extents, and we discuss whether the deficit can be reduced or even abolished. We review the theoretical models that have been proposed to explain the phenomenon. Finally, we identify exciting questions for future research, and elucidate useful frameworks to guide future investigations.

Not self-aware? Psychological antecedents and consequences of alienating from one’s actual motives, emotions, and goals

Philosophers and scientists have been puzzling over the potential antecedents and consequences of self-awareness or its relative absence since time immemorial. One major reason is the difficulty of identifying individuals’ actual needs, emotions, or goals and thus making statements about their level of self-awareness. Drawing on a “duality of mind” approach, we review our research that quantified discrepancies between first-person perspective and third-person perspective assessments of motives (“needs”), emotions, and goals as indicators of relative self-awareness. Also, we expand on their proximal causes related to personality–situation interactions and their emotional and motivational consequences. We discuss similarities among the three branches of research on motives, emotions, and goals and, lastly, provide an outlook for future research.

Experiences of maltreatment in childhood and attention to facial emotions in healthy young women

Using reaction-time measures, research on the relationship between childhood maltreatment and biased attention to emotional stimuli in adults has obtained inconsistent results. To help clarify this issue, we conducted an eye-tracking study on the link between childhood maltreatment and allocation of attention to facial emotions analyzing gaze behavior in addition to manual reactions. In contrast to prior investigations, we excluded individuals with tendencies to minimize maltreatment experiences from analyses. Gaze behavior and manual response time of 58 healthy women were examined in a dot-probe task in which pairs of emotional (happy, sad, or disgusted) and neutral faces were presented. In our analyses, participants’ affectivity, level of alexithymia, and intelligence were controlled. Entry time and dwell time on facial expressions were used as indicators of attention allocation. Childhood maltreatment showed no effect on response latencies but was associated with shorter entry times on emotional faces and shorter dwell time on disgusted faces. Experiences of childhood maltreatment seem to be linked to an increased early vigilance to emotional social signals and to an attentional avoidance of hostile facial expressions at a later stage of perception. The present results suggest a vigilance-avoidance pattern of attention allocation associated with childhood maltreatment.

The Role of Approach and Avoidance Motivation and Emotion Regulation in Coping Via Health Information Seeking

When dealing with a health threat, health information seeking (HIS) is a prominent way of engagement coping. Yet, there is only limited research as to its motivational and emotion regulatory antecedents. We present a theoretical model integrating approach and avoidance motivation, emotion regulation, HIS self-efficacy, and problem and emotion coping focus as predictors of HIS. We propose that, in the context of HIS, (1) approach and avoidance motivation have a direct effect on emotion regulation ability (positive and negative, respectively), (2) approach and avoidance motivation have indirect effects on intended comprehensiveness of search via emotion regulation, HIS self-efficacy and problem coping focus, (3) avoidance motivation has a direct effect on emotion coping focus. Our model was tested by means of structural equation modeling in a sample of university students (N = 283). Model fit was good, and all three hypotheses were supported. We show that emotion regulation ability is essential to explain the effects of approach and avoidance motivation on HIS as it fosters self-efficacy and a problem coping focus. The direct effect of avoidance motivation on emotion focus may represent an alternative way of coping with a health threat for those individuals who are highly sensitive to threat-related emotions.

Stressful Life Events Are Related to More Negative Interpretations, but Not Under Acute Stress

Studies have identified deleterious effects of stress on multiple cognitive processes such as memory and attention. Little is known about the impact of stress on interpretation. We investigated how an induced acute stress and more long-term stress related to life events were associated with interpretations of ambiguous stimuli. Fifty participants answered a questionnaire indexing the number of stressful life events. A median split was used to compare those reporting few or more events. Half of participants performed an arithmetic task that induced acute stress; they were compared to a control group performing a less stressful task. We measured the interpretation of ambiguous visual stimuli, which participants had to judge as “negative” or “positive”. We found a significant interaction between the number of stressful life events and the induced acute stress on the proportion of positive interpretations. In the control group, participants reporting more stressful events produced less positive interpretations than those reporting few events. In the induced stress condition, no significant difference was found. Life events tend to influence interpretation in the absence of an acute stressor, which seems to be more influent in the short term.

'It kinda sucks': Illness perception of a group of South African adolescents with type 1 diabetes mellitus

Background

Living with diabetes is challenging, especially for adolescents at risk of poor glycaemic control. Understanding the illness perceptions of this group is important to be able to develop interventions for this growing population in need.

