1
|
Kim W, Kim MJ. Adaptive-to-maladaptive gradient of emotion regulation tendencies are embedded in the functional-structural hybrid connectome. Psychol Med 2024; 54:2299-2311. [PMID: 38533787 DOI: 10.1017/s0033291724000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Emotion regulation tendencies are well-known transdiagnostic markers of psychopathology, but their neurobiological foundations have mostly been examined within the theoretical framework of cortical-subcortical interactions. METHODS We explored the connectome-wide neural correlates of emotion regulation tendencies using functional and diffusion magnetic resonance images of healthy young adults (N = 99; age 20-30; 28 females). We first tested the importance of considering both the functional and structural connectome through intersubject representational similarity analyses. Then, we employed a canonical correlation analysis between the functional-structural hybrid connectome and 23 emotion regulation strategies. Lastly, we sought to externally validate the results on a transdiagnostic adolescent sample (N = 93; age 11-19; 34 females). RESULTS First, interindividual similarity of emotion regulation profiles was significantly correlated with interindividual similarity of the functional-structural hybrid connectome, more so than either the functional or structural connectome. Canonical correlation analysis revealed that an adaptive-to-maladaptive gradient of emotion regulation tendencies mapped onto a specific configuration of covariance within the functional-structural hybrid connectome, which primarily involved functional connections in the motor network and the visual networks as well as structural connections in the default mode network and the subcortical-cerebellar network. In the transdiagnostic adolescent dataset, stronger functional signatures of the found network were associated with higher general positive affect through more frequent use of adaptive coping strategies. CONCLUSIONS Taken together, our study illustrates a gradient of emotion regulation tendencies that is best captured when simultaneously considering the functional and structural connections across the whole brain.
Collapse
Affiliation(s)
- Wonyoung Kim
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychology, Sungkyunkwan University, Seoul, South Korea
| | - M Justin Kim
- Department of Psychology, Sungkyunkwan University, Seoul, South Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
| |
Collapse
|
2
|
Oestreich LKL, Lo JW, Di Biase MA, Sachdev PS, Mok AH, Wright P, Crawford JD, Lam B, Traykov L, Köhler S, Staals JEA, van Oostenbrugge R, Chen C, Desmond DW, Yu KH, Lee M, Klimkowicz-Mrowiec A, Bordet R, O'Sullivan MJ, Zalesky A. Network analysis of neuropsychiatric, cognitive, and functional complications of stroke: implications for novel treatment targets. Psychiatry Clin Neurosci 2024; 78:229-236. [PMID: 38113307 DOI: 10.1111/pcn.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/13/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023]
Abstract
AIM Recovery from stroke is adversely affected by neuropsychiatric complications, cognitive impairment, and functional disability. Better knowledge of their mutual relationships is required to inform effective interventions. Network theory enables the conceptualization of symptoms and impairments as dynamic and mutually interacting systems. We aimed to identify interactions of poststroke complications using network analysis in diverse stroke samples. METHODS Data from 2185 patients were sourced from member studies of STROKOG (Stroke and Cognition Consortium), an international collaboration of stroke studies. Networks were generated for each cohort, whereby nodes represented neuropsychiatric symptoms, cognitive deficits, and disabilities on activities of daily living. Edges characterized associations between them. Centrality measures were used to identify hub items. RESULTS Across cohorts, a single network of interrelated poststroke complications emerged. Networks exhibited dissociable depression, apathy, fatigue, cognitive impairment, and functional disability modules. Worry was the most central symptom across cohorts, irrespective of the depression scale used. Items relating to activities of daily living were also highly central nodes. Follow-up analysis in two studies revealed that individuals who worried had more densely connected networks than those free of worry (CASPER [Cognition and Affect after Stroke: Prospective Evaluation of Risks] study: S = 9.72, P = 0.038; SSS [Sydney Stroke Study]: S = 13.56, P = 0.069). CONCLUSION Neuropsychiatric symptoms are highly interconnected with cognitive deficits and functional disabilities resulting from stroke. Given their central position and high level of connectedness, worry and activities of daily living have the potential to drive multimorbidity and mutual reinforcement between domains of poststroke complications. Targeting these factors early after stroke may have benefits that extend to other complications, leading to better stroke outcomes.
Collapse
Affiliation(s)
- Lena K L Oestreich
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Advanced Imaging and Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
| | - Jessica W Lo
- (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton, Victoria, Australia
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Perminder S Sachdev
- (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Alice H Mok
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul Wright
- Biomedical Engineering Department, King's College London, London, UK
| | - John D Crawford
- (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben Lam
- (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Latchezar Traykov
- Department of Neurology, UH Alexandrovska, Medical University-Sofia, Sofia, Bulgaria
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Julie E A Staals
- Department of Neurology, School for Cardiovascular diseases (CARIM), Maastricht University Medical Center (MUMC+), The Netherlands
| | - Robert van Oostenbrugge
- Department of Neurology, School for Cardiovascular diseases (CARIM), Maastricht University Medical Center (MUMC+), The Netherlands
| | - Christopher Chen
- Memory Ageing and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | | | - Régis Bordet
- Department of Pharmacology, Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Michael J O'Sullivan
- Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton, Victoria, Australia
- Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
3
|
Bemmouna D, Weiner L. Linehan's biosocial model applied to emotion dysregulation in autism: a narrative review of the literature and an illustrative case conceptualization. Front Psychiatry 2023; 14:1238116. [PMID: 37840783 PMCID: PMC10570453 DOI: 10.3389/fpsyt.2023.1238116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Emotion dysregulation (ED) is a transdiagnostic difficulty prevalent in autism spectrum condition (ASC). Importantly, recent research has suggested that ED is involved in self-harm and suicidality. Pre-existing models on the etiology of ED in ASC focus mainly on biological factors to ASC features, such as sensory sensitivities, poor flexibility, and sensitivity to change. However, although psychosocial factors seem to play a role in the emergence of ED in ASC as well (e.g., childhood maltreatment and camouflaging), there is a lack of a comprehensive model conceptualizing biosocial factors involved in ED in autistic people. Linehan's biosocial model (1993) is one of the leading etiological models of ED in borderline personality disorder (BPD). It conceptualizes ED as emerging from transactions between a pre-existing emotional vulnerability in the child and an invalidating developmental environment. Beyond its clinical relevance, Linehan's model has gathered empirical evidence supporting its pertinence in BPD and in other psychiatric disorders. Although ASC and BPD are two distinct diagnoses, because they may share ED, Linehan's biosocial model might be useful for understanding the development of ED in ASC. Hence, this article aims to provide an application and extension of Linehan's model to conceptualize ED in ASC. To do so, we conducted a narrative review of the literature on ED and its underlying factors in ASC from a developmental perspective. To investigate the pertinence of the biosocial model applied to ED in autistic people, we were interested on data on (i) ED and its behavioral correlates in ASC, in relation to the biosocial model, (ii) the potential biological and psychosocial correlates of ED in ASC and (iii) the overlapping difficulties in ASC and BPD. Finally, to assess the pertinence of the model, we applied it to the case of an autistic woman presenting with ED and suicidal behaviors. Our review and application to the case of an autistic woman suggest that ED in ASC encompasses factors related to both biological and psychosocial risk factors as conceptualized in the BPD framework, although in both domains ASC-specific factors might be involved.
