The electrocortical modulation effects of different emotion regulation strategies

The current event-related potential study investigated the modulation effects of different emotion regulation strategies on electrocortical responses. When watching negative or neutral pictures, participants were instructed to perform three tasks: cognitive reappraisal, expressive suppression and passive viewing. We found that negative pictures elicited a larger late positive potential (LPP) than neutral pictures. Moreover, processes involved in strategy also had an effect on LPP amplitude, which was indicated by a larger LPP in reappraisal compared with suppression and viewing tasks when neutral pictures were presented. After the influence of processes on LPP was excluded, results showed that reappraisal effectively decreased the emotion-enhanced LPP than suppression and viewing. The difference in regulatory effect may be determined by the underlying processing mechanism. A larger frontal-central component, N2, was observed in suppression than reappraisal and viewing, which suggested that it involved the processes focusing on behavioral response. While the larger LPP found in reappraisal implicated that it recruited cognitive processes focusing on the picture meaning.     

The role of dorsal anterior cingulate cortex in the regulation of craving by reappraisal in smokers

Rationale and Objective

Drug cues can induce craving for drugs of abuse. Dysfunctional regulation of emotion and motivation regarding rewarding objects appears to be an integral part of addiction. It has been found that cognitive strategies decreased the intensity of craving in addicts. Reappraisal strategy is a type of cognitive strategy that requires participants to reinterpret the meaning of an emotional situation. In addition, studies have found that activation of the dorsal anterior cingulate cortex (dACC) is associated with the selection and application of cognitive reappraisal. In present study, we sought to determine whether such cognitive regulation engages the dACC and improves inhibition of craving in smokers.

Methods

Sixteen smokers underwent functional magnetic resonance imaging (fMRI) during performance of a cigarette reward-conditioning procedure with cognitive reappraisal. We focused our analyses on the dACC as a key structure of cognitive control of craving. Cue induced craving under different conditions was obtained. Correlational analysis between the functional response in the dACC and the subjective craving was performed.

Results

We found that using a cognitive reappraisal was successful in decreasing the conditioned craving. Right dACC (BA 24/32) engaged in the cognitive reappraisal. In addition, the individual’s subjective craving was negatively correlated with the right dACC activation.

Conclusions

These findings suggest that the dACC are important substrates of Inhibition of cue induced craving in smokers. Cognitive regulation by cognitive reappraisal may help addicted individuals avoid the anticipated situations where they are exposed to conditioned cues.     

A Functional Magnetic Resonance Imaging (fMRI) Study of Cue-Induced Smoking Craving in Virtual Environments

Smokers who are exposed to smoking-related cues show cardiovascular reactivity and smoking craving compared with their responses to neutral cues, and increased cue reactivity predicts decreased likelihood of successful cessation. Several brain imaging studies suggested four candidate brain regions that might differ in gray matter volumes and densities between smokers and nonsmokers. However, in these studies, smokers were only exposed to smoking-related objects. In our pilot study utilizing a virtual reality (VR) technique, virtual environments (VEs) were more immersive and evoked smoking craving more effectively than traditionally used methods. In this study, we sought to test whether smokers could experience cue-induced smoking craving inside the MRI scanner by using the VR system. The smoking cue reactivity scenario was based in part on our preliminary task and consisted of 2D and 3D (or VE) conditions. The group mean of participants had increased activity in the prefrontal cortex (PFC), left anterior cingulate gyrus (ACC), left supplementary motor area, left uncus, right inferior temporal gyrus, right lingual gyrus, and right precuneus in the 2D condition. Areas of differential activation in the 3D condition were as follows: left superior temporal gyrus, right superior frontal gyrus, and left inferior occipital gyrus in the 3D condition. This finding is consistent with those of previous studies of nicotine craving showing PFC and ACC activation. However, in the 3D condition, the PFC including the superior frontal gyrus as well as the superior temporal gyrus, inferior occipital gyrus, and cerebellum were activated. Therefore, in the 3D condition, participants seemed to have more attention, visual balance, and coordinating movement than in the 2D condition.     

