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Yue P, An Z, Lin R. How do "words poorly expressed emotion" affect mental health? The mediating role of affect labelling effect. Cogn Emot 2024:1-16. [PMID: 38837896 DOI: 10.1080/02699931.2024.2362377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
Previous studies have found that people with high negative emotional granularity(NEG) tend to have better health levels. It is generally believed that this is due to the selection and application of explicit emotion regulation strategies that affect mental health. However, no research has yet examined a more fundamental process, the role of affect labelling, an implicit emotion regulation strategy. This study focuses on the aforementioned issues and uses the experience sampling method to categorise participants into groups with high and low NEG. Using an affect labelling paradigm with ERP(event-related potential) technology, the study measures the effects of affect labelling in participants. Furthermore, it assesses the mental health levels of the participants through questionnaires to explore whether the affect labelling effect serves as a mediator between NEG and mental health. The results show that: (1) The high-NEG group exhibited significantly lower LPP wave amplitudes under affect labelling compared to under non-affect labelling, whereas the low-NEG group did not show significant differences. The results indicate that only the high-NEG group can produce the affect labelling effect. (2) The affect labelling effect mediates the relationship between NEG and mental health, meaning that NEG predicts mental health through the affect labelling effect.
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Affiliation(s)
- Pengfei Yue
- School of Education Science, Hubei Normal University, Huangshi, People's Republic of China
| | - Zhou An
- School of Education Science, Xinyang Normal University, Xinyang, People's Republic of China
| | - Ruxin Lin
- School of Education Science, Xinyang Normal University, Xinyang, People's Republic of China
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2
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Wang HY, Li LZ, Chang Y, Pang XM, Zhang BW. Impaired implicit emotion regulation in patients with panic disorder: An event-related potential study on affect labeling. World J Psychiatry 2024; 14:234-244. [PMID: 38464769 PMCID: PMC10921280 DOI: 10.5498/wjp.v14.i2.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Panic disorder (PD) involves emotion dysregulation, but its underlying mechanisms remain poorly understood. Previous research suggests that implicit emotion regulation may play a central role in PD-related emotion dysregulation and symptom maintenance. However, there is a lack of studies exploring the neural mechanisms of implicit emotion regulation in PD using neurophysiological indicators. AIM To study the neural mechanisms of implicit emotion regulation in PD with event-related potentials (ERP). METHODS A total of 25 PD patients and 20 healthy controls (HC) underwent clinical eva-luations. The study utilized a case-control design with random sampling, selecting participants for the case group from March to December 2018. Participants performed an affect labeling task, using affect labeling as the experimental condition and gender labeling as the control condition. ERP and behavioral data were recorded to compare the late positive potential (LPP) within and between the groups. RESULTS Both PD and HC groups showed longer reaction times and decreased accuracy under the affect labeling. In the HC group, late LPP amplitudes exhibited a dynamic pattern of initial increase followed by decrease. Importantly, a significant group × condition interaction effect was observed. Simple effect analysis revealed a reduction in the differences of late LPP amplitudes between the affect labeling and gender labeling conditions in the PD group compared to the HC group. Furthermore, among PD patients under the affect labeling, the late LPP was negatively correlated with disease severity, symptom frequency, and intensity. CONCLUSION PD patients demonstrate abnormalities in implicit emotion regulation, hampering their ability to mobilize cognitive resources for downregulating negative emotions. The late LPP amplitude in response to affect labeling may serve as a potentially valuable clinical indicator of PD severity.
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Affiliation(s)
- Hai-Yang Wang
- Department of Neurology, Jining No. 1 People's Hospital, Shandong First Medical University, Jining 272000, Shandong Province, China
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Li-Zhu Li
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
- Department of Neurology, Sixth Peoples' Hospital of Shenyang, Shenyang 110003, Liaoning Province, China
| | - Yi Chang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Xiao-Mei Pang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Bing-Wei Zhang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
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Petell JA, Bilsky SA. An Examination of the Association between Emotion Regulation and Emetophobia Symptoms. Psychol Rep 2023:332941231213855. [PMID: 37934134 DOI: 10.1177/00332941231213855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
BACKGROUND Specific phobia of vomiting, referred to as emetophobia, is a specific phobia characterized by persistent and severe fear of vomit. Individuals with emetophobia engage in a variety of emotional and behavioral avoidance strategies to distance themselves from perceived vomit-related threat. As such, individuals may struggle to effectively use emotion regulation (ER) skills; however, to date, limited work has examined the association between emotion regulation and emetophobia symptoms. The present study aimed to address this gap in the literature and examine the association between ER and emetophobia symptoms. METHODS Participants (N = 508) were a remote, clinical sample of individuals recruited via social media forums dedicated to the disorder who self-identified as experiencing emetophobia. Hierarchical linear regressions were used to assessed unique contributions of ER to emetophobia symptoms. Age, gender, and depressive symptoms were entered as covariates in the hierarchical regression. RESULTS Results demonstrated ER was significantly related to emetophobia symptoms above and beyond the effects of depressive symptoms, age and gender in the current sample. CONCLUSIONS The findings provide initial support for an association between ER and emetophobia, and suggest future directions for refining the conceptualization of emetophobia. Limitations and considerations include the recruitment strategy via social media websites for individuals with emetophobia, limited diversity of the sample, and cross-sectional nature.
