Alfons O. Hamm

The facilitated processing of threatening faces: an ERP analysis.

Threatening, friendly, and neutral faces were presented to test the hypothesis of the facilitated perceptual processing of threatening faces. Dense sensor event-related brain potentials were measured while subjects viewed facial stimuli. Subjects had no explicit task for emotional categorization of the faces. Assessing early perceptual stimulus processing, threatening faces elicited an early posterior negativity compared with nonthreatening neutral or friendly expressions. Moreover, at later stages of stimulus processing, facial threat also elicited augmented late positive potentials relative to the other facial expressions, indicating the more elaborate perceptual analysis of these stimuli. Taken together, these data demonstrate the facilitated perceptual processing of threatening faces. Results are discussed within the context of an evolved module of fear (A. Ohman & S. Mineka, 2001).

Selective Visual Attention to Emotion

Visual attention can be voluntarily directed toward stimuli and is attracted by stimuli that are emotionally significant. The present study explored the case when both processes coincide and attention is directed to emotional stimuli. Participants viewed a rapid and continuous stream of high-arousing erotica and mutilation stimuli as well as low-arousing control images. Each of the three stimulus categories served in separate runs as target or nontarget category. Event-related brain potential measures revealed that the interaction of attention and emotion varied for specific processing stages. The effects of attention and emotional significance operated additively during perceptual encoding indexed by negative-going potentials over posterior regions (∼200–350 ms after stimulus onset). In contrast, thought to reflect the process of stimulus evaluation, P3 target effects (∼400–600 ms after stimulus onset) were markedly augmented when erotica and mutilation compared with control stimuli were the focus of attention. Thus, emotion potentiated attention effects specifically during later stages of processing. These findings suggest to specify the interaction of attention and emotion in distinct processing stages.

Fear appears fast: Temporal course of startle reflex potentiation in animal fearful subjects

The temporal course of startle reflex modulation and autonomic response patterns to fear-relevant and fear-irrelevant pictures in subjects with high and low levels of animal fear was investigated. Thirty-eight high-fear and 48 low-fear volunteers viewed photos of snakes and spiders and pictures of neutral and pleasant content. The slides were presented for 6 s or for only 150 ms, depending on the group. Acoustic startle probes were presented at five different times after slide onset. Relative potentiation of the startle responses started 300 ms after onset of snake/spider pictures in fearful subjects. This fear-potentiated startle effect was maintained for the later probe times and was identical in the 150-ms condition. Fear-relevant pictures also prompted a sympathetically dominated autonomic response profile in fearful persons. These data support the idea that fear can be activated very rapidly, requiring only minimal stimulus input.

Genetic Gating of Human Fear Learning and Extinction Possible Implications for Gene-Environment Interaction in Anxiety Disorder

Pavlovian fear conditioning is a widely used model of the acquisition and extinction of fear. Neural findings suggest that the amygdala is the core structure for fear acquisition, whereas prefrontal cortical areas are given pivotal roles in fear extinction. Forty-eight volunteers participated in a fear-conditioning experiment, which used fear potentiation of the startle reflex as the primary measure to investigate the effect of two genetic polymorphisms (5-HTTLPR and COMTval158met) on conditioning and extinction of fear. The 5-HTTLPR polymorphism, located in the serotonin transporter gene, is associated with amygdala reactivity and neuroticism, whereas the COMTval158met polymorphism, which is located in the gene coding for catechol-O-methyltransferase (COMT), a dopamine-degrading enzyme, affects prefrontal executive functions. Our results show that only carriers of the 5-HTTLPR s allele exhibited conditioned startle potentiation, whereas carriers of the COMT met/met genotype failed to extinguish conditioned fear. These results may have interesting implications for understanding gene-environment interactions in the development and treatment of anxiety disorders.

