Automatic emotional information processing and the cortisol response to acute psychosocial stress

Older adults’ mental health information preferences: a call for more balanced information to empower older adults’ mental health help-seeking

A small minority of older adults seek psychological help when they need it. Barriers to mental health service use among older adults include low mental health literacy and reduced opportunities for shared decision-making in health care. There is a gap in the literature examining the mental health information preferences of older adults. The objectives of this study were to describe the information preferences and predictors of preferences among older adults. In total, 229 adults aged 50 years and older in central Canada responded to a questionnaire investigating socio-demographic, psycho-social and health-related characteristics, as well as mental health information preferences. Descriptive analysis quantified participants’ ratings of information preferences and hierarchical linear regression analysis determined predictors of their preferences. Older adults rated all mental health content items as very important. Most participants preferred detailed information (two to six pages) on all treatment options (psychological, pharmacological, combined and self-help). Older adults significantly preferred discussion with a heath-care provider and written information, in comparison to other formats. Older adults also significantly preferred to consult family, friends and heath-care professionals over other sources. Socio-demographic and psycho-social characteristics accounted for some of the variance in predicting older adults’ information preferences. Findings highlight older adults’ desire to be involved in decisions concerning mental health supports. Providing balanced information concerning mental health treatment may increase empowerment in mental health help-seeking.

Resting-state dynamic functional connectivity predicts the psychosocial stress response

Acute stress triggers a complex cascade of psychological, physiological, and neural responses, which show large and enduring individual differences. Although previous studies have examined the relationship between the stress response and dynamic features of the brain's resting state, no study has used the brain's dynamic activity in the resting state to predict individual differences in the psychosocial stress response. In the current study, resting-state scans of forty-eight healthy participants were collected, and then their individual acute stress responses during the Montreal Imaging Stress Test (MIST) paradigm were recorded. Results defined a connectivity state (CS) characterized by positive correlations across the whole brain during resting-state that could negatively predict participants' feelings of social evaluative threat during stress tasks. Another CS characterized by negative correlations between the frontal-parietal network (FPN) and almost all other networks, except the dorsal attentional network (DAN), could predict participants' subjective stress, feelings of uncontrollability, and feelings of social evaluative threat. However, no CS could predict participants' salivary cortisol stress response. Overall, these results suggested that the brain state characterized as attentional regulation, linking self-control, and top-down regulation ability, could predict the psychosocial stress response. This study also developed an objective indicator for predicting human stress responses.

Increase in Beta Power Reflects Attentional Top-Down Modulation After Psychosocial Stress Induction

Selective attention depends on goal-directed and stimulus-driven modulatory factors, each relayed by different brain rhythms. Under certain circumstances, stress-related states can change the balance between goal-directed and stimulus-driven factors. However, the neuronal mechanisms underlying these changes remain unclear. In this study, we explored how psychosocial stress can modulate brain rhythms during an attentional task and a task-free period. We recorded the EEG and ECG activity of 42 healthy participants subjected to either the Trier Social Stress Test (TSST), a controlled procedure to induce stress, or a comparable control protocol (same physical and cognitive effort but without the stress component), flanked by an attentional task, a 90 s of task-free period and a state of anxiety questionnaire. We observed that psychosocial stress induced an increase in heart rate (HR), self-reported anxiety, and alpha power synchronization. Also, psychosocial stress evoked a relative beta power increase during correct trials of the attentional task, which correlates positively with anxiety and heart rate increase, and inversely with attentional accuracy. These results suggest that psychosocial stress affects performance by redirecting attentional resources toward internal threat-related thoughts. An increment of endogenous top-down modulation reflected an increased beta-band activity that may serve as a compensatory mechanism to redirect attentional resources toward the ongoing task. The data obtained here may contribute to designing new ways of clinical management of the human stress response in the future and could help to minimize the damaging effects of persistent stressful experiences.

Hormonal and modality specific effects on males' emotion recognition ability

Successful emotion recognition is a key component of human socio-emotional communication skills. However, little is known about the factors impacting males' accuracy in emotion recognition tasks. This pre-registered study examined potential candidates, focusing on the modality of stimulus presentation, emotion category and individual baseline hormone levels. In an additional exploratory analysis, we examined the association of testosterone x cortisol interaction with recognition accuracy and reaction times. We obtained accuracy and reaction time scores from 282 males who categorized voice, face and voice-face stimuli for nonverbal emotional content. Results showed that recognition accuracy was significantly higher in the audio-visual than in the auditory or visual modality. While Spearman's rank correlations showed no significant association of testosterone (T) with recognition accuracy or with response times for specific emotions, the logistic and linear regression models uncovered some evidence for a positive association between T and recognition accuracy as well as between cortisol (C) and reaction time. In addition, the overall effect size of T by C interaction with recognition accuracy and reaction time was significant, but small. Our results establish that audio-visual congruent stimuli enhance recognition accuracy and provide novel empirical support by showing that the interaction of testosterone and cortisol relates to males' accuracy and response times in emotion recognition tasks.

