Publications by authors named "Frances Meeten"

22 Publications

  • Page 1 of 1

Cortical thickness and resting-state cardiac function across the lifespan: A cross-sectional pooled mega-analysis.

Psychophysiology 2020 Oct 10. Epub 2020 Oct 10.

Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting-state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, particularly cortical thickness [CT]. While findings have been mixed regarding the anatomical distribution and direction of the associations, these inconsistencies may be due to sex and age differences in HR/HRV and CT. Previous studies have been limited by small sample sizes, which impede the assessment of sex differences and aging effects on the association between ANS function and CT. To overcome these limitations, 20 groups worldwide contributed data collected under similar protocols of CT assessment and HR/HRV recording to be pooled in a mega-analysis (N = 1,218 (50.5% female), mean age 36.7 years (range: 12-87)). Findings suggest a decline in HRV as well as CT with increasing age. CT, particularly in the orbitofrontal cortex, explained additional variance in HRV, beyond the effects of aging. This pattern of results may suggest that the decline in HRV with increasing age is related to a decline in orbitofrontal CT. These effects were independent of sex and specific to HRV; with no significant association between CT and HR. Greater CT across the adult lifespan may be vital for the maintenance of healthy cardiac regulation via the ANS-or greater cardiac vagal activity as indirectly reflected in HRV may slow brain atrophy. Findings reveal an important association between CT and cardiac parasympathetic activity with implications for healthy aging and longevity that should be studied further in longitudinal research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/psyp.13688DOI Listing
October 2020

Mega-analysis methods in ENIGMA: The experience of the generalized anxiety disorder working group.

Hum Brain Mapp 2020 Jun 29. Epub 2020 Jun 29.

National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, Maryland, USA.

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hbm.25096DOI Listing
June 2020

Impact of imagery-enhanced interpretation training on offline and online interpretations in worry.

Behav Res Ther 2020 01 26;124:103497. Epub 2019 Oct 26.

Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, UK. Electronic address:

Worry and rumination are forms of repetitive negative thinking (RNT) that are maintained by negative interpretations and a predominance of abstract, verbal thinking. Hence, facilitating more positive interpretations and imagery-based thinking in combination may reduce RNT. Study 1 administered interpretation training with and without enhanced imagery, and an active control condition (designed not to change interpretations), in individuals with high levels of RNT (worry and/or rumination). Combining interpretation training with sustained imagery resulted in the highest levels of positive interpretation bias using an offline test of interpretation bias (when individuals have time to reflect). Study 2 investigated whether imagery-enhanced interpretation training influences online interpretations when ambiguous information is first encountered, indexed by reaction times and amplitude of the N400 event-related potential, as well as enhances offline positive interpretations in high worriers. It also examined whether imagery-enhanced interpretation training reduces negative thought intrusions associated with worry. Both online (reaction time) and offline interpretations were more positive following imagery-enhanced interpretation training, and negative thoughts were reduced, compared to the active control. However, no differences emerged on neurophysiological markers during the online task. Hence, brief interpretation training encompassing sustained imagery modifies online and offline interpretations, but further training may be required to impact upon neurophysiological measures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.brat.2019.103497DOI Listing
January 2020

tDCS increases anxiety reactivity to intentional worry.

J Psychiatr Res 2020 01 12;120:34-39. Epub 2019 Oct 12.

Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Australia.

While considerable experimental research has examined the impact of transcranial direct current stimulation (tDCS) on a range of cognitive processes associated with emotional pathology, the impact of tDCS on worry has been comparatively neglected. Given that anxiety pathology is characterised by motivated engagement in worry, and that frontal tDCS has the capacity to enhance goal-oriented cognition, it is important to examine whether tDCS would increase or ameliorate the cognitive and emotional effects of worry. In the current study we examined how tDCS influenced the anxiety response to worry, and the frequency of negative intrusive thoughts. We additionally examined whether stimulation delivered in isolation, or in combination with a mindful-focus task would augment the effects of tDCS. Ninety-seven (75 female) healthy participants received either active or sham anodal tDCS to the left dorsolateral prefrontal cortex, delivered either in isolation or concurrently with a mindful task (four conditions). The frequency of negative thought intrusions was assessed before and after a period of instructed worry, and state anxiety was assessed across the study. Active tDCS was associated with significantly greater elevation in anxiety in response to the worry induction. No effects were observed on the frequency of negative thought intrusions, and the combined delivery of tDCS with the concurrent mindful task did not alter the pattern of observed effects. While inviting replication in a high anxious sample, the present results highlight the possibility that tDCS may interact with motivated engagement in negative patterns of cognition, such as worry, to produce greater emotional reactivity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpsychires.2019.10.013DOI Listing
January 2020

Using event-related potential and behavioural evidence to understand interpretation bias in relation to worry.

Biol Psychol 2019 11 27;148:107746. Epub 2019 Aug 27.

