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Hong JS, Lee D, Han DH, Sim M. Development and validation of the trauma-specific emotional counting Stroop paradigm for fMRI study. J Affect Disord 2024; 350:118-124. [PMID: 38163567 DOI: 10.1016/j.jad.2023.12.081] [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] [Received: 04/04/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The emotional-counting Stroop (ecStroop) is a cognitive task to evaluate emotional information processing. This study aimed to develop a trauma-specific ecStroop protocol for firefighters and assess its validity as a functional magnetic resonance imaging (fMRI) activation paradigm. METHODS To develop the ecStroop protocol, trauma-related words for firefighters were selected from previous studies, and general negative and neutral words were matched corresponding to the number of letters and syllables, parts of speech, and frequency in the Korean language. The negative emotional valence of whole words was investigated in 520 healthy participants. To compare brain activation between three categories, 25 healthy individuals underwent fMRI during the ecStroop task. RESULTS Eight trauma-related words, eight general negative words, and sixteen neutral words were selected by emotional valence scores. The general negative words were related to increased activation in the right inferior and middle temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus compared to the neutral words. When exposed to the trauma-related words, participants' brain activation was increased in the right inferior temporal gyrus, right medial frontal gyrus, left superior temporal gyrus, and left inferior frontal gyrus as compared to when exposed to the neutral words. LIMITATIONS The fact that all participants in the phase 2 fMRI study were male could limit generalization to all genders. CONCLUSIONS These findings suggest that the ecStroop paradigm successfully activated the brain regions for emotional processing. This paradigm could be valuable in assessing the trauma-specific neural changes in firefighters.
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Affiliation(s)
- Ji Sun Hong
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Dayoung Lee
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
| | - Minyoung Sim
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Republic of Korea.
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2
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Rutter LA, Norton DJ, Brown TA. Visual attention toward emotional stimuli: Anxiety symptoms correspond to distinct gaze patterns. PLoS One 2021; 16:e0250176. [PMID: 33983969 PMCID: PMC8118267 DOI: 10.1371/journal.pone.0250176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
Abstract
Decades of research have established a link between emotional disorders and attentional biases for emotional stimuli, but the relationship between symptom severity and visual attention is still not fully understood. Depression has been associated with increased attention towards dysphoric stimuli and decreased attention on positive stimuli (“negativity bias”), and some studies have also shown this trend in anxiety disorders. We examined eye fixation variables in 47 participants with emotional disorders completing an emotion recognition task. Results showed that depression severity was not associated with increased fixations on dysphoric stimuli, however, higher levels of generalized anxiety predicted increased fixations in the mouth region of sad and happy faces. Higher levels of social interaction anxiety predicted reduced fixations in the eye region of happy faces. While we did not replicate the negativity bias that has been shown in prior studies, our sample was highly comorbid, indicating the need to consider comorbidity, disorder severity, and the task itself when conducting research on visual attention in clinical samples. Additionally, more attention should be paid to the mouth region of emotional faces, as it may provide more specific information regarding the visual processing of emotions.
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Affiliation(s)
- Lauren A. Rutter
- Department of Psychological and Brain Sciences, Indiana University-Bloomington, Bloomington, Indiana, United States of America
- * E-mail:
| | - Daniel J. Norton
- Department of Psychology, Gordon College, Wenham, Massachusetts, United States of America
| | - Timothy A. Brown
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
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3
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Inhibitory Control in Individuals with Clinical Levels of Depression and Anxiety Symptoms. SPANISH JOURNAL OF PSYCHOLOGY 2021; 24:e19. [PMID: 33745479 DOI: 10.1017/sjp.2021.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previous research has shown that individuals suffering from depression and generalized anxiety disorder (GAD) seem to have inhibitory control deficits compared with healthy controls. However, few studies have been conducted in Spanish-speaking countries. Thus, this study aims to analyze the performance on the Stroop Color and Word Test (SCWT) between groups of Colombian participants with clinical levels of depression and GAD symptoms and a nonclinical control group. According to previous research, we expected to find significant differences in inhibitory control among groups. An ex post facto design was implemented. The SCWT was administered to a total sample of 105 individuals (64.8% women, M = 22.94 years, SD = 4.62), including 27 depressed and 15 anxious participants according to their scores on the Personal Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Bayesian t-tests showed that depressed participants showed the same processing speed but lower scores on inhibitory control than healthy controls, BF = 13.70, δ = 0.50, 95% CI [0.08, 0.94]. Conversely, anxious participants showed deficits in processing speed, SCWT-Word: BF = 16.19, δ = 0.68, 95% CI [0.15, 1.24]; SCWT-Color: BF = 5.98, δ = 0.50, 95% CI [-0.01, 1.04], but not in inhibitory control compared with the nonanxious counterparts. This study provides preliminary evidence concerning the inhibitory control deficits in Colombian depressed individuals and processing speed deficits in those experiencing clinical levels of GAD symptoms.