Poor inhibition of personally-relevant facial expressions of sadness and anger predicts an elevated cortisol response following awakening six months later

Failure to inhibit interference from distracting emotional stimuli may obstruct an individual's ability to regulate their behavioural and emotional responses to environmental stressors. Few studies have examined the longitudinal association between cognitive inhibition and regulation of the hypothalamic-pituitary-adrenal axis (HPA) in the natural environment. Seventy-nine healthy adults underwent two assessments 6 months apart. Participants' ability to suppress interference from distracting emotional stimuli was assessed using a negative affective priming task that included both generic and personally-relevant (i.e., participants' intimate partners) facial expressions of emotion. Poorer inhibition of personally-relevant sad and angry faces, but not generic stimuli, significantly predicted an increased cortisol awakening response (CAR) six months later. Moreover, poor inhibition of personally-relevant sad faces mediated the relation between chronic stress and an elevated CAR. Difficulties inhibiting personally-relevant emotional information may represent a key mechanism in understanding how environmental stress influences HPA functioning.

The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression

Depression is among the most significant public mental health issues. A growing body of research implicates inflammation in the etiology and pathophysiology of depression. Yet, the results are somewhat inconsistent, leading to burgeoning attempts to identify associations between components of innate immune system involved in inflammation and specific symptoms of depression, including attention to emotional information. Negative attentional bias, defined as a tendency to direct attention toward negatively valenced information, is one of the core cognitive features of depression and is reliably demonstrated in depressed and vulnerable individuals. Altered attentional processing of emotional information and immunological changes are often precipitated by stressful events. Psychological stress triggers inflammatory activity and affective-cognitive changes that play a critical role in the onset, maintenance, and recurrence of depression. Using various designs, recent studies have reported a positive relationship between markers of inflammation and negative attentional bias on behavioral and neural levels, suggesting that the association between inflammation and emotional attention might represent a neurobiological pathway linking stress and depression. This mini-review summarizes current research on the reciprocal relationships between different types of stressors, emotional attention, inflammation, and depression, and discusses potential neurobiological mechanisms underlying these interactions. The integration provided aims to contribute toward understanding how biological and psychological processes interact to influence depression outcomes.

Social anxiety and employment interviews: does nonverbal feedback differentially predict cortisol and performance?

BACKGROUND & OBJECTIVES

Interviewers often provide positive nonverbal feedback to reduce interviewees' anxiety. Socially anxious individuals typically harbor negative self-views discrepant with positive feedback. We examined whether nonverbal feedback and social anxiety jointly influence cortisol responses to, and performance during, interviews.

DESIGN

An experimental between-subjects design randomly assigned participants to feedback condition.

METHODS

Undergraduate students (N = 130) provided saliva and completed social anxiety, interview anxiety, and affective measures before a simulated interview. Following a standardized script, a confederate interviewer provided positive, ambiguous, or negative nonverbal feedback. Participants then provided saliva and completed self-focused attention and self-awareness measures. Confederate interviewers and an external rater evaluated participants' anxiety displays, assertive behavior, and performance.

RESULTS

Positive feedback decreased cortisol and improved performance for low social anxiety participants. Socially anxious participants exhibited higher cortisol but did not exhibit significant differences in performance after positive compared to negative feedback.

CONCLUSIONS

Consistent with previous findings, positive feedback did not benefit socially anxious interviewees. Positive feedback increased physiological arousal relative to negative feedback but did not hinder performance among people high in social anxiety. These results provide novel information about the interactive influence of social anxiety and nonverbal interviewer feedback on arousal, self-focus, and interview performance.

Heart rate variability is associated with psychosocial stress in distinct social domains

OBJECTIVE

Psychosocial stress is associated with substantial morbidity and mortality. Accordingly, there is a growing interest in biomarkers that indicate whether individuals show adaptive (i.e., stress-buffering and health-promoting) or maladaptive (i.e., stress-escalating and health-impairing) stress reactions in social contexts. As heart rate variability (HRV) has been suggested to be a biomarker of adaptive behavior during social encounters, it may be possible that inter-individual differences in HRV are associated with inter-individual differences regarding stress in distinct social domains.

