Uta-Susan Donges

Proton magnetic resonance spectroscopy in anorexia nervosa: correlations with cognition.

The aim of this study was to investigate the relationship between cognitive impairment and cerebral metabolites in patients with anorexia nervosa (AN). N-acetylaspartate (NAA), creatine/phosphocreatine (Cr), choline-containing compounds, glutamate/glutamine (Glx) and myoinositol were measured by proton magnetic resonance spectroscopy (1H-MRS) of the left prefrontal cortex. Compared with healthy controls, AN patients displayed a significantly poorer performance in verbal learning and in attentional and executive tasks. Performance in the divided attention task was correlated with NAA and Cr in the dorsolateral prefrontal cortex, while executive functioning and depressive symptomatology were associated with Glx levels in the anterior cingulate. Our results provide evidence for cognitive impairment in AN patients which is associated with cerebral metabolism in the prefrontal cortex.

20-Item Toronto Alexithymia Scale: do difficulties describing feelings assess proneness to shame instead of difficulties symbolizing emotions?

A hallmark of alexithymia is the difficulty putting emotional states into words which has to be differentiated from problems to communicate emotion to others. Shame proneness is a personality trait that is expected to be closely related to a reduced emotional self-disclosure in social interactions. The present investigation was conducted to examine construct validity of the Difficulties Describing Feelings scale of the 20-Item Toronto Alexithymia Scale (TAS-20). The TAS-20 was administered to 68 subjects (30 psychiatric inpatients and 38 normals) along with the Levels of Emotional Awareness Scale (LEAS), a direct measure of the ability to express feelings verbally, and the Shame-Guilt-Scale. Difficulties Describing Feelings was associated with shame assessing scales but not with guilt assessing scales or the LEAS. Thus, in view of our data one should be cautious in interpreting scores from the TAS-20 scale Difficulties Describing Feelings as indices of a difficulty to symbolize ones emotions. Instead, this TAS-20 scale seems to evaluate aspects of social shame.

Reduced awareness of others' emotions in unipolar depressed patients.

The present study was conducted to examine depressed patients’ awareness of their own and other persons’ emotions in the course of an inpatient psychotherapeutic treatment program. To this aim, the Levels of Emotional Awareness Scale (LEAS) was administered twice, approximately 7 weeks apart, to 22 patients with a unipolar depression and 22 normal controls. From test 1 to test 2, severity of patients’ depressive symptoms as measured by the Beck Depression Inventory improved significantly. Depressed patients did not differ from normal individuals on the LEAS-self score, but at time 1, they exhibited lower LEAS-other scores than normal controls. In the whole sample, LEAS-other scores increased significantly from time 1 to time 2. Acutely depressed patients seem not to be impaired in the complexity of their own emotional experience, but they exhibit a reduction in the ability to empathize with other persons.

Alexithymia and automatic processing of emotional stimuli: a systematic review

Abstract Alexithymia is a personality trait characterized by difficulties in recognizing and verbalizing emotions and the utilization of a cognitive style that is oriented toward external events, rather than intrapsychic experiences. Alexithymia is considered a vulnerability factor influencing onset and course of many psychiatric disorders. Even though emotions are, in general, elicited involuntarily and emerge without conscious effort, it is surprising that little attention in etiological considerations concerning alexithymia has been given to deficits in automatic emotion processing and their neurobiological bases. In this article, results from studies using behavioral or neurobiological research methods were systematically reviewed in which automatic processing of external emotional information was investigated as a function of alexithymia in healthy individuals. Twenty-two studies were identified through a literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2016. The review reveals deficits in the automatic processing of emotional stimuli in alexithymia at a behavioral and neurobiological level. The vast majority of the reviewed studies examined visual processing. The alexithymia facets externally oriented thinking and difficulties identifying feelings were found to be related to impairments in the automatic processing of threat-related facial expressions. Alexithymic individuals manifest low reactivity to barely visible negative emotional stimuli in brain regions responsible for appraisal, encoding, and affective response, e.g. amygdala, occipitotemporal areas, and insula. Against this background, it appears plausible to assume that deficits in automatic emotion processing could be factors contributing to alexithymic personality characteristics. Directions for future research on alexithymia and automatic emotion perception are suggested.

Borderline Personality Disorder and Automatic Processing of Valence and Self-Other Relevance Information

Background: Enhanced sensitivity to emotion stimuli and poor differentiation between self and others have been proposed to be important features of borderline personality disorder (BPD). Automatic processing of affective stimuli provides information about valence (positive vs. negative) and relevance of valence (self vs. other). The objectives of our study were to investigate the efficiency of automatic processing of valence and relevance at a semantic level in BPD compared to healthy individuals. Sampling and Methods: A masked affective priming task, varying the valence and relevance of prime and target adjectives, was administered to 33 women with BPD and 33 healthy women. The forward and backward masked primes were shown for 50 ms. Subjects had the task of evaluating target words. Results: In the whole sample, a significant affective priming effect and a significant relevance priming effect occurred. BPD patients did not significantly differ from healthy individuals in affective priming or relevance priming after controlling for age, education, and intelligence. The presence of comorbid somatoform disorders was associated with increased affective priming and reduced relevance priming in BPD patients. Conclusions: The efficiency of automatic recognition and the processing of valence information at a semantic level are not impaired in BPD. Moreover, BPD patients are able to perceive and differentiate automatically self- versus other-relevance during the perception of affective information like healthy controls. Thus, there is no evidence for enhanced sensitivity to emotion stimuli or poor differentiation between self and others in BPD at a very early stage of processing. The presence of somatoform disorders appears to influence affective as well as relevance priming in BPD.