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Hirsch CR, Beale S, Grey N, Liness S. Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective. Front Psychiatry 2019; 10:796. [PMID: 31780964 PMCID: PMC6852150 DOI: 10.3389/fpsyt.2019.00796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/07/2019] [Indexed: 12/01/2022] Open
Abstract
Generalized anxiety disorder (GAD), with uncontrollable worry at its core, is a common psychological disorder with considerable individual and societal costs. Cognitive behavior therapy (CBT) is recommended as the first-line treatment for GAD; however, further investigation into its effectiveness in routine clinical care is indicated and improvement is required in treatment outcomes for worry. Improvements to CBT need to be guided by experimental research that identifies key mechanisms maintaining core aspects of the disorder. This paper summarizes how theory-driven experimental research guided selection and refinements of CBT techniques originally developed by Borkovec and Costello, to target key cognitive processes that maintain worry in GAD. Hirsch and Mathews' model specifies three key research-supported processes that maintain uncontrollable worry in GAD: implicit cognitive biases such as negative interpretation bias and attention bias, generalized verbal thinking style, and impaired ability to re-direct attentional control away from worry. Specific CBT techniques outlined in this paper aim to target these key processes. Clinical data from clients treated using our refined CBT protocol for GAD in a routine clinical care service with a special interest in anxiety disorders were collected as part of service procedures. Large pre-to-posttreatment effect sizes were obtained for anxiety (GAD-7), depression (PHQ-9), and worry (PSWQ) (d=.90-2.54), and a moderate effect size was obtained for quality of life (WASA; d=.74). Recovery was indicated for 74% of cases for anxiety, 78% for depression, and 53% for worry. These findings exceeded most previous effectiveness studies in routine care and were in-line with GAD efficacy trials. This paper also outlines the application of specific clinical techniques selected, adapted or developed to target key cognitive mechanisms which maintain worry in GAD.
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Affiliation(s)
- Colette R. Hirsch
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sarah Beale
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Nick Grey
- Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
| | - Sheena Liness
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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5
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Harber L, Hamidian R, Bani-Fatemi A, Wang KZ, Dada O, Messina G, Monda M, Chieffi S, De Luca V. Meta-Analysis of Neuropsychological Studies in Panic Disorder Patients: Evidence of Impaired Performance during the Emotional Stroop Task. Neuropsychobiology 2019; 78:7-13. [PMID: 30970364 DOI: 10.1159/000496623] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent investigations have highlighted significant differences in verbal recall between patients with panic disorder (PD) and controls. These studies have highlighted that verbal memory and working memory could be impaired in PD. OBJECTIVES The objective of the present meta-analysis is to confirm this hypothesis, reviewing the studies that have investigated neurocognitive testing in PD. METHODS We performed a systematic literature search for studies published between 1980 and 2015 that reported cognitive measurements in PD patients and controls. Effect size estimates were computed using the restricted maximum likelihood model. Only case-control studies were selected for this meta-analysis. We included studies that made a direct comparison between PD subjects and healthy controls. The diagnostic group consisted of adult patients aged over 18 years diagnosed with PD. We excluded the studies that did not employ a case-control design. All statistical analyses were carried out on R using the "metafor" package version 1.9-8. The effect size for each study neuropsychological test was calculated using the mean and SD of performance results, and p values < 0.05 were considered significant. RESULTS We identified few studies that tested verbal memory and executive functions in PD patients and controls, and this difference was not significant. On the other hand, there are several studies that have used the emotional Stroop task to assess cognitive functions in PD. There is no robust evidence of impairment of memory function in PD; however, when considering the emotional Stroop task, it was found that PD patients performed slower (p < 0.01) than healthy controls for all three types of stimuli (neutral, negative, positive). CONCLUSION This meta-analysis included a small number of studies, which may have introduced bias into the analysis. However, there is some evidence of impairment of neurocognitive functions in PD when performing the emotional Stroop task. Furthermore, the paucity of studies evaluating neurocognition in PD suggests the need for further research in this field in order to draw meaningful conclusions.