METHODS

To test this hypothesis, resting state HRV and psychosocial stress was assessed in 83 healthy community-dwelling individuals (age: 18-35years). HRV was derived from heart rate recordings during spontaneous and instructed breathing to assess the robustness of possible associations between inter-individual differences in HRV and inter-individual differences in psychosocial stress. Psychosocial stress was determined with a self-report questionnaire assessing stress in distinct social domains.

RESULTS

A series of categorical and dimensional analyses revealed an association between inter-individual differences in HRV and inter-individual differences in psychosocial stress: Individuals with high HRV reported less stress in social life, but not in family life, work life or everyday life, than individuals with low HRV.

CONCLUSIONS

On basis of these findings, it may be assumed that individuals with high HRV experience less psychosocial stress than individuals with low HRV. Although such an assumption needs to be corroborated by further findings, it seems to be consistent with previous findings showing that individuals with high HRV suffer less from stress and stress-related disorders than individuals with low HRV.

Arginine Vasopressin Alters Both Spontaneous and Phase-Locked Synaptic Inputs to Airway Vagal Preganglionic Neuron via Activation of V1a Receptor: Insights into Stress-Related Airway Vagal Excitation

The airway vagal preganglionic neurons (AVPNs) in the external formation of the nucleus ambiguus (eNA) play a major role in the vagal control of tracheobronchial smooth muscle tone and maintenance of airway resistance. The eNA receives vasopressinergic projection from the hypothalamic paraventricular nucleus (PVN), the key node for the genesis of psychological stress. Since airway vagal excitation is reportedly to be associated with the psychological stress-induced/exacerbated airway hyperresponsiveness in asthmatics, arginine vasopressin (AVP) might be involved in stress-related airway vagal excitation. However, this possibility has not been validated. This study aimed to test whether and how AVP regulates AVPNs. In rhythmically active medullary slices of newborn rats, retrogradely labeled AVPNs were identified as inspiratory-activated and inspiratory-inhibited AVPNs (IA- and II-AVPNs) using patch-clamp techniques according to their inspiratory-related firing behavior and synaptic activities. The results show that under current clamp, AVP depolarized both IA- and II-AVPNs, and significantly increased their spontaneous firing rate. Under voltage clamp, AVP elicited a slow inward current, and significantly increased the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) in both types of AVPNs. In addition, AVP significantly enhanced the phase-locked excitatory inspiratory inward current in inspiratory-activated airway vagal preganglionic neurons (IA-AVPNs), but significantly suppressed the phase-locked inhibitory inspiratory outward current in II-AVPNs. In both types AVPNs, AVP significantly increased the frequency and amplitude of pharmacologically isolated spontaneous GABAergic and glycinergic inhibitory postsynaptic currents (IPSCs). All of the AVP-induced effects were prevented by SR49059, an antagonist of V_1a receptors, but unaffected by SSR149415, an antagonist of V_1b receptors. AVP did not cause significant changes in the miniature excitatory postsynaptic currents (mEPSCs), miniature inhibitory postsynaptic currents (mIPSCs) and membrane input resistance of either type of AVPNs. These results demonstrate that AVP, via activation of V_1a receptors, enhanced the spontaneous excitatory and inhibitory inputs similarly in the two types of AVPNs, but differentially altered their phase-locked inspiratory excitatory and inhibitory inputs. The overall effects of AVP are excitatory in both types AVPNs. These results suggest that increased central AVP release may be involved in the stress-induced augmentation of airway vagal activity, and, consequently, the induction or exacerbation of some airway diseases.

Interplay between stress response genes associated with attention-deficit hyperactivity disorder and brain volume