Effective neuroleptic medication removes prepulse inhibition deficits in schizophrenia patients

BACKGROUND The magnitude of the startle eyeblink response is reduced if the startle eliciting stimulus is shortly preceded by another stimulus. There is evidence that schizophrenia patients exhibit impairments in this so-called prepulse inhibition. Our study investigated whether prepulse inhibition is affected by neuroleptic drug treatment as is suggested by animal research. METHODS Prepulse inhibition was tested in five unmedicated and 20 medicated inpatients with schizophrenia, and 12 normal controls. RESULTS The unmedicated schizophrenia patients showed a strong impairment of sensorimotor gating as indexed by the absence of prepulse inhibition. By contrast, the medicated patients showed a pronounced prepulse inhibition that did not differ from that of the normal controls. There was a substantial covariation between the rated severity of the positive syndrome and the amount of prepulse inhibition--i.e., the patients whose positive symptoms were rated as more severe showed less prepulse inhibition. CONCLUSIONS These data suggest that the impaired sensorimotor gating of schizophrenia patients is not a stable vulnerability indicator, but may rather be related to the positive syndrome and may be improved by treatments with neuroleptic medication.

Explicit attention interferes with selective emotion processing in human extrastriate cortex

BackgroundBrain imaging and event-related potential studies provide strong evidence that emotional stimuli guide selective attention in visual processing. A reflection of the emotional attention capture is the increased Early Posterior Negativity (EPN) for pleasant and unpleasant compared to neutral images (~150–300 ms poststimulus). The present study explored whether this early emotion discrimination reflects an automatic phenomenon or is subject to interference by competing processing demands. Thus, emotional processing was assessed while participants performed a concurrent feature-based attention task varying in processing demands.ResultsParticipants successfully performed the primary visual attention task as revealed by behavioral performance and selected event-related potential components (Selection Negativity and P3b). Replicating previous results, emotional modulation of the EPN was observed in a task condition with low processing demands. In contrast, pleasant and unpleasant pictures failed to elicit increased EPN amplitudes compared to neutral images in more difficult explicit attention task conditions. Further analyses determined that even the processing of pleasant and unpleasant pictures high in emotional arousal is subject to interference in experimental conditions with high task demand. Taken together, performing demanding feature-based counting tasks interfered with differential emotion processing indexed by the EPN.ConclusionThe present findings demonstrate that taxing processing resources by a competing primary visual attention task markedly attenuated the early discrimination of emotional from neutral picture contents. Thus, these results provide further empirical support for an interference account of the emotion-attention interaction under conditions of competition. Previous studies revealed the interference of selective emotion processing when attentional resources were directed to locations of explicitly task-relevant stimuli. The present data suggest that interference of emotion processing by competing task demands is a more general phenomenon extending to the domain of feature-based attention. Furthermore, the results are inconsistent with the notion of effortlessness, i.e., early emotion discrimination despite concurrent task demands. These findings implicate to assess the presumed automatic nature of emotion processing at the level of specific aspects rather than considering automaticity as an all-or-none phenomenon.

Individual differences in fear-potentiated startle as a function of resting heart rate variability: Implications for panic disorder

BACKGROUND Anticipatory anxiety, which can be indexed by the startle potentiation to a threat of shock, has been implicated in the development of panic disorder. Large individual differences exist in startle potentiation to threat of shock but few differences have been found between panic patients in general and non-anxious controls. The present studies explored resting heart rate variability (HRV) as a source of individual differences in startle potentiation in students at risk for panic disorder and in unmedicated panic patients. METHODS Participants in Study 1 were 22 students high and 21 students low in anxiety sensitivity (AS). Nine unmedicated panic patients and 15 matched non-anxious controls were included in Study 2. Startle potentiation to the threat of shock was examined as a function of AS (Study 1) and diagnostic category (Study 2) as well as resting HRV. RESULTS Whereas no differences in startle potentiation were found as a function of AS or panic disorder diagnosis in general, both studies revealed that low resting HRV was associated with exaggerated startle responses to the threat of shock. CONCLUSIONS The present results replicate and extend the sparse literature on fear-potentiated startle in panic disorder. Low HRV was associated with more pronounced startle potentiation to both explicit and contextual cues. Thus, low HRV may be a useful endophenotype for at least some anxiety disorders.

Emotional vulnerability in borderline personality disorder is cue specific and modulated by traumatization.

