Sandra Schönfelder

How to Regulate Emotion? Neural Networks for Reappraisal and Distraction

The regulation of emotion is vital for adaptive behavior in a social environment. Different strategies may be adopted to achieve successful emotion regulation, ranging from attentional control (e.g., distraction) to cognitive change (e.g., reappraisal). However, there is only scarce evidence comparing the different regulation strategies with respect to their neural mechanisms and their effects on emotional experience. We, therefore, directly compared reappraisal and distraction in a functional magnetic resonance imaging study with emotional pictures. In the distraction condition participants performed an arithmetic task, while they reinterpreted the emotional situation during reappraisal to downregulate emotional intensity. Both strategies were successful in reducing subjective emotional state ratings and lowered activity in the bilateral amygdala. Direct contrasts, however, showed a stronger decrease in amygdala activity for distraction when compared with reappraisal. While both strategies relied on common control areas in the medial and dorsolateral prefrontal and inferior parietal cortex, the orbitofrontal cortex was selectively activated for reappraisal. In contrast, the dorsal anterior cingulate and large clusters in the parietal cortex were active in the distraction condition. Functional connectivity patterns of the amygdala activation confirmed the roles of these specific activations for the 2 emotion regulation strategies.

Neural correlates of emotion regulation deficits in remitted depression: The influence of regulation strategy, habitual regulation use, and emotional valence

Regulating emotions through reappraisal has been shown to elicit abnormal neural activation patterns in currently depressed patients. It is, however, unclear if this deficit generalizes to other emotion regulation strategies, if it persists when patients recover, and if it is related to habitual use of reappraisal strategies. Therefore, we measured the neural responses to emotional images with functional magnetic resonance imaging in remitted patients with previous episodes of major depression and healthy controls. While viewing the images participants regulated the elicited emotions using either a reappraisal or a distraction strategy. Habitual reappraisal use was measured with the Cognitive Emotion Regulation Questionnaire. Depressed patients showed a selective deficit in down-regulating amygdala responses to negative emotional stimuli using reappraisal. This down-regulation of amygdala activity was strongest in participants high in habitual reappraisal use. Activity in the regulating control-network including anterior cingulate and lateral orbitofrontal cortex was increased during both emotion regulation strategies. The findings in remitted patients with previous episodes of major depression suggest that altered emotion regulation is a trait-marker for depression. This interpretation is supported by the relation of habitual reappraisal use to amygdala down-regulation success.

Time course of emotion-related responding during distraction and reappraisal

Theoretical accounts of emotion regulation (ER) discriminate various cognitive strategies to voluntarily modify emotional states. Amongst these, attentional deployment (i.e. distraction) and cognitive change (i.e. reappraisal), have been shown to successfully down-regulate emotions. Neuroimaging studies found that both strategies differentially engage neural structures associated with selective attention, working memory and cognitive control. The aim of this study was to further delineate similarities and differences between the ER strategies reappraisal and distraction by investigating their temporal brain dynamics using event-related potentials (ERPs) and their patterns of facial expressive behavior. Twenty-one participants completed an ER experiment in which they had to either passively view positive, neutral and negative pictures, reinterpret them to down-regulate affective responses (reappraisal), or solve a concurrently presented mathematical equation (distraction). Results demonstrate the efficacy of both strategies in the subjective control of emotion, accompanied by reductions of facial expressive activity (Corrugator supercilii and Zygomaticus major). ERP results indicated that distraction, compared with reappraisal, yielded a stronger and earlier attenuation of the late positive potential (LPP) magnitude for negative pictures. For positive pictures, only distraction but not reappraisal had significant effect on LPP attenuation. The results support the process model of ER, separating subtypes of cognitive strategies based on their specific time course.