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Affiliation(s)
- Jennifer A Petell
- Department of Psychology, University of Mississippi, University, MS, USA
| | - Sarah A Bilsky
- Department of Psychology, University of Mississippi, University, MS, USA
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Zsido AN, Lang A, Labadi B, Deak A. Phobia-specific patterns of cognitive emotion regulation strategies. Sci Rep 2023; 13:6105. [PMID: 37055493 PMCID: PMC10102078 DOI: 10.1038/s41598-023-33395-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/12/2023] [Indexed: 04/15/2023] Open
Abstract
Although fear plays a vital role in survival, an overly active threat detection system could be maladaptive due to its negative health consequences. Putatively maladaptive emotion regulation (ER) strategies are a core problem in phobias. In contrast, adaptive ER strategies could help downregulate the emotion elicited by a threatening stimulus and decrease anxiety. Yet, the number of studies directly examining the pattern of ER strategies linked to various phobias is still scarce. Thus, this study sought to map the patterns of adaptive and maladaptive ER strategies linked to the three most common phobias (social, animal, and blood-injection-injury [BII]). A total of 856 healthy participants filled out our survey including self-reported measures of social anxiety, snake-, spider-, BII phobia, and cognitive ER strategies. Structural equation modeling was used to test the effects between the variables. The results show that social anxiety and animal phobia were linked to both adaptive and maladaptive ER strategies, while BII was only associated with maladaptive ones. Further analyses showed that the most prominent ER strategies differed by subtype. This is in line with previous neuroimaging studies claiming that the neurocognitive mechanisms underlying phobias are also different. Theoretical as well as practical implications are discussed.
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Affiliation(s)
- Andras N Zsido
- Institute of Psychology, University of Pécs, 6 Ifjusag Street, Pécs, Baranya, 7624, Hungary.
- Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
| | - Andras Lang
- Institute of Psychology, University of Pécs, 6 Ifjusag Street, Pécs, Baranya, 7624, Hungary
| | - Beatrix Labadi
- Institute of Psychology, University of Pécs, 6 Ifjusag Street, Pécs, Baranya, 7624, Hungary
| | - Anita Deak
- Institute of Psychology, University of Pécs, 6 Ifjusag Street, Pécs, Baranya, 7624, Hungary
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Barberis N, Cannavò M, Trovato M, Verrastro V. Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem. J Affect Disord 2023; 331:362-368. [PMID: 36906111 DOI: 10.1016/j.jad.2023.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. METHODS Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. RESULTS Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LIMITATIONS The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DISCUSSION These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.
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Affiliation(s)
- Nadia Barberis
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Marco Cannavò
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Mariachiara Trovato
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Valeria Verrastro
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
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Sindermann L, Leehr EJ, Redlich R, Meinert S, Böhnlein J, Grotegerd D, Pollack D, Reepen M, Thiel K, Winter A, Waltemate L, Lemke H, Enneking V, Borgers T, Opel N, Repple J, Goltermann J, Brosch K, Meller T, Pfarr JK, Ringwald KG, Schmitt S, Stein F, Jansen A, Krug A, Nenadić I, Kircher T, Dannlowski U. Emotion processing in depression with and without comorbid anxiety disorder. J Affect Disord 2022; 314:133-142. [PMID: 35803393 DOI: 10.1016/j.jad.2022.06.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Among mental disorders, major depressive disorder (MDD) is highly prevalent and associated with emotional dysfunctions linked to activity alterations in the brain, mainly in prefrontal regions, the insula, the anterior cingulate cortex and the amygdala. However, this evidence is heterogeneous, perhaps because magnetic resonance imaging (MRI) studies on MDD tend to neglect comorbid anxiety (COM-A). METHODS To address this, here a sample of age- and sex-matched patients, nMDD = 90 and nCOM-A = 85, underwent functional MRI to assess neurofunctional group differences during a negative emotional face-matching task using a hypothesis-driven region of interest approach (dorsolateral prefrontal cortex, insula, anterior cingulate cortex, amygdala) and an explorative whole-brain approach. We also assessed these relationships with state-trait anxiety measures, a state depression measure, general functioning and medication load. RESULTS During face processing, COM-A (compared to MDD) had significantly increased bilateral insula activity. No activity differences were found in the anterior cingulate cortex or the amygdala. Whole-brain analyses revealed increased inferior temporal activation and frontal activation (comprising the inferior and middle frontal gyrus) in COM-A that was positively linked to state anxiety as well as general functioning across groups. LIMITATIONS Still, the lack of a healthy control and small effects mean this study should be replicated to further interpret the results. CONCLUSIONS The findings highlight a discriminative activation pattern between MDD and COM-A regarding emotion processing and may present a correlate of potentially anxiety-related psychopathology. In future, further investigations in potential discriminative activity patterns could help to elucidate the origin, development and treatment of depression.
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Affiliation(s)
- Lisa Sindermann
- Institute of Human Genetics, University of Bonn, Germany; Institute for Translational Psychiatry, University of Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Germany; Institute of Psychology, Martin-Luther University of Halle, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Germany; Institute for Translational Neuroscience, University of Münster, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Daniel Pollack
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Marieke Reepen
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | | | | | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany.