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Affiliation(s)
- Lillian Harber
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Reza Hamidian
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Ali Bani-Fatemi
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kevin Z Wang
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Oluwagbenga Dada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | | | | | - Vincenzo De Luca
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada, .,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,
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6
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Joyal M, Wensing T, Levasseur-Moreau J, Leblond J, T. Sack A, Fecteau S. Characterizing emotional Stroop interference in posttraumatic stress disorder, major depression and anxiety disorders: A systematic review and meta-analysis. PLoS One 2019; 14:e0214998. [PMID: 30964902 PMCID: PMC6456228 DOI: 10.1371/journal.pone.0214998] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 03/25/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder is a debilitating psychiatric disorder characterized by symptoms of intrusive re-experiencing of trauma, avoidance and hyper-arousal. Diagnosis and treatment of PTSD is further complicated by concurrently occurring disorders, the most frequent being major depressive disorder and anxiety disorders. Previous research highlights that attentional processing in posttraumatic stress disorder is associated with substantial interference by emotional stimuli, a phenomenon also observed in these concurrently occurring psychiatric disorders. However, the diagnosis-relevance of this interference remains elusive. Here, we investigated the emotional Stroop interference for diagnosis-related stimuli, generally negative stimuli, and generally positive stimuli in posttraumatic stress disorder, major depressive disorder and anxiety disorders. METHODS We performed a systematic database search in PubMed (Medline), Cochrane Library and PsycINFO on emotional Stroop performance in individuals with a diagnosis of posttraumatic stress disorder, major depressive disorder or anxiety disorders separately. Mean effect sizes, standard errors and confidence intervals were estimated for each clinical group and healthy control group comparison using random effect models. RESULTS As compared to healthy control group, the posttraumatic stress disorder group displayed greater interference by diagnosis-related stimuli and positive stimuli but not for generally negative stimuli. The major depressive disorder and anxiety disorders groups showed greater interference by diagnosis-related and negative stimuli, but not by positive stimuli. The age and sex had no significant impact on interference. CONCLUSIONS These findings highlight the importance of diagnosis-relevant information on attentional processing in all three clinical populations, posttraumatic stress disorder, major depressive disorder and anxiety disorders. Further, the impact of generally negative stimuli but not generally positive stimuli in major depressive disorder and anxiety disorders indicate impaired attentional bias for mood-congruent stimuli but not for general stimuli. Finally, it remains to be studied whether the influence of generally positive stimuli in posttraumatic stress disorder indicate that positive stimuli are perceived as PTSD related.
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Affiliation(s)
- Marilyne Joyal
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Tobias Wensing
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Jean Levasseur-Moreau
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Jean Leblond
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Alexander T. Sack
- Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
| | - Shirley Fecteau
- Medical School, Laval University, Quebec City, QC, Canada
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- * E-mail:
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Gibson LE, Cooper S, Reeves LE, Olino TM, Ellman LM. Attentional biases and trauma status: Do psychotic-like experiences matter? PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2018; 11:300-306. [PMID: 30010376 DOI: 10.1037/tra0000380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE In a large undergraduate sample, we explored whether attentional biases were similar between individuals reporting positive psychotic-like experiences (PLEs) with a history of traumatic life events (TLEs) compared with individuals with a TLE history alone. METHOD Participants completed the Emotional Stroop Task, and self-report questionnaires of TLEs and PLEs. RESULTS Although reaction time (RT) to physical, sexual, emotional, and overall trauma words was associated with TLEs, only RT to physical abuse and overall trauma words remained significantly associated with TLE status after controlling for age, race, and neutral word RT. Contrary to our hypotheses, PLEs were not associated with RT to TLE words and there were no significant interactions between TLE history and PLEs on RT to TLE-salient stimuli. CONCLUSION Findings suggest that psychosis risk alone does not appear to exacerbate attentional biases and that TLE history may exert similar influence on attention regardless of psychosis risk. In conclusion, phenotypes associated with TLEs may be similar in populations potentially at risk for psychosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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8