Aim

This study explored the illness perception amongst adolescents living with type 1 diabetes (T1D) and how these perceptions interacted with the management of T1D.

Setting

This study was conducted at a medical centre providing care for adolescents living with T1D in Parktown, South Africa.

Methods

A qualitative, explorative design with semi-structured interviews was followed. A non-random purposive sampling method was utilised. The illness perception amongst eight adolescents, aged 12–18 years, at risk of poor glycaemic control, was analysed through thematic analysis.

Results

Two subthemes related to illness perception were generated, namely (1) illness perception of T1D is negative and (2) living with T1D leads to a sense of being different. Furthermore, two subthemes were generated in relation to how illness perceptions interacted with diabetes management, namely (3) management of T1D is challenging and (4) management of T1D is motivated by fear.

Conclusion

This group of adolescents with at-risk glycaemic control believed that T1D is difficult to manage, leading to a largely negative perception of the disease. This study contributes to the body of literature on adolescents where illness perception may play a role in adhering to diabetes care plans. This research may give additional insights into the awareness of illness perception in designing successful interventions.

Defense Mechanisms and Repressive Coping Among Male Breast Cancer Patients

Objectives: The concept of defense mechanisms has undergone extensive revision and expansion since Freud first described these processes. Initially formulated as an unconscious repression of unpleasant memories, with further development focusing on the role of defense mechanisms in the regulation of internal conflicts, the concept shifted and evolved to incorporate the adaptation to external demands, including intrapsychic and interpersonal handling of burden of illness. In addition to defense mechanisms, coping provides another perspective on human adjustment to difficult life events. While there is substantial research on both coping and defense mechanisms in various psychiatric and somatic diseases, including cancer, little is known about defensive regulation, coping, and their interaction in male breast cancer patients. Methods: The present study is part of the N-Male project conducted between 2016 and 2018 in Germany (Male breast cancer: patients' needs in prevention, diagnosis, treatment, rehabilitation, and follow-up care). Semi-standardized interviews with 27 male breast cancer patients were analyzed with regard to defense mechanisms. In addition, fear of progression and repressive coping was assessed by self-report. Results: There was considerable variety in levels of defensive functioning as well as repressive coping in our sample. We found no difference in overall levels of defensive functioning between men with vs. without repressive coping. However, patients with repressive coping demonstrated a decopupled association between fear of progression and defensive functioning as compared to patients without repressive coping. Discussion: The study provides the first evidence of disease processing in male breast cancer patients Knowledge of patients' defense patterns and repressive coping seems promising for better planning targeted intervention strategies.

Attentional processing of information related to illness: Biases and associations with emotional response in young adults with different levels of illness anxiety

This study investigated attentional processing of illness-related information and associations with emotional reactivity. 100 young adults with low to high illness anxiety levels underwent free and cued viewing tasks, while eye-tracking and emotional reactivity were recorded. During free viewing, participants showed early orienting bias and sustained vigilance bias toward illness vs neutral pictures. Increased illness anxiety predicted vigilance bias to illness vs fearful pictures. During cued viewing, participants showed avoidance bias for illness vs neutral pictures, predicted by greater cardiac acceleration. Task nature appears to influence attentional processing patterns of illness stimuli. Preliminary evidence supports that attention allocation may be an emotion regulation mechanism.

Memory for pictures of sexual assault: Sensitive maintenance of ambiguous stimuli

Individual differences in dispositional coping might influence how ambiguous situations involving interactions of men and women are interpreted and remembered. Specifically, we hypothesized that women with a sensitive coping style actively maintain ambiguously threatening stimuli in their memory, showing so-called sensitive maintenance. As a prerequisite to investigate this hypothesis, two surveys (Studies 1 and 2; N = 151 and N = 252) were conducted to answer the questions whether fear of sexual assault is of relevance for young women in Germany and whether ambiguous (rather than only unambiguously threatening) situations are experienced to a significant extent. After confirming this for our target population, our main hypothesis was tested in Study 3 (N = 192) by combining tasks assessing the appraisal and the forgetting of nonthreatening, threatening, and ambiguous pictures showing interactions of men and women, and by varying the cognitive load during the retention interval. Whereas fear of rape predicted the appraisal of pictures, coping dispositions predicted forgetting of ambiguously and unambiguously threatening pictures in the hypothesized way. Results are discussed from the perspective of adaptivity and functionality of memory.