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Sindermann L, Redlich R, Opel N, Böhnlein J, Dannlowski U, Leehr EJ. Systematic transdiagnostic review of magnetic-resonance imaging results: Depression, anxiety disorders and their co-occurrence. J Psychiatr Res 2021; 142:226-239. [PMID: 34388482 DOI: 10.1016/j.jpsychires.2021.07.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and anxiety disorders (ANX) share core symptoms such as negative affect and often co-exist. Magnetic-resonance imaging (MRI) research suggests shared neuroanatomical/neurofunctional underpinnings. So far, studies considering transdiagnostic and disorder-specific neural alterations in MDD and ANX as well as the comorbid condition (COM) have not been reviewed systematically. METHODS Following PRISMA guidelines, the literature was screened and N = 247 articles were checked according to the PICOS criteria: MRI studies investigating transdiagnostic (across MDD, ANX, COM compared to healthy controls) and/or disorder-specific (between MDD, ANX, COM) neural alterations. N = 35, thereof n = 13 structural MRI and diffusion-tensor imaging studies and n = 22 functional MRI studies investigating emotional, cognitive deficits and resting state were included and quality coded. RESULTS Results indicated transdiagnostic structural/functional alterations in the orbitofrontal cortex/middle frontal cortex and in limbic regions (amygdala, cingulum, hippocampus). Few and inconsistent disorder-specific alterations were reported. However, depression-specific functional alterations were reported for the inferior frontal gyrus and dorsolateral prefrontal cortex during emotional tasks, and limbic regions at rest. Preliminary results for anxiety-specific functional alterations were found in the insula and frontal regions during emotional tasks, in the inferior parietal lobule, superior frontal gyrus and superior temporal gyrus during cognitive tasks, and (para)limbic alterations at rest. CONCLUSIONS This review provides evidence to support existing transdiagnostic fronto-limbic neural models in MDD and ANX. On top, it expands existing knowledge taking into account comorbidity and comparing MDD with ANX. Heterogeneous evidence exists for disorder-specific alterations. Research focusing on ANX sub-types, and the consideration of COM would contribute to a better understanding of basic neural underpinnings.
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Affiliation(s)
- Lisa Sindermann
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany; Department of Psychiatry, University of Halle, Emil-Abderhalden-Str. 26-27, 06108, Halle, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany
| | - Elisabeth Johanna Leehr
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany
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Effects of Mindfulness Training on Emotion Regulation in Patients With Depression: Reduced Dorsolateral Prefrontal Cortex Activation Indexes Early Beneficial Changes. Psychosom Med 2021; 83:579-591. [PMID: 34213860 DOI: 10.1097/psy.0000000000000955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Mindfulness-based interventions (MBIs) have been found to be a promising approach for the treatment of recurrent courses of depression. However, little is known about their neural mechanisms. This functional magnetic resonance imaging study set out to investigate activation changes in corticolimbic regions during implicit emotion regulation. METHODS Depressed patients with a recurrent lifetime history were randomized to receive a 2-week MBI (n = 16 completers) or psychoeducation and resting (PER; n = 22 completers). Before and after, patients underwent functional magnetic resonance imaging while labeling the affect of angry, happy, and neutral facial expressions and completed questionnaires assessing ruminative brooding, the ability to decenter from such thinking, and depressive symptoms. RESULTS Activation decreased in the right dorsolateral prefrontal cortex (dlPFC) in response to angry faces after MBI (p < .01, voxel-wise family-wise error rate correction, T > 3.282; 56 mm3; Montreal Neurological Institute peak coordinate: 32, 24, 40), but not after PER. This change was highly correlated with increased decentring (r = -0.52, p = .033), decreased brooding (r = 0.60, p = .010), and decreased symptoms (r = 0.82, p = .005). Amygdala activation in response to happy faces decreased after PER (p < .01, family-wise error rate corrected; 392 mm3; Montreal Neurological Institute peak coordinate: 28, -4, -16), whereas the MBI group showed no significant change. CONCLUSIONS The dlPFC is involved in emotion regulation, namely, reappraisal or suppression of negative emotions. Decreased right dlPFC activation might indicate that, after the MBI, patients abstained from engaging in elaboration or suppression of negative affective stimuli; a putatively important mechanism for preventing the escalation of negative mood.Trial Registration: The study is registered at ClinicalTrials.gov (NCT02801513; 16/06/2016).
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Dricu M, Frühholz S. A neurocognitive model of perceptual decision-making on emotional signals. Hum Brain Mapp 2020; 41:1532-1556. [PMID: 31868310 PMCID: PMC7267943 DOI: 10.1002/hbm.24893] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/18/2019] [Accepted: 11/29/2019] [Indexed: 01/09/2023] Open
Abstract
Humans make various kinds of decisions about which emotions they perceive from others. Although it might seem like a split-second phenomenon, deliberating over which emotions we perceive unfolds across several stages of decisional processing. Neurocognitive models of general perception postulate that our brain first extracts sensory information about the world then integrates these data into a percept and lastly interprets it. The aim of the present study was to build an evidence-based neurocognitive model of perceptual decision-making on others' emotions. We conducted a series of meta-analyses of neuroimaging data spanning 30 years on the explicit evaluations of others' emotional expressions. We find that emotion perception is rather an umbrella term for various perception paradigms, each with distinct neural structures that underline task-related cognitive demands. Furthermore, the left amygdala was responsive across all classes of decisional paradigms, regardless of task-related demands. Based on these observations, we propose a neurocognitive model that outlines the information flow in the brain needed for a successful evaluation of and decisions on other individuals' emotions. HIGHLIGHTS: Emotion classification involves heterogeneous perception and decision-making tasks Decision-making processes on emotions rarely covered by existing emotions theories We propose an evidence-based neuro-cognitive model of decision-making on emotions Bilateral brain processes for nonverbal decisions, left brain processes for verbal decisions Left amygdala involved in any kind of decision on emotions.