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Abbott D, Shirali Y, Haws JK, Lack CW. Biobehavioral assessment of the anxiety disorders: Current progress and future directions. World J Psychiatry 2017; 7:133-147. [PMID: 29043151 PMCID: PMC5632598 DOI: 10.5498/wjp.v7.i3.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/08/2017] [Accepted: 07/03/2017] [Indexed: 02/05/2023] Open
Abstract
It is difficult to accurately assess and differentially diagnose the anxiety disorders. The current system of assessment relies heavily on the subjective measures of client self-report, clinical observation, and clinical judgment. Fortunately, recent technological advances may enable practitioners to utilize objective, biobehavioral measures of assessment in a clinical setting. The current body of literature on two of these biobehavioral tools (eye-tracking and electrocardiogram devices) is promising, but more validation and standardization research is needed to maximize the utility of these devices. Eye-tracking devices are uniquely capable of providing data that can be used to differentially diagnose anxiety disorders from both other commonly comorbid and misdiagnosed disorders. Both eye-tracking and electrocardiogram devices are able to provide change-sensitive assessment information. This objective, real-time feedback can assist clinicians and researchers in assessing treatment efficacy and symptom fluctuation. Recently developed wearable and highly portable electrocardiogram devices, like the wearable fitness and behavior tracking devices used by many consumers, may be particularly suited for providing this feedback to clinicians. Utilizing these biobehavioral devices would supply an objective, dimensional component to the current categorical diagnostic assessment system. We posit that if adequate funding and attention are directed at this area of research, it could revolutionize diagnostic and on-going assessment practices and, in doing so, bring the field of diagnosis out of the 20th century.
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Affiliation(s)
- Deah Abbott
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Yasmin Shirali
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - J Kyle Haws
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Caleb W Lack
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
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9
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Goodwin H, Yiend J, Hirsch CR. Generalized Anxiety Disorder, worry and attention to threat: A systematic review. Clin Psychol Rev 2017; 54:107-122. [PMID: 28448826 DOI: 10.1016/j.cpr.2017.03.006] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 03/10/2017] [Accepted: 03/25/2017] [Indexed: 11/29/2022]
Abstract
Among anxious populations, attention has been demonstrated to be preferentially biased to threatening material compared to neutral or other valenced material. Individuals who have high levels of trait worry, such as those with Generalized Anxiety Disorder (GAD), may be biased to threat but research has produced equivocal findings. This review aimed to systematically review the extant experimental literature to establish the current evidence of attentional bias to threat among trait worriers compared to healthy controls and other clinical populations. Twenty-nine published articles were included in the final review. There was strong evidence of a bias to threat among GAD patients compared to other groups and this was found across most experimental paradigms. Few studies had investigated this bias in non-clinical trait worriers. Among GAD patients this bias to threat was most strongly evidenced when visual threat material was in a verbal-linguistic format (i.e., words) rather than when in pictorial form (i.e., images or faces). The bias was also found across several domains of negative material, supporting the general nature of worry. Further research should look to examine the specific components of the threat bias in GAD, as well as investigating the bias to threat in trait worriers.
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Affiliation(s)
- Huw Goodwin
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Jenny Yiend
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Colette R Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom.
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10
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Turano MT, Viggiano MP. The relationship between face recognition ability and socioemotional functioning throughout adulthood. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 24:613-630. [PMID: 27754777 DOI: 10.1080/13825585.2016.1244247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The relationship between face recognition ability and socioemotional functioning has been widely explored. However, how aging modulates this association regarding both objective performance and subjective-perception is still neglected. Participants, aged between 18 and 81 years, performed a face memory test and completed subjective face recognition and socioemotional questionnaires. General and social anxiety, and neuroticism traits account for the individual variation in face recognition abilities during adulthood. Aging modulates these relationships because as they age, individuals that present a higher level of these traits also show low-level face recognition ability. Intriguingly, the association between depression and face recognition abilities is evident with increasing age. Overall, the present results emphasize the importance of embedding face metacognition measurement into the context of these studies and suggest that aging is an important factor to be considered, which seems to contribute to the relationship between socioemotional and face-cognitive functioning.
