Nancy S. Koven

Emotion-Modulated Performance and Activity in Left Dorsolateral Prefrontal Cortex

Functional MRI (fMRI) was used to examine the relationship between processing of pleasant and unpleasant stimuli and activity in prefrontal cortex. Twenty volunteers identified the colors in which pleasant, neutral, and unpleasant words were printed. Pleasant words prompted more activity bilaterally in dorsolateral prefrontal cortex (DLPFC) than did unpleasant words. In addition, pleasant words prompted more activity in left than in right DLPFC. Response speed to pleasant words was correlated with DLPFC activity. These data directly link positive affect, enhanced performance, and prefrontal activity, providing some of the first fMRI evidence supporting models of emotional valence and frontal brain asymmetry based on electroencephalography (EEG).

Neural mechanisms of affective interference in schizotypy

Negatively valenced stimuli foster cognitive impairment in schizotypy and schizophrenia. To identify relevant brain mechanisms, the authors had 16 positive-schizotypy and 16 control participants perform an emotional Stroop task, judging the ink color of negative and neutral words during functional magnetic resonance imaging (fMRI) of regional brain activity. Schizotypy individuals showed increased right and decreased left activity in dorsolateral prefrontal cortex, indicating a deficit in maintenance of attentional set in the presence of negative emotional distractors. They also showed abnormal activity in ventral limbic areas, including decreased activity in nucleus accumbens and increased activity in hippocampus and amygdala, a circuit involved in the integration of cognitive and affective processes. These results indicate that aspects of emotion-cognition processes and the brain mechanisms that implement them are similar in schizotypy and schizophrenia.

The clinical basis of orthorexia nervosa: emerging perspectives

Orthorexia nervosa describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Although prompted by a desire to achieve optimum health, orthorexia may lead to nutritional deficiencies, medical complications, and poor quality of life. Despite its being a distinct behavioral pattern that is frequently observed by clinicians, orthorexia has received very little empirical attention and is not yet formally recognized as a psychiatric disorder. In this review, we synthesize existing research to identify what is known about the symptoms, prevalence, neuropsychological profile, and treatment of orthorexia. An examination of diagnostic boundaries reveals important points of symptom overlap between orthorexia and anorexia nervosa, obsessive–compulsive disorder (OCD), obsessive–compulsive personality disorder (OCPD), somatic symptom disorder, illness anxiety disorder, and psychotic spectrum disorders. Neuropsychological data suggest that orthorexic symptoms are independently associated with key facets of executive dysfunction for which some of these conditions already overlap. Discussion of cognitive weaknesses in set-shifting, external attention, and working memory highlights the value of continued research to identify intermediate, transdiagnostic endophenotypes for insight into the neuropathogenesis of orthorexia. An evaluation of current orthorexia measures indicates a need for further psychometric development to ensure that subsequent research has access to reliable and valid assessment tools. Optimized assessment will not only permit a clearer understanding of prevalence rates, psychosocial risk factors, and comorbid psychopathology but will also be needed to index intervention effectiveness. Though the field lacks data on therapeutic outcomes, current best practices suggest that orthorexia can successfully be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication.

Relationships of distinct affective dimensions to performance on an emotional Stroop task

Few studies have examined the nature of enhanced selective attention to threatening stimuli with regard to distinct affective dimensions in nonclinical samples. No study to date has explored the relationships of multiple anxiety-related dimensions to performance on an emotional Stroop task. An adult sample without history of spontaneous panic attacks (N = 138) participated in an emotional Stroop task, and performance was analyzed in light of several types of self-reported anxiety. Only anxiety sensitivity distinguished individuals who showed a pattern of interference to threat information from those who showed a pattern of facilitation. No anxiety type was associated with reaction time patterns to appetitive distractors. These results highlight the importance of deconstructing anxiety into separate dimensions such that unique relationships between anxiety types and cognitive processing can be examined.

Specificity of emotion-related effects on attentional processing in schizotypy.

OBJECTIVES In the schizophrenia spectrum, cognitive functions such as perception, language, and attention have been shown to be adversely influenced by negative affect. The present study addressed three issues of specificity and one issue of mechanism regarding affect-related attentional disruption in schizotypy: (1) Is attentional disturbance from negative affective stimuli specific to positive (PS) but not negative schizotypy (NS)? (2) Do positive affective stimuli also foster attentional disturbance? (3) Are anxiety and depression differentially related to PS and NS? (4) Whatever the degree of specificity in these relationships, does anxiety mediate the relationship between schizotypy and attentional disturbance? METHODS Nonpatient participants (N=162) provided responses on scales of schizotypy, anxiety, and depression and performed an emotional Stroop task, judging the ink color of positive, neutral, and negative words. RESULTS PS but not NS was associated with poorer attentional performance. This attentional disturbance was specific to negative words. PS was associated with anxiety and depression, whereas NS was associated only with depression. Finally, anxiety and depression did not fully mediate the relationship between PS and attentional interference related to negative affective stimuli. CONCLUSIONS Findings of attentional disturbance in the presence of negative affective stimuli, particularly in positive schizotypy, have substantial theoretical implications. They provide a path by which the interplay of cognitive and affective phenomena could lead to the formation, maintenance, and exacerbation of positive symptoms, including delusions and hallucinations. Findings from this study also underscore the importance of examining the differential contribution of comorbid anxiety and depression to cognitive and affective function in the schizophrenia spectrum.

Specificity of meta-emotion effects on moral decision-making.