Collapse
Affiliation(s)
- Doha Bemmouna
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
| | - Luisa Weiner
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
- Département de Psychiatrie Adulte, Hôpitaux Universitaires de Strasbourg, Strasbourg, Alsace, France
| |
Collapse
|
4
|
Lieberman JM, Rabellino D, Densmore M, Frewen PA, Steyrl D, Scharnowski F, Théberge J, Neufeld RWJ, Schmahl C, Jetly R, Narikuzhy S, Lanius RA, Nicholson AA. Posterior cingulate cortex targeted real-time fMRI neurofeedback recalibrates functional connectivity with the amygdala, posterior insula, and default-mode network in PTSD. Brain Behav 2023; 13:e2883. [PMID: 36791212 PMCID: PMC10013955 DOI: 10.1002/brb3.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Alterations within large-scale brain networks-namely, the default mode (DMN) and salience networks (SN)-are present among individuals with posttraumatic stress disorder (PTSD). Previous real-time functional magnetic resonance imaging (fMRI) and electroencephalography neurofeedback studies suggest that regulating posterior cingulate cortex (PCC; the primary hub of the posterior DMN) activity may reduce PTSD symptoms and recalibrate altered network dynamics. However, PCC connectivity to the DMN and SN during PCC-targeted fMRI neurofeedback remains unexamined and may help to elucidate neurophysiological mechanisms through which these symptom improvements may occur. METHODS Using a trauma/emotion provocation paradigm, we investigated psychophysiological interactions over a single session of neurofeedback among PTSD (n = 14) and healthy control (n = 15) participants. We compared PCC functional connectivity between regulate (in which participants downregulated PCC activity) and view (in which participants did not exert regulatory control) conditions across the whole-brain as well as in a priori specified regions-of-interest. RESULTS During regulate as compared to view conditions, only the PTSD group showed significant PCC connectivity with anterior DMN (dmPFC, vmPFC) and SN (posterior insula) regions, whereas both groups displayed PCC connectivity with other posterior DMN areas (precuneus/cuneus). Additionally, as compared with controls, the PTSD group showed significantly greater PCC connectivity with the SN (amygdala) during regulate as compared to view conditions. Moreover, linear regression analyses revealed that during regulate as compared to view conditions, PCC connectivity to DMN and SN regions was positively correlated to psychiatric symptoms across all participants. CONCLUSION In summary, observations of PCC connectivity to the DMN and SN provide emerging evidence of neural mechanisms underlying PCC-targeted fMRI neurofeedback among individuals with PTSD. This supports the use of PCC-targeted neurofeedback as a means by which to recalibrate PTSD-associated alterations in neural connectivity within the DMN and SN, which together, may help to facilitate improved emotion regulation abilities in PTSD.
Collapse
Affiliation(s)
- Jonathan M. Lieberman
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada
- Imaging, Lawson Health Research InstituteLondonOntarioCanada
| | - Daniela Rabellino
- Imaging, Lawson Health Research InstituteLondonOntarioCanada
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
| | - Maria Densmore
- Imaging, Lawson Health Research InstituteLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
| | - Paul A. Frewen
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychologyWestern UniversityLondonOntarioCanada
| | - David Steyrl
- Department of Cognition, Emotion, and Methods in PsychologyUniversity of ViennaViennaAustria
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in PsychologyUniversity of ViennaViennaAustria
| | - Jean Théberge
- Imaging, Lawson Health Research InstituteLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of Medical BiophysicsWestern UniversityLondonOntarioCanada
- Department of Diagnostic ImagingSt. Joseph's HealthcareLondonOntarioCanada
| | - Richard W. J. Neufeld
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of PsychologyWestern UniversityLondonOntarioCanada
- Department of PsychologyUniversity of British Columbia, OkanaganKelownaBritish ColumbiaCanada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and PsychotherapyCentral Institute of Mental Health MannheimHeidelberg UniversityHeidelbergGermany
| | - Rakesh Jetly
- The Institute of Mental Health ResearchUniversity of Ottawa, Royal Ottawa HospitalOntarioCanada
| | - Sandhya Narikuzhy
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada
| | - Ruth A. Lanius
- Imaging, Lawson Health Research InstituteLondonOntarioCanada
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Homewood Research InstituteGuelphOntarioCanada
| | - Andrew A. Nicholson
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada
- Department of Cognition, Emotion, and Methods in PsychologyUniversity of ViennaViennaAustria
- Department of Medical BiophysicsWestern UniversityLondonOntarioCanada
- The Institute of Mental Health ResearchUniversity of Ottawa, Royal Ottawa HospitalOntarioCanada
- Homewood Research InstituteGuelphOntarioCanada
- Atlas Institute for Veterans and FamiliesOttawaOntarioCanada
- School of PsychologyUniversity of OttawaOttawaCanada
| |
Collapse
|
5
|
Applebaum AJ, Loschiavo M, Morgan K, Mennin DS, Fresco DM, Hoyt MA, Schofield E, O’Toole MS, Cohn J, Jacobs JM. A randomized controlled trial of emotion regulation therapy for cancer caregivers: A mechanism-targeted approach to addressing caregiver distress. Contemp Clin Trials 2022; 122:106923. [PMID: 36115638 PMCID: PMC9769581 DOI: 10.1016/j.cct.2022.106923] [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: 02/15/2022] [Revised: 08/18/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Caregivers of patients with cancer play a crucial role in the health of the person they care for, and in the healthcare system at large. Family caregivers receive minimal support, despite being at greater risk for anxiety and depression than patients themselves. Cognitive behavioral therapy (CBT), an effective therapy for anxiety and depression, has shown mixed efficacy when delivered to cancer caregivers. Emotion Regulation Therapy (ERT), a contemporary CBT, may uniquely target processes underlying distress associated with caregiving. Therefore, we adapted both CBT and ERT to target the needs of caregivers (i.e., CBT-C and ERT-C) and are conducting a multi-site randomized trial to examine the comparative efficacy of these interventions. METHODS Family cancer caregivers (n = 200) reporting distress related to caregiving are recruited from two academic cancer centers and randomly assigned to either ERT-C or CBT-C. Caregivers in both interventions engage in eight weekly one-hour sessions by videoconference with a trained interventionist. Caregiver participants complete study assessments at baseline, post-treatment, 3-and 6-months follow-up. Patients of each caregiver can also enroll in the study and complete assessments at baseline and 3-months follow-up. Outcome measures include psychosocial constructs such as anxiety, depression, quality of life, as well as proposed mechanistic constructs and salivary markers of stress and inflammation. CONCLUSIONS The results of this study will advance the science of caregiving interventions in cancer by addressing a critical gap in our ability to mitigate anxiety and depression in caregivers, as well as further our understanding of how these changes may influence patients' outcomes.
