Mikko J. Peltola

Seeing direct and averted gaze activates the approach-avoidance motivational brain systems.

Gaze direction is known to be an important factor in regulating social interaction. Recent evidence suggests that direct and averted gaze can signal the senders motivational tendencies of approach and avoidance, respectively. We aimed at determining whether seeing another persons direct vs. averted gaze has an influence on the observers neural approach-avoidance responses. We also examined whether it would make a difference if the participants were looking at the face of a real person or a picture. Measurements of hemispheric asymmetry in the frontal electroencephalographic activity indicated that another persons direct gaze elicited a relative left-sided frontal EEG activation (indicative of a tendency to approach), whereas averted gaze activated right-sided asymmetry (indicative of avoidance). Skin conductance responses were larger to faces than to control objects and to direct relative to averted gaze, indicating that faces, in general, and faces with direct gaze, in particular, elicited more intense autonomic activation and strength of the motivational tendencies than did control stimuli. Gaze direction also influenced subjective ratings of emotional arousal and valence. However, all these effects were observed only when participants were facing a real person, not when looking at a picture of a face. This finding was suggested to be due to the motivational responses to gaze direction being activated in the context of enhanced self-awareness by the presence of another person. The present results, thus, provide direct evidence that eye contact and gaze aversion between two persons influence the neural mechanisms regulating basic motivational-emotional responses and differentially activate the motivational approach-avoidance brain systems.

Emergence of enhanced attention to fearful faces between 5 and 7 months of age

The adult brain is endowed with mechanisms subserving enhanced processing of salient emotional and social cues. Stimuli associated with threat represent one such class of cues. Previous research suggests that preferential allocation of attention to social signals of threat (i.e. a preference for fearful over happy facial expressions) emerges during the second half of the first year. The present study was designed to determine the age of onset for infants attentional bias for fearful faces. Allocation of attention was studied by measuring event-related potentials (ERPs) and looking times (in a visual paired comparison task) to fearful and happy faces in 5- and 7-month-old infants. In 7-month-olds, the preferential allocation of attention to fearful faces was evident in both ERPs and looking times, i.e. the negative central mid-latency ERP amplitudes were more negative, and the looking times were longer for fearful than happy faces. No such differences were observed in the 5-month-olds. It is suggested that an enhanced sensitivity to facial signals of threat emerges between 5 and 7 months of age, and it may reflect functional development of the neural mechanisms involved in processing of emotionally significant stimuli.

Differential electrocortical responses to increasing intensities of fearful and happy emotional expressions.

Previous studies have shown differential event-related potentials (ERPs) to fearful and happy/neutral facial expressions. To investigate whether the brain systems underlying these ERP differences are sensitive to the intensity of fear and happiness, behavioral recognition accuracy and reaction times as well as ERPs were measured while observers categorized low-intensity (50%), prototypical (100%), and caricatured (150%) fearful and happy facial expressions. The speed and accuracy of emotion categorization improved with increasing levels of expression intensity, and 100% and 150% expressions were consistently classified as expressions of the intended emotions. Comparison of ERPs to 100% and 150% expressions revealed a differential pattern of ERPs to 100% and 150% fear expressions over occipital-temporal electrodes 190-290 ms post-stimulus (a negative shift in ERP activity for high-intensity fearful expressions). Similar ERP differences were not observed for 100% and 150% happy expressions, ruling out the possibility that the ERPs to high-intensity fear reflected a response to increased expression intensity per se. Together, these results suggest that differential electrocortical responses to fearful facial expressions over posterior electrodes are generated by a neural system that responds to the intensity of negative but not positive emotional expressions.

Fearful faces modulate looking duration and attention disengagement in 7-month-old infants

The present study investigated whether facial expressions modulate visual attention in 7-month-old infants. First, infants looking duration to individually presented fearful, happy, and novel facial expressions was compared to looking duration to a control stimulus (scrambled face). The face with a novel expression was included to examine the hypothesis that the earlier findings of greater allocation of attention to fearful as compared to happy faces could be due to the novelty of fearful faces in infants rearing environment. The infants looked longer at the fearful face than at the control stimulus, whereas no such difference was found between the other expressions and the control stimulus. Second, a gap/overlap paradigm was used to determine whether facial expressions affect the infants ability to disengage their fixation from a centrally presented face and shift attention to a peripheral target. It was found that infants disengaged their fixation significantly less frequently from fearful faces than from control stimuli and happy faces. Novel facial expressions did not have a similar effect on attention disengagement. Thus, it seems that adult-like modulation of the disengagement of attention by threat-related stimuli can be observed early in life, and that the influence of emotionally salient (fearful) faces on visual attention is not simply attributable to the novelty of these expressions in infants rearing environment.

The Effect of Birth in Secondary- or Tertiary-Level Hospitals in Finland on Mortality in Very Preterm Infants: A Birth-Register Study

OBJECTIVE. Our goal was to test the hypothesis that the level of the delivery hospital affects 1-year mortality of very preterm infants in Finland. PATIENTS AND METHODS. This retrospective national medical birth-register study included 2291 very preterm infants (gestational age of <32 weeks at birth or birth weight of ≤1500 g) born in 14 level II (central) and 5 level III (university) hospitals in 2000–2003. The main outcome measures were adjusted total mortality (including stillbirths) and mortality of live-born infants until the age of 1 year. RESULTS. Both the total 1-year mortality and the 1-year mortality of live-born infants were higher in level II hospitals compared with level III hospitals. Total mortality was higher in very preterm infants who were not born during office hours. In theory, delivery of all very preterm infants in level III instead of level II hospitals translates into an annual prevention of 69 of the 170 total deaths and prevention of 18 of the 45 deaths of live-born infants. CONCLUSIONS. Resources in neonatal intensive care should be increased, especially during non–office hours, to have an equally distributed service through the 24-hour day. More efficient regionalization of very preterm deliveries may improve 1-year survival of very preterm infants in Finland.