The integrative effects of cognitive reappraisal on negative affect: associated changes in secretory immunoglobulin A, unpleasantness and ERP activity

Although the regulatory role of cognitive reappraisal in negative emotional responses is widely recognized, this reappraisal's effect on acute saliva secretory immunoglobulin A (SIgA), as well as the relationships among affective, immunological, and event-related potential (ERP) changes, remains unclear. In this study, we selected only people with low positive coping scores (PCSs) as measured by the Trait Coping Style Questionnaire to avoid confounding by intrinsic coping styles. First, we found that the acute stress of viewing unpleasant pictures consistently decreased SIgA concentration and secretion rate, increased perceptions of unpleasantness and amplitude of late positive potentials (LPPs) between 200-300 ms and 400-1000 ms. After participants used cognitive reappraisal, their SIgA concentration and secretion rate significantly increased and their unpleasantness and LPP amplitudes significantly decreased compared with a control condition. Second, we found a significantly positive correlation between the increases in SIgA and the decreases in unpleasantness and a significantly negative correlation between the increases in SIgA and the increases in LPP across the two groups. This study is the first to demonstrate that cognitive reappraisal reverses the decrease of SIgA. In addition, it revealed strong correlations among affective, SIgA and electrophysiological changes with convergent multilevel evidence.     

“A Cigarette a Day Keeps the Goodies Away”: Smokers Show Automatic Approach Tendencies for Smoking—But Not for Food-Related Stimuli

Smoking leads to the development of automatic tendencies that promote approach behavior toward smoking-related stimuli which in turn may maintain addictive behavior. The present study examined whether automatic approach tendencies toward smoking-related stimuli can be measured by using an adapted version of the Approach-Avoidance Task (AAT). Given that progression of addictive behavior has been associated with a decreased reactivity of the brain reward system for stimuli signaling natural rewards, we also used the AAT to measure approach behavior toward natural rewarding stimuli in smokers. During the AAT, 92 smokers and 51 non-smokers viewed smoking-related vs. non-smoking-related pictures and pictures of natural rewards (i.e. highly palatable food) vs. neutral pictures. They were instructed to ignore image content and to respond to picture orientation by either pulling or pushing a joystick. Within-group comparisons revealed that smokers showed an automatic approach bias exclusively for smoking-related pictures. Contrary to our expectations, there was no difference in smokers’ and non-smokers’ approach bias for nicotine-related stimuli, indicating that non-smokers also showed approach tendencies for this picture category. Yet, in contrast to non-smokers, smokers did not show an approach bias for food-related pictures. Moreover, self-reported smoking attitude could not predict approach-avoidance behavior toward nicotine-related pictures in smokers or non-smokers. Our findings indicate that the AAT is suited for measuring smoking-related approach tendencies in smokers. Furthermore, we provide evidence for a diminished approach tendency toward food-related stimuli in smokers, suggesting a decreased sensitivity to natural rewards in the course of nicotine addiction. Our results indicate that in contrast to similar studies conducted in alcohol, cannabis and heroin users, the AAT might only be partially suited for measuring smoking-related approach tendencies in smokers. Nevertheless, our findings are of special importance for current etiological models and smoking cessation programs aimed at modifying nicotine-related approach tendencies in the context of a nicotine addiction.     

Time window for cognitive activity involved in emotional processing

Background

From previous studies it is becoming evident that the processing of unpleasant stimuli occurs early (0 to 300 ms); however, it is not clear how cognitive processing related to pleasant/unpleasant emotions occurs at later time windows (≥300 ms). On the other hand, as evident from the previous reports, BIS and BAS personality traits are strongly associated with unpleasant and pleasant responses, respectively. Therefore, in the present study, we aim to identify the time window involved in human pleasant/unpleasant emotional processing by investigating ERP components correlated with BIS/BAS personality traits.

Methods

Twenty-nine men took part in the study and recording ERP during presented sounds. BIS/BAS score was calculated using the Japanese edition of the BIS/BAS questionnaire.

Results

Significant correlation was not observed between BIS and BAS scores. A significant and positive correlation was observed between N100 amplitude and BIS score. A positive correlation was found between BAS fun seeking subscale score and LPP amplitude. Our findings did not contradict previous study results.

Conclusions

Our results suggest that the processing of unpleasant emotions takes place early on, since N100 response was larger in high BIS subjects who are known to be sensitive to unpleasant emotions. LPP was larger in high BAS subjects who are known to be sensitive to pleasant emotions. The LPP was considered to be augmented because the ACC activity level during pleasant emotions reflected on LPP.     

