Lauren M. Sippel

An ERP study of conflict monitoring in 4–8-year old children: Associations with temperament

Although there is great interest in identifying the neural correlates of cognitive processes that create risk for psychopathology, there is a paucity of research in young children. One event-related potential (ERP), the N2, is thought to index conflict monitoring and has been linked cognitive and affective risk factors for anxiety. Most of this research, however, has been conducted with adults, adolescents, and older children, but not with younger children. To address this gap, the current study examined 26 4-8-year-olds, who completed a cued flanker task while EEG was continuously recorded. We assessed whether the N2 was detectable in this group of young children and examined associations between the N2 and factors reflecting affective risk (e.g., reduced executive attention, temperamental effortful control, and temperamental surgency). We documented an N2 effect (greater N2 amplitude to incongruent versus congruent flankers), but only in children older than 6 years of age. Increases in the N2 effect were associated with less efficient executive attention and lower temperamental effortful control. We discuss the implications of these findings and consider how they may inform future studies on biomarkers for cognitive and affective risk factors for anxiety.

How does social support enhance resilience in the trauma-exposed individual?

Although most resilience science has focused on individual-level psychosocial factors that promote individual resilience, theorists and researchers have begun to examine neurobiological and systems-level factors implicated in resilience. In this commentary we argue that the development of effective interventions to enhance resilience necessitates understanding that resilience in the individual is dependent on multiple layers of society. Further, we suggest that there is a bidirectional relationship between systems-level resilience (i.e., resilience of romantic partners, family members, neighborhoods, and larger social contexts) and individual resilience. We suggest directions for future research and interventions, with the goal of stimulating research efforts that address these questions among traumaexposed individuals.

Why are some individuals more resilient than others: the role of social support.

a number of practice considerations should be made. Refugee children are likely to have different constructs of mental ill health, attributions that associate it with their asylum applications, and fears of stigma and deportation. Engaging them and alleviating such misconceptions is thus a major step towards a successful outcome. Their psychological mindedness will vary, as many refugee children first experience predominantly somatizing symptoms, and may require several attempts before accepting a trauma-focused treatment. Involving their carers and initially setting goals of, for instance, risk management while developing a trusting relationship can lead to a therapeutic phase, while they also become more adjusted in their country of reception. In conclusion, refugee children and young people pose a significant public health challenge across the world. Their complex needs require closer collaboration between mental health and non-statutory services to maximize their respective skills and resources. A comprehensive multi-modal service should include clear care pathways, case management, evidence-based traumafocused interventions, consultancy, and training.

Negatively Biased Emotion Perception in Depression as a Contributing Factor to Psychological Aggression Perpetration: A Preliminary Study

ABSTRACT Based on research linking depressive symptoms and intimate partner aggression perpetration with negatively biased perception of social stimuli, the present authors examined biased perception of emotional expressions as a mechanism in the frequently observed relationship between depression and psychological aggression perpetration. In all, 30 university students made valence ratings (negative to positive) of emotional facial expressions and completed measures of depressive symptoms and psychological aggression perpetration. As expected, depressive symptoms were positively associated with psychological aggression perpetration in an individuals current relationship, and this relationship was mediated by ratings of negative emotional expressions. These findings suggest that negatively biased perception of emotional expressions within the context of elevated depressive symptoms may represent an early stage of information processing that leads to aggressive relationship behaviors.

Fear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes

Posttraumatic stress disorder (PTSD) is associated with alterations in critical brain regions such as the amygdala, hippocampus, and prefrontal cortex. This brief review has two objectives: (1) to discuss research examining extinction and reconsolidation processes as mechanisms in PTSD psychotherapy, and (2) present possibilities for augmenting extinction and reconsolidation within treatment through alterations to therapeutic interventions and novel approaches. A key component of many effective PTSD therapies is exposure, which involves intentional confrontation and processing of the traumatic memory. Our review suggests that extinction and reconsolidation processes underlie effective exposure-based treatment, but the neurobiological mechanisms of these processes in behavioral treatments for PTSD remains unclear. We argue that enhancing extinction and/or disrupting reconsolidation of a feared memory may improve the efficacy of existing treatments (e.g., increased change for limited/non-responders, faster/greater changes for responders), which can be done through multiple channels. Potential avenues for augmentation of the processes of extinction and reconsolidation in PTSD psychotherapies are reviewed, including behavioral modifications, pharmacotherapy agents, and the use of devices during therapy. We further suggest that investigations towards understanding the extent to which extinction and reconsolidation processes are necessary in effective PTSD psychotherapy is an important future direction for enhancing clinical care among PTSD populations.

Posttraumatic Stress Disorder and Fear of Emotions: The Role of Attentional Control

Individuals with posttraumatic stress disorder (PTSD) experience elevated concerns about their capacity to control, and the consequences of, strong emotions that occur in response to trauma reminders. Anxiety is theorized to compromise attentional control (Eysenck, Derakshan, Santos, & Calvo, 2007). In turn, diminished attentional control may increase vulnerability to threat cues and emotional reactivity (Ehlers & Clark, 2001). Consequently, attentional control may play a role in the fear of emotions frequently experienced by individuals with PTSD. Study participants included 64 men and 64 women with a mean age of 37 years, 86% of whom were White, non-Hispanic. Participants experienced an average of 7.68 types of traumatic events, most commonly including motor vehicle accidents and intimate partner violence. PTSD symptoms positively correlated with fear of emotions (r = .53) and negatively correlated with attentional control (r = -.38). Attentional control was negatively correlated with fear emotions (r = -.77) and partially mediated the link between PTSD and fear of emotions (R(2) = .22). Given the findings regarding top-down attentional control, these results have implications for cognitive and emotional processing theories of PTSD and emphasize the importance of clinical consideration of fear of emotions and attentional control in the treatment of PTSD.

