The impact of attention bias modification training on behavioral and physiological responses

Attention bias modification training aims to alter attentional deployment to symptom-relevant emotionally salient stimuli. Such training has therapeutic applications in the management of disorders including anxiety, depression, addiction and chronic pain. In emotional reactions, attentional biases interact with autonomically-mediated changes in bodily arousal putatively underpinning affective feeling states. Here we examined the impact of attention bias modification training on behavioral and autonomic reactivity. Fifty-eight participants were divided into two groups. A training group (TR) received attention bias modification training to enhance attention to pleasant visual information, while a control group (CT) performed a procedure that did not modify attentional bias. After training, participants performed an evaluation task in which pairs of emotional and neutral images (unpleasant-neutral, pleasant-neutral, neutral-neutral) were presented, while behavioral (eye movements) and autonomic (skin conductance; heart rate) responses were recorded. At the behavioral level, trained participants were faster to orientate attention to pleasant images, and slower to orientate to unpleasant images. At the autonomic level, trained participants showed attenuated skin conductance responses to unpleasant images, while stronger skin conductance responses were generally associated with higher anxiety. These data argue for the use of attentional training to address both the attentional and the physiological sides of emotional responses, appropriate for anxious and depressive symptomatology, characterized by atypical attentional deployment and autonomic reactivity.

Sex differences in stress responses among underrepresented minority adolescents at risk for substance use disorder

Adolescence is a period of dramatic physiological changes preparing individuals to face future challenges. Prolonged exposure to stressors during childhood can result in dysregulated stress systems which alter normative physiological progression, leading to exacerbated risk for developing psychiatric disorders. Parental substance use disorder (SUD) is considered a significant childhood stressor which increases risk for the offspring to develop SUD. Thus, it is important to understand stress reactivity among adolescents with parental SUD. We used the Trier Social Stress Task (TSST), which includes a public speech presentation, as an acute stressor. Changes in heart-rate (HR) were measured while disadvantaged minority adolescents with and without a family history (FH+/FH-) of SUD performed the TSST. We investigated sex-specific stress response patterns during the TSST. HR peaked during the speech presentation and was overall higher in females than males. Changes in HR measures between baseline and speech showed an interaction between biological sex and FH group. Specifically, FH- females and FH+ males had significantly larger positive HR changes than FH- males. These results suggest that male and female adolescents with parental SUD have atypical, but divergent changes in stress reactivity that could explain their increased risk for developing SUD via different sexually dimorphic mechanisms.

Need for Multidimensional and Multidisciplinary Management of Depressed Preadolescents and Adolescents: A Review of Randomized Controlled Trials on Oral Supplementations (Omega-3, Fish Oil, Vitamin D3)

(1) Background: Depression is a serious health problem with a high cost for public administration. Epidemiological studies report that one in five children have a mental disorder and about 50% of mental health problems exacerbate in childhood and adolescence. Moreover, the antidepressant efficacy in children and adolescents is poorly demonstrated and can cause severe behavioral adverse events such as suicidal ideation. (2) Methods: This systematic literature review examined oral supplementations (Omega-3, fish oil, Vitamin D₃) to treat depressed children, preadolescents, and adolescents. MEDLINE, Scopus, Embase, and PsycInfo were searched for articles published in the last five years. Six studies met the eligibility criteria. The inclusion criteria encompassed children, preadolescents, and adolescents, a diagnosis of depression, and an intervention of oral supplementations such as Omega-3, fish oil, and Vitamin D₃. (3) Results: Most of the studies demonstrated that dietary intervention provides positive outcomes in terms of depression symptoms. (4) Conclusions: Overall, the results demonstrate a positive effect for oral supplementation suggesting an increase intake of Omega-3, fish oil, and Vitamin D₃. However, only a few studies assess the effectiveness of diet recommendations, as a monotherapy or combined treatment, for the management of depression at developmental ages. Thus, there is still a need to further investigate these aspects and to look more specifically at adolescents and preadolescents.

The psychophysiology of guilt in healthy adults

Guilt is a negative emotion, elicited by realizing one has caused actual or perceived harm to another person. Anecdotally, guilt often is described as a visceral and physical experience. However, while the way that the body responds to and contributes to emotions is well known in basic emotions, little is known about the characteristics of guilt as generated by the autonomic nervous system. This study investigated the physiologic signature associated with guilt in adults with no history of psychological or autonomic disorder. Healthy adults completed a novel task, including an initial questionnaire about their habits and attitudes, followed by videos designed to elicit guilt, as well as the comparison emotions of amusement, disgust, sadness, pride, and neutral. During the video task, participants' swallowing rate, electrodermal activity, heart rate, respiration rate, and gastric activity rate were continuously recorded. Guilt was associated with alterations in gastric rhythms, electrodermal activity, and swallowing rate relative to some or all the comparison emotions. These findings suggest that there is a mixed pattern of sympathetic and parasympathetic activation during the experience of guilt. These results highlight potential therapeutic targets for modulation of guilt in neurologic and psychiatric disorders with deficient or elevated levels of guilt, such as frontotemporal dementia, posttraumatic stress disorder, and Obsessive-compulsive disorder.

A Systematic Review of Clinical Psychophysiology of Obsessive-Compulsive Disorders: Does the Obsession with Diet Also Alter the Autonomic Imbalance of Orthorexic Patients?

