Subclinical alexithymia modulates early audio-visual perceptive and attentional event-related potentials

Role of Alexithymia in the Association Between Childhood Abuse and Risk Perception for Sexual Victimization in College Women

Sexual victimization is prevalent among college women with a history of childhood abuse (CA), which some research suggests is linked to impaired risk perception for sexual victimization or difficulties identifying and responding to unwanted sexual advances. Alexithymia is one construct yet to be examined in the association between CA and risk perception for sexual victimization. The purpose of this study was to elucidate the associations between CA, alexithymia, and risk perception for sexual victimization in a sample of college women with a history of CA. Participants included 294 undergraduate women with a history of childhood emotional, physical, and/or sexual abuse (Mage = 20.6, 80.6% White). An a priori path analysis was conducted to examine whether alexithymia indirectly explains the association between CA and risk perception for sexual victimization (i.e., comprising two related constructs, including threat detection and behavioral response to threat). Supplementary analyses were conducted post hoc to examine potential differences across CA subtypes (emotional, physical, and sexual). Alexithymia indirectly explained the relationship between CA and threat detection, and behavioral response to threat. However, indirect effects were negative, suggesting that undergraduate women with more severe CA and alexithymia identify sexual assault threat cues and intentions to "leave" a hypothetical sexual assault scenario sooner rather than later. The same pattern of results was observed for emotional and physical (but not sexual) CA when examining their indirect effects on threat detection, and for emotional CA when examining behavioral response to threat. Findings contribute to the literature on sexual victimization by clarifying the role of alexithymia in risk perception for sexual victimization. Results also highlight the potential utility of increasing emotional literacy among college women with a history of CA (and especially emotional abuse) to facilitate adaptive responding to unwanted sexual advances.

The impact of pandemic-related stress on attentional bias and anxiety in alexithymia during the COVID-19 pandemic

The COVID-19 pandemic had negative consequences for mental health, yet it is unknown how and to what extent the psychological outcomes of this stressful event are moderated by individual traits. Alexithymia is a risk factor for psychopathology, and thus likely predicted individual differences in resilience or vulnerability to stressful events during the pandemic. This study explored the moderating role of alexithymia in the relationships of pandemic-related stress with anxiety levels and attentional bias. The participants were 103 Taiwanese individuals who completed a survey during the outbreak of the Omicron wave. Additionally, an emotional Stroop task including pandemic-related or neutral stimuli was used to measure attentional bias. Our results demonstrate that pandemic-related stress had a lesser impact on anxiety in individuals with a higher level of alexithymia. Moreover, we found that in individuals with higher exposure to pandemic-related stressors, a higher level of alexithymia indicated less attentional bias toward COVID-19-related information. Thus, it is plausible that individuals with alexithymia tended to avoid pandemic-related information, which could temporarily relieve stressors during the pandemic.

Perceptive and Affective Impairments In Emotive Eye-Region Processing in Alexithymia

Alexithymia is characterized by impairments in emotion processing, frequently linked to facial expressions of emotion. The eye-region conveys information necessary for emotion processing. It has been demonstrated that alexithymia is associated with reduced attention to the eyes, but little is known regarding the cognitive and electrophysiological mechanisms underlying emotive eye-region processing in alexithymia. Here, we recorded behavioral and electrophysiological responses of individuals with alexithymia (ALEX; n = 25) and individuals without alexithymia (NonALEX; n = 23) while they viewed intact and eyeless faces with angry and sad expressions during a dual-target rapid serial visual presentation task. Results showed different eye-region focuses and differentiating N1 responses between intact and eyeless faces to anger and sadness in NonALEX, but not in ALEX, suggesting deficient perceptual processing of the eye-region in alexithymia. Reduced eye-region focus and smaller differences in frontal alpha asymmetry in response to sadness between intact and eyeless faces were observed in ALEX than NonALEX, indicative of impaired affective processing of the eye-region in alexithymia. These findings highlight perceptual and affective abnormalities of emotive eye-region processing in alexithymia. Our results contribute to understanding the neuropsychopathology of alexithymia and alexithymia-related disorders.

