Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2024; 14(2): 234-244
Published online Feb 19, 2024. doi: 10.5498/wjp.v14.i2.234
Impaired implicit emotion regulation in patients with panic disorder: An event-related potential study on affect labeling
Hai-Yang Wang, Li-Zhu Li, Yi Chang, Xiao-Mei Pang, Bing-Wei Zhang
Hai-Yang Wang, Department of Neurology, Jining No. 1 People's Hospital, Shandong First Medical University, Jining 272000, Shandong Province, China
Hai-Yang Wang, Li-Zhu Li, Yi Chang, Xiao-Mei Pang, Bing-Wei Zhang, Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Li-Zhu Li, Department of Neurology, Sixth Peoples' Hospital of Shenyang, Shenyang 110003, Liaoning Province, China
Co-first authors: Hai-Yang Wang and Li-Zhu Li.
Author contributions: Wang HY contributed to conceptualization, visualization, initial draft writing, funding acquisition, review and editing; Li LZ contributed to investigation, data curation, review and editing; Chang Y contributed to investigation, review and editing; Pang XM contributed to investigation, review and editing; and Zhang BW contributed to review and editing, supervision, project administration, funding acquisition.
Supported by The National Natural Science Foundation of China, No. 81871080; the Key R&D Program of Jining (Major Program), No. 2023YXNS004; the National Natural Science Foundation of China, No. 81401486; the Natural Science Foundation of Liaoning Province of China, No. 20170540276; and the Medicine and Health Science Technology Development Program of Shandong Province, No. 202003070713.
Institutional review board statement: This study was approved by the Ethics Committee of the First Hospital of Dalian Medical University, No. KY2014-30.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Bing-Wei Zhang, MD, PhD, Professor, Researcher, Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, Liaoning Province, China.
Received: September 30, 2023
Peer-review started: September 30, 2023
First decision: December 6, 2023
Revised: December 12, 2023
Accepted: December 29, 2023
Article in press: December 29, 2023
Published online: February 19, 2024
Research background

The background of this study is rooted in clinical observations and research findings that identify emotion regulation dysfunction as a significant factor in the occurrence of panic disorder (PD). However, the neurophysiological mechanisms underlying implicit emotion regulation abnormalities in patients with PD remain unclear.

Research motivation

We aim to analyze neurophysiological changes in PD patients during implicit emotion regulation, identifying a concise and effective electrophysiological marker to assess potential anomalies in implicit emotion regulation.

Research objectives

The study aims to determine if there are anomalies in implicit emotion regulation in PD. Past research suggests abnormal Late Positive Potential (LPP) during emotion regulation in PD patients, indicating that LPP in event-related potentials (ERP) could be an effective tool for assessing implicit emotion regulation deficits.

Research methods

We assessed PD patients using clinical and psychological scales, conducting an emotion labeling task and recording behavioral and ERP data.

Research results

In the control group, late LPP initially increased, then decreased. A significant group × condition interaction effect was observed. Simple effect analysis showed reduced differences in late LPP amplitudes between affect labeling and gender labeling conditions in PD compared to controls. Additionally, under affect labeling, late LPP in PD negatively correlated with disease severity.

Research conclusions

PD patients have implicit emotion regulation impairments, and the late LPP amplitude in response to affect labeling may be a valuable clinical indicator of PD severity.

Research perspectives

Future considerations should include longitudinal treatment studies with follow-ups, assessing whether PD patients regain regulatory function post-successful treatment.