Emotion Regulation and Excess Weight: Impaired Affective Processing Characterized by Dysfunctional Insula Activation and Connectivity

Emotion-regulation strategies are understood to influence food intake. This study examined the neurophysiological underpinnings of negative emotion processing and emotion regulation in individuals with excess weight compared to normal-weight controls. Fifteen participants with excess-weight (body mass index >25) and sixteen normal-weight controls (body mass index 18–25) performed an emotion-regulation task during functional magnetic resonance imaging. Participants were exposed to 24 negative affective or neutral pictures that they were instructed to Observe (neutral pictures), Maintain (sustain the emotion elicited by negative pictures) or Regulate (down-regulate the emotion provoked by negative pictures through previously trained reappraisal techniques). When instructed to regulate negative emotions by means of cognitive reappraisal, participants with excess weight displayed persistently heightened activation in the right anterior insula. Decreased responsivity was also found in right anterior insula, the orbitofrontal cortex and cerebellum during negative emotion experience in participants with excess weight. Psycho-physiological interaction analyses showed that excess-weight participants had decreased negative functional coupling between the right anterior insula and the right dlPFC, and the bilateral dmPFC during cognitive reappraisal. Our findings support contentions that excess weight is linked to an abnormal pattern of neural activation and connectivity during the experience and regulation of negative emotions, with the insula playing a key role in these alterations. We posit that ineffective regulation of emotional states contributes to the acquisition and preservation of excess weight.     

Smoking at the workplace: effects of genetic and environmental causal accounts on attitudes toward smoking employees and restrictive policies

People hold diverse beliefs regarding the etiologies of individual and group differences in behaviors which, in turn, might affect their attitudes and behaviors. It is important to establish how perceived etiologies of smoking might affect the effectiveness of policy initiatives and prevention efforts. The present study assessed whether exposure to genetic vs. environmental accounts for smoking affects attitudes toward (a) workplace-related smoking policies and (b) smokers at the workplace. Results indicate that exposure to a genetic explanation led to stronger objections to a smoking restrictive policy compared with a non-genetic explanation. Additionally, participants in the genetic condition were more accepting of a smoker in the workplace than those in the environmental condition. Evidently, beliefs about the etiology of smoking influence a range of attitudes related to smokers and smoking-related policies.     

Cue-reactors: individual differences in cue-induced craving after food or smoking abstinence

Background

Pavlovian conditioning plays a critical role in both drug addiction and binge eating. Recent animal research suggests that certain individuals are highly sensitive to conditioned cues, whether they signal food or drugs. Are certain humans also more reactive to both food and drug cues?

Methods

We examined cue-induced craving for both cigarettes and food, in the same individuals (n = 15 adult smokers). Subjects viewed smoking-related or food-related images after abstaining from either smoking or eating.

Results

Certain individuals reported strong cue-induced craving after both smoking and food cues. That is, subjects who reported strong cue-induced craving for cigarettes also rated stronger cue-induced food craving.

Conclusions

In humans, like in nonhumans, there may be a “cue-reactive” phenotype, consisting of individuals who are highly sensitive to conditioned stimuli. This finding extends recent reports from nonhuman studies. Further understanding this subgroup of smokers may allow clinicians to individually tailor therapies for smoking cessation.     

Visual stimuli in distraction strategies for increasing pain tolerance. The confounding of affect with other stimulus characteristics

Recent experimental studies in pain control have questioned the value of pleasant affect in strategies employing distraction. It appears that pleasant affect may have been systematically confounded with task complexity or novelty in past research that found pleasant imagery or slides effective in increasing pain tolerance with the cold pressor test. The present study was a follow-up to a study conducted by this author (Greenstein, 1984) in which unpleasant slides had significantly increased pain tolerance above pleasant slide level. In the present study, 69 college students (35 females, 34 males) rated either the pleasant or unpleasant slides used in the original study on their perceived pleasantness, complexity, and uniqueness (novelty). Results indicated that the unpleasant slides were rated significantly more complex (P less than 0.001) and unique (P less than 0.001) than the pleasant slides. Additionally, as in the earlier study, ratings of the unpleasant slides on pleasantness deviated significantly farther from neutrality than did ratings of the pleasant slides (t = 5.04, P less than 0.001). Thus the unpleasant slides were also perceived as being more significant (i.e., pertinent) than were the pleasant slides. The results indicate that affect was confounded with other stimulus characteristics in the Greenstein (1984) pain control study and probably in a significant number of other studies as well. Researchers are cautioned to control for the stimulus characteristics of visual distraction strategies used in pain control studies. The assumption that pleasantness, per se, contributes to strategy effectiveness is no longer tenable; future research must demonstrate an independent effect.(ABSTRACT TRUNCATED AT 250 WORDS)     