The glucocorticoid receptor plays a pivotal role in the brain's response to stress; a haplotype of functional polymorphisms in the NR3C1 gene encoding this receptor has been associated with attention-deficit hyperactivity disorder (ADHD). The serotonin transporter (5-HTT) gene polymorphism 5-HTTLPR is known to influence the relation between stress exposure and ADHD severity, which may be partly because of its reported effects on glucocorticoid levels. We therefore investigated if NR3C1 moderates the relation of stress exposure with ADHD severity and brain structure, and the potential role of 5-HTTLPR. Neuroimaging, genetic and stress exposure questionnaire data were available for 539 adolescents and young adults participating in the multicenter ADHD cohort study NeuroIMAGE (average age: 17.2 years). We estimated the effects of genetic variation in NR3C1 and 5-HTT, stress exposure and their interactions on ADHD symptom count and gray matter volume. We found that individuals carrying the ADHD risk haplotype of NR3C1 showed significantly more positive relation between stress exposure and ADHD severity than non-carriers. This gene-environment interaction was significantly stronger for 5-HTTLPR L-allele homozygotes than for S-allele carriers. These two- and three-way interactions were reflected in the gray matter volume of the cerebellum, parahippocampal gyrus, intracalcarine cortex and angular gyrus. Our findings illustrate how genetic variation in the stress response pathway may influence the effects of stress exposure on ADHD severity and brain structure. The reported interplay between NR3C1 and 5-HTT may further explain some of the heterogeneity between studies regarding the role of these genes and hypothalamic-pituitary-adrenal axis activity in ADHD.

Stress-Related Changes in Attentional Bias to Social Threat in Young Adults: Psychobiological Associations with the Early Family Environment

This study investigated the association of chronic childhood stress exposure with acute stress-related attentional alterations that have been previously linked to vulnerability to mental and physical illness in early adulthood. Participants were randomized in a crossover design to complete both a mild laboratory social stress task and a computerized task assessing attentional bias to socially threatening words. Salivary cortisol was measured throughout the study. Exposure to acute laboratory stress altered attentional processing, and this relationship was moderated by chronic childhood stress exposure. Also, a positive association between cortisol reactivity and attentional bias was observed, with cortisol reactivity negatively related to childhood chronic stress exposure. While previous work has supported a role for early chronic stress exposure in influencing acute stress reactivity, this work provides initial insight into how both prior chronic childhood stress and current acute stress together relate to the attentional gateway and may be associated with stress adaptation and psychological vulnerability into adulthood.

The impact of attentional training on the salivary cortisol and alpha amylase response to psychosocial stress: importance of attentional control

INTRODUCTION

This study examined the effects of three consecutive days of attentional training on the salivary alpha amylase (sAA), cortisol, and mood response to the Trier Social Stress Test (TSST). The training was designed to elicit faster disengagement of attention away from threatening facial expressions and faster shifts of attention toward positive ones.

METHOD

Fifty-six healthy participants between the ages of 18 and 30 participated in a double-blind, within-subject experiment. Participants were randomly assigned to one of three attentional training conditions - supraliminal training: pictures shown with full conscious awareness, masked training: stimuli presented with limited conscious awareness, or control training: both supraliminal and masked pictures shown but no shifting of attention required. Following training, participants underwent the TSST. Self-reported mood and saliva samples were collected for the determination of emotional reactivity, cortisol, and sAA in response to stress post-training.

RESULTS

Unexpectedly, participants in both attentional training groups exhibited a higher salivary cortisol response to the TSST relative to participants who underwent the control training, F (4, 86)=4.07, p=.005, ηp(2)=.16. Supraliminal training was also associated with enhanced sAA reactivity, F (2, 44)=13.90, p=.000, ηp(2)=.38, and a more hostile mood response (p=.021), to the TSST. Interestingly, the effect of attention training on the cortisol response to stress was more robust in those with high attentional control than those with low attentional control (β=-0.134; t=-2.24, p=.03).

CONCLUSION

This is among the first experimental manipulations to demonstrate that attentional training can elicit a paradoxical increase in three different markers of stress reactivity. These findings suggest that attentional training, in certain individuals, can have iatrogenic effects.

Cognitive function is preserved in older adults with a reported history of childhood sexual abuse

Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding.

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.

Salivary cortisol and interpersonal functioning: an event-contingent recording study in the offspring of parents with bipolar disorder

Despite a large body of research in non-human primates, the relationship between naturalistic patterns of social behaviour and basal cortisol levels has been understudied in humans. The present study examined the relationship between patterns of interpersonal functioning and cortisol levels in 23 offspring of parents with bipolar disorder (BD), at high risk for the development of an affective disorder, and 22 offspring of parents with no affective disorder (controls) in late adolescence and young adulthood. Using event-contingent recording, participants rated their dominance, submissiveness, quarrelsomeness, and agreeableness in naturally occurring social interactions over 14 consecutive days and provided salivary cortisol twice daily in the afternoon over the same period. In the full sample, multilevel modelling analyses revealed that dominance was a significant positive predictor of afternoon basal cortisol levels, t(35)=2.58, p<0.05. Moreover, risk group (having a parent with BD or parents with no affective disorder) significantly interacted with mean levels of quarrelsomeness to predict afternoon cortisol levels, t(29)=2.06, p<0.05. Offspring of parents with BD who reported more frequent quarrelsome behaviours exhibited lower levels of afternoon cortisol relative to high-risk offspring reporting few quarrelsome behaviours and control offspring. The results are consistent with evidence that dominance is associated with high cortisol levels in an unstable environment, and suggest that quarrelsomeness among high risk youth contributes to altered hypothalamic-pituitary-adrenal activity.