A recently proposed dual process theory of moral decision-making posits that utilitarian reasoning (approving of harmful actions that maximize good consequences) is the result of cognitive control of emotion. This suggests that deficits in emotional awareness will contribute to increased utilitarianism. The present study explored the relative contributions of the different facets of alexithymia and the closely related constructs of emotional intelligence and mood awareness to utilitarian decision making. Participants (N = 86) completed the Toronto Alexithymia Scale, Trait Meta Mood Scale, the Mood Awareness Scale, and a series of high-conflict, personal moral dilemmas validated by Greene et al. (2008). A brief neuropsychological battery was also administered to assess the possible confounds of verbal reasoning and abstract thinking ability. Principal components analysis revealed two latent factors-clarity of emotion and attention to emotion-which cut across all three meta-emotion instruments. Of these, low clarity of emotion-reflecting difficulty in reasoning thoughtfully about ones emotions-predicted utilitarian outcomes and provided unique variance beyond that of verbal and abstract reasoning abilities. Results are discussed in the context of individual differences in emotion regulation.

Executive Function and Emotion Regulation Strategy Use in Adolescents

Development of emotion regulation strategy use involves a transition from reliance on suppression during childhood to greater use of reappraisal in adolescence and adulthood—a transition that parallels developmental changes in executive functions. We evaluated the relationship between emotion regulation strategy use and executive functioning in the everyday life of 70 typically developing adolescents who completed the Emotion Regulation Questionnaire for Youth and the Behavior Rating Inventory of Executive Function-Self-Report. Results indicated that greater reliance on reappraisal was associated with better executive functions, while reliance on suppression was related to poorer executive functions. Findings suggest that adolescents who rely on reappraisal may have more cognitive resources to help them remain attentive and well regulated in their daily lives. On the other hand, if better executive functions facilitate the use of reappraisal, adolescents’ ability to regulate their emotions could potentially be enhanced via supports for executive functions.

Apathy and the Processing of Novelty in Schizophrenia

Apathy is a common negative symptom in schizophrenia that has been associated with poor medication compliance and treatment outcome. Recent studies in neurological patients have observed an association between apathy and reduced attention to novel stimuli. We evaluated whether patients with schizophrenia demonstrate a similar relationship. Participants included 20 patients with schizophrenia and 20 healthy comparison subjects matched for age, sex, handedness, and parental education. A self-paced visual novelty task was presented which assessed the duration that participants looked at frequent standard stimuli, infrequent target stimuli, and novel stimuli. Attention to novelty was defined as the duration of viewing novel relative to standard stimuli. Apathy was assessed with the Marin Apathy Evaluation Scale. Results revealed significantly greater self- and informant-reported apathy, slower reaction time to target stimuli, and longer viewing times to the stimuli, but not reduced attention to the novel stimuli, in the patient group. Although greater self-report of apathy was associated with longer viewing times for all stimuli in the patient group, this was accounted for by depressed mood. The present findings indicate that schizophrenia is associated with slowed information processing, but do not support the hypothesis that apathy in schizophrenia is associated with abnormal processing of novelty.

Basal salivary oxytocin level predicts extra- but not intra-personal dimensions of emotional intelligence.

A wealth of literature suggests that oxytocin is an important mediator of social cognition, but much of the research to date has relied on pharmaceutical administration methods that can raise oxytocin to artificially high levels. The present study builds upon previous work by examining whether basal oxytocin level predicts intra- and extra-personal (i.e., self- and other-focused) elements of emotional intelligence (EI), independent of shared variance with current mood. The sample included 71 healthy young adults (46 women). Assessment measures included the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 (MSCEIT), the Trait Meta-Mood Scale, and the Profile of Mood States. Peripheral oxytocin levels were examined with enzyme-linked immunosorbent assay from saliva after solid phase extraction. Oxytocin level was unrelated to TMMS scores but was positively associated with performance in the Experiential EI domain of the MSCEIT. However, total mood disturbance was positively related to MSCEIT scores. Hierarchical regression analysis indicated that oxytocin level added unique variance to the prediction of MSCEIT performance beyond that of current mood. These results confirm an association between endogenous levels of oxytocin in healthy adults and a subset of EI abilities, including extra-personal emotion recognition and the channeling of emotions to enhance social proficiency.

Vitamin D and long-term memory in multiple sclerosis.

Background and Objective:Memory disturbance is a frequent cognitive complaint by patients with multiple sclerosis (MS). Recent dementia research suggests a beneficial role for vitamin D in long-term memory functioning. While data suggest ameliorative effects of vitamin D for the physical impairments of MS, it is unknown whether vitamin D can benefit the cognitive sequelae. We examined the relationship between serum levels of vitamin D and performance on verbal and nonverbal tests of long-term memory in patients with MS. Methods:A sample of 35 adults with relapsing-remitting MS completed cognitive testing and a vitamin D serum (25[OH]D) assay. Memory assessment used clinically established neuropsychological tests with multiple testing formats to determine whether vitamin D level was associated with memory during conditions of varying retrieval demands. Intellectual functioning and mood were also assessed to control for potential confounds. Results:Vitamin D level was positively associated with performance on immediate and delayed recall trials of the Rey Complex Figure Test, effects that held after controlling for intelligence and disease duration. Vitamin D level was not associated with mood, intelligence, or verbal memory performance on the California Verbal Learning Test, Second Edition. Conclusions:Higher vitamin D level was associated with better nonverbal long-term memory performance in MS, particularly in conditions when no aid was given to help retrieval. These results supplement the literature on the neuroprotective effects of vitamin D and suggest that vitamin D is a worthwhile adjunct treatment for MS.