Social-Specific Impairment of Negative Emotion Perception in Alexithymia

Alexithymia has been characterized as an impaired ability of emotion processing and regulation. The definition of alexithymia does not include a social component. However, there is some evidence that social cognition may be compromised in individuals with alexithymia. Hence, emotional impairments associated with alexithymia may extend to socially relevant information. Here, we recorded electrophysiological responses of individuals meeting the clinically relevant cutoff for alexithymia (ALEX; n = 24) and individuals without alexithymia (NonALEX; n = 23) while they viewed affective scenes that varied on the dimensions of sociality and emotional valence during a rapid serial visual presentation task. We found that ALEX exhibited lower accuracy and larger N2 than NonALEX in the perception of social negative scenes. Source reconstruction revealed that the group difference in N2 was localized at the dorsal anterior cingulate cortex. Irrespective of emotional valence, ALEX showed stronger alpha power than NonALEX in social but not non-social conditions. Our findings support the hypothesis of social processing being selectively affected by alexithymia, especially for stimuli with negative valence. Electrophysiological evidence suggests altered deployment of attentional resources in the perception of social-specific emotional information in alexithymia. This work sheds light on the neuropsychopathology of alexithymia and alexithymia-related disorders.

Deficient auditory emotion processing but intact emotional multisensory integration in alexithymia

Alexithymia has been associated with emotion recognition deficits in both auditory and visual domains. Although emotions are inherently multimodal in daily life, little is known regarding abnormalities of emotional multisensory integration (eMSI) in relation to alexithymia. Here, we employed an emotional Stroop‐like audiovisual task while recording event‐related potentials (ERPs) in individuals with high alexithymia levels (HA) and low alexithymia levels (LA). During the task, participants had to indicate whether a voice was spoken in a sad or angry prosody while ignoring the simultaneously presented static face which could be either emotionally congruent or incongruent to the human voice. We found that HA performed worse and showed higher P2 amplitudes than LA independent of emotion congruency. Furthermore, difficulties in identifying and describing feelings were positively correlated with the P2 component, and P2 correlated negatively with behavioral performance. Bayesian statistics showed no group differences in eMSI and classical integration‐related ERP components (N1 and N2). Although individuals with alexithymia indeed showed deficits in auditory emotion recognition as indexed by decreased performance and higher P2 amplitudes, the present findings suggest an intact capacity to integrate emotional information from multiple channels in alexithymia. Our work provides valuable insights into the relationship between alexithymia and neuropsychological mechanisms of emotional multisensory integration.

Our behavioral and electrophysiological data provide substantial evidence for intact emotion multisensory integration in relation to alexithymia. With high ecological validity, these findings are of particular importance given that humans are constantly exposed to competing, complex audiovisual emotional information in social interaction contexts. Our work has important implications for the psychophysiology of alexithymia and emotional processing.

A crowd of emotional voices influences the perception of emotional faces: Using adaptation, stimulus salience, and attention to probe audio-visual interactions for emotional stimuli

Correctly assessing the emotional state of others is a crucial part of social interaction. While facial expressions provide much information, faces are often not viewed in isolation, but occur with concurrent sounds, usually voices, which also provide information about the emotion being portrayed. Many studies have examined the crossmodal processing of faces and sounds, but results have been mixed, with different paradigms yielding different results. Using a psychophysical adaptation paradigm, we carried out a series of four experiments to determine whether there is a perceptual advantage when faces and voices match in emotion (congruent), versus when they do not match (incongruent). We presented a single face and a crowd of voices, a crowd of faces and a crowd of voices, a single face of reduced salience and a crowd of voices, and tested this last condition with and without attention directed to the emotion in the face. While we observed aftereffects in the hypothesized direction (adaptation to faces conveying positive emotion yielded negative, contrastive, perceptual aftereffects), we only found a congruent advantage (stronger adaptation effects) when faces were attended and of reduced salience, in line with the theory of inverse effectiveness.