On the social nature of eyes: The effect of social cues in interaction and individual choice tasks

In an experimental setting, we applied a dual strategy to better understand the effect of pictures of eyes on human behavior. First, we investigated whether the effect of eyes was limited to interaction tasks in which the subjects' decisions influenced the outcomes of other subjects. We expanded the range of tasks to include individual choice tasks in which the subjects' decisions only influenced their own outcomes. Second, we investigated whether pictures of eyes were one of many social cues or were unique in their effect. We compared the effect of pictures of eyes with the effect of a different condition in which we presented the subjects with pictures of other students (peers). Our results suggest that the effect of pictures of eyes is limited to interaction tasks and that eyes should be considered distinct from other social cues, such as reminders of peers. While pictures of eyes uniformly enhanced pro-social behavior in interaction tasks, this was not the case for reminders of peers. Furthermore, the reminders of peers led to more rational behavior in individual choice tasks, whereas the effect of pictures of eyes was limited to situations involving interaction. Combined, these findings are in line with the claim that the effect of pictures of eyes on behavior is caused by a social exchange heuristic that works to enhance mutual cooperative behavior.     

Sex Differences in Orienting to Pictures with and without Humans: Evidence from the Cardiac Evoked Response (ECR) and the Cortical Long Latency Parietal Positivity (LPP)

Objective

This study investigated the effect of social relevance in affective pictures on two orienting responses, i.e. the evoked cardiac response (ECR), and a long latency cortical evoked potential (LPP) and whether this effect would differ between males and females. Assuming that orienting to affective social information is fundamental to experiencing affective empathy, associations between self-report measures of empathy and the two orienting responses were investigated.

Method

ECRs were obtained from 34 female and 30 male students, and LPPs from 25 female and 27 male students viewing 414 pictures from the International Affective Picture System. Pictures portrayed pleasant, unpleasant and neutral scenes with and without humans.

Results

Both the ECR and LPP showed the largest response to pictures with humans in unpleasant situations. For both measures, the responses to pictures with humans correlated with self-report measures of empathy. While we found a greater male than female responsiveness to the pictures without humans in the ECR, a greater female than male responsiveness was observed in the LPP response to pictures with humans.

Conclusion and Significance

The sensitivity of these orienting responses to social relevance and their differential contribution to the prediction of individual differences underline the validity of their combined use in clinical studies investigating individuals with social disabilities.     

The ‘Positive Effect’ Is Present in Older Chinese Adults: Evidence from an Eye Tracking Study

The ''Positive Effect'' is defined as the phenomenon of preferential cognitive processing of positive affective information, and avoidance or dismissal of negative affective information in the social environment. The ‘Positive Effect’ is found for older people compared with younger people in western societies and is believed to reflect a preference for positive emotional regulation in older adults. It is not known whether such an effect is Universal, and in East Asian cultures, there is a highly controversial debate concerning this question. In the current experiment we explored whether Chinese older participants showed a ''Positive Effect'' when they inspected picture pairs that were either a positive or a negative picture presented with a neutral picture, or a positive and negative picture paired together. The results indicated that both groups of participants showed an attentional bias to both pleasant (more processing of) and unpleasant pictures (initial orienting to) when these were paired with neutral pictures. When pleasant and unpleasant pictures were paired together both groups showed an initial orientation bias for the pleasant picture, but the older participants showed this bias for initial orienting and increased processing measures, providing evidence of a ‘Positive Effect’ in older Chinese adults.     