BACKGROUND A general emotional vulnerability (intense, easily triggered affective reactions) is considered a core symptom in borderline personality disorder (BPD), but evidence from psychophysiological studies for this hypothesis is not very consistent. Given the high comorbidity of posttraumatic stress disorder (PTSD) in BPD patients, current comorbid PTSD might also modulate emotional reactivity. In the present study using a script-driven imagery paradigm, idiographic aversive, disorder-specific (scenes about rejection and abandonment), and standard unpleasant, neutral, and pleasant scripts were presented to investigate emotional reactivity in patients with BPD. METHODS Forty nonmedicated BPD patients and 32 healthy control subjects first read and then imagined the scripts. Acoustic startle probes were presented during reading and imagery and the eye-blink responses, as well as changes in heart rate and skin conductance level were recorded. RESULTS Imagery of disorder-specific scripts resulted in a clear potentiation of the startle responses and increased autonomic arousal in BPD patients but not in control subjects. Borderline personality disorder patients with current comorbid PTSD (n = 26 out of 40) showed attenuated startle potentiation during aversive imagery that was not the case in BPD patients without current PTSD. This effect was most pronounced in BPD patients with severe PTSD. CONCLUSIONS Scenes about rejection and abandonment are specifically able to activate defensive response mobilization in BPD patients. These findings suggest that BPD patients are not more physiologically reactive to emotional cues in general but show increased emotional vulnerability if borderline-specific schemas are activated. Moreover, emotional reactivity is attenuated in BPD patients with PTSD.

Fear Conditioning following Unilateral Temporal Lobectomy: Dissociation of Conditioned Startle Potentiation and Autonomic Learning

The present study investigated fear-potentiated startle and autonomic learning in brain-lesioned patients in a classical fear-conditioning paradigm. Startle blink and skin conductance responses of 30 patients who underwent unilateral temporal lobectomy because of drug-resistant epilepsy were compared with those of 32 healthy controls. As expected, temporal lobectomy patients showed a general impairment in fear conditioning relative to controls. This impairment did not differ with respect to the affected hemisphere. Moreover, while fear-conditioned startle potentiation in healthy controls was independent of contingency awareness, skin conductance discrimination was only observed for those participants who correctly recognized the stimulus contingencies. Patients who acquired a declarative memory of the contingencies also showed intact skin conductance discrimination but failed to exhibit fear-potentiated startle. The present findings support a two-levels-of-learning account of human fear conditioning and also demonstrate that the amygdala is crucially involved in fear learning.

MAOA and mechanisms of panic disorder revisited: from bench to molecular psychotherapy

Panic disorder with agoraphobia (PD/AG) is a prevalent mental disorder featuring a substantial complex genetic component. At present, only a few established risk genes exist. Among these, the gene encoding monoamine oxidase A (MAOA) is noteworthy given that genetic variation has been demonstrated to influence gene expression and monoamine levels. Long alleles of the MAOA-uVNTR promoter polymorphism are associated with PD/AG and correspond with increased enzyme activity. Here, we have thus investigated the impact of MAOA-uVNTR on therapy response, behavioral avoidance and brain activity in fear conditioning in a large controlled and randomized multicenter study on cognitive behavioral therapy (CBT) in PD/AG. The study consisted of 369 PD/AG patients, and genetic information was available for 283 patients. Carriers of the risk allele had significantly worse outcome as measured by the Hamilton Anxiety scale (46% responders vs 67%, P=0.017). This was accompanied by elevated heart rate and increased fear during an anxiety-provoking situation, that is, the behavioral avoidance task. All but one panic attack that happened during this task occurred in risk allele carriers and, furthermore, risk allele carriers did not habituate to the situation during repetitive exposure. Finally, functional neuroimaging during a classical fear conditioning paradigm evidenced that the protective allele is associated with increased activation of the anterior cingulate cortex upon presentation of the CS+ during acquisition of fear. Further differentiation between high- and low-risk subjects after treatment was observed in the inferior parietal lobes, suggesting differential brain activation patterns upon CBT. Taken together, we established that a genetic risk factor for PD/AG is associated with worse response to CBT and identify potential underlying neural mechanisms. These findings might govern how psychotherapy can include genetic information to tailor individualized treatment approaches.