Adaptive and maladaptive emotion processing and regulation, and the case of alexithymia

In this conceptual review, we discuss models of emotion and its regulation and identify a spectrum of processes that characterise adaptive adjustment to the affective environment. We describe a dynamic-phasic model of emotion processing and regulation, focusing on five stages: anticipation, response, recovery, habituation and rest as part of a cascade of responses to emotional challenges, as these become progressively expected, proximal, chronic or repeated. We argue for the need to investigate beyond simple reactivity to emotional stimuli, in order to understand mental and physical health conditions where emotional dysregulation plays a role. We propose that a hallmark of an effective and adaptive emotion regulation system is its flexibility, in the service of life goals and values. Consistent with McEwen's model (1998, Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33-44), inflexible emotion regulation can lead to increased allostatic load, from frequent stress, inadequate reactivity, failed shutdown and habituation, which may result in physical and mental illness. Alexithymia exemplifies inflexible emotion regulation, with dysfunctions potentially across all stages of emotion processing, both psychologically and physiologically. These maladaptive processes and their consequence on allostatic load potentially explain the association between alexithymia and physical and mental illness.

Seeing a Face in a Crowd of Emotional Voices: Changes in Perception and Cortisol in Response to Emotional Information across the Senses

One source of information we glean from everyday experience, which guides social interaction, is assessing the emotional state of others. Emotional state can be expressed through several modalities: body posture or movements, body odor, touch, facial expression, or the intonation in a voice. Much research has examined emotional processing within one sensory modality or the transfer of emotional processing from one modality to another. Yet, less is known regarding interactions across different modalities when perceiving emotions, despite our common experience of seeing emotion in a face while hearing the corresponding emotion in a voice. Our study examined if visual and auditory emotions of matched valence (congruent) conferred stronger perceptual and physiological effects compared to visual and auditory emotions of unmatched valence (incongruent). We quantified how exposure to emotional faces and/or voices altered perception using psychophysics and how it altered a physiological proxy for stress or arousal using salivary cortisol. While we found no significant advantage of congruent over incongruent emotions, we found that changes in cortisol were associated with perceptual changes. Following exposure to negative emotional content, larger decreases in cortisol, indicative of less stress, correlated with more positive perceptual after-effects, indicative of stronger biases to see neutral faces as happier.

The importance of stimulus variability when studying face processing using fast periodic visual stimulation: A novel 'mixed-emotions' paradigm

Fast Periodic Visual Stimulation (FPVS) with oddball stimuli has been used to investigate discrimination of facial identity and emotion, with studies concluding that oddball responses indicate discrimination of faces at the conceptual level (i.e., discrimination of identity and emotion), rather than low-level perceptual (visual, image-based) discrimination. However, because previous studies have utilised identical images as base stimuli, physical differences between base and oddball stimuli, rather than recognition of identity or emotion, may have been responsible for oddball responses. This study tested two new FPVS paradigms designed to distinguish recognition of expressions of emotion from detection of visual change from the base stream. In both paradigms, the oddball emotional expression was different from that of the base stream images. However, in the 'fixed-emotion' paradigm, stimulus image varied at every presentation but the emotion in the base stream remained constant, and in the 'mixed-emotions' paradigm, both stimulus image and emotion varied at every presentation, with only the oddball emotion (disgust) remaining constant. In the fixed-emotion paradigm, typical inversion effects were observed at occipital sites. In the mixed-emotions paradigm, however, inversion effects in a central cluster (indicative of higher level emotion processing) were present in typical participants, but not those with alexithymia (who are impaired at emotion recognition), suggesting that only the mixed-emotions paradigm reflects emotion recognition rather than detection of a lower-level visual change from baseline. These results have significant methodological implications for future FPVS studies (of both facial emotion and identity), suggesting that it is crucial to vary base stimuli sufficiently, such that simple physical differences between base and oddball stimuli cannot give rise to neural oddball responses.