Aging, health expenditure, proximity to death, and income in Finland.

This study revisits the debate on the red herring, i.e. the claim that population aging will not have a significant impact on health care expenditure (HCE), using a Finnish data set. We decompose HCE into several components and include both survivors and deceased individuals into the analyses. We also compare the predictions of health expenditure based on a model that takes into account the proximity to death with the predictions of a naïve model, which includes only age and gender and their interactions. We extend our analysis to include income as an explanatory variable. According to our results, total expenditure on health care and care of elderly people increases with age but the relationship is not as clear as is usually assumed when a naïve model is used in health expenditure projections. Among individuals not in long-term care, we found a clear positive relationship between expenditure and age only for health centre and psychiatric inpatient care. In somatic care and prescribed drugs, the expenditure clearly decreased with age among deceased individuals. Our results emphasize that even in the future, health care expenditure might be driven more by changes in the propensity to move into long-term care and medical technology than age and gender alone, as often claimed in public discussion. We do not find any strong positive associations between income and expenditure for most non-LTC categories of health care utilization. Income was positively related to expenditure on prescribed medicines, in which cost-sharing between the state and the individual is relatively high. Overall, our results indicate that the future expenditure is more likely to be determined by health policy actions than inevitable trends in the demographic composition of the population.

Fearful faces but not fearful eyes alone delay attention disengagement in 7-month-old infants.

Adult-like attentional biases toward fearful faces can be observed in 7-month-old infants. It is possible, however, that infants merely allocate attention to simple features such as enlarged fearful eyes. In the present study, 7-month-old infants (n = 15) were first shown individual emotional faces to determine their visual scanning patterns of the expressions. Second, an overlap task was used to examine the latency of attention disengagement from centrally presented faces. In both tasks, the stimuli were fearful, happy, and neutral facial expressions, and a neutral face with fearful eyes. Eye-tracking data from the first task showed that infants scanned the eyes more than other regions of the face; however, there were no differences in scanning patterns across expressions. In the overlap task, infants were slower in disengaging attention from fearful as compared to happy and neutral faces and also to neutral faces with fearful eyes. Together, these results provide evidence that threat-related stimuli tend to hold attention preferentially in 7-month-old infants and that the effect does not reflect a simple response to differentially salient eyes in fearful faces.

Serotonin and early cognitive development: variation in the tryptophan hydroxylase 2 gene is associated with visual attention in 7-month-old infants

BACKGROUNDnAllelic variation in the promoter region of a gene that encodes tryptophan hydroxylase isoform 2 (TPH2), a rate-limiting enzyme of serotonin synthesis in the central nervous system, has been associated with variations in cognitive function and vulnerability to affective spectrum disorders. Little is known about the effects of this gene variant on cognition during development and about possible intermediate developmental steps that lead to the adult phenotype. Here, we examined the hypothesis that the TPH2 -703 may act during early stages of development and bias the acquisition of elementary cognitive processes involved in attention and emotion regulation.nnnMETHODSnSeven-month-old infants (n = 66) were genotyped for the TPH2 -703 G/T polymorphism (rs4570625) and tested for the efficiency of attention shifts from a stimulus at fixation to a new stimulus in the visual periphery.nnnRESULTSnCompared to TPH2 G/G homozygotes, infants with the T-carrier genotype exhibited a significantly higher number of missing attention shifts. This genotype effect tended to be particularly pronounced when infants had to disengage from an affectively salient stimulus before shifting attention to the peripheral stimulus. The results also showed that TPH2 genotype was indirectly associated, via its effect on attention disengagement, with temperamental emotion regulation (soothability).nnnCONCLUSIONSnTogether, these results implicate serotonin system genes in early cognitive development and suggest variations in the early-emerging cognitive capacities as a potential developmental precursor of individual differences in emotion regulation and vulnerability to affective disorders.

Morbidities and Hospital Resource Use During the First 3 Years of Life Among Very Preterm Infants

OBJECTIVE: The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g). METHODS: The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model. RESULTS: A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities. CONCLUSIONS: Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.

The observer observed : Frontal EEG asymmetry and autonomic responses differentiate between another person´s direct and averted gaze when the face is seen live

Recently, we showed that another persons gaze direction influenced the perceivers frontal EEG asymmetry and autonomic arousal in response to freely viewed real faces, but not in response to face pictures. However, the lack of a task during the viewing may have resulted in less attention allocation to face pictures vs. live faces. In the present study, the participants performed two online tasks while viewing the faces presented live through an electronic shutter and as pictures on a computer screen. The results replicated those from our previous experiment showing that direct gaze elicited greater relative left-sided frontal EEG asymmetry and autonomic arousal than averted gaze but, again, only in the live condition. However, the results also showed that two live stimulus faces (male and female) elicited differential EEG asymmetry responses in our participants (all females), and the effects of gaze direction were observed only for the (live) female faces. The results suggest that the discriminative responses to live faces vs. pictures are likely to reflect the participants enhanced mental-state attributions and self-awareness when looking at and being looked by live faces. Thus, the motivation- and affect-related psychophysiological responses to gaze direction are most discriminative in the presence of another person, regardless of whether the face/gaze is actively monitored or not.