Associations between hypothalamic-pituitary-adrenal axis function and facial emotion processing in depressed and control participants

AIM

The current study examined the relation between facial emotion processing accuracy and an aspect of hypothalamic-pituitary-adrenal axis function in 64 inpatients with major depression and 49 healthy controls over a 2-week period.

METHODS

The Dexamethasone Suppression Test and a Facial Expression Recognition Task were completed at baseline and 10-14 days after baseline. Treatment response was determined 6 weeks after baseline by change in the Montgomery-Asberg Depression Rating Scale.

RESULTS

Increased cortisol response to dexamethasone was significantly correlated with reduced ability to recognize facial expressions of anger, sadness and disgust within the total sample, but these correlations did not remain significant at 10-14 days. Surprisingly, cortisol response to dexamethasone was comparable in acutely depressed inpatients and healthy controls, and did not change over time in relation to treatment response.

CONCLUSION

The study findings provide preliminary evidence that hypothalamic-pituitary-adrenal axis functioning and processing threat-related facial expressions are related, perhaps through involvement of the amygdala.

Acutely elevated cortisol in response to stressor is associated with attentional bias toward depression-related stimuli but is not associated with attentional function

Cortisol induces attentional bias toward a negative stimulus and impaired attentional function. Depressed individuals have high levels of cortisol, and exhibit an attentional bias toward a depression-related stimulus and impaired processing speed and executive attention, which are components of attentional function. Therefore, the study tested the hypotheses that an acute increase in cortisol in response to a stressor is associated with attentional bias toward a depression-related stimulus and impaired processing speed and executive attention. Thirty-six participants were administered the dot-probe task for the measurement of attentional bias toward a depression-related stimulus and the Trail Making Test A and B for the measurement of processing speed and executive attention before and after a mental arithmetic task. It was revealed that attentional bias toward a depression-related stimulus following the stressor was observed only among the responders (i.e., participants with cortisol elevation in response to a stressor). On the other hand, no differences in the performance of processing speed and executive attention were noted between the responders and non-responders. The results indicate that acutely elevated cortisol is related to attentional bias, but is not related to processing speed and executive attention. The results have an implication for the etiology of depression.

Age and cortisol levels modulate judgment of positive and negative facial expressions

There is some evidence that older adults respond to emotional stimuli differently to young adults, and that they may exhibit better performance on measures of memory and attention when stimuli are positive rather than negative in valence. A relation between cortisol levels and attention/memory for emotional stimuli in young adults has also been reported. The relationship between cortisol levels and the judgment of facial expressions of emotion in aging, however, has yet to be explored. The aim of this study was to investigate performance on a simple emotional face judgment task in young (N=37) and middle-aged (N=37) adults in association with salivary cortisol levels. Middle-aged participants were slower in responding to stimuli than younger participants. Cortisol levels were found to be associated with shorter response latencies to categorise emotional but not neutral faces, and with a greater tendency to judge neutral faces as being emotional. An interaction between age and cortisol levels emerged in response to angry faces; such that higher cortisol levels predicted significantly shorter reaction times to angry faces in young adults, but not in middle-aged adults. Thus, cortisol may be differently related to the processing of emotional facial expressions, particularly of anger, in middle-aged and young individuals. The findings are discussed in relation to the hypothesised changes in emotion regulation with aging.

Attentional control in depression: A translational affective neuroscience approach

Translational research refers to the application of basic science to address clinical problems and acquire knowledge that can be used to guide and refine clinical practice. This special issue of Cognitive, Affective, & Behavioral Neuroscience seeks to explore and integrate some of the most promising findings offered by recent cognitive and affective neuroscience studies in hopes of filling the gap between basic and applied research, thereby heightening our understanding of vulnerability for depression. The studies presented in this special issue focus specifically on attentional processes. We solicited contributions from leading researchers involved in basic cognitive and neuroscience research investigating processes underlying depression-related disturbances in emotion processing. In this introductory article, we present an integrative overview to demonstrate how these specific contributions might be valuable for translational research.