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Affiliation(s)
- Maria Teresa Turano
- a Department of Neuroscience, Psychology, Drug Research & Child's Health , University of Florence , Firenze , Italy
| | - Maria Pia Viggiano
- a Department of Neuroscience, Psychology, Drug Research & Child's Health , University of Florence , Firenze , Italy
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11
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MacNamara A, Kotov R, Hajcak G. Diagnostic and symptom-based predictors of emotional processing in generalized anxiety disorder and major depressive disorder: An event-related potential study. COGNITIVE THERAPY AND RESEARCH 2015; 40:275-289. [PMID: 27346901 DOI: 10.1007/s10608-015-9717-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The delineation of specific versus overlapping mechanisms in GAD and MDD could shed light on the integrity of these diagnostic categories. For example, negative emotion generation is one mechanism that may be especially relevant to both disorders. Emotional processing abnormalities were examined among 97 outpatients with generalized anxiety disorder (GAD) or major depressive disorder (MDD) and 25 healthy adults, using the late positive potential (LPP), an event-related potential that is larger for emotional versus neutral stimuli. GAD and MDD were also assessed dimensionally across all participants. Both MDD diagnosis and dimensional depression scores were associated with reduced ΔLPP. When controlling for MDD diagnosis/dimension, both the diagnosis and dimension of GAD were associated with increased ΔLPP. Both MDD and GAD dimensions, but not diagnoses, were associated with increased ΔRT to targets that followed emotional pictures. Therefore, MDD and GAD have distinguishable and opposing features evident in neural measures of emotion processing.
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Affiliation(s)
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University
| | - Greg Hajcak
- Department of Psychology, Stony Brook University
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12
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Zullino D, Chatton A, Fresard E, Stankovic M, Bondolfi G, Borgeat F, Khazaal Y. Venlafaxine versus applied relaxation for generalized anxiety disorder: a randomized controlled study on clinical and electrophysiological outcomes. Psychiatr Q 2015; 86:69-82. [PMID: 25464934 DOI: 10.1007/s11126-014-9334-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Some components of generalized anxiety disorder, such as physical symptoms, are thought to reflect autonomic nervous system arousal. This study primarily assessed the relationships between psychophysiological and clinical measures using venlafaxine extended release or applied relaxation, and secondarily, the impact of combination treatment in patients not remitting after 8 weeks. Fifty-eight patients were randomly assigned to 8 weeks of treatment with either venlafaxine or applied relaxation (Phase I). Non-remitted patients received combination treatment for an additional 8 weeks (Phase II). Assessments included the Hamilton Anxiety Scale (HAM-A), Beck Depression Inventory, Penn State Worry Questionnaire and the Stroop Color-Word Task coupled with electrophysiological measures (skin conductance and frontalis electromyography (EMG)). In Phase 1, a time effect was found for the clinical and skin conductance measures. Thirteen patients from each group were in remission. In Phase 2, seven additional patients remitted. Baseline psychophysiological measures were not associated with baseline clinical variables or with clinical outcomes. Independently of treatment allocation, a reduction in frontal EMG values at week 4 was significantly associated with a decrease in HAM-A scores at week 8. At week 4, responders from the applied relaxation group had lower electrophysiological activity than the venlafaxine group. Baseline psychophysiological measures were not linked with clinical measures at study inclusion or with treatment response. Frontal EMG response at week 4 is a possible predictor of treatment response. Treatment combination enhances treatment response after initial failure.
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Affiliation(s)
- Daniele Zullino
- Geneva University Hospitals and Geneva University, Geneva, Switzerland
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13
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Burkhouse KL, Woody ML, Owens M, Gibb BE. Influence of worry on sustained attention to emotional stimuli: evidence from the late positive potential. Neurosci Lett 2015; 588:57-61. [PMID: 25445353 DOI: 10.1093/scan/nsw18418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/05/2014] [Accepted: 11/06/2014] [Indexed: 05/26/2023]
Abstract
There is preliminary evidence to suggest that worry is associated with dysregulated emotion processing resulting from sustained attention to emotional versus neutral stimuli; however, this hypothesis has not been directly tested in prior research. Therefore, the current study used the event-related late positive potential (LPP) to directly examine if high levels of trait worry moderate sustained attention to emotional versus neutral stimuli. Electroencephalogram data was recorded while twenty-two women passively viewed neutral, positive, dysphoric, and threatening emotional images. Consistent with our hypotheses, higher levels of worry were associated with larger LPP amplitudes for emotional images but not neutral images. Importantly, the positive correlations between trait worry and LPP responses to threatening and positive images were maintained even when controlling for the influence of current anxiety symptoms, suggesting that worry may influence emotion processing whether or not the person is currently anxious. This sustained attention to emotional information may be one mechanism underlying how trait worry increases risk for anxiety disorders.