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Affiliation(s)
- Mihai Dricu
- Department of PsychologyUniversity of BernBernSwitzerland
| | - Sascha Frühholz
- Cognitive and Affective Neuroscience Unit, Department of PsychologyUniversity of ZurichZurichSwitzerland
- Neuroscience Center Zurich (ZNZ)University of Zurich and ETH ZurichZurichSwitzerland
- Center for Integrative Human Physiology (ZIHP)University of ZurichZurichSwitzerland
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Changes in functional connectivity with cognitive behavioral therapy for social anxiety disorder predict outcomes at follow-up. Behav Res Ther 2020; 129:103612. [PMID: 32276238 DOI: 10.1016/j.brat.2020.103612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 01/27/2023]
Abstract
Approximately half of individuals with Social Anxiety Disorder (SAD) treated with psychological intervention do not achieve clinically significant improvement or retain long-term gains. Neurobiological models of SAD propose that disruptions in functioning of amygdala-prefrontal circuitry is implicated in short-term treatment response. However, whether treatment-related changes in functional connectivity predict long-term well-being after psychotherapy is unknown. Patients with SAD completed an incidental emotion regulation task during fMRI before and after treatment with cognitive behavioral therapy or acceptance and commitment therapy (n = 23, collapsed across groups). Psychophysiological interaction analyses using amygdala seed regions were conducted to assess changes in functional connectivity from pre-to post-treatment that predicted symptom change from 6 to 12-month follow-up. Negative change (i.e., greater inverse/weaker positive) in amygdala connectivity with the dorsomedial prefrontal cortex (dmPFC) and dorsal anterior cingulate cortex (dACC) predicted greater symptom reduction during follow-up. Positive change in amygdala connectivity with the cerebellum, fusiform gyrus, and pre-central and post-central gyri predicted less symptom reduction (e.g., no change or worsening). Results suggest that strengthened amygdala connectivity with regulatory regions may promote better long-term outcomes, whereas changes with visual and sensorimotor regions may represent sensitization to emotion-related cues, conferring poorer outcomes. Clinical implications for treatment personalization are discussed, should effects replicate in larger samples.
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Tabak BA, Young KS, Torre JB, Way BM, Burklund LJ, Eisenberger NI, Lieberman MD, Craske MG. Preliminary Evidence That CD38 Moderates the Association of Neuroticism on Amygdala-Subgenual Cingulate Connectivity. Front Neurosci 2020; 14:11. [PMID: 32116489 PMCID: PMC7033443 DOI: 10.3389/fnins.2020.00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/08/2020] [Indexed: 11/15/2022] Open
Abstract
CD38 genetic variation has been associated with autism spectrum disorders and social anxiety disorder, which may result from CD38’s regulation of oxytocin secretion. Converging evidence has found that the rs3796863 A-allele contributes to increased social sensitivity compared to the CC genotype. The current study examined the moderating role of CD38 genetic variants (rs3796863 and rs6449182) that have been associated with enhanced (or reduced) social sensitivity on neural activation related to neuroticism, which is commonly elevated in individuals with social anxiety and depression. Adults (n = 72) with varying levels of social anxiety and depression provided biological samples for DNA extraction, completed a measure of neuroticism, and participated in a standardized emotion processing task (affect matching) while undergoing fMRI. A significant interaction effect was found for rs3796863 x neuroticism that predicted right amygdala-subgenual anterior cingulate cortex (sgACC) functional connectivity. Simple slopes analyses showed a positive association between neuroticism and right amygdala-sgACC connectivity among rs3796863 A-allele carriers. Findings suggest that the more socially sensitive rs3796863 A-allele may partially explain the relationship between a known risk factor (i.e. neuroticism) and promising biomarker (i.e. amygdala-sgACC connectivity) in the development and maintenance of social anxiety and depression.
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Affiliation(s)
- Benjamin A Tabak
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Katherine S Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jared B Torre
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Baldwin M Way
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Lisa J Burklund
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Naomi I Eisenberger
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Matthew D Lieberman
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
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Depressive Suppression: Effects of Emotion Suppression on Multiple Emotions for Depressed Versus Nondepressed Individuals. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Use your words: The role of emotion labeling in regulating emotion in borderline personality disorder. Behav Res Ther 2019; 120:103447. [PMID: 31374483 DOI: 10.1016/j.brat.2019.103447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/13/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022]
Abstract
Borderline personality disorder (BPD) treatments emphasize emotion labeling to decrease negative emotion and facilitate emotion regulation. However, no studies have examined emotion labeling in BPD or its impact on intentional emotion regulation. The present study examined the impact of emotion labeling on emotion and intentional emotion regulation attempts across self-reported and physiological indices (i.e., skin conductance response [SCR], respiratory sinus arrhythmia [RSA]) in BPD and healthy control (HC) groups. Participants listened to emotionally-evocative scripts and were either instructed to type the emotions that they were experiencing (labeling) or the objects they could imagine seeing in the script (control) into a computer. Following this, they were instructed to use either mindfulness or cognitive reappraisal to decrease their emotion. Self-reported, RSA, and SCR indices of negative emotion were collected throughout and analyzed using generalized estimating equations. Findings indicated that the BPD group experienced higher RSA during emotion labeling compared to the control task, but the HC group did not. HCs reported lower negative emotion after emotion labeling when implementing both emotion regulation strategies compared to the control task, but the BPD group did not. These findings suggest that emotion labeling may activate emotion regulatory systems in BPD and can potentiate intentional emotion regulation in HCs.