Oxytocin and Stress-related Disorders: Neurobiological Mechanisms and Treatment Opportunities:

Novel pharmacotherapies that improve outcomes for individuals with stress-related psychiatric disorders are needed. The neurohormone oxytocin (OT) is a promising candidate given its influence on the social–emotional brain. In this review, we present an overview of evidence supporting OT’s utility for treating major depressive disorder and posttraumatic stress disorder. We first discuss endogenous OT, which research suggests is not yet a reliable biomarker of stress-related disorders. Second, we review effects of intranasal (IN) OT on processes relevant to stress-related disorders in healthy populations (anhedonia, reward processing, psychosocial stress reactivity, fear/anxiety, and social behavior) and their neurobiological mechanisms (e.g., the salience network and hypothalamic–pituitary–adrenal axis). Third, we present the sparse but promising findings from clinical populations, followed by discussion of critical moderating variables to consider in the service of maximizing the therapeutic potential of OT (e.g., patient sex and child maltreatment). We also identify heterogeneous findings and limitations of existing research, including reliance on single-dose studies in psychiatrically healthy samples and unanswered questions regarding the effectiveness of IN drug delivery and dosing schedules. Well-controlled multidose studies including women and measures of potentially moderating variables are sorely needed and would inform our understanding of the utility of OT for preventing and treating stress-related psychiatric disorders.

Borderline personality disorder and related constructs as risk factors for intimate partner violence perpetration

In this manuscript we systematically reviewed 29 articles from 2010 to 2014 that addressed the association between borderline personality disorder (BPD) and intimate partner violence (IPV) perpetration, with particular attention paid to the role of perpetrator sex. Our primary objective was to provide a summary of (1) the operationalization and measurement of BPD and IPV, (2) mechanisms of the BPD-IPV association, and (3)the current understanding of the role of perpetrator sex related to BPD and IPV. We observed three distinct operational definitions of BPD which are measured in a variety of ways. IPV measurement tends to be more consistent. Further, emotion perception, impulsivity, attachment, and substance use are proposed mechanisms to explain the BPD IPV relation. The findings regarding potential perpetrator sex differences in the BPD-IPV association are mixed. Finally, we also provide recommendations for future research and clinical practice.

The differential diagnostic accuracy of the PTSD Checklist among men versus women in a community sample.

We evaluated the specific version of the PTSD Checklist (PCL-S) as a screening tool for the recruitment of community-residing men and women with diverse trauma experiences. We administered the PCL-S via telephone in the context of participant recruitment, as well as in a laboratory setting preceding administration of the Clinician Administered PTSD Scale (CAPS), the gold standard PTSD assessment tool. In the laboratory, the PCL-S performed reasonably well for men and women, yielding overall diagnostic efficiency (ODE) values (representing percentage of cases accurately identified) of 0.78 and 0.73, respectively, for our recommended cut-points of 42 for men and 49 for women. In contrast, as a recruitment tool, the PCL-S yielded an acceptable ODE of 0.79 for men at the recommended cut-point of 47, but only an ODE of 0.56 (representing diagnostic efficiency no greater than chance) for women at the recommended cut-point of 50. A recruitment cut-point of 57 for women yields a similarly modest ODE of 0.61, but with substantial cost to sensitivity. These findings suggest that use of the PCL-S to screen for PTSD among potential study participants may lead to gender biased study results, even when separate diagnostic cut-points for men and women are used.

Hostility and telomere shortening among U.S. military veterans: results from the National Health and Resilience in Veterans Study

Chronic disorders of aging are critical concerns for the U.S. veteran population, which is, on average, two decades older than the non-veteran population. Characterization of risk factors that may accelerate biological aging is important in identifying targets for prevention and intervention. In the current study, we analyzed data from a contemporary, and nationally representative sample of U.S. veterans to evaluate the relationship between a broad range of sociodemographic, military, and clinical variables, and peripheral telomere length, which is an indicator of biological age and linked to risk for aging-related disorders and mortality. Data from 468U.S. military veterans who participated in the National Health and Resilience in Veterans Study were analyzed. Telomere length was assessed from cells isolated from saliva using quantitative polymerase chain reaction methods. A multivariable binary logistic regression analysis was conducted to evaluate the relations between hostility and telomere length, while controlling for sociodemographic, military, and clinical variables. Greater scores on a measure of hostility were independently associated with telomere shortening, even after adjustment for a broad range of other variables (odds ratio [OR]=1.58, 95% confidence interval [CI]=1.15-2.18). Secondary analyses revealed that this association was driven by difficulties controlling anger (OR=1.72, 95%CI=1.14-2.61), which reflect the external manifestation of hostility, rather than aggressive urges or impulses. Hostility, particularly difficulties controlling anger, is associated with peripheral telomere shortening in U.S. military veterans. Prevention and treatment efforts designed to reduce hostility may help mitigate risk for accelerated cellular aging in this growing segment of the U.S. POPULATION