Impaired regulation of emotion: neural correlates of reappraisal and distraction in bipolar disorder and unaffected relatives

Deficient emotion regulation has been proposed as a crucial pathological mechanism in bipolar disorder (BD). We therefore investigated emotion regulation impairments in BD, the related neural underpinnings and their etiological relevance for the disorder. Twenty-two euthymic patients with bipolar-I disorder and 17 unaffected first-degree relatives of BD-I patients, as well as two groups of healthy gender-, age- and education-matched controls (N=22/17, respectively) were included. Participants underwent functional magnetic resonance imaging while applying two different emotion regulation techniques, reappraisal and distraction, when presented with emotional images. BD patients and relatives showed impaired downregulation of amygdala activity during reappraisal, but not during distraction, when compared with controls. This deficit was correlated with the habitual use of reappraisal. The negative connectivity of amygdala and orbitofrontal cortex (OFC) observed during reappraisal in controls was reversed in BD patients and relatives. There were no significant differences between BD patients and relatives. As being observed in BD patients and unaffected relatives, deficits in emotion regulation through reappraisal may represent heritable neurobiological abnormalities underlying BD. The neural mechanisms include impaired control of amygdala reactivity to emotional stimuli and dysfunctional connectivity of the amygdala to regulatory control regions in the OFC. These are, thus, important aspects of the neurobiological basis of increased vulnerability for BD.

Goal-directed behavior under emotional distraction is preserved by enhanced task-specific activation

Despite the distracting effects of emotional stimuli on concurrent task performance, humans are able to uphold goal-directed behavior. Here, we investigated the hypothesis that this effect is due to the enhanced recruitment of task-specific neural resources. In a two-step functional magnetic resonance imaging study, we first localized those areas involved in mental arithmetics by contrasting arithmetic problems with a number detection task. The resulting activation maps were then used as masks in a second experiment that compared the effects of neutral and emotional distracter images on mental arithmetics. We found increased response times in the emotional distracter condition, accompanied by enhanced activation in task-specific areas, including superior parietal cortex, dorsolateral and dorsomedial prefrontal cortex. This activation increase correlated with larger behavioral impairment through emotional distraction. Similar error rates in both conditions indicate that cognitive task performance is preserved through enhanced recruitment of task-specific neural resources when emotional distracter stimuli are present.

Neural Correlates of Emotional Distractibility in Bipolar Disorder Patients, Unaffected Relatives, and Individuals With Hypomanic Personality

OBJECTIVE Neuropsychological deficits and emotion dysregulation are present in symptomatic and euthymic patients with bipolar disorder. However, there is little evidence on how cognitive functioning is influenced by emotion, what the neural correlates of emotional distraction effects are, and whether such deficits are a consequence or a precursor of the disorder. The authors used functional MRI (fMRI) to investigate these questions. METHOD fMRI was used first to localize the neural network specific to a certain cognitive task (mental arithmetic) and then to test the effect of emotional distractors on this network. Euthymic patients with bipolar I disorder (N=22), two populations at high risk for developing the disorder (unaffected first-degree relatives of individuals with bipolar disorder [N=17]), and healthy participants with hypomanic personality traits [N=22]) were tested, along with three age-, gender-, and education-matched healthy comparison groups (N=22, N=17, N=24, respectively). RESULTS There were no differences in performance or activation in the task network for mental arithmetic. However, while all participants exhibited slower responses when emotional distractors were present, this response slowing was greatly enlarged in bipolar patients. Similarly, task-related activation was generally increased under emotional distraction; however, bipolar patients exhibited a further increase in right parietal activation that correlated positively with the response slowing effect. CONCLUSIONS The results suggest that emotional dysregulation leads to exacerbated neuropsychological deficits in bipolar patients, as evidenced by behavioral slowing and task-related hyperactivation. The lack of such a deficit in high-risk populations suggests that it occurs only after disease onset, rather than representing a vulnerability marker.

Increased impulsivity as a vulnerability marker for bipolar disorder: Evidence from self-report and experimental measures in two high-risk populations

BACKGROUND Heightened impulsivity has been suggested as a possible risk factor for bipolar disorder (BD). However, studies on high-risk populations are scarce and have mainly focused on individuals with a genetic risk. The present study investigated two high-risk samples for BD with regard to several aspects of the impulsivity construct. METHODS Unaffected relatives of BD patients (genetically defined high-risk group, N=29) and participants scoring high on the Hypomanic Personality Scale (psychometrically defined high-risk sample, N=25) were being compared to respective control groups (N=27 and N=25) using a multi-method approach. Participants were accessed on the Barratt Impulsiveness Scale-11 (BIS-11, trait impulsivity), the Stop Signal Task (response inhibition), and the Cambridge Gambling Task (impulsive behavior in decision-making processes). RESULTS Both high-risk groups reported heightened impulsivity on the BIS-11, as well as impulsive decision-making, whereas no significant group differences in response inhibition were observed. LIMITATIONS Limitations were the lack in specificity of the results for BD and the cross-sectional study design, which does not allow conclusions about the influence of impulsivity on the development of or resilience for BD in risk groups. CONCLUSIONS Our findings support the assumption that increased trait impulsivity and impulsive decision-making are a vulnerability marker for and an endophenotype of BD.