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Guex R, Hofstetter C, Domínguez-Borràs J, Méndez-Bértolo C, Sterpenich V, Spinelli L, Seeck M, Vuilleumier P. Neurophysiological evidence for early modulation of amygdala activity by emotional reappraisal. Biol Psychol 2019; 145:211-223. [DOI: 10.1016/j.biopsycho.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 01/27/2023]
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15
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Brown LA, Young KS, Goldin PR, Torre JB, Burklund LJ, Davies CD, Niles AN, Lieberman MD, Saxbe DE, Craske MG. Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation. Psychiatry Res Neuroimaging 2019; 284:13-20. [PMID: 30622047 PMCID: PMC6415528 DOI: 10.1016/j.pscychresns.2018.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 01/08/2023]
Abstract
Self-referential processing is critical to understanding social anxiety disorder (SAD). This study examined neural differences in self-referential processing in healthy controls (HC) and participants with SAD at pre- and post-treatment. Participants (n = 64) underwent fMRI scanning while viewing a video of themselves ("Self") or another person ("Other"). SAD participants were randomized to cognitive behavior therapy (CBT), acceptance and commitment therapy (ACT), or waitlist, and were re-scanned at post-treatment. In SAD vs. HC, the fusiform face area (FFA) showed significantly more activation during Self vs. Other, and greater SAD severity was associated with significantly more activation during Self vs. Other in the right FFA and the left extrastriate body area (EBA). Greater reduction in SAD severity was associated with stronger connectivity between the amygdala and FFA during Self vs. Other at post-treatment, whereas the strength of connectivity during Self and Other was comparable at post-treatment for those with less SAD reduction. Thus, there were significant differences in activation and functional connectivity of brain regions implicated in self-referential processing in SAD. Change in connectivity between the amygdala and FFA were observed as a function of change in SAD severity, suggesting that improvements in SAD severity may correct this altered functional connectivity.
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Affiliation(s)
- Lily A Brown
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA; Department of Psychiatry, University of Pennsylvania, 3535 Market Street Suite 600 N Philadelphia, PA 19104, USA.
| | - Katherine S Young
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA; Social, Genetic and Development Psychiatry (SGDP) Centre, Institute of Psychology, Psychiatry and Neuroscience, King's College London, UK.
| | - Philippe R Goldin
- Betty Irene Moore School of Nursing, University of California, Davis, 4610 X Street Suite 4202, Sacramento, CA 95817, USA.
| | - Jared B Torre
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
| | - Lisa J Burklund
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA; NeuroGen Technologies, Inc., P.O. Box 775 Burbank, CA 91505, USA.
| | - Carolyn D Davies
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
| | - Andrea N Niles
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
| | - Matthew D Lieberman
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, 3620 South McClintock Avenue, Los Angeles, CA 90089, USA.
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
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Marks EH, Walker RS, Ojalehto H, Bedard-Gilligan MA, Zoellner LA. Affect Labeling to Facilitate Inhibitory Learning: Clinical Considerations. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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17
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Young KS, LeBeau RT, Niles AN, Hsu KJ, Burklund LJ, Mesri B, Saxbe D, Lieberman MD, Craske MG. Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder. J Affect Disord 2019; 242:105-110. [PMID: 30173058 PMCID: PMC6816743 DOI: 10.1016/j.jad.2018.08.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/17/2018] [Accepted: 08/07/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although psychological treatments for social anxiety disorder (SAD) can be highly effective, many individuals do not respond to treatment. Identifying factors associated with improved outcomes can facilitate individualized treatment choices. We investigated whether patterns of neural connectivity predicted treatment responses and whether treatment type, cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), moderated this effect. METHODS Participants with SAD (n = 34) underwent fMRI prior to treatment and completed implicit and explicit emotion regulation tasks. Neural connectivity measures were estimates of amygdala-prefrontal cortex connectivity. Treatment responder status was defined using the 'clinically significant change index' (Loerinc et al., 2015). RESULTS Right amygdala-right ventrolateral prefrontal cortex connectivity during implicit emotion regulation was a significant predictor of treatment response (OR = 9.01, 95% CI = 1.77, 46.0, p = .008). Stronger inverse connectivity was associated with greater likelihood of treatment response. There were no significant neural moderators of treatment response to CBT versus ACT. LIMITATIONS The primary limitation of this work was the small sample size which restricted the power to detect significant moderation effects, and results should be interpreted as preliminary. CONCLUSIONS Amygdala-vlPFC connectivity during affect labeling predicted treatment responder status following CBT or ACT for social anxiety disorder. This suggests that the functioning of neural circuitry supporting emotion regulation capacities may be a 'gateway' to receiving benefit from psychological treatments. Future work should aim to replicate this effect in a larger sample and consider methods for enhancing functional connectivity within this circuitry as a potential treatment adjunct.