The Neural Mechanisms Underlying the Acute Effect of Cigarette Smoking on Chronic Smokers

Although previous research had related structural changes and impaired cognition to chronic cigarette smoking, recent neuroimaging studies have associated nicotine, which is a main chemical substance in cigarettes, with improvements in cognitive functions (e.g. improved attention performance). However, information about the alterations of whole-brain functional connectivity after acute cigarette smoking is limited. In this study, 22 smokers underwent resting-state functional magnetic resonance imaging (rs-fMRI) after abstaining from smoking for 12 hours (state of abstinence, SOA). Subsequently, the smokers were allowed to smoke two cigarettes (state of satisfaction, SOS) before they underwent a second rs-fMRI. Twenty non-smokers were also recruited to undergo rs-fMRI. In addition, high-resolution 3D T1-weighted images were acquired using the same magnetic resonance imaging(fMRI)scanner for all participants. The results showed that smokers had structural changes in insula, thalamus, medial frontal cortex and several regions of the default mode network (DMN) compared with non-smokers. Voxel-wise group comparisons of newly developed global brain connectivity (GBC) showed that smokers in the SOA condition had higher GBC in the insula and superior frontal gyrus compared with non-smokers. However, smokers in the SOS condition demonstrated significantly lower GBC in several regions of the DMN, as compared with smokers in the SOA condition. These results suggest that structural integrity combined with dysfunction of the DMN might be involved in relapses after a short period of time among smokers.     

Determinants of Smoking and Quitting in HIV-Infected Individuals

BackgroundCigarette smoking is widespread among HIV-infected patients, who confront increased risk of smoking-related co-morbidities. The effects of HIV infection and HIV-related variables on smoking and smoking cessation are incompletely understood. We investigated the correlates of smoking and quitting in an HIV-infected cohort using a validated natural language processor to determine smoking status.MethodWe developed and validated an algorithm using natural language processing (NLP) to ascertain smoking status from electronic health record data. The algorithm was applied to records for a cohort of 3487 HIV-infected from a large health care system in Boston, USA, and 9446 uninfected control patients matched 3:1 on age, gender, race and clinical encounters. NLP was used to identify and classify smoking-related portions of free-text notes. These classifications were combined into patient-year smoking status and used to classify patients as ever versus never smokers and current smokers versus non-smokers. Generalized linear models were used to assess associations of HIV with 3 outcomes, ever smoking, current smoking, and current smoking in analyses limited to ever smokers (persistent smoking), while adjusting for demographics, cardiovascular risk factors, and psychiatric illness. Analyses were repeated within the HIV cohort, with the addition of CD4 cell count and HIV viral load to assess associations of these HIV-related factors with the smoking outcomes.ResultsUsing the natural language processing algorithm to assign annual smoking status yielded sensitivity of 92.4, specificity of 86.2, and AUC of 0.89 (95% confidence interval [CI] 0.88–0.91). Ever and current smoking were more common in HIV-infected patients than controls (54% vs. 44% and 42% vs. 30%, respectively, both P<0.001). In multivariate models HIV was independently associated with ever smoking (adjusted rate ratio [ARR] 1.18, 95% CI 1.13–1.24, P <0.001), current smoking (ARR 1.33, 95% CI 1.25–1.40, P<0.001), and persistent smoking (ARR 1.11, 95% CI 1.07–1.15, P<0.001). Within the HIV cohort, having a detectable HIV RNA was significantly associated with all three smoking outcomes.ConclusionsHIV was independently associated with both smoking and not quitting smoking, using a novel algorithm to ascertain smoking status from electronic health record data and accounting for multiple confounding clinical factors. Further research is needed to identify HIV-related barriers to smoking cessation and develop aggressive interventions specific to HIV-infected patients.     

Association of BDNF and COMT genotypes with cognitive processing of anti-smoking PSAs

Anti-smoking public service announcements (PSAs) often use persuasive arguments to attempt to influence attitudes about smoking. The persuasiveness of a PSA has previously been associated with factors that influence the cognitive processing of its message. Genetic factors that influence cognitive processing might thus affect individuals' responses to the persuasive arguments presented in PSAs. In the present study, we examined polymorphisms in the genes encoding brain-derived neurotrophic factor (BDNF Val66Met) and catechol-O-methyltransferase (COMT Val158Met), which affect cognitive processing in the prefrontal cortex, to identify genetic factors associated with self-reported outcomes of message processing, perceived effectiveness and quitting intentions among smokers viewing PSAs. A total of 120 smokers viewed sets of four PSAs that varied with respect to features of argument strength (AS) and message sensation value. We observed significant associations of BDNF genotype with central processing, narrative processing, perceived effectiveness of the anti-smoking PSAs and participant quitting intentions; the BDNF Met allele was associated with lower scores on all these measures. Central processing acted as a mediator of the association of genotype with quitting intentions and perceived effectiveness. There was a significant interaction of COMT genotype by AS in the model of narrative processing, such that individuals homozygous for the COMT Val allele reported higher narrative processing in the high-AS condition but not in the low-AS condition. To our knowledge, this is the first study to identify genetic factors associated with cognitive processing of anti-smoking PSAs.     