Structural and functional neural correlates of vigilant and avoidant regulation style

BACKGROUND

Regulation of emotional arousal is a relevant factor for mental health. The investigation of neural underpinnings of regulation styles in healthy individuals may provide important insights regarding potential risk factors. To fill the gap of structural correlates of regulation styles and to expand previous results, we focused on the association between brain structure, neural responsiveness and vigilant/avoidant regulation style.

METHODS

In n = 302 healthy individuals regulation style was assessed with the Mainz Coping Inventory (MCI). Participants underwent structural and functional MRI during an emotion-processing paradigm. Structural MRI (voxel-based morphometry) and functional MRI were analysed in two regions of interest (amygdala and anterior cingulate cortex [ACC]).

RESULTS

Regulation styles did not show an association with brain structure after correction for gender, age, trait anxiety, depressive symptoms. During emotion processing, a vigilant regulation style was negatively associated with ACC activation.

LIMITATIONS

The cross-sectional study in a non-pathological sample is not adequate to unveil causalities or draw conclusions regarding prevention interventions.

CONCLUSION

Regulation styles are associated with specific neural activation patterns. The association of a high-vigilant regulation style and low ACC activation during emotion processing in healthy participants might be a potential risk factor.

What sentimentalists should say about emotion

Recent work by emotion researchers indicates that emotions have a multilevel structure. Sophisticated sentimentalists should take note of this work - for it better enables them to defend a substantive role for emotion in moral cognition. Contra May's rationalist criticisms, emotions are not only able to carry morally relevant information, but can also substantially influence moral judgment and reasoning.

Trait Sensitivity, Anxiety, and Personality Are Predictive of Central Sensitization Symptoms in Patients with Chronic Low Back Pain

BACKGROUND

Sensitivity-related trait characteristics involving physical and emotional sensitivities and high trait anxiety personality types have been observed in individuals with nonspecific chronic low back pain (NSCLBP). High trait sensitivity to sensory stimulation combined with interpretation biases based on personality type may contribute to the development of central sensitization (CS) symptoms. To date, there is limited research that has considered both sensitivity levels and personality type in NSCLBP with CS. The purpose of this study was to investigate (1) relationships between trait sensory profiles, trait anxiety, and CS symptoms, and (2) the predictive capacity of sensory profiles, trait anxiety, and personality types on CS symptoms in people with NSCLBP.

METHODS

This was a cross-sectional observational study using 4 self-report measures on adults (N = 165, mean age = 45 ± 12 [standard deviation] years) from physiotherapy clinics in England, Ireland, and New Zealand. Inclusion: NSCLBP > 6 months, age 18 to 64 years, predominant CS pain presentation, no other pathology. Parametric and nonparametric correlation statistics and regression analyses were used.

RESULTS

Positive correlations were found between central sensitization inventory (CSI) scores and sensory hypersensitivity profiles and trait anxiety. CSI score increases could be predicted by sensory-sensitive, low-registration profiles; trait anxiety scores; and extreme defensive high anxious personality type.

CONCLUSIONS

Trait sensory hyper- and/or hyposensitivity and high trait anxiety-related personality type characteristics predict the extent of CS symptoms in people with NSCLBP. Further investigation is required to establish causality between these characteristics and CS symptoms.

Vigilance/Avoidance to Expected and Presented Stimuli in Trauma Survivors: An Eye-Tracking Study

Attention in trauma-related disorders has been characterized by both vigilance and avoidance of trauma-related or aversive stimuli. This study used eye-tracking technology to investigate how cumulative trauma, as well as hypervigilance and dissociative symptoms, affected attentional patterns to anticipated negative stimuli and actual negative stimuli. A sample of forty-two trauma participants recruited from the community had a choice about where to look on a computer screen knowing which segments of the screen negative stimuli were likely to appear. Participants could look at those stimuli for as long as they chose before pushing a button to move onto the next trial. A measure of hypervigilance predicted looking to quadrants in which a negative stimulus was to appear. Cumulative trauma predicted avoidance of those stimuli. Neither cumulative trauma or symptom profiles predicted how long participants looked at the negative pictures once they were presented. These data suggest that hypervigilance is associated with looking for threats that are not yet present, and that cumulative trauma may be associated with motivation to avoid negative stimuli. The findings are discussed with respect to the characteristics of the sample and the limited dissociative pathology.