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Affiliation(s)
| | | | - Andrea N. Niles
- Department of Psychiatry, University of California, San Francisco
| | | | | | - Bita Mesri
- Department of Psychology, University of California, Los Angeles
| | - Darby Saxbe
- Department of Psychology, University of Southern California
| | | | - Michelle G. Craske
- Department of Psychology, University of California, Los Angeles,Correspondence: Michelle Craske, Department of Psychology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, 310-825-8403,
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Dochnal R, Vetró Á, Kiss E, Baji I, Lefkovics E, Bylsma LM, Yaroslavsky I, Rottenberg J, Kovacs M, Kapornai K. Emotion Regulation Among Adolescents With Pediatric Depression As a Function of Anxiety Comorbidity. Front Psychiatry 2019; 10:722. [PMID: 31649566 PMCID: PMC6790632 DOI: 10.3389/fpsyt.2019.00722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Both depression and anxiety (two of the most common internalizing psychopathologies among youths) are associated with difficulties in emotion regulation (ER). Little is known about whether anxiety as a comorbid condition has an effect on the habitual use of different ER strategies in youngsters with depression histories. We aimed 1) to compare ER in adolescents with histories of childhood onset major depressive disorder (MDD) with and without comorbid anxiety and 2) to examine whether certain ER response clusters (Cognitive, Social, and Behavioral/Physical) characterize comorbid children and adolescents. Methods: We analyzed data on 217 youth (11-18 years old) with depression history: 85 subjects with lifetime anxiety comorbidity (comorbid group) and 132 without lifetime anxiety (non-comorbid group). Psychiatric diagnosis was established by a comprehensive Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-based diagnostic procedure. ER strategies were examined via the self-rated "Feelings and Me" Child version questionnaire (FAM-C). Results: The comorbid group used maladaptive ER strategies significantly more frequently than the non-comorbid youngsters. The Behavioral/Physical and Social ER skills, especially those reflecting social withdrawal and self-harm, were responsible for the higher maladaptive scores. Limitations: Because our study is a cross-sectional analysis, we have no information about the development or the onset of maladaptive ER strategies. Therefore, we were unable to examine whether maladaptive ER was a risk factor or a consequence of the internalizing psychopathology and comorbidity. Conclusions: Comorbid anxiety worsens the impaired use of ER strategies in depression-prone youths. Further longitudinal research is needed to explore the causal role of dysfunctional ER in the development of internalizing psychopathology.
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Affiliation(s)
- Roberta Dochnal
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Ágnes Vetró
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Enikö Kiss
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Ildikó Baji
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Eszter Lefkovics
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Lauren M Bylsma
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ilya Yaroslavsky
- Department of Psychology, Cleveland State University, Cleveland, OH, United States
| | - Jonathan Rottenberg
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Maria Kovacs
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Krisztina Kapornai
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
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20
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Emotion Regulation in Generalized Anxiety and Social Anxiety: Examining the Distinct and Shared Use of Emotion Regulation Strategies. IRANIAN JOURNAL OF PSYCHIATRY 2018; 13:160-167. [PMID: 30319698 PMCID: PMC6178328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective: According to the transdiagnostic view, emotion regulation strategies are common among emotional disorders. Despite the vast majority of studies demonstrating the common role of emotion regulation strategies in emotional disorders including generalized anxiety disorder (GAD) and social anxiety disorder (SAD), distinct functions of these strategies are largely unknown. So, the aim of the present study was to assess the distinct and shared use of emotion regulation strategies in individuals with GAD and SAD symptoms. Method : Participants were recruited from a community sample of Tehran using purposive sampling method. The sample (N = 346) consisted of 269 nonclinical individuals, 47 individuals with generalized anxiety symptoms, and 30 individuals with social anxiety symptoms. Informed consent was obtained from all the participants and they were asked to fill in a series of self -report questionnaires including GAD-IV, SIAS, DERS, EQ, ACS, and RRS. Data were analyzed by discriminant function analysis using SPSS-23. Results: Findings revealed significant differences between the 3 groups in non-acceptance, focusing, shifting, brooding, and decentering (P<0.01). Results of discriminant function analysis showed 2 functions: the first accounted for 87.4% of the variance (Wilk`s Lambda = 0.81, df = 10, P<0.01, χ2 = 70.06), and the second for 12.6% of the variance (Wilk`s Lambda = 0.97, df = 4, P<0.05, χ2 = 9.43) of between group variability. Non-acceptance and focusing discriminated GAD and SAD the most. Conclusion: The findings of the present study support both splitter and lumper approaches as there were some emotion regulation strategies common between GAD and SAD, including shifting, decentering, and brooding. However, some of them were distinct, such as focusing and non-acceptance. Nevertheless, there are still inconsistencies in research about the findings, and thus examining the pathways may illuminate these findings.
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21
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Torre JB, Lieberman MD. Putting Feelings Into Words: Affect Labeling as Implicit Emotion Regulation. EMOTION REVIEW 2018. [DOI: 10.1177/1754073917742706] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Putting feelings into words, or “affect labeling,” can attenuate our emotional experiences. However, unlike explicit emotion regulation techniques, affect labeling may not even feel like a regulatory process as it occurs. Nevertheless, research investigating affect labeling has found it produces a pattern of effects like those seen during explicit emotion regulation, suggesting affect labeling is a form of implicit emotion regulation. In this review, we will outline research on affect labeling, comparing it to reappraisal, a form of explicit emotion regulation, along four major domains of effects—experiential, autonomic, neural, and behavioral—that establish it as a form of implicit emotion regulation. This review will then speculate on possible mechanisms driving affect labeling effects and other remaining unanswered questions.