Collapse
Affiliation(s)
| | - Morgan Loschiavo
- Memorial Sloan Kettering Cancer Center, NY, New York, United States of America
| | - Katherine Morgan
- Massachusetts General Hospital Cancer Center, Boston, MA, United States of America
| | - Douglas S. Mennin
- Teachers College, Columbia University, NY, New York, United States of America
| | - David M. Fresco
- University of Michigan, Ann Arbor, MI, United States of America
| | - Michael A. Hoyt
- University of California- Irvine, Irvine, CA, United States of America
| | - Elizabeth Schofield
- Memorial Sloan Kettering Cancer Center, NY, New York, United States of America
| | | | - Julia Cohn
- Massachusetts General Hospital Cancer Center, Boston, MA, United States of America
| | - Jamie M. Jacobs
- Massachusetts General Hospital Cancer Center, Boston, MA, United States of America,Corresponding author at: 55 Fruit Street, Yawkey Center for Outpatient Care, Suite 10B, Boston, MA 02114, United States of America. (J.M. Jacobs)
| |
Collapse
|
6
|
Chow TK, Bowie CR, Morton M, Lalovic A, McInerney SJ, Rizvi SJ. Contributors of Functional Impairment in Major Depressive Disorder: a Biopsychosocial Approach. Curr Behav Neurosci Rep 2022. [DOI: 10.1007/s40473-022-00247-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Zhu Z, Wang Y, Lau WKW, Wei X, Liu Y, Huang R, Zhang R. Hyperconnectivity between the posterior cingulate and middle frontal and temporal gyrus in depression: Based on functional connectivity meta-analyses. Brain Imaging Behav 2022; 16:1538-1551. [PMID: 35088354 DOI: 10.1007/s11682-022-00628-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 12/18/2022]
Abstract
Disrupted whole-brain resting-state functional connectivity (RSFC) of the posterior cingulate (PCC) has been highlighted to associate with cognitive and affective dysfunction in major depressive disorder (MDD). However, prior findings showed certain inconsistency about the RSFC of the PCC in MDD. This study aims to investigate the aberrant RSFC of the PCC in MDD using anisotropic effect-size version of seed-based d mapping (AES-SDM). Web of Science and PubMed were searched for studies investigating PCC-based RSFC in MDD. A total of 17 studies, involving 804 patients and 724 healthy controls (HCs), fit our selection criteria. Additionally, to seek for the link between functional and structural differences, we did a meta-analysis on the studies in conjunction with voxel-based morphology (VBM) analysis. The PCC showed higher RSFC with the left middle temporal gyrus (MTG) and the right middle frontal gyrus (MFG), and lower RSFC with the left superior frontal gyrus (SFG) and the left precuneus in patients with MDD than HCs. Moreover, the meta-regression analysis revealed a negative correlation between the FC alteration of the right MFG with the PCC and depression severity. Notably, the left MTG and the left MFG demonstrated gray matter deviations in conjunction analysis. Our results indicated that the aberrant RSFC between the PCC and brain regions sub-serving cognitive control and emotional regulation in patients with MDD. And such functional alterations may have structural basis. These findings may underlie the mechanisms of deficits in cognitive control and emotional regulation of MDD.
Collapse
Affiliation(s)
- Ziqing Zhu
- Department of Psychology, School of Public Health, Southern Medical University, Room 202, Guangzhou, People's Republic of China.,Laboratory of Cognitive Control and Brain Healthy, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - You Wang
- Department of Psychology, School of Public Health, Southern Medical University, Room 202, Guangzhou, People's Republic of China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Way K W Lau
- Department of Special Education and Counseling, The Education University of Hong Kong, Hong Kong, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First Affiliate Hospital, Guangzhou, China
| | - Yingjun Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China
| | - Ruiwang Huang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Ruibin Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Room 202, Guangzhou, People's Republic of China. .,Laboratory of Cognitive Control and Brain Healthy, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China. .,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
| |
Collapse
|
8
|
Bendall RCA, Eachus P, Thompson C. The influence of stimuli valence, extraversion, and emotion regulation on visual search within real-world scenes. Sci Rep 2022; 12:948. [PMID: 35042925 PMCID: PMC8766590 DOI: 10.1038/s41598-022-04964-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022] Open
Abstract
Affective traits, including extraversion and emotion regulation, are important considerations in clinical psychology due to their associations with the occurrence of affective disorders. Previously, emotional real-world scenes have been shown to influence visual search. However, it is currently unknown whether extraversion and emotion regulation can influence visual search towards neutral targets embedded within real-world scenes, or whether these traits can impact the effect of emotional stimuli on visual search. An opportunity sample of healthy individuals had trait levels of extraversion and emotion regulation recorded before completing a visual search task. Participants more accurately identified search targets in neutral images compared to positive images, whilst response times were slower in negative images. Importantly, individuals with higher trait levels of expressive suppression displayed faster identification of search targets regardless of the emotional valence of the stimuli. Extraversion and cognitive reappraisal did not influence visual search. These findings add to our understanding regarding the influence of extraversion, cognitive reappraisal, and expressive suppression on our ability to allocate attention during visual search when viewing real-world scenes.
Collapse
Affiliation(s)
- Robert C A Bendall
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Allerton Building, Frederick Road, Salford, M5 4WT, UK.
| | - Peter Eachus
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Allerton Building, Frederick Road, Salford, M5 4WT, UK
| | - Catherine Thompson
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Allerton Building, Frederick Road, Salford, M5 4WT, UK
| |
Collapse
|
9
|
Francis SEB, Shawyer F, Cayoun B, Enticott J, Meadows GN. Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial. Front Psychiatry 2022; 13:815170. [PMID: 35711582 PMCID: PMC9193586 DOI: 10.3389/fpsyt.2022.815170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of interoception and its interaction with cognition in emotional experience. These interactions are represented in the co-emergence model of reinforcement, in which non-reactivity (equanimity) to interoceptive signals facilitates adaptive behavior. METHODS Participants (n = 125, aged 20-72) were randomized to two groups (MiCBT), and treatment-as-usual (TAU). Outcomes were assessed at pre-, mid-, and post-intervention and at 6-month follow-up. The primary outcome was psychological distress, measured by the Depression, Anxiety and Stress Scale (DASS-21). Secondary outcome measures were the Kessler Psychological Distress Scale-10 (K10), Satisfaction with Life Scale (SWLS), and Flourishing Scale (FS). Mediator or process measures of interoceptive awareness, metacognitive awareness (decentering), equanimity, and social functioning were included to investigate putative mediators. RESULTS The MiCBT intervention significantly reduced DASS-21 scores at mid and post-treatment and the gains were maintained at 6-month follow-up (p < 0.0001, d = 0.38). Flourishing scores also showed significant improvement post-treatment and at 6-month follow-up (d = 0.24, p < 0.0001). All measures selected showed a similar pattern of positive change, with the exception of the SWLS, which failed to reach significance. Mediation analysis suggested equanimity to be the most influential mediator of the primary outcome. CONCLUSIONS The results support the effectiveness of MiCBT in creating rapid and sustainable reduction of psychological distress and improvement in flourishing in a primary mental health care setting with heterogenous groups. These promising results support the scaled-up implementation of this intervention. CLINICAL TRIAL REGISTRATION This trial is registered with the Australian and New Zealand Clinical Trial Registry: https://www.anzctr.org.au/ACTRN12617000061336.