Ongoing monitoring of mindwandering in avoidant grief through cortico-basal-ganglia interactions

An avoidant grief style is marked by repeated and often unsuccessful attempts to prevent thinking about loss. Prior work shows avoidant grief involves monitoring the external environment in order to avoid reminders of the loss. Here we sought to determine whether avoidant grievers also monitor the internal environment in attempts to minimize conscious awareness of loss-related thoughts. Individuals bereaved of a first-degree relative, spouse or partner within the last 14 months participated in a functional magnetic resonance imaging (fMRI) study (N = 29). We first applied machine learning to train neural patterns for attentional control and representation of the deceased (N = 23). The attentional pattern was trained using fMRI data from a modified Stroop task assessing selective attention to reminders of the deceased. The representational pattern was trained using fMRI data from a task presenting pictures and stories of the deceased. We observed spontaneous fluctuations in these processes occurring during a neutral mindwandering fMRI task (N = 27). At higher levels of avoidant grieving, activation of attentional control disrupted the relationship between the representational process and thoughts of loss. These findings show that avoidant grief involves attentional control to reduce the likelihood that deceased-related representations reach full conscious awareness.

Exploring the pre-morbid contexts in which central sensitisation developed in individuals with non-specific chronic low back pain. A qualitative study

BACKGROUND

Central sensitisation pain is a predominant mechanism in a proportion of individuals with non-specific chronic low back pain and is associated with poor outcomes. It is proposed that the pre-morbid experiences and contexts may be related to the development of central sensitisation.

OBJECTIVES

The objective of this study was to explore the pre-morbid experiences and personal characteristics of participants with central sensitisation pain from a non-specific chronic low back pain population.

METHODS

This was a qualitative, exploratory study, using a concurrent nested design within a mixed methods protocol. n=9 participants were recruited purposively based on sensory profiles and trait anxiety-related personality types. Data were collected through semi structured interviews, managed using QSR NVivo 10 software and analysed using theoretical thematic analysis.

RESULTS

Four themes emerged: developmental learning experiences, personal characteristics, sensitivity and trauma. Reported was lack of confidence, low esteem and a need to please others, physical hyper-sensitivities (smell, light, sound) and emotional sensitivity (anxiety) as well as physical hypo-sensitivity. Participants had also suffered emotional and/or physical trauma. Learning difficulties, sensory sensitivities and trauma are associated with autonomic stress responses, which in turn have been linked to physiological changes seen in central sensitisation pain.

CONCLUSION

Central sensitisation pain developed in the context of sensory processing differences related to learning difficulties, sensitivities and trauma, and personal characteristics of low confidence and control, in a group of participants with non-specific chronic low back pain. The role of pre-existing sensory processing differences, as a component of altered central nervous system function, in relation to central sensitisation pain warrants further investigation.

The effect of anxiety on emotional recognition: evidence from an ERP study

Anxiety-related bias in the recognition memory based on trait anxiety has induced some studies. Their results, however, were conflicting. In fact, anxious differences not only differed from personality traits but also from different anxiety mood levels. We explored the emotional memory bias in both trait and state anxiety individuals, the high trait and high state anxiety group, the high trait and low state anxiety group, the low trait and high state anxiety group, and the low trait and low state anxiety group, on classic recognition paradigm using event-related potentials (ERPs). The behavioral results showed high state anxiety levels increased the d' of negative words, regardless of the trait anxiety of participant is high or low, and a lower d' of recognition memory for negative words than for neutral and positive words in all participants. Moreover, Electrophysiological results supported the findings of behavior, showing an earlier N400 (250-500 ms) latency elicited for new-negative words in high state level than in low state levels in right parietal region. These results suggested that the memory bias to negative events resides in state anxiety, but not in trait anxiety.

Emotionally aligned: Preliminary results on the effects of a mindfulness-based intervention for depression on congruence between implicit and explicit mood

BACKGROUND

Mindfulness-based interventions (MBIs) are effective in treating major depression. Because mindfulness involves monitoring and accepting current experiences, it may lead people resolve incongruencies between emotional responses that would otherwise remain unnoticed. Mindfulness may thus foster congruence between implicit and explicit emotions. The current randomized controlled trial tested this notion.