Increased Neural Activity in Hazardous Drinkers During High Workload in a Visual Working Memory Task: A Preliminary Assessment Through Event-Related Potentials

Despite equated behavioral performance levels, hazardous drinkers generally exhibited increased neural activity while performing simple cognitive tasks compared to light drinkers. Here, 49 participants (25 hazardous and 24 light drinkers) participated in an event-related potentials (ERPs) study while performing an n-back working memory task. In the control zero-back (N0) condition, the subjects were required to press a button when the number "2" or "6" was displayed. In the two-back and three-back (N2; N3) conditions, the subjects had to press a button when the displayed number was identical to the number shown two/three trials earlier. To assess for the impact of alcohol consumption on the updating of working memory processes under various cognitive loads, difference waveforms of "N2 minus N0" and "N3 minus N0" were computed by subtracting waveforms in the N0 condition from waveforms in the N2 and N3 conditions, for the light and the hazardous drinkers. Three main ERP components were noted for both groups: a P200/N200 complex, a P300 component, and an N400/P600 activity. The results show that, to perform the task at the same level as the light drinkers, the hazardous drinkers exhibited larger amplitude differences, mainly around the P300 and P600 components. These data may be considered, at the preventive level, as vulnerability factors for developing adult substance use disorders, and they stress the importance, at a clinical level, to consider such working memory processes in the management of alcohol dependence.

The Study of Visual-Auditory Interactions on Lower Limb Motor Imagery

In order to improve the activation of the mirror neuron system and the ability of the visual-cued motor imagery further, the multi-stimuli-cued unilateral lower limb motor imagery is studied in this paper. The visual-auditory evoked pathway is proposed and the sensory process is studied. To analyze the visual-auditory interactions, the kinesthetic motor imagery with the visual-auditory stimulus, visual stimulus and no stimulus are involved. The motor-related rhythm suppression is applied on quantitative evaluation. To explore the statistical sensory process, the causal relationships among the functional areas and the event-related potentials are investigated. The results have demonstrated the outstanding performances of the visual-auditory evoked motor imagery on the improvement of the mirror neuron system activation and the motor imagery ability. Besides, the abundant information interactions among functional areas and the positive impacts of the auditory stimulus in the motor and the visual areas have been revealed. The possibility that the sensory processes evoked by the visual-auditory interactions differ from the one elicited by kinesthetic motor imagery, has also been indicated. This study will promisingly offer an efficient way to motor rehabilitation, thus favorable for hemiparesis and partial paralysis patients.

The Ryerson Audio-Visual Database of Emotional Speech and Song (RAVDESS): A dynamic, multimodal set of facial and vocal expressions in North American English

The RAVDESS is a validated multimodal database of emotional speech and song. The database is gender balanced consisting of 24 professional actors, vocalizing lexically-matched statements in a neutral North American accent. Speech includes calm, happy, sad, angry, fearful, surprise, and disgust expressions, and song contains calm, happy, sad, angry, and fearful emotions. Each expression is produced at two levels of emotional intensity, with an additional neutral expression. All conditions are available in face-and-voice, face-only, and voice-only formats. The set of 7356 recordings were each rated 10 times on emotional validity, intensity, and genuineness. Ratings were provided by 247 individuals who were characteristic of untrained research participants from North America. A further set of 72 participants provided test-retest data. High levels of emotional validity and test-retest intrarater reliability were reported. Corrected accuracy and composite "goodness" measures are presented to assist researchers in the selection of stimuli. All recordings are made freely available under a Creative Commons license and can be downloaded at https://doi.org/10.5281/zenodo.1188976.

Alexithymia and emotional reactions to odors

Alexithymia is a psychological construct characterized by deficits in processing emotional stimuli. However, little is known about the processing of odours in alexithymia, even though there is extensive proof that emotion and olfaction are closely linked. The present study is aimed at investigating how alexithymic individuals process emotions conveyed by odors. Emotional responses to unpleasant, neutral odors and clean air were collected through self-report ratings and psychophysiological measures in a sample of 62 healthy participants with high (HA), medium (MA) and low (LA) levels of alexithymia. Moreover, participants performed tests on odors identification and threshold and completed questionnaires assessing olfactory imagery and awareness. Two main results have been found: first, HA and MA groups showed altered physiological responses to odors, compared to LA, while no differences among the groups were observed in odor ratings; and second, affective and cognitive alexithymia components were differently associated with the performance on olfactory tests, skin conductance response to odors, reaction times in the rating task, and scores on olfactory questionnaires. We conclude that alexithymia is characterized by altered physiological reactions to olfactory stimuli; moreover, we stress the importance of evaluating the different alexithymia components since they affect emotional stimuli processing in different ways.