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14
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Burkhouse KL, Woody ML, Owens M, Gibb BE. Influence of worry on sustained attention to emotional stimuli: evidence from the late positive potential. Neurosci Lett 2014; 588:57-61. [PMID: 25445353 DOI: 10.1016/j.neulet.2014.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/05/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022]
Abstract
There is preliminary evidence to suggest that worry is associated with dysregulated emotion processing resulting from sustained attention to emotional versus neutral stimuli; however, this hypothesis has not been directly tested in prior research. Therefore, the current study used the event-related late positive potential (LPP) to directly examine if high levels of trait worry moderate sustained attention to emotional versus neutral stimuli. Electroencephalogram data was recorded while twenty-two women passively viewed neutral, positive, dysphoric, and threatening emotional images. Consistent with our hypotheses, higher levels of worry were associated with larger LPP amplitudes for emotional images but not neutral images. Importantly, the positive correlations between trait worry and LPP responses to threatening and positive images were maintained even when controlling for the influence of current anxiety symptoms, suggesting that worry may influence emotion processing whether or not the person is currently anxious. This sustained attention to emotional information may be one mechanism underlying how trait worry increases risk for anxiety disorders.
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15
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Wang S, Zhao Y, Chen S, Lin G, Sun P, Wang T. EEG biofeedback improves attentional bias in high trait anxiety individuals. BMC Neurosci 2013; 14:115. [PMID: 24099141 PMCID: PMC4124890 DOI: 10.1186/1471-2202-14-115] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 09/13/2013] [Indexed: 11/10/2022] Open
Abstract
Background Emotion-related attentional bias is implicated in the aetiology and maintenance of anxiety disorders. Electroencephalogram (EEG) biofeedback can obviously improve the anxiety disorders and reduce stress level, and can also enhance attention performance in healthy subjects. The present study examined the effects and mechanisms of EEG biofeedback training on the attentional bias of high trait anxiety (HTA) individuals toward negative stimuli. Results Event-related potentials were recorded while HTA (n=24) and nonanxious (n=21) individuals performed the color-word emotional Stroop task. During the emotional Stroop task, HTA participants showed longer reaction times and P300 latencies induced by negative words, compared to nonanxious participants. The EEG biofeedback significantly decreased the trait anxiety inventory score and reaction time in naming the color of negative words in the HTA group. P300 latencies evoked by negative stimuli in the EEG biofeedback group were significantly reduced after the alpha training, while no significant changes were observed in the sham biofeedback group after the intervention. Conclusion The prolonged P300 latency is associated with attentional bias to negative stimuli in the HTA group. EEG biofeedback training demonstrated a significant improvement of negative emotional attentional bias in HTA individuals, which may be due to the normalization of P300 latency.
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Affiliation(s)
- Sheng Wang
- Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Bittencourt J, Velasques B, Teixeira S, Basile LF, Salles JI, Nardi AE, Budde H, Cagy M, Piedade R, Ribeiro P. Saccadic eye movement applications for psychiatric disorders. Neuropsychiatr Dis Treat 2013; 9:1393-409. [PMID: 24072973 PMCID: PMC3783508 DOI: 10.2147/ndt.s45931] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The study presented here analyzed the patterns of relationship between oculomotor performance and psychopathology, focusing on depression, bipolar disorder, schizophrenia, attention-deficit hyperactivity disorder, and anxiety disorder. METHODS Scientific articles published from 1967 to 2013 in the PubMed/Medline, ISI Web of Knowledge, Cochrane, and SciELO databases were reviewed. RESULTS Saccadic eye movement appears to be heavily involved in psychiatric diseases covered in this review via a direct mechanism. The changes seen in the execution of eye movement tasks in patients with psychopathologies of various studies confirm that eye movement is associated with the cognitive and motor system. CONCLUSION Saccadic eye movement changes appear to be heavily involved in the psychiatric disorders covered in this review and may be considered a possible marker of some disorders. The few existing studies that approach the topic demonstrate a need to improve the experimental paradigms, as well as the methods of analysis. Most of them report behavioral variables (latency/reaction time), though electrophysiological measures are absent.
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Affiliation(s)
- Juliana Bittencourt
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil ; Institute of Applied Neuroscience, Rio de Janeiro, Brazil ; Neurophysiology and Neuropsychology of Attention, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil ; Laboratory of Physical Therapy, Veiga de Almeida University, Rio de Janeiro, Brazil
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