METHODS

N = 39 patients with an acute depressive episode were randomly assigned to an 8-week MBI (n = 24) or a psychopharmacological consultation condition (n = 15). Explicit and implicit mood and depressive symptoms were assessed before treatment and at the end of treatment.

RESULTS

Compared with the control condition, patients receiving MBI demonstrated higher congruence between implicit and explicit negative mood after treatment. There was no such difference in congruence of implicit and explicit positive mood. Additional analyses showed that only within the MBI group, individual differences in explicit mood became less stable. In contrast, individual differences in implicit mood remained stable in both groups.

LIMITATIONS

There was no control group including an active psychological intervention, the sample was small, and emotional congruence was not assessed within persons.

CONCLUSIONS

These findings correspond with the idea that mindfulness reduces incongruencies between implicit and explicit emotional responses. We found preliminary evidence for this effect for negative emotional responses. There was suggestive evidence that congruence arose from the alignment of explicit responses (which became less stable) to implicit responses (which remained stable). Studying the interplay between implicit and explicit processes may shed light on the working mechanisms of clinical-psychological interventions.

How do illness-anxious individuals process health-threatening information? A systematic review of evidence for the cognitive-behavioral model

According to the cognitive-behavioral model, illness anxiety is developed and maintained through biased processing of health-threatening information and maladaptive responses to such information.

OBJECTIVE

This study is a systematic review of research that attempted to validate central tenets of the cognitive-behavioral model regarding etiological and maintenance mechanisms in illness anxiety.

METHODS

Sixty-two studies, including correlational and experimental designs, were identified through a systematic search of databases and were evaluated for their quality.

RESULTS

Outcomes were synthesized following a qualitative thematic approach under categories of theoretically driven mechanisms derived from the cognitive-behavioral model: attention, memory and interpretation biases, perceived awareness and inaccuracy in perception of somatic sensations, negativity bias, emotion dysregulation, and behavioral avoidance.

CONCLUSIONS

Findings partly support the cognitive-behavioral model, but several of its hypothetical mechanisms only receive weak support due to the scarcity of relevant studies. Directions for future research are suggested based on identified gaps in the existing literature.

Attentional avoidant biases as mediators in the association between experiential avoidance and blood pressure in dementia family caregivers

OBJECTIVES

Experiential avoidance in caregiving (EAC) has been found to be related with dementia family caregivers´ distress and blood pressure (BP). The association between EAC and avoidant attentional biases to emotional stimuli in dementia caregivers, and the potential mediating role of these attentional biases in the association between EAC and increased BP are explored.

METHOD

Seventy nine dementia family caregivers performed a dot-probe task with emotional pictures (distressing and positive) varying in content (general vs. caregiving-related (CR)) and time of exposure (100 vs. 500 ms). They also completed measures of EAC, anxiety, depression, alexithymia and rumination, and their BP was measured.

RESULTS

EAC was associated with avoidant attentional biases to CR emotional pictures and negative pictures in general at 100 ms. Experiential Avoidance in Caregiving Questionnaire (EACQ) 'avoidant behaviors' and EACQ 'intolerance of negativity' factors were associated with diastolic and systolic BP, respectively, with attentional avoidance of CR emotional pictures (distressing and positive, respectively) mediating this association.

CONCLUSION

Attentional avoidance of CR emotional stimuli may be the link between EAC and increased BP, as it prevents emotional processing and facilitates the maintenance of physiological activation. EAC may pose a risk for cardiovascular disease in dementia caregivers.

Continuity and discontinuity in memory for threat

Using a paradigm that allows a quasi-continuous tracking of memory performance over time, two experiments were designed to test the hypotheses that (a) persons with a cognitively avoidant style of coping with threat manifest a dissociation between (intact) short-term and (reduced) long-term retrieval of aversive information and (b) persons with a vigilant coping style recall aversive information particularly well after long retention intervals, provided they are free to think about aversive events. Study 1 (N = 75) showed that avoiders manifest a poor memory for aversive pictures after long retention intervals only. Study 2 (N = 95) replicated this finding. In addition, manipulation of the cognitive load during the retention interval influenced vigilants' recall of aversive information in the predicted way. Results indicate that processes occurring during the retention interval are essential for individual difference in memory for aversive information and require similar attention as encoding, appraisal, and retrieval processes.