Emotional Oddball: A Review on Variants, Results, and Mechanisms

It is of the utmost importance for an organism to rapidly detect and react to changes in its environment. The oddball paradigm has repeatedly been used to explore the underlying cognitive and neurophysiological components of change detection. It is also used to investigate the special role of emotional content in perception and attention (emotional oddball paradigm; EOP). In this article, the EOP is systematically reviewed. The EOP is, for instance, used as a tool to address questions as to what degree emotional deviant stimuli trigger orientation reactions, which role the emotional context plays in the processing of deviant information, and how the processing of emotional deviant information differs interindividually (including clinical populations). Two main variants with regard to the emotionality of standards and deviants are defined. Most of the identified EOP studies report EEG data but an overview of behavioral data is also provided in this review. We integrate evidence from 99 EOP experiments and shape the EOP's theoretical background under the consideration of other paradigms’ mechanisms and theories.

Methodological Considerations about the Use of Bimodal Oddball P300 in Psychiatry: Topography and Reference Effect

Event-related potentials (ERPs) bimodal oddball task has disclosed increased sensitivity to show P300 modulations to subclinical symptoms. Even if the utility of such a procedure has still to be confirmed at a clinical level, gathering normative values of this new oddball variant may be of the greatest interest. We specifically addressed the challenge of defining the best location for the recording of P3a and P3b components and selecting the best reference to use by investigating the effect of an offline re-reference procedure on recorded bimodal P3a and P3b. Forty young and healthy subjects were submitted to a bimodal (synchronized and always congruent visual and auditory stimuli) three-stimulus oddball task in which 140 frequent bimodal stimuli, 30 deviant “target” stimuli and 30 distractors were presented. Task consisted in clicking as soon as possible on the targets, and not paying attention to frequent stimuli and distractors. This procedure allowed us to record, for each individual, the P3a component, referring to the novelty process related to distractors processing, and the P3b component, linked to the processing of the target stimuli. Results showed that both P3a and P3b showed maximal amplitude in Pz. However, P3a displayed a more central distribution. Nose reference was also shown to give maximal amplitudes compared with average and linked mastoids references. These data were discussed in light of the necessity to develop multi-site recording guidelines to furnish sets of ERPs data comparable across laboratories.

The bimodal P300 oddball component is decreased in patients with an adjustment disorder: An event-related potentials study

OBJECTIVE

We found previously that use of a bimodal oddball design with synchronized pairs of audio-visual stimuli increased the sensitivity of the P300 wave to detect subclinical anxiety-depression in otherwise healthy subjects. Here, we wished to determine whether these P300 modulations would also be encountered when a clinical population comprised of patients with an adjustment disorder (AJD) was compared to healthy controls.

METHOD

Two groups, each comprised of twenty-five participants (AJD patients, and controls; N=50) had to detect deviant stimuli among frequent stimuli in an oddball task by clicking on a button. Separate blocks involving audio (A), visual (V) or bimodal congruent (AV) stimuli were used and compared.

RESULTS

P300 amplitudes of the control group were higher than those displayed by AJD patients, but only in the bimodal AV oddball task, while unimodal (visual or auditory) oddball tasks did not reveal any significant differences.

CONCLUSIONS

The increased sensitivity of the bimodal P300 that we observed previously in subclinical anxiety-depression was also observed in AJD patients.

SIGNIFICANCE

The impaired "bimodal congruence effect" in AJD suggests that these patients have altered integrative processes, which has potential implications for cognitive therapy.

Time course of facial emotion processing in women with borderline personality disorder: an ERP study

BACKGROUND

Borderline personality disorder (BPD) is characterized by a negative perception of others. Previous studies have revealed deficits and biases in facial emotion recognition. This study investigates the behavioural and electrophysiological correlates underlying facial emotion processing in individuals with BPD.