Regulating the blink: Cognitive reappraisal modulates attention.

Our brain is unable to fully process all the sensory signals we encounter. Attention is the process that helps selecting input from all available information for detailed processing and it is largely influenced by the affective value of the stimuli. This study examined if attentional bias toward emotional stimuli can be modulated by cognitively changing their emotional value. Participants were presented with negative and neutral images from four different scene-categories depicting humans (“Reading”, “Working”, “Crying” and “Violence”). Using cognitive reappraisal subjects decreased and increased the negativity of one negative (e.g., “Crying”) and one neutral (e.g., “Reading”) category respectively, whereas they only had to watch the other two categories (e.g., “Working” and “Violence”) without changing their feelings. Subsequently, subjects performed the attentional blink paradigm. Two targets were embedded in a stream of distractors, with the previously seen human pictures serving as the first target (T1) and rotated landmark/landscape images as the second (T2). Subjects then reported T1 visibility and the orientation of T2. We investigated if the detection accuracy of T2 is influenced by the change of the emotional value of T1 due to the reappraisal manipulation. Indeed, T2 detection rate was higher when T2 was preceded by a negative image that was only viewed compared to negative images that were reappraised to be neutral. Thus, more resources were captured by images that have been reappraised before, i.e., their negativity has been reduced. This modulatory effect of reappraisal on attention was not found for neutral images. Possibly upon re-exposure to negative stimuli subjects had to recall the previously performed affective change. In this case resources may be allocated to maintain the reappraised value and therefore hinder the detection of a temporally close target. Complimentary self-reported ratings support the reappraisal manipulation of negative images.

Emotional modulation of the attentional blink and the relation to interpersonal reactivity

The extent of the attentional blink effect on detection rates in rapid serial visual presentations is modulated by the emotionality of the stimuli. Emotionally salient stimuli are detected more often, even if presented in the attentional blink period, and elicit an enlarged P3 response, which has been interpreted as enhanced consolidation. This effect correlates with individual differences in trait affectivity such as anxiety or dysphoria. Here, we ask if it is also related to the capacity to detect emotions in others, i.e., to interpersonal social traits. We therefore presented emotional and neutral images depicting social scenes as targets in an attentional blink design and measured detection rates and event-related potentials. In addition, we recorded self-reports of empathy as measured by the Interpersonal Reactivity Index. The results show enhanced performance for emotional stimuli and increased P3 amplitudes, which correlated with individual differences in empathy. The data suggest that self-reported empathy goes along with enhanced processing of emotion in social stimuli, even under stimulus conditions that are suboptimal for conscious target detection.

Self-compassion buffers the link between self-criticism and depression in trauma-exposed firefighters.

Firefighters are frequently exposed to highly stressful, potentially traumatic events (PTEs). More than 50%, however, show no significant elevation in trauma-related symptomatology (e.g., depression). In the past, self-compassion has been discussed to promote psychological and behavioral flexibility that is vital to a successful adaptation to PTEs. The goal of this study was to understand whether and how self-compassion may alleviate personal suffering in the face of PTEs. We hypothesized that individuals who encounter their profession-related affective experiences with greater self-compassion, show lower levels of depressive symptoms because self-compassion buffers processes that perpetuate negative affectivity in response to PTEs (i.e., self-critical tendencies). Male firefighters (N = 123) completed self-report questionnaires about the severity of current depressive symptoms; prior traumatic, duty-related events; and the self-compassion scale that assesses two distinct factors: self-criticism and self-compassion. A stepwise regression model was employed to examine differential and interactive contributions of self-criticism and self-compassion to symptoms of depression across the cumulative range of exposure to PTEs. Our results indicate that the positive association between self-criticism and depression is buffered by enhanced levels of self-compassion. This moderation, however, only emerged for firefighters with substantial amounts of PTEs experience in the past. The present work provides insight into protective effects of self-compassion in the face of cumulative PTEs. It suggests that, particularly for severely trauma-exposed firefighters, self-compassion may confer resilience, that is, act as a protective factor from the development of depressive symptoms. Findings are discussed in light of counseling implications.