Alexandre Heeren

The effects of mindfulness on executive processes and autobiographical memory specificity

Previous studies have found that mindfulness training reduces overgeneral memories and increases autobiographical memory specificity (e.g., [Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Soulsby, J. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology, 109, 150-155]). However, little work has investigated the mechanisms underlying this effect. The present study explored the role of executive processes as a mediator of MBCT effects in an unselected sample. An autobiographical memory task, a cognitive inhibition task, a motor inhibition task, a cognitive flexibility task and a motor flexibility task were administered before and after intervention. Compared to matched controls, MBCT participants showed increased autobiographical memory specificity, decreased overgenerality, and improved cognitive flexibility capacity and capacity to inhibit cognitive prepotent responses. Mediational analyses indicated that changes in cognitive flexibility partially mediate the impact of MBCT on overgeneral memories. Results are discussed in terms of Conways [2005. Memory and the self. Journal of Memory and Language, 53, 594-628] autobiographical memory model.

Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.

Attention bias modification for social anxiety: A systematic review and meta-analysis

Research on attention bias modification (ABM) for social anxiety disorder (SAD) is inconclusive, with some studies finding clear positive effects and other studies finding no significant benefit relative to control training procedures. In this meta-analysis, we assessed the efficacy of ABM for SAD on symptoms, reactivity to speech challenge, attentional bias (AB) toward threat, and secondary symptoms at posttraining as well as SAD symptoms at 4-month follow-up. A systematic search in bibliographical databases uncovered 15 randomized studies involving 1043 individuals that compared ABM to a control training procedure. Data were extracted independently by two raters. The Q statistic was used to assess homogeneity across trials. All analyses were conducted on intent-to-treat data. ABM produced a small but significant reduction in SAD symptoms (g=0.27), reactivity to speech challenge (g=0.46), and AB (g=0.30). These effects were moderated by characteristics of the ABM procedure, the design of the study, and trait anxiety at baseline. However, effects on secondary symptoms (g=0.09) and SAD symptoms at 4-month follow-up (g=0.09) were not significant. Although there was no indication of significant publication bias, the quality of the studies was substandard and wedged the effect sizes. From a clinical point of view, these findings imply that ABM is not yet ready for wide-scale dissemination as a treatment for SAD in routine care. Theoretical implications for the integration of AB in the conceptualization of SAD are discussed.

How does attention training work in social phobia : disengagement from threat or re-engagement to non-threat?

Social phobics exhibit an attentional bias for threat in probe detection paradigms. Attention training, whereby probes always replace non-threat in a display presenting both threat and non-threat, reduces attentional bias for threat and social anxiety. However, it remains unclear whether therapeutic benefits result from learning to disengage attention from threat or learning to orient attention towards non-threat. In this experiment, social phobics were randomly assigned to one of four training conditions: (1) disengagement from threat, (2) engagement towards non-threat, (3) disengagement from threat and re-engagement towards non-threat, and (4) a control condition. Effects were examined on subjective and behavioral responses to a subsequent stressor. Data revealed that training to disengage from threat reduces behavioral indices of anxiety. Engagement towards non-threat faces did not have effects in itself. These results support that the difficulty in disengaging attention from threat is a critical process in maintenance of the disorder.

How can we conceptualize behavioural addiction without pathologizing common behaviours

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.

Disrupted regulation of social exclusion in alcohol dependence: An fMRI study.

Alcohol-dependence is associated with cognitive and biological alterations, and also with interpersonal impairments. Although overwhelming in clinical settings and involved in relapse, these social impairments have received little attention from researchers. Particularly, brain alterations related to social exclusion have not been explored in alcohol-dependence. Our primary purpose was to determine the neural correlates of social exclusion feelings in this population. In all, 44 participants (22 abstinent alcohol-dependent patients and 22 paired controls) played a virtual game (‘cyberball’) during fMRI recording. They were first included by other players, then excluded, and finally re-included. Brain areas involved in social exclusion were identified and the functional connectivity between these areas was explored using psycho-physiological interactions (PPI). Results showed that while both groups presented dorsal anterior cingulate cortex (dACC) activations during social exclusion, alcohol-dependent participants exhibited increased insula and reduced frontal activations (in ventrolateral prefrontal cortex) as compared with controls. Alcohol-dependence was also associated with persistent dACC and parahippocampal gyrus activations in re-inclusion. PPI analyses showed reduced frontocingulate connectivity during social exclusion in alcohol-dependence. Alcohol-dependence is thus linked with increased activation in areas eliciting social exclusion feelings (dACC–insula), and with impaired ability to inhibit these feelings (indexed by reduced frontal activations). Altered frontal regulation thus appears implied in the interpersonal alterations observed in alcohol-dependence, which seem reinforced by impaired frontocingulate connectivity. This first exploration of the neural correlates of interpersonal problems in alcohol-dependence could initiate the development of a social neuroscience of addictive states.