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22
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Craske MG, Hermans D, Vervliet B. State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170025. [PMID: 29352025 PMCID: PMC5790824 DOI: 10.1098/rstb.2017.0025] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 01/10/2023] Open
Abstract
Through advances in both basic and clinical scientific research, Pavlovian fear conditioning and extinction have become an exemplary translational model for understanding and treating anxiety disorders. Discoveries in associative and neurobiological mechanisms underlying extinction have informed techniques for optimizing exposure therapy that enhance the formation of inhibitory associations and their consolidation and retrieval over time and context. Strategies that enhance formation include maximizing prediction-error correction by violating expectancies, deepened extinction, occasional reinforced extinction, attentional control and removal of safety signals/behaviours. Strategies that enhance consolidation include pharmacological agonists of NMDA (i.e. d-cycloserine) and mental rehearsal. Strategies that enhance retrieval include multiple contexts, retrieval cues, and pharmacological blockade of contextual encoding. Stimulus variability and positive affect are posited to influence the formation and the retrieval of inhibitory associations. Inhibitory regulation through affect labelling is considered a complement to extinction. The translational value of extinction will be increased by more investigation of elements central to extinction itself, such as extinction generalization, and interactions with other learning processes, such as instrumental avoidance reward learning, and with other clinically relevant cognitive-emotional processes, such as self-efficacy, threat appraisal and emotion regulation, will add translational value. Moreover, framing fear extinction and related processes within a developmental context will increase their clinical relevance.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA, USA
| | - Dirk Hermans
- Center for Excellence on Generalization, University of Leuven, Leuven, Belgium
| | - Bram Vervliet
- Center for Excellence on Generalization, University of Leuven, Leuven, Belgium
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23
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Rabany L, Diefenbach GJ, Bragdon LB, Pittman BP, Zertuche L, Tolin DF, Goethe JW, Assaf M. Resting-State Functional Connectivity in Generalized Anxiety Disorder and Social Anxiety Disorder: Evidence for a Dimensional Approach. Brain Connect 2018; 7:289-298. [PMID: 28478685 DOI: 10.1089/brain.2017.0497] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are currently considered distinct diagnostic categories. Accumulating data suggest the study of anxiety disorders may benefit from the use of dimensional conceptualizations. One such dimension of shared dysfunction is emotion regulation (ER). The current study evaluated dimensional (ER) and categorical (diagnosis) neurocorrelates of resting-state functional connectivity (rsFC) in participants with GAD and SAD and healthy controls (HC). Functional magnetic resonance imaging (fMRI) rsFC was estimated between all regions of the default mode network (DMN), salience network (SN), and bilateral amygdala (N = 37: HC-19; GAD-10; SAD-8). Thereafter, rsFC was predicted by both ER, (using the Difficulties in Emotion Regulation Scale [DERS]), and diagnosis (DSM-5) within a single unified analysis of covariance (ANCOVA). For the ER dimension, there was a significant association between impaired ER abilities and anticorrelated rsFC of amygdala and DMN (L.amygdala-ACC: p = 0.011, beta = -0.345), as well as amygdala and SN (L.amygdala-posterior cingulate cortex [PCC]: p = 0.032, beta = -0.409). Diagnostic status was significantly associated with rsFC differences between the SAD and HC groups, both within the DMN (PCC-MPFC: p = 0.009) and between the DMN and SN (R.LP-ACC: p = 0.010). Although preliminary, our results exemplify the potential contribution of the dimensional approach to the study of GAD and SAD and support a combined categorical and dimensional model of rsFC of anxiety disorders.
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Affiliation(s)
- Liron Rabany
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut
| | - Gretchen J Diefenbach
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
| | - Laura B Bragdon
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut
| | - Brian P Pittman
- 3 Yale University School of Medicine , New Haven, Connecticut
| | - Luis Zertuche
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut
| | - David F Tolin
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
| | - John W Goethe
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut
| | - Michal Assaf
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
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Abstract
The theme of the Association for Behavioral and Cognitive Therapies (ABCT) 50th Anniversary was to honor the past and envision the future. From the wisdom, foresight, and determination of the pioneers of our organization, and the continuous upholding of the scientific method over the last 50 years, cognitive behavioral therapy (CBT) has become the most empirically supported psychological treatment for a wide array of mental health problems. Yet, we still have a long way to go. This address outlines a vision for the future of CBT, which involves greater collaborative science, with all minds working together on the same problem, and greater attention to the risk factors and critical processes that underlie psychopathology and explain treatment change. Such knowledge generation can inform the development of new, more efficient and more effective therapies that are tailored with more precision to the needs of each person. Latest technologies provide tools for a precision focus while at the same time increasing the reach of our treatments to the many for whom traditional therapies are unavailable. Our impact will be greatly enhanced by large samples with common methods and measures that inform a precision approach. We have come a long way since ABCT was founded in 1966, and we are poised to make even larger strides in our mission to enhance health and well-being by harnessing science, our major guiding principle.