Collapse
Affiliation(s)
- Sarah E B Francis
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Bruno Cayoun
- Mindfulness-Integrated Cognitive Behavior Therapy Institute, Hobart, TAS, Australia
| | - Joanne Enticott
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Graham N Meadows
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.,Mental Health Program, Monash Health, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
10
|
Sklivanioti Greenfield M, Wang Y, Msghina M. Behavioral, cortical and autonomic effects of single-dose escitalopram on the induction and regulation of fear and disgust: Comparison with single-session psychological emotion regulation with reappraisal. Front Psychiatry 2022; 13:988893. [PMID: 36684004 PMCID: PMC9845894 DOI: 10.3389/fpsyt.2022.988893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Adaptive and successful emotion regulation, the ability to flexibly exert voluntary control over emotional experience and the ensuing behavior, is vital for optimal daily functioning and good mental health. In clinical settings, pharmacological and psychological interventions are widely employed to modify pathological emotion processing and ameliorate its deleterious consequences. METHODS In this study, we investigated the acute effects of single-dose escitalopram on the induction and regulation of fear and disgust in healthy subjects. Furthermore, we compared these pharmacological effects with psychological emotion regulation that utilized a cognitive strategy with reappraisal. Emotion induction and regulation tasks were performed before and 4 h after ingestion of placebo or 10 mg escitalopram in a randomized, double-blind design. The International Affective Picture System (IAPS) was used as a source of images, with threat-related pictures selected for fear and disease and contamination-related pictures for disgust. Behavioral data, electrodermal activity (EDA), and functional near-infrared spectroscopy (fNIRS) recordings were collected. RESULTS Escitalopram significantly reduced emotion intensity for both fear and disgust during emotion induction, albeit with differing electrodermal and hemodynamic activity patterns for the two negative emotions. At rest, i.e., in the absence of emotive stimuli, escitalopram increased sympathetic activity during the fear but not during the disgust experiments. For both fear and disgust, emotion regulation with reappraisal was more effective in reducing emotion intensity compared to pharmacological intervention with escitalopram or placebo. DISCUSSION We concluded that emotion regulation with reappraisal and acute administration of escitalopram, but not placebo, reduce emotion intensity for both fear and disgust, with cognitive regulation being significantly more efficient compared to pharmacological regulation under the conditions of this study. Results from the fNIRS and EDA recordings support the concept of differential mechanisms of emotion regulation that could be emotion-specific.
Collapse
Affiliation(s)
| | - Yanlu Wang
- Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Stockholm, Sweden.,MR Physics, Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mussie Msghina
- Department of Clinical Neuroscience (CNS), Karolinska Institute, Stockholm, Sweden.,Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
11
|
Chen Y, Cui Q, Sheng W, Tang Q, Lu F, Pang Y, Nan X, He Z, Li D, Lei T, Chen H. Anomalous neurovascular coupling in patients with generalized anxiety disorder evaluated by combining cerebral blood flow and functional connectivity strength. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110379. [PMID: 34111495 DOI: 10.1016/j.pnpbp.2021.110379] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 01/10/2023]
Abstract
Coupling between neuronal activity and blood perfusion is termed neurovascular coupling, and it provides a new mechanistic perspective into understanding numerous brain diseases. Although abnormal brain activity and blood supply have been separately reported in generalized anxiety disorder (GAD), whether anomalous neurovascular coupling would still be presented in such disease is hitherto unknown. In this study, the neuronal activity and blood supply were measured using the functional connectivity strength (FCS) and cerebral blood flow (CBF). The voxel-wise CBF-FCS correlations and CBF/FCS ratio were separately used to assess global and local neurovascular coupling in participants. Patients with GAD showed decreased voxel-wise CBF-FCS correlation, implicating global neurovascular decoupling. They also exhibited increased CBF/FCS ratio in the right superior parietal gyrus (SPG), and the enhanced CBF/FCS ratio in this region was negatively correlated with the self-esteem scores of GAD. The abnormal neurovascular coupling of GAD may indicate the disrupted balance between the intrinsic functional organization of the brain and corresponding blood perfusion of patients, and the abnormally increased local neurovascular coupling of the right SPG may be correlated with the abnormal self in GAD. These findings provide new information in understanding the brain dysfunction and abnormal cognition of GAD from the perspective of neurovascular coupling.
Collapse
Affiliation(s)
- Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, China
| | - Xiaoyu Nan
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Lei
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China; Department of Radiology, First Affiliated Hospital to Army Medical University, Chongqing, China.
| |
Collapse
|
12
|
Applebaum AJ, Panjwani AA, Buda K, O'Toole MS, Hoyt MA, Garcia A, Fresco DM, Mennin DS. Emotion regulation therapy for cancer caregivers-an open trial of a mechanism-targeted approach to addressing caregiver distress. Transl Behav Med 2021; 10:413-422. [PMID: 30395306 DOI: 10.1093/tbm/iby104] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient's illness-notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge's g range: 0.36-0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.
Collapse
Affiliation(s)
- Allison J Applebaum
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Kara Buda
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mia S O'Toole
- Department of Psychology & Behavioral Sciences, Aarhus, Denmark
| | | | - Adam Garcia
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David M Fresco
- Department of Psychological Sciences, Kent State University, Kent, OH
| | - Douglas S Mennin
- Department of Psychology, Teachers College, Columbia, New York, NY
| |
Collapse
|
13
|
Wendt FR, Pathak GA, Levey DF, Nuñez YZ, Overstreet C, Tyrrell C, Adhikari K, De Angelis F, Tylee DS, Goswami A, Krystal JH, Abdallah CG, Stein MB, Kranzler HR, Gelernter J, Polimanti R. Sex-stratified gene-by-environment genome-wide interaction study of trauma, posttraumatic-stress, and suicidality. Neurobiol Stress 2021; 14:100309. [PMID: 33665242 PMCID: PMC7905234 DOI: 10.1016/j.ynstr.2021.100309] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/20/2021] [Accepted: 02/10/2021] [Indexed: 12/27/2022] Open
Abstract
Epidemiologic studies recognize that trauma and posttraumatic stress are associated with heightened suicidal behavior severity, yet examination of these associations from a genetic perspective is limited. We performed a multivariate gene-by-environment genome-wide interaction study (GEWIS) of suicidality in 123,633 individuals using a covariance matrix based on 26 environments related to traumatic experiences, posttraumatic stress, social support, and socioeconomic status. We discovered five suicidality risk loci, including the male-associated rs2367967 (CWC22), which replicated in an independent cohort. All GEWIS-significant loci exhibited interaction effects where at least 5% of the sample had environmental profiles conferring opposite SNP effects from the majority. We identified PTSD as a primary driving environment for GxE at suicidality risk loci. The male suicidality GEWIS was enriched for three middle-temporal-gyrus inhibitory neuron transcriptomic profiles: SCUBE- and PVALB-expressing cells (β = 0.028, p = 3.74 × 10-4), OPRM1-expressing cells (β = 0.030, p = 0.001), and SPAG17-expressing cells (β = 0.029, p = 9.80 × 10-4). Combined with gene-based analyses (CNTN5 p association = 2.38 × 10-9, p interaction = 1.51 × 10-3; PSMD14 p association = 2.04 × 10-7, p interaction = 7.76 × 10-6; HEPACAM p association = 2.43 × 10-6, p interaction = 3.82 × 10-7) including information about brain chromatin interaction profiles (UBE2E3 in male neuron p = 1.07 × 10-5), our GEWIS points to extracellular matrix biology and synaptic plasticity as biological interactors with the effects of potentially modifiable lifetime traumatic experiences on genetic risk for suicidality. Characterization of molecular basis for the effects of traumatic experience and posttraumatic stress on risk of suicidal behaviors may help to identify novel targets for which more effective treatments can be developed for use in high-risk populations.