The (neuro)cognitive mechanisms behind attention bias modification in anxiety: Proposals based on theoretical accounts of attentional bias.

Recently, researchers have investigated the causal nature of attentional bias for threat (AB) in the maintenance of anxiety disorders by experimentally manipulating it. They found that training anxious individuals to attend to non-threat stimuli reduces AB, which, in turn, reduces anxiety. This effect supports the hypothesis that AB can causally impact the maintenance of anxiety. At a fundamental level, however, uncertainty still abounds regarding the nature of the processes that mediate this effect. In the present paper, we propose that two contrasting approaches may be derived from theoretical accounts of AB. According to a first class of models, called the “valence-specific bias” models, modifying AB requires the modification of valence-specific attentional selectivity. According to a second class of models, called the “attention control models,” modifying AB requires the modification of attention control, driven by the recruitment of the dorsolateral prefrontal cortex. We formulate a series of specific predictions, to provide suggestions to trial these two approaches one against the other. This knowledge is critical for understanding the mechanisms of AB in anxiety disorders, which bares important clinical implications.

Does attention bias modification improve attentional control? A double-blind randomized experiment with individuals with social anxiety disorder.

People with anxiety disorders often exhibit an attentional bias for threat. Attention bias modification (ABM) procedure may reduce this bias, thereby diminishing anxiety symptoms. In ABM, participants respond to probes that reliably follow non-threatening stimuli (e.g., neutral faces) such that their attention is directed away from concurrently presented threatening stimuli (e.g., disgust faces). Early studies showed that ABM reduced anxiety more than control procedures lacking any contingency between valenced stimuli and probes. However, recent work suggests that no-contingency training and training toward threat cues can be as effective as ABM in reducing anxiety, implying that any training may increase executive control over attention, thereby helping people inhibit their anxious thoughts. Extending this work, we randomly assigned participants with DSM-IV diagnosed social anxiety disorder to either training toward non-threat (ABM), training toward threat, or no-contingency condition, and we used the attention network task (ANT) to assess all three components of attention. After two training sessions, subjects in all three conditions exhibited indistinguishably significant declines from baseline to post-training in self-report and behavioral measures of anxiety on an impromptu speech task. Moreover, all groups exhibited similarly significant improvements on the alerting and executive (but not orienting) components of attention. Implications for ABM research are discussed.

Enhanced perceptual responses during visual processing of facial stimuli in young socially anxious individuals.

The present study investigated whether social anxiety modulates the processing of facial expressions. Event-related potentials were recorded during an oddball task in young adults reporting high or low levels of social anxiety as evaluated by the Liebowitz Social Anxiety Scale. Repeated pictures of faces with a neutral expression were infrequently replaced by pictures of the same face displaying happiness, anger, fear or disgust. For all participants, response latencies were shorter in detecting faces expressing disgust and happiness as compared to fear or anger. Low social anxiety individuals evoked enhanced P1 in response to angry faces as compared to other stimuli while high socially anxious participants displayed enlarged P1 for all emotional stimuli as compared to neutral ones, and general higher amplitudes as compared to non-anxious individuals. Conversely, the face-specific N170 and the task-related decision P3b were not influenced by social anxiety. These results suggest increased pre-attentive detection of facial cues in socially anxious individuals and are discussed within the framework of recent models of anxiety.

The Causal Role of Attentional Bias for Threat Cues in Social Anxiety: A Test on a Cyber-Ostracism Task

Cognitive models of social phobia postulate that attentional biases for threat play an important role in the maintenance of this disorder (e.g., Clark 2001). Consistent with this idea, studies have demonstrated that training social phobics to attend to non-threatening stimuli results in clinical benefits (Amir et al. in J Abnorm Psychol 117:860–868, 2008). However, no study has directly examined the causal status of selective attentional bias in social phobia. The present study explicitly investigated this issue. We used an experimental design similar to MacLeod et al. (J Abnorm Psychol 111:107–123, 2002), which involved two consecutive experimental phases: an attentional bias induction phase and a stress phase. During the attentional bias induction, participants completed modified versions of a dot-probe task; for half of the participants the task was designed to induce a biased attentional response for faces expressing disgust, for the other half, the task induced no bias. Then, all participants were exposed to a task inducing social rejection. Results indicate that the induction of an attentional bias for threatening information resulted in increased anxiety during social rejection. Implications for cognitive models of social phobia are discussed.