An examination of generalized anxiety disorder and dysthymia utilizing the Rorschach inkblot method

This study examined transdiagnostic features of generalized anxiety disorder (GAD) and dysthymia in an outpatient clinical sample. Fifteen patients who met DSM-IV criteria for GAD and twenty-one patients who met DSM-IV criteria for dysthymia but who did not have comorbid anxiety disorder were evaluated utilizing the Rorschach. Salient clinical variables were then compared. Results showed that patients with GAD scored significantly higher on variables related to cognitive agitation and a desire/need for external soothing. In addition, there was a trend for patients with GAD to produce higher scores on a measure of ruminative focus on negative aspects of the self. Thus, not surprisingly, GAD patients' experienced more distress than the dysthymic patients. The implications of these findings are discussed with regards to better understanding the shared and distinct features of GAD and dysthymia.

Population Behavior Patterns in Response to the Risk of Influenza A(H7N9) in Hong Kong, December 2013-February 2014

Background

A novel avian influenza A(H7N9) virus, first identified in Mainland China in February and March 2013, caused an outbreak in humans in April and May, 2013. Closure of live poultry markets in some affected cities dramatically reduced numbers of cases during summer of 2013, but the epidemic resurged during the winter 2013–14, increasing reported cases to 393 in Mainland China as of 30 March 2014.

Purpose

The study aimed to explore population behavior patterns responding to an epidemic of influenza A(H7N9) virus.

Method

Three cross-sectional surveys were conducted among 1000, 680, and 1011 respondents in December 2013, January 2014, and February 2014, with response rates of 68.0, 64.4, and 66.6 %, respectively, in Hong Kong. Adults were recruited and interviewed using random digit-dialing telephone survey. Latent class analysis was employed to explore heterogeneity in protective behavior patterns across the three surveys. Multinomial regression models were developed to determine factors associated with latent class membership.

Results

Three comparable latent classes were identified across the three surveys: Moderate hygiene compliance (Class 1), High hygiene compliance (Class 2), and Vigilance (Class 3). The prevalence of Class 1 was 48–52 % across the three surveys while Class 3 prevalence increased significantly from 13 % in the Dec-2013 survey to 20 % in the Feb-2014 survey. Compared with Class 1, Class 3 were more likely to be female, older, better educated, married, perceive higher susceptibility to H7N9, attribute greater severity to H7N9, report higher current worry, and anticipated worry about H7N9 infection.

Conclusion

The three classes reflect different levels of adoption of protection and thereby may have different levels of vulnerability toward contracting H7N9 infection. It appears that as the epidemic intensifies, Class 2 (Good hygiene compliance) members are likely to transfer to Class 3 (Vigilance) while Class 1 (Moderate hygiene compliance) could be unchanged. The young, mostly single males and those with lower educational achievement represent a group for whom public health messages need to be targeted.

Personality Type Influences Attentional Bias in Individuals with Chronic Back Pain

Attentional biases reflect an individual's selective attention to salient stimuli within their environment, for example an experience of back pain. Eysenck suggests that different personality types show different attentional biases to threatening information. This study is the first to test Eysenck's theory within a chronic back pain population by investigating the attentional biases of four different personality types using a back pain specific dot-probe paradigm. Participants were 70 volunteers (45 female) recruited from a back rehabilitation program at an NHS Trust. The four groups were selected on their trait anxiety and defensiveness scores: defensive high-anxious; high-anxious; repressor and non-extreme. Participants completed a dot probe task comprising 20 practice trials and 250 experimental trials. The experimental trials contained 100 threat-neutral pairs, 100 positive-neutral pairs and 50 neutral-neutral image pairings. The threat images were taken from the Photograph Series of Daily Activities (PHODA) and the neutral and positive images from the International Affective Picture System (IAPS) image bank. The results provided partial support for Eysenck's theory; defensive high-anxious individuals showed an attentional bias for threatening information compared to high-anxious individuals who demonstrated no bias. Repressors showed an avoidant bias to threatening images and an attentional bias to positive stimuli relative to neutral images. The clear difference in responses demonstrated by high-anxious individuals who vary in defensiveness highlight the need for separate investigation of these heterogeneous groups and help to explain the cognitive processes of defensive high-anxious individuals within a pain population. The demonstration of an attentional bias in this group to threatening information could explain why defensive high-anxious individuals are more likely to re-present for treatment.