Collapse
Affiliation(s)
- Frank R. Wendt
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Gita A. Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Daniel F. Levey
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Yaira Z. Nuñez
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Cassie Overstreet
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
- National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven CT, 06520, USA
| | - Chelsea Tyrrell
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Keyrun Adhikari
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Flavio De Angelis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Daniel S. Tylee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Aranyak Goswami
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Chadi G. Abdallah
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Murray B. Stein
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
- Departments of Psychiatry and Family Medicine & Public Health, University of California San Diego, La Jolla, CA, USA
| | - Henry R. Kranzler
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| |
Collapse
|
14
|
Abstract
BACKGROUND Racial discrimination is one of many barriers experienced by African Americans that interfere with health self-care management. Discrimination stress may decrease the tendency for individuals to resonate with the social-emotional appeals embedded in persuasive health information, which are known to play a key role in producing behavior change. Understanding the neurobehavioral underpinnings of discrimination stress experienced by African Americans may help reduce or resolve this important health disparity. OBJECTIVES The purpose of this secondary analysis was to examine the association between neural processing of health information and perceived discrimination. In particular, we focused on three previously identified measures of health information processing associated with distinct brain areas: analytic network, empathy network, and the ventral medial prefrontal cortex. METHODS Data were obtained from 24 African Americans enrolled in a blood pressure self-care management study. Participants completed surveys assessing racial discrimination and global stress, as well as a 40-minute functional magnetic resonance imaging protocol used to measure neural activation associated with processing different types of health information. RESULTS Discrimination stress was significantly related to reduced activation of the empathy network and ventral medial prefrontal cortex, whereas there was a nonsignificant positive relationship with activity in the analytic network. DISCUSSION Uncovering associations between patient experiences, such as racial discrimination, and their neural processing of health information can lead to the development of tailored health messages and self-care management interventions. This may inform strategies to close the gap on health outcomes.
Collapse
|
15
|
Enhanced functional connectivity between insular subregions correlates with the efficacy of music and instruction-guided relaxation in depression. Neuroreport 2020; 31:1215-1224. [PMID: 33105441 DOI: 10.1097/wnr.0000000000001534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Music and instruction-guided relaxation (MIGR) is a complementary therapeutic tool used in the treatment of the major depressive disorder (MDD). However, the neural mechanism that underlies the effect of MIGR on MDD patients is not known. Twenty-three right-handed MDD patients and 23 age-, sex-, handedness-, and educational level-matched healthy controls were enrolled. Resting-state functional MRI data were acquired from patients before and after MIGR and from healthy controls. The relationships between insular subregion-based functional connectivity and Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAM-A), Automatic Thoughts Questionnaire, and Ruminative Responses Scale scores were examined. One-way analysis of variance exhibited significant differences among the three groups in functional connectivity between the left dorsal anterior insula (dAI) and left superior medial frontal gyrus (SMFG), left dAI and left precuneus, left posterior insula and left gyrus rectus, right ventral anterior insula (vAI) and left posterior cingulate cortex (PCC), right vAI and right inferior frontal gyrus (R-IFG). Further comparisons in regions of interest showed that MDD patients before MIGR showed decreased functional connectivity between the left dAI and left SMFG, left dAI and left precuneus, left posterior insula, and left gyrus rectus, right vAI and left PCC, right vAI and R-IFG relative to those in healthy controls. The strength of functional connectivity between the right dAI and left putamen also exhibited a negative correlation with the HAM-A score in MDD cases before MIGR. MIGR may result in enhanced functional connectivity in insular subregions, thereby potentially increasing the regulatory influence of cognitive reappraisal.
Collapse
|
16
|
Frewen P, Schroeter ML, Riva G, Cipresso P, Fairfield B, Padulo C, Kemp AH, Palaniyappan L, Owolabi M, Kusi-Mensah K, Polyakova M, Fehertoi N, D’Andrea W, Lowe L, Northoff G. Neuroimaging the consciousness of self: Review, and conceptual-methodological framework. Neurosci Biobehav Rev 2020; 112:164-212. [DOI: 10.1016/j.neubiorev.2020.01.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 01/06/2020] [Accepted: 01/20/2020] [Indexed: 01/04/2023]
|
17
|
Mazefsky CA, Collier A, Golt J, Siegle GJ. Neural features of sustained emotional information processing in autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:941-953. [PMID: 32106690 DOI: 10.1177/1362361320903137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Many individuals with autism spectrum disorder struggle with emotions that are intense and interfering, which is referred to as emotion dysregulation. Prior research has established that individuals with autism may be more likely than individuals who are not autistic to have repetitive thoughts. It is possible that persistent thoughts about negative or distressing stimuli may contribute to emotion dysregulation in autism spectrum disorder. This study aimed to identify areas of the brain with evidence of persistent processing of negative information via functional magnetic resonance neuroimaging. We used a task that alternated between emotional processing of personally relevant negative words, neutral words, and a non-emotional task. Criteria were developed to define heightened and persistent emotional processing, and analyses were conducted to identify all brain regions satisfying these criteria. Participants included 25 adolescents with autism spectrum disorder and 23 typically developing adolescents who were similar to the autism spectrum disorder group in IQ, age, and gender ratios. Brain regions identified as having greater and continued processing following negative stimuli in the autism spectrum disorder group as compared with the typically developing group included the salience network and the prefrontal dorsolateral cortex. These areas have been previously implicated in emotion dysregulation outside of autism spectrum disorder. Collectively, brain activity in the identified regions was associated with parent-reported emotion dysregulation in the autism spectrum disorder group. These results help to identify a potential process in the brain associated with emotion dysregulation in autism spectrum disorder. This information may be useful for the development of treatments to decrease emotion dysregulation in autism spectrum disorder.
Collapse
Affiliation(s)
| | | | - Josh Golt
- University of Pittsburgh, USA.,The University of Alabama, USA
| | | |
Collapse
|
18
|
Chen Y, Cui Q, Xie A, Pang Y, Sheng W, Tang Q, Li D, Huang J, He Z, Wang Y, Chen H. Abnormal dynamic functional connectivity density in patients with generalized anxiety disorder. J Affect Disord 2020; 261:49-57. [PMID: 31600587 DOI: 10.1016/j.jad.2019.09.084] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/03/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Numerous studies have revealed the abnormal static functional connectivity (FC) among different brain regions in patients with generalized anxiety disorder (GAD). However, little is known about the dynamic changes of FC in patients with GAD. METHODS This study investigated the whole-brain dynamic changes of FC in patients with GAD by combining global FC density (FCD) and sliding window correlation analyses. The standard deviation of dynamic FCD (dFCD) was calculated to evaluate its temporal variability along time. Support vector regression was then employed to predict the symptom severity of patients based on abnormal dynamic connectivity patterns. RESULTS The abnormal dFCD variability between 81 GAD patients and 80 healthy controls showed that the patients had higher dFCD variability in the bilateral dorsomedial prefrontal cortex (dmPFC) and left hippocampus while lower dFCD variability in the right postcentral gyrus. The abnormal dFCD variability of the left dmPFC is an important feature for anxiety prediction. LIMITATIONS The selection of sliding window length remains controversial, and most of our patients have been treated with medications. Future studies are expected to rule out the potential confounding effects from applying different parameters of the sliding window and recruiting large samples of medication-free patients. CONCLUSION The altered patterns of time-varying brain connectivity in the frontolimbic and sensorimotor areas may reflect abnormal dynamic neural communication between these regions and other regions of the brain, which may deepen our understanding of the disease.