(1) Background: A new mental illness is attracting the attention of researchers and mental health professionals. Orthorexia nervosa (ON) is a possible new mental disorder, the main symptom of which is an obsessive and insecure focus on healthy foods and consequent compulsive behaviors. There is a common consensus among researchers that ON is considered partly overlapping with obsessive-compulsive disorders (OCDs). (2) Methods: MEDLINE and Scopus were searched for articles published in the last 10 years regarding the psychophysiological aspects of OCD and ON. Eight studies met the eligibility criteria. The inclusion criteria encompassed adults diagnosed with OCD and/or ON. However, only studies involving OCD patients were found. (3) Results: Some research groups have shown that OCD disorders can be considered among anxiety disorders because they are characterized by anxious hyper activation. Other research, however, has shown profiles characterized by low psychophysiological reactivity to stressful stimuli. Despite this, there seems to be a consensus on the poor inhibition abilities, even when activation is low, and the dissociation between cognitive and psychophysiological activation emerged. (4) Conclusions: However discordant, some points seem to bring the researchers to agreement. In fact, there is consensus on conducting a multidimensional assessment that can measure all of the aspects of suffering (cognition, emotion, and behavior) and highlight the poor body-mind integration. This clinical approach would make it possible to propose interventions aimed at treating some mental illnesses such as food obsession that can paradoxically impair the psychophysical balance. Nevertheless, the applied systematizing approach to existing studies on ON is very much needed for better understanding of the psychophysical nature of this new mental illness and its implications for prevention and treatment.

Cognition, Behavior, Sexuality, and Autonomic Responses of Women with Hypothalamic Amenorrhea

(1) Background: Functional Hypothalamic Amenorrhea (FHA) can be caused by the hyper activation of neuro-endocrine responses to stress. Among other endocrine factors and hypothalamic dysfunctions, the psychophysiological stress response can very frequently lead to an inhibition of the gonadal-pituitary axis. The aim of this study was to investigate the level of neurovegetative activation in a group of young women affected by this condition. (2) Methods: Twenty-five women (mean age = 21.1 ± 4.34) with FHA were consecutively recruited. Information on psycho-physiological distress was collected through a Psychopathological assessment (with the administration of three psychometric tests) and the Psychophysiological Stress Profile (PSP). Their data were compared with a control group. (3) Results: In the PSP, the patients displayed significantly higher values compared to controls in terms of the parameters of muscle tension (sEMG), skin conductance (SCL/SCR), heart rate (HR), and peripheral temperature (PT). Furthermore, autonomic hyper-activation at rest, marked reactivity to stress, and reduced recovery were seen. Moreover, a condition characterized by psychological distress (anxiety and somatic complaints, depressed and irritable mood, obsessive-compulsive traits) emerged. (4) Conclusions: The results highlight autonomic hyper-activation in FHA, which is also associated with psychological distress. Considering that FHA is a condition that affects multiple systems between mind and body, a multimodal, multidimensional, and multidisciplinary assessment of stress is becoming an emerging need.

Autonomic reactivity to emotion: A marker of sub-clinical anxiety and depression symptoms?

Anxiety and depression are both characterized by dysregulated autonomic reactivity to emotion. However, most experiments until now have focused on autonomic reactivity to stimuli presented in central vision (CV) even if affective saliency is also observed in peripheral vision (PV). We compared autonomic reactivity to CV and PV emotional stimulation in 58 participants with high anxious (HA) or low anxious (LA) and high depressive (HD) or low depressive (LD) symptomatology, based on STAI-B and BDI scores, respectively. Unpleasant (U), pleasant (P), and neutral (N) pictures from IAPS were presented at three eccentricities (0°: CV; -12 and 12°: PV). Skin conductance (SC), skin temperature, pupillary diameter, and heart rate (HR) were recorded. First, HA participants showed greater pupil dilation to emotional than to neutral stimuli in PV than in CV. Second, in contrast to HD, the valence effect indexed by SC and emotional arousal effect indexed by skin temperature were observed in LD. Third, both anxiety and depression lead to a valence effect indexed by pupillary light reflex and heart rate. These results suggest a hyperreactivity to emotion and hypervigilance to PV in anxiety. Depression is associated with an attenuation of positive effect and a global blunted autonomic reactivity to emotion. Moreover, anxiety mostly modulates the early processes of autonomic reactivity whereas depression mainly affects the later processes. The differential impact of emotional information over the visual field suggests the use of new stimulation strategies in order to attenuate anxious and depressive symptoms.

Automatic detection of major depressive disorder using electrodermal activity

Major depressive disorder (MDD) is a common psychiatric disorder and the leading cause of disability worldwide. However, current methods used to diagnose depression mainly rely on clinical interviews and self-reported scales of depressive symptoms, which lack objectivity and efficiency. To address this challenge, we present a machine learning approach to screen for MDD using electrodermal activity (EDA). Participants included 30 patients with MDD and 37 healthy controls. Their EDA was measured during five experimental phases consisted of baseline, mental arithmetic task, recovery from the stress task, relaxation task, and recovery from the relaxation task, which elicited multiple alterations in autonomic activity. Selected EDA features were extracted from each phase, and differential EDA features between two distinct phases were evaluated. By using these features as input data and performing feature selection with SVM-RFE, 74% accuracy, 74% sensitivity, and 71% specificity could be achieved by our decision tree classifier. The most relevant features selected by SVM-RFE included differential EDA features and features from the stress and relaxation tasks. These findings suggest that automatic detection of depression based on EDA features is feasible and that monitoring changes in physiological signal when a subject is experiencing autonomic arousal and recovery may enhance discrimination power.