The Effects of Intrapersonal Anger and Its Regulation in Economic Bargaining

Anger is a common cause of strained negotiations. This research investigated the effects of experiencing anger (Experiment 1) and regulating anger (Experiment 2) on ultimatum bargaining. Experiment 1 showed that relative to a control condition, angered participants proposed less fair offers and rejected more offers when bargaining with the person who angered them. Experiment 2 replicated Experiment 1, and additionally showed that regulating anger via reappraisal and distraction both reduced anger. However, only reappraisal effectively reduced anger for the duration of the negotiation. Participants who reappraised proposed fairer offers than those in the distraction condition, but did not differ in offers accepted. This research may have implications for what emotion regulation strategy should be employed in economic bargaining. However, future research is required to determine the most effective timing and components of reappraisal for promoting beneficial outcomes in bargaining contexts.     

Different Timing Features in Brain Processing of Core and Moral Disgust Pictures: An Event-Related Potentials Study

Disgust, an emotion motivating withdrawal from offensive stimuli, protects us from the risk of biological pathogens and sociomoral violations. Homogeneity of its two types, namely, core and moral disgust has been under intensive debate. To examine the dynamic relationship between them, we recorded event-related potentials (ERPs) for core disgust, moral disgust and neutral pictures while participants performed a modified oddball task. ERP analysis revealed that N1 and P2 amplitudes were largest for the core disgust pictures, indicating automatic processing of the core disgust-evoking pictures. N2 amplitudes were higher for pictures evoking moral disgust relative to core disgust and neutral pictures, reflecting a violation of social norms. The core disgust pictures elicited larger P3 and late positive potential (LPP) amplitudes in comparison with the moral disgust pictures which, in turn, elicited larger P3 and LPP amplitudes when compared to the neutral pictures. Taken together, these findings indicated that core and moral disgust pictures elicited different neural activities at various stages of information processing, which provided supporting evidence for the heterogeneity of disgust.     

The effect of systematic clinical interventions with cigarette smokers on quit status and the rates of smoking-related primary care office visits

Background

The United States Public Health Service (USPHS) Guideline for Treating Tobacco Use and Dependence includes ten key recommendations regarding the identification and the treatment of tobacco users seen in all health care settings. To our knowledge, the impact of system-wide brief interventions with cigarette smokers on smoking prevalence and health care utilization has not been examined using patient population-based data.

Methods and Findings

Data on clinical interventions with cigarette smokers were examined for primary care office visits of 104,639 patients at 17 Harvard Vanguard Medical Associates (HVMA) sites. An operational definition of “systems change” was developed. It included thresholds for intervention frequency and sustainability. Twelve sites met the criteria. Five did not. Decreases in self-reported smoking prevalence were 40% greater at sites that achieved systems change (13.6% vs. 9.7%, p<.01). On average, the likelihood of quitting increased by 2.6% (p<0.05, 95% CI: 0.1%–4.6%) per occurrence of brief intervention. For patients with a recent history of current smoking whose home site experienced systems change, the likelihood of an office visit for smoking-related diagnoses decreased by 4.3% on an annualized basis after systems change occurred (p<0.05, 95% CI: 0.5%–8.1%). There was no change in the likelihood of an office visit for smoking-related diagnoses following systems change among non-smokers.

Conclusions

The clinical practice data from HVMA suggest that a systems approach can lead to significant reductions in smoking prevalence and the rate of office visits for smoking-related diseases. Most comprehensive tobacco intervention strategies focus on the provider or the tobacco user, but these results argue that health systems should be included as an integral component of a comprehensive tobacco intervention strategy. The HVMA results also give us an indication of the potential health impacts when meaningful use core tobacco measures are widely adopted.