Collapse
Affiliation(s)
- Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Ailing Xie
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| |
Collapse
|
19
|
Renna ME, Fresco DM, Mennin DS. Emotion Regulation Therapy and Its Potential Role in the Treatment of Chronic Stress-Related Pathology Across Disorders. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2020; 4:2470547020905787. [PMID: 32440604 PMCID: PMC7219947 DOI: 10.1177/2470547020905787] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/22/2020] [Indexed: 02/04/2023]
Abstract
Although stress is an inevitable part of everyday life, its chronicity, severity, and perceived burden can result in enduring distress, which may manifest as heightened emotionality, contributing to a number of self-regulatory failures. Specifically, distress disorders are characterized, in part, by heightened sensitivity to underlying motivational systems related to threat/safety, reward/loss, or both. Further, individuals suffering from these conditions typically engage in perseverate negative thinking (e.g., worry, rumination, self-criticism) in an effort to manage motivationally relevant distress and often utilize these processes at the detriment of engaging in new contextual learning. Distress disorders are often brought on by enduring chronic stress, coupled with these maladaptive emotional, cognitive, and behavioral responses and ensuing impairment which contribute to and in turn worsen the deficits from these purported mechanisms. Emotion regulation therapy is a theoretically derived treatment that is based upon affective science to offer a blueprint for improving intervention by focusing on targeting the motivational responses and corresponding regulatory failures of individuals with distress disorders. Open and randomized controlled trials have demonstrated considerable preliminary evidence for the utility of emotion regulation therapy and its proposed mechanisms in treating the distress conditions.
Collapse
Affiliation(s)
- Megan E. Renna
- Institute for Behavioral Medicine Research & Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA
| | - David M. Fresco
- Department of Psychiatry & Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Douglas S. Mennin
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, USA
| |
Collapse
|
20
|
O’Toole MS, Renna ME, Mennin DS, Fresco DM. Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression. Behav Ther 2019; 50:1042-1052. [PMID: 31735240 PMCID: PMC7441462 DOI: 10.1016/j.beth.2018.12.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 12/18/2022]
Abstract
Emotion Regulation Therapy (ERT) has demonstrated efficacy in both open and randomized trials for generalized anxiety disorder (GAD) with and without co-occurring depression. An important goal in ERT is to teach clients adaptive emotion regulation, including healthier metacognitive abilities such as decentering and cognitive reappraisal. A few studies thus far have demonstrated a mediating role for these metacognitive abilities in other cognitive behavioral therapies (CBTs) for GAD. However, a drawback to most of these has been the ability to demonstrate a causal role for improved metacognitive abilities in outcome. In the present study, we utilized multilevel time-lagged segment analyses to explore the temporal dynamics between session-by-session changes in metacognition and anxiety outcomes from ERT. Thirty-one young adults diagnosed with GAD with and without co-occurring depression received 16 sessions of ERT. Prior to each session, participants completed questionnaires pertaining to metacognition (i.e., decentering and cognitive reappraisal) and anxiety symptoms (i.e., worry, trait anxiousness, and generalized anxiety). Changes in decentering temporally preceded changes in worry and trait anxiousness of a medium to large magnitude, and changes in cognitive reappraisal temporally preceded changes in all three outcomes of a medium to large magnitude. The reverse direction, where mediators were predicted by outcomes, was nonsignificant. These findings support the notion that adaptive metacognitive emotion regulation is involved in reducing worry and anxiety in GAD. Having a clearer understanding of the temporal dynamics between metacognitive abilities and symptoms of anxiety can inform and improve not only ERT but other CBTs for GAD, as well.
Collapse
Affiliation(s)
| | | | | | - David M. Fresco
- Kent State University & Case Western Reserve University School of Medicine
| |
Collapse
|
21
|
Fresco DM, Mennin DS. All together now: utilizing common functional change principles to unify cognitive behavioral and mindfulness-based therapies. Curr Opin Psychol 2019; 28:65-70. [PMID: 30502664 PMCID: PMC6491260 DOI: 10.1016/j.copsyc.2018.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/26/2018] [Indexed: 12/29/2022]
Abstract
Cognitive behavior therapy (CBT) and mindfulness-based interventions (MBI) have made important contributions to resolving the global burden of mental illness. However, response rates are comparatively more modest for the distress disorders. Newer CBTs enriched with MBI components have emerged with promising findings for distress disorders but with a high degree of heterogeneity and, subsequently, an unclear path for determining the unique and synergistic contributions from CBTs and MBIs. We propose that one way to elucidate and improve upon this union is to identify common overarching principles (i.e. attention change; metacognitive change) that guide both approaches and to refine therapeutic processes to optimally reflect these common targets and their interplay (e.g. sequencing and dosing).
Collapse
Affiliation(s)
- David M Fresco
- Kent State University, Case Western Reserve University, United States.
| | | |
Collapse
|
22
|
Bozzatello P, Morese R, Valentini MC, Rocca P, Bosco F, Bellino S. Autobiographical memories, identity disturbance and brain functioning in patients with borderline personality disorder: An fMRI study. Heliyon 2019; 5:e01323. [PMID: 30949597 PMCID: PMC6430005 DOI: 10.1016/j.heliyon.2019.e01323] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/21/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022] Open
Abstract
Identity disturbance is a core feature of borderline personality disorder (BPD). Autobiographical memory is a process of reflective thinking through which we form links between elements of life and self. It can be considered as an indirect index of identity integration. The present study was aimed to investigate the differences in brain activity patterns between BPD patients with identity diffusion and healthy controls using fMRI. We enrolled 24 BPD patients and 24 healthy controls. Identity integration in patients and controls was assessed with the Identity Disturbance Questionnaire (IDQ) score and was significantly different (p = 0.001). We analysed hemodynamic response in the regions of interest during presentation of resolved and unresolved life events. With reference to the condition "resolved", increased cerebral activity in right anterior cingulate cortex (ACC), right medial prefrontal cortex (MPFC), right dorsolateral prefrontal cortex (DLPFC), and bilateral insula was registered in BPD patients compared with controls. In the condition "unresolved", increased brain activity was observed in patients in bilateral ACC, bilateral DLPFC, and right temporo-parietal junction. Hyperactivity in ACC and DLPFC in BPD patients with both conditions (resolved and unresolved contexts) may be due to an inefficient attempt to reconstruct a coherent narrative of life events (resolved or not).