Adult attachment orientation and automatic processing of emotional information on a semantic level: A masked affective priming study

Early adverse social experiences leading to attachment insecurity could cause heightened sensitivity to emotional information. Automatic processing of emotional stimuli conveys information about positive-negative differentiation and the so-called possessor vs. other-relevance of valence. The aim of the present study was to examine automatic processing of emotional and relevance type information on a semantic level as a function of adult attachment avoidance and anxiety. A masked affective priming task, varying valence and relevance of prime and target adjectives, was presented to a sample of 153 healthy adults. The Experiences in Close Relationships scale was administered to assess attachment orientation. Significant priming effects for valence and relevance were observed. Attachment avoidance, but not attachment anxiety, was significantly related to affective priming independently of trait anxiety and depression. Specifically, attachment avoidance was found to be related to affective priming effects based on other-relevant words. It can be concluded that automatic processing of emotional adjectives used to characterize safe or risky social environments is heightened in avoidant individuals. The avoidantly attached processing style has similarities with repressive coping, which is characterized by an enhanced early response to emotion stimuli followed by avoidant biases at a controlled processing level.

Rethinking Social Desirability Scales: From Impression Management to Interpersonally Oriented Self-Control

Social desirability (specifically, impression management) scales are widely used by researchers and practitioners to screen individuals who bias self-reports in a self-favoring manner. These scales also serve to identify individuals at risk for psychological and health problems. The present review explores the evidence with regard to the ability of these scales to achieve these objectives. In the first part of the review, I present six criteria to evaluate impression management scales and conclude that they are unsatisfactory as measures of response style. Next, I explore what individual differences in impression management scores actually do measure. I compare two approaches: a defensiveness approach, which argues that these scales measure defensiveness that stems from vulnerable self-esteem, and an adjustment approach, which suggests that impression management is associated with personal well-being and interpersonal adjustment. Data from a wide variety of fields including social behavior, affect and well-being, health, and job performance tend to favor the adjustment approach. Finally, I argue that scales measuring impression management should be redefined as measures of interpersonally oriented self-control that identify individuals who demonstrate high levels of self-control, especially in social contexts.

The relationship between two types of impaired emotion processing: repressive coping and alexithymia

The constructs of repressive coping and alexithymia are both related to impaired emotion processing, yet individuals with a repressive coping style (repressors) score lower than controls on standard self-report measures of alexithymia. A large body of evidence indicates that repressors avoid negative affect. Therefore, the current study examined the relationship between repressive coping and alexithymia by using independently-rated interviews with the aim of bypassing repressors’ tendency of avoiding negative affect. Results showed that repressors scored high on alexithymia, similar to anxious individuals on the independently-rated interview, but scored low on alexithymia on a questionnaire measure. Our findings confirm a link between alexithymia and repressive coping and stress the need for non-standard measures in exploring the nature of the relationship between repressive coping and alexithymia.

Increased skin conductance responses and neural activity during fear conditioning are associated with a repressive coping style

The investigation of individual differences in coping styles in response to fear conditioning is an important issue for a better understanding of the etiology and treatment of psychiatric disorders. It has been assumed that an avoidant (repressive) coping style is characterized by increased emotion regulation efforts in context of fear stimuli as compared to a more vigilant coping style. However, no study so far has investigated the neural correlates of fear conditioning of repressors and sensitizers. In the present fMRI study, 76 participants were classified as repressors or as sensitizers and were exposed to a fear conditioning paradigm, in which the CS+ predicted electrical stimulation, while another neutral stimulus (CS-) did not. In addition, skin conductance responses (SCRs) were measured continuously. As the main findings, we found increased neural activity in repressors as compared to sensitizers in the ventromedial prefrontal cortex and the anterior cingulate cortex (ACC) during fear conditioning. In addition, elevated activity to the CS+ in amygdala, insula, occipital, and orbitofrontal cortex (OFC) as well as elevated conditioned SCRs were found in repressors. The present results demonstrate increased neural activations in structures linked to emotion down-regulation mechanisms like the ventromedial prefrontal cortex, which may reflect the increased coping effort in repressors. At the same time, repressors showed increased activations in arousal and evaluation-associated structures like the amygdala, the occipital cortex (OCC), and the OFC, which was mirrored in increased SCRs. The present results support recent assumptions about a two-process model of repression postulating a fast vigilant response to fear stimuli, and a second process associated with the down-regulation of emotional responses.