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Young KS, Burklund LJ, Torre JB, Saxbe D, Lieberman MD, Craske MG. Treatment for social anxiety disorder alters functional connectivity in emotion regulation neural circuitry. Psychiatry Res 2017; 261:44-51. [PMID: 28129555 PMCID: PMC5330298 DOI: 10.1016/j.pscychresns.2017.01.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/05/2017] [Accepted: 01/12/2017] [Indexed: 11/27/2022]
Abstract
Social anxiety disorder (SAD) is characterized at a neurobiological level by disrupted activity in emotion regulation neural circuitry. Previous work has demonstrated amygdala hyperreactivity and disrupted prefrontal responses to social cues in individuals with SAD (Kim et al., 2011). While exposure-based psychological treatments effectively reduce SAD symptoms, not all individuals respond to treatment. Better understanding of the neural mechanisms involved offers the potential to improve treatment efficacy. In this study, we investigated functional connectivity in emotion regulation neural circuitry in a randomized controlled treatment trial for SAD. Participants with SAD underwent fMRI scanning while performing an implicit emotion regulation task prior to treatment (n=62). Following 12 weeks of cognitive behavioral therapy, acceptance and commitment therapy, or wait-list, participants completed a second scan (n=42). Psychophysiological interaction analyses using amygdala seed regions demonstrated differences between SAD and healthy control participants (HC; n=16) in right amygdala-vmPFC connectivity. SAD participants demonstrated more negative amygdala-to-vmPFC connectivity, compared to HC participants, an effect that was correlated with SAD symptom severity. Post-treatment symptom reduction was correlated with altered amygdala-to-vm/vlPFC connectivity, independent of treatment type. Greater symptom reduction was associated with more negative amygdala-to-vm/vlPFC connectivity. These findings suggest that effective psychological treatment for SAD enhances amygdala-prefrontal functional connectivity.
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Affiliation(s)
- Katherine S Young
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA
| | - Lisa J Burklund
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA
| | - Jared B Torre
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA
| | - Darby Saxbe
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Matthew D Lieberman
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA
| | - Michelle G Craske
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA.
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26
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Burklund LJ, Torre JB, Lieberman MD, Taylor SE, Craske MG. Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder. Psychiatry Res 2017; 261:52-64. [PMID: 28129556 PMCID: PMC5435374 DOI: 10.1016/j.pscychresns.2016.12.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/19/2016] [Accepted: 12/27/2016] [Indexed: 02/08/2023]
Abstract
Previous research has often highlighted hyperactivity in emotion regions to simple, static social threat cues in social anxiety disorder (SAD). Investigation of the neurobiology of SAD using more naturalistic paradigms can further reveal underlying mechanisms and how these relate to clinical outcomes. We used fMRI to investigate responses to novel dynamic rejection stimuli in individuals with SAD (N=70) and healthy controls (HC; N=17), and whether these responses predicted treatment outcomes following cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). Both HC and SAD groups reported greater distress to rejection compared to neutral social stimuli. At the neural level, HCs exhibited greater activations in social pain/rejection regions, including dorsal anterior cingulate cortex and anterior insula, to rejection stimuli. The SAD group evidenced a different pattern, with no differences in these rejection regions and relatively greater activations in the amygdala and other regions to neutral stimuli. Greater responses in anterior cingulate cortex and the amygdala to rejection vs. neutral stimuli predicted better CBT outcomes. In contrast, enhanced activity in sensory-focused posterior insula predicted ACT responses.
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Affiliation(s)
- Lisa J Burklund
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States.
| | - Jared B Torre
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Matthew D Lieberman
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Shelley E Taylor
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Michelle G Craske
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
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27
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Crane NA, Jenkins LM, Dion C, Meyers KK, Weldon AL, Gabriel LB, Walker SJ, Hsu DT, Noll DC, Klumpp H, Phan KL, Zubieta JK, Langenecker SA. Comorbid anxiety increases cognitive control activation in Major Depressive Disorder. Depress Anxiety 2016; 33:967-977. [PMID: 27454009 PMCID: PMC5050098 DOI: 10.1002/da.22541] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/31/2016] [Accepted: 06/11/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) and anxiety disorders often co-occur, with poorer treatment response and long-term outcomes. However, little is known about the shared and distinct neural mechanisms of comorbid MDD and anxiety (MDD+Anx). This study examined how MDD and MDD+Anx differentially impact cognitive control. METHODS Eighteen MDD, 29 MDD+Anx, and 54 healthy controls (HC) completed the Parametric Go/No-Go (PGNG) during fMRI, including Target, Commission, and Rejection trials. RESULTS MDD+Anx had more activation in the anterior dorsolateral prefrontal cortex, hippocampus, and caudate during Rejections, and inferior parietal lobule during correct Targets than MDD and HC. During Rejections HC had greater activation in a number of cognitive control regions compared to MDD; in the posterior cingulate compared to MDD+Anx; and in the fusiform gyrus compared to all MDD. During Commissions HC had greater activation in the right inferior frontal gyrus than all MDD. MDD had more activation in the mid-cingulate, inferior parietal lobule, and superior temporal gyrus than MDD+Anx during Commissions. CONCLUSIONS Despite similar performance, MDD and MDD+Anx showed distinct differences in neural mechanisms of cognitive control in relation to each other, as well as some shared differences in relation to HC. The results were consistent with our hypothesis of hypervigilance in MDD+Anx within the cognitive control network, but inconsistent with our hypothesis that there would be greater engagement of salience and emotion network regions. Comorbidity of depression and anxiety may cause increased heterogeneity in study samples, requiring further specificity in detection and measurement of intermediate phenotypes and treatment Targets.
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Affiliation(s)
| | | | | | | | - Anne L. Weldon
- University of Illinois at Chicago,University of Michigan
| | | | - Sara J. Walker
- University of Michigan,Oregon Health and Science University
| | - David T. Hsu
- University of Michigan,State University of New York, Stony Brook
| | | | - Heide Klumpp
- University of Illinois at Chicago,University of Michigan
| | - K. Luan Phan
- University of Illinois at Chicago,University of Michigan,Jesse Brown VA
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Craske M. Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach. VERHALTENSTHERAPIE 2015. [DOI: 10.1159/000381574] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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