Collapse
Affiliation(s)
- Paola Bozzatello
- Centre for Personality Disorders, Department of Neuroscience, University of Turin, Turin, Italy
| | - Rosalba Morese
- Department of Psychology, University of Turin, Italy.,Faculty of Communication Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | | | - Paola Rocca
- Department of Neuroscience, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Italy
| | - Francesca Bosco
- Department of Psychology, University of Turin, Italy.,Neuroscience Institute of Turin, Italy
| | - Silvio Bellino
- Centre for Personality Disorders, Department of Neuroscience, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Italy
| |
Collapse
|
23
|
A neurobehavioral account for decentering as the salve for the distressed mind. Curr Opin Psychol 2019; 28:285-293. [PMID: 31059966 DOI: 10.1016/j.copsyc.2019.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/21/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
Distress is commonly characterized by prolonged internal suffering that can range from self-focused processing of negative emotions and stressors, to highly intensely aversive and prolonged emotional states, thereby, worsening or complicating emotional and physical conditions. Decentering represents a metacognitive capacity thought to reflect three interrelated processes: meta-awareness, disidentification from internal experience, and reduced reactivity to thought content-which is reliably increased with mindfulness-based interventions. In this essay, we seek to link the clinical presentation of distress disorders to known or hypothesized disruptions in neural networks that underlie emotion, cognition, and goal directed behavior, and offer a neurobehavioral account for how and why treatments imbued with mindfulness meditation might ameliorate these conditions, in part through increases in decentering.
Collapse
|
24
|
Scult MA, Fresco DM, Gunning FM, Liston C, Seeley SH, García E, Mennin DS. Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy. Front Behav Neurosci 2019; 13:10. [PMID: 30778290 PMCID: PMC6369363 DOI: 10.3389/fnbeh.2019.00010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/15/2019] [Indexed: 12/21/2022] Open
Abstract
Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (SN) reflecting emotion/motivation and the default mode network (DMN) reflecting self-referentiality. Using resting-state functional connectivity (rsFC) analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized anxiety disorder (GAD) patients [with and without major depressive disorder (MDD)] drawn from a larger intervention trial (Renna et al., 2018a), who completed resting state fMRI scans before and after receiving 16 sessions of ERT. We utilized seed-based connectivity analysis with seeds in the posterior cingulate cortex (PCC), right anterior insula, and right posterior insula, to investigate whether ERT was associated with changes in connectivity of nodes of the DMN and SN networks to regions across the brain. Findings revealed statistically significant treatment linked changes in both the DMN and SN network nodes, and these changes were associated with clinical improvement corresponding to medium effect sizes. The results are discussed in light of a nuanced understanding of the role of connectivity changes in GAD and MDD, and begin to provide neural network support for the hypothesized treatment model predicated by ERT.
Collapse
Affiliation(s)
- Matthew A Scult
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States.,Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - David M Fresco
- Department of Psychological Science, Kent State University, Kent, OH, United States.,Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States.,Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
| | - Saren H Seeley
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Emmanuel García
- The Graduate Center, City College of New York, City University of New York (CUNY), New York, NY, United States.,Hunter College, City University of New York, New York, NY, United States
| | - Douglas S Mennin
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| |
Collapse
|
25
|
Scult MA, Fresco DM, Gunning FM, Liston C, Seeley SH, García E, Mennin DS. Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy. Front Behav Neurosci 2019; 13:10. [PMID: 30778290 DOI: 10.3389/fnbeh.2019.00010/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/15/2019] [Indexed: 05/20/2023] Open
Abstract
Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (SN) reflecting emotion/motivation and the default mode network (DMN) reflecting self-referentiality. Using resting-state functional connectivity (rsFC) analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized anxiety disorder (GAD) patients [with and without major depressive disorder (MDD)] drawn from a larger intervention trial (Renna et al., 2018a), who completed resting state fMRI scans before and after receiving 16 sessions of ERT. We utilized seed-based connectivity analysis with seeds in the posterior cingulate cortex (PCC), right anterior insula, and right posterior insula, to investigate whether ERT was associated with changes in connectivity of nodes of the DMN and SN networks to regions across the brain. Findings revealed statistically significant treatment linked changes in both the DMN and SN network nodes, and these changes were associated with clinical improvement corresponding to medium effect sizes. The results are discussed in light of a nuanced understanding of the role of connectivity changes in GAD and MDD, and begin to provide neural network support for the hypothesized treatment model predicated by ERT.
Collapse
Affiliation(s)
- Matthew A Scult
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - David M Fresco
- Department of Psychological Science, Kent State University, Kent, OH, United States
- Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
| | - Saren H Seeley
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Emmanuel García
- The Graduate Center, City College of New York, City University of New York (CUNY), New York, NY, United States
- Hunter College, City University of New York, New York, NY, United States
| | - Douglas S Mennin
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| |
Collapse
|
26
|
|
27
|
Hayes-Skelton SA, Lee CS. Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder. Behav Ther 2018; 49:809-822. [PMID: 30146146 PMCID: PMC6112177 DOI: 10.1016/j.beth.2018.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 01/08/2018] [Accepted: 01/20/2018] [Indexed: 01/11/2023]
Abstract
To further improve treatments, we need to better understand potential common treatment mechanisms, such as decentering, or the ability to observe thoughts and feelings as objective events in the mind rather than personally identifying with them (Safran & Segal, 1990). Therefore, this study examined whether 12 sessions of Cognitive Behavioral Group Therapy (CBGT) for 63 clients (57.6% female, 50.8% White) diagnosed with social anxiety disorder led to increases in decentering and whether increased decentering was associated with improved outcome. Furthermore, this study examined whether decentering was associated with outcome over and above a competing mechanism-cognitive reappraisal. Overall, results indicated that CBGT in this study led to similar outcomes compared to previous studies and decentering increased over CBGT (d's from 0.81 to 2.23). Change in decentering predicted improvement on most, but not all, measures of outcome and those who no longer met criteria for social anxiety disorder at posttreatment had significantly greater change in decentering across therapy and significantly higher decentering scores at post-treatment compared to those who retained a social anxiety disorder diagnosis at posttreatment. Finally, changes in decentering predicted outcome over and above changes in reappraisal on all outcome measures. These results largely support the role of decentering in CBGT for social anxiety; however, the implications of the inconsistencies in results based on which outcome measure was used are discussed.
Collapse
|
28
|
Bendall RCA, Royle S. Decentering mediates the relationship between vmPFC activation during a stressor and positive emotion during stress recovery. J Neurophysiol 2018; 120:2379-2382. [PMID: 30133385 DOI: 10.1152/jn.00353.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The stress response has profound implications on health and behavior and stress is considered a risk factor for the development of psychopathologies including depression. The neural mechanisms supporting successful stress recovery are not fully understood; however, a novel study by Yang et al. (Yang X, Garcia KM, Jung Y, Whitlow CT, McRae K, Waugh CE. Soc Cogn Affect Neurosci 13: 256-268, 2018) demonstrates that ventromedial prefrontal cortex (vmPFC) activation during a stressor is related to improved stress recovery, and that decentering is able to mediate this relationship, suggesting a role during stress recovery. It was also revealed that vmPFC activation at different time points during the stressor predicts altering aspects of stress recovery, an observation that was only possible due to the adoption of change-point analysis.