METHODS

The present study was conducted between July 2012 and May 2014. In an emotion classification task, unmedicated female patients with BPD as well as healthy women had to classify faces displaying blends of anger and happiness while the electroencephalogram was recorded. We analyzed visual event-related potentials (ERPs) reflecting early (P100), structural (N170) and categorical (P300) facial processing in addition to behavioural responses.

RESULTS

We included 36 women with BPD and 29 controls in our analysis. Patients with BPD were more likely than controls to classify predominantly happy faces as angry. Independent of facial emotion, women with BPD showed enhanced early occipital P100 amplitudes. Additionally, temporo-occipital N170 amplitudes were reduced at right hemispherical electrode sites. Centroparietal P300 amplitudes were reduced particularly for predominantly happy faces and increased for highly angry faces in women with BPD, whereas in healthy volunteers this component was modulated by both angry and happy facial affect.

LIMITATIONS

Our sample included only women, and no clinical control group was investigated.

CONCLUSION

Our findings suggest reduced thresholds for facial anger and deficits in the discrimination of facial happiness in individuals with BPD. This biased perception is associated with alterations in very early visual as well as deficient structural and categorical processing of faces. The current data could help to explain the negative perception of others that may be related to the patients' impairments in interpersonal functioning.

Endogenous event-related potentials in patients with primary Sjögren's syndrome without central nervous system involvement

OBJECTIVES

Endogenous cognitive event-related potentials (CERPs) reflect higher-level processing of sensory information and can be used to evaluate cognitive functions. The aim of this paper was to determine whether there are any abnormalities in the electrophysiological parameters of CERPs in patients with primary Sjögren's syndrome (pSS) but without symptoms of central nervous system (CNS) involvement or mental disorder. The analysis of CERP parameters was then correlated with the clinical status of the patients and with some of the immunological parameters in the patient group.

METHOD

Thirty consecutive patients with pSS (29 females, one male) were included in the study. All the patients underwent CERP examination.

RESULTS

There was a significant prolongation of the latency of P300 and N200 potentials in patients with pSS. Abnormalities in electrophysiological parameters of CERPs correlated with the duration of the disease, salivary gland abnormalities, and elevated erythrocyte sedimentation rate (ESR) values. Patients with coexisting chronic fatigue syndrome (CFS) had larger P300 amplitudes. There were no statistically significant changes in the electrophysiological parameters of CERPs in patients with pSS dependent on the presence of peripheral nervous system (PNS) lesions, skin changes, arthritis, abnormalities in white blood cells and the immune system or the levels of blood lipids.

CONCLUSIONS

The results of the study suggest the presence of a minor cognitive dysfunction in patients with pSS without symptoms of CNS involvement or mental disorder. Cognitive dysfunction correlated with the disease duration time and the severity of inflammatory changes (salivary gland abnormalities and inflammatory markers in the blood). Further and larger longitudinal studies are necessary for confirmation of this correlation.

The integration of facial and vocal cues during emotional change perception: EEG markers

The ability to detect emotional changes is of primary importance for social living. Though emotional signals are often conveyed by multiple modalities, how emotional changes in vocal and facial modalities integrate into a unified percept has yet to be directly investigated. To address this issue, we asked participants to detect emotional changes delivered by facial, vocal and facial-vocal expressions while behavioral responses and electroencephalogram were recorded. Behavioral results showed that bimodal emotional changes were detected with higher accuracy and shorter response latencies compared with each unimodal condition. Moreover, the detection of emotional change, regardless of modalities, was associated with enhanced amplitudes in the N2 and P3 component, as well as greater theta synchronization. More importantly, the P3 amplitudes and theta synchronization were larger for the bimodal emotional change condition than for the sum of the two unimodal conditions. The superadditive responses in P3 amplitudes and theta synchronization were both positively correlated with the magnitude of the bimodal superadditivity in accuracy. These behavioral and electrophysiological data consistently illustrated an effect of audiovisual integration during the detection of emotional changes, which is most likely mediated by the P3 activity and theta oscillations in brain responses.