Collapse
Affiliation(s)
- Robert C A Bendall
- Directorate of Psychology & Public Health, School of Health Sciences, University of Salford , Salford , United Kingdom
| | - Sam Royle
- Directorate of Psychology & Public Health, School of Health Sciences, University of Salford , Salford , United Kingdom
| |
Collapse
|
29
|
Renna ME, Quintero JM, Soffer A, Pino M, Ader L, Fresco DM, Mennin DS. A Pilot Study of Emotion Regulation Therapy for Generalized Anxiety and Depression: Findings From a Diverse Sample of Young Adults. Behav Ther 2018; 49:403-418. [PMID: 29704969 PMCID: PMC7486678 DOI: 10.1016/j.beth.2017.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/25/2017] [Accepted: 09/01/2017] [Indexed: 01/29/2023]
Abstract
Emotion regulation therapy (ERT) for generalized anxiety disorder (GAD) and accompanying major depressive disorder (MDD) is a theoretically derived, evidence-based treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding self-referential regulatory characteristics. Preliminary evidence supports the efficacy of a 20-session version of ERT. However, previous trials of ERT and other traditional and contemporary cognitive-behavioral therapies have often utilized relatively homogeneous samples. Various contextual and demographic factors may be associated with challenges that increase risk for negative mental and social outcomes for young adults ages 18-29, particularly for individuals from diverse backgrounds. The aim of this pilot study was to examine the effectiveness of a briefer 16-session version of ERT in a racially and ethnically diverse sample of young adults. Participants (N = 31) were enrolled at an urban-based, commuter college who consented to treatment for anxiety, worry, or depression at an on-campus counseling center. Open-trial results demonstrate strong ameliorative changes in worry, rumination, self-reported and clinician-rated GAD and MDD severity, social disability, quality of life, attentional flexibility, decentering/distancing, reappraisal, trait mindfulness, and negative emotionality from pre- to posttreatment. These gains were maintained throughout a 3- and 9-month follow-up. These findings provide preliminary evidence for the efficacy of ERT in treating a racially and ethnically heterogeneous population. Further, this study highlights comparable effectiveness of a briefer 16-session version of ERT.
Collapse
Affiliation(s)
| | | | | | | | | | - David M. Fresco
- Kent State University Case, Western Reserve University School of Medicine
| | | |
Collapse
|
30
|
Ottaviani C. Brain-heart interaction in perseverative cognition. Psychophysiology 2018; 55:e13082. [PMID: 29607505 DOI: 10.1111/psyp.13082] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/28/2022]
Abstract
The move from the concept of homeostasis to that of allostasis has led reactivity stress research to widen the object of its investigation: from the brief physiological response that occurs when one is facing a stressor to what happens when one is anticipating or recovering from a stressor. A paradigmatic example is represented by perseverative cognition, during which human beings react "as if" they were constantly facing a concrete stressor. The core idea behind this review is that the cognitive inflexibility that characterizes perseverative cognition is reflected in both our body (by increased autonomic nervous system rigidity assessed by heart rate variability; HRV) and our brain (by reduced prefrontal-amygdala functional connectivity). This is a review of studies conducted in different settings (laboratory, daily life), populations (healthy, major depression, generalized anxiety), location (United States, Europe), and age groups (children, adults) that consistently replicated the association between autonomic, subjective, and behavioral measures of cognitive inflexibility during perseverative cognition. Moreover, compelling neuroimaging data suggest that HRV reduction from pre- to post-induction of perseverative cognition is associated with both structural and functional brain abnormalities reflecting impaired prefrontal inhibitory control over subcortical structures (e.g., diminished prefrontal-amygdala functional connectivity). The integration of neuroscience techniques with clinical autonomic research has advanced our understanding of the neurobiology of brain-heart interaction during perseverative cognition, potentially yielding to more effective treatment packages. This is clinically relevant if one considers that perseverative cognition is a pervasive transdiagnostic factor that carries prognostic risk for both psychological and somatic health.
Collapse
Affiliation(s)
- Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
31
|
Mennin DS, Fresco DM, O'Toole MS, Heimberg RG. A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression. J Consult Clin Psychol 2018; 86:268-281. [PMID: 29504794 PMCID: PMC5841545 DOI: 10.1037/ccp0000289] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Generalized anxiety disorder (GAD) and major depression (MDD), especially when they co-occur, are associated with suboptimal treatment response. One common feature of these disorders is negative self-referential processing (NSRP; i.e., worry, rumination), which worsens treatment outcome. Emotion Regulation Therapy (ERT) integrates principles from affect science with traditional and contemporary cognitive-behavioral treatments to identify and modify the functional nature of NSRP by targeting motivational and regulatory mechanisms, as well as behavioral consequences. METHOD Building on encouraging open trial findings, 53 patients with a primary diagnosis of GAD (43% with comorbid MDD) were randomly assigned to immediate treatment with ERT (n = 28) or a modified attention control condition (MAC, n = 25). RESULTS ERT patients, as compared with MAC patients, evidenced statistically and clinically meaningful improvement on clinical indicators of GAD and MDD, worry, rumination, comorbid disorder severity, functional impairment, quality of life, as well as hypothesized mechanisms reflecting mindful attentional, metacognitive, and overall emotion regulation, which all demonstrated mediation of primary outcomes. This superiority of ERT exceeded medium effect sizes with most outcomes surpassing conventions for a large effect. Treatment effects were maintained for nine months following the end of acute treatment. Overall, ERT resulted in high rates of high endstate functioning for both GAD and MDD that were maintained into the follow-up period. CONCLUSIONS Findings provide encouraging support for the efficacy and hypothesized mechanisms underlying ERT and point to fruitful directions for improving our understanding and treatment of complex clinical conditions such as GAD with co-occurring MDD. (PsycINFO Database Record
Collapse
Affiliation(s)
- Douglas S Mennin
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - David M Fresco
- Department of Psychological Sciences, Kent State University
| | | | | |
Collapse
|
32
|
Stange JP, Hamilton JL, Fresco DM, Alloy LB. Perseverate or decenter? Differential effects of metacognition on the relationship between parasympathetic inflexibility and symptoms of depression in a multi-wave study. Behav Res Ther 2017; 97:123-133. [PMID: 28772194 DOI: 10.1016/j.brat.2017.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/26/2017] [Accepted: 07/14/2017] [Indexed: 02/08/2023]
Abstract
Depression often is characterized by inflexible autonomic and metacognitive processes that interfere with effective self-regulation. However, few studies have integrated these factors to improve the prediction of which individuals are at greatest risk for depression. Among 134 undergraduates, we evaluated whether parasympathetic inflexibility (a lack of reduction in respiratory sinus arrhythmia) in response to a sadness induction involving loss would prospectively predict symptoms of depression across four waves of follow-up over twelve weeks. Furthermore, we evaluated whether metacognitive components of perseverative cognition (PC) and decentering (identified by a principal component analysis) would moderate this relationship in opposite directions. Multilevel modeling demonstrated that the relationship between parasympathetic inflexibility and prospective symptoms of depression was exacerbated by PC, but attenuated by decentering. Furthermore, individuals with parasympathetic inflexibility, PC, and low decentering were at greatest risk for symptoms of depression across follow-up. These results support the utility of integrating autonomic and metacognitive risk factors to identify individuals at risk for depression.
Collapse
|