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Electronic address:

The tendency to interpret ambiguous information in a consistent (e.g., negative) manner (interpretation bias) may maintain worry. This study explored whether high and low worriers generate different interpretations and examined at which stages of information processing these interpretations can occur. Participants completed interpretation assessment tasks yielding behavioural and N400 event-related potential indices, which index whether a given interpretation was generated. High worriers lacked the benign interpretation bias found in low worriers. This was evident for early "online" interpretations (reflected in reaction times to relatedness judgments and lexical decisions, as well as at a neurophysiological level, N400, for lexical decisions only), to later "offline" interpretations (observed at a behavioural level on the scenario task and recognition task) when participants had time for reflection. Results suggest that a benign interpretation bias may be a protective factor for low worriers, and that these interpretations remain active across online and offline stages of processing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.biopsycho.2019.107746DOI Listing
November 2019

Response time as a proxy of ongoing mental state: A combined fMRI and pupillometry study in Generalized Anxiety Disorder.

Neuroimage 2019 05 21;191:380-391. Epub 2019 Feb 21.

Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy.

In Generalized Anxiety Disorder (GAD), fluctuations in ongoing thoughts (i.e., mind-wandering) often take the form of rigid and intrusive perseverative cognition, such as worry. Here, we sought to characterise the neural correlates of mind-wandering and perseverative cognition, alongside autonomic nervous system indices of central arousal, notably pupil dilation. We implemented a protocol incorporating the dynamic delivery of thought-probes within a functional neuroimaging task. Sixteen individuals with GAD and sixteen matched healthy controls (HC) underwent functional magnetic resonance imaging with concomitant pupillometry. Participants performed a series of low-demand tracking tasks, responding to occasional changes in a target stimulus. Such a task is typically accompanied by self-generated, off-task thinking. Thought-probes were triggered based on an individual's response time (RT) when responding to the change in the target. Subjective reports showed that long RT predicted off-task thinking/mind-wandering. Moreover, long RT and mind-wandering were also associated with larger pupil diameter. This effect was exaggerated in GAD patients during perseverative cognition. Within brain, during both pre-target periods and target events, there were distinct neural correlates for mind-wandering (e.g., anterior cingulate and paracingulate activation at target onset) and perseverative cognition (e.g., opposite patterns of activation in posterior cingulate and cerebellum at target onset in HC and GAD). Results suggest that not only attention systems but also sensory-motor cortices are important during off-task states. Interestingly, changes across the 'default mode network' also tracked fluctuations in pupillary size. Autonomic expression in pupillary changes mirrors brain activation patterns that occur during different forms of repetitive thinking.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuroimage.2019.02.038DOI Listing
May 2019

Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder.

Auton Neurosci 2019 03 4;217:41-48. Epub 2019 Jan 4.

Department of Psychology, Sapienza University of Rome, Italy; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy. Electronic address:

Generalized anxiety disorder (GAD) is associated with both autonomic dysfunction, notably decreased vagally-mediated heart rate variability (vmHRV), and neurostructural abnormalities. Regional differences in brain morphometry correlate with vmHRV in healthy individuals. Here, we tested the hypothesis that specific focal abnormalities in cortical structure in GAD underpin decreased vmHRV. Adult female patients with GAD (n = 17) and matched controls (n = 18) underwent structural magnetic resonance imaging after characterization of symptoms and quantification of resting vmHRV derived from continuous pulse oximetry. Cortical reconstruction was performed using the FreeSurfer image analysis suite. A priori analysis was conducted only within brain regions involved in vagal control of heart rate. Compared to controls, patients with GAD showed cortical thinning of the (i) left rostral anterior cingulate cortex, (ii) left medial orbitofrontal cortex, and (iii) right isthmus cingulate gyrus. Significant negative relationships were identified between the severity of anxiety symptoms and cortical thickness of the left medial orbitofrontal cortex and right isthmus cingulate gyrus. Compared to controls, patients with GAD showed decreased vmHRV at rest. In controls only, cortical thickness of the left caudal anterior cingulate cortex correlated positively with resting vmHRV. These results extend evidence in GAD for structural abnormalities within cortical areas implicated in emotion regulation and cognition. In addition, these findings may implicate abnormal integrity of anterior cingulate cortex in the psychophysiological expression of GAD and suggest that interventional targeting of this region may normalize autonomic function in GAD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.autneu.2019.01.001DOI Listing
March 2019

Computerized Exposure Therapy for Spider Phobia: Effects of Cardiac Timing and Interoceptive Ability on Subjective and Behavioral Outcomes.

Psychosom Med 2019 01;81(1):90-99

From the Department of Neuroscience (Watson, Garfinkel, van Praag, Willmott, Wong, Meeten, Critchley), Trafford Centre for Medical Research, Brighton and Sussex Medical School, Brighton, United Kingdom; Sackler Centre for Consciousness Science (Garfinkel, van Praag, Critchley), University of Sussex, Brighton, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience (Meeten), King's College London, London, United Kingdom; and Sussex Partnership NHS Foundation Trust (Critchley), Sussex Education Centre Millview, Hove, United Kingdom.

Objective: Spider phobia is a common form of anxiety disorder for which exposure therapy is an effective first-line treatment. Motivated by the observed modulation of threat processing by afferent cardiac signals, we tested the hypothesis that interoceptive information concerning cardiovascular arousal can influence the outcomes of computerized exposure therapy for spider phobia.

Method: Fifty-three normal healthy participants with high spider phobia scores underwent one of the following three modified computerized exposure protocols, defined by the timing of exposure to brief spider stimuli within the cardiac cycle: systole (during afferent baroreceptor firing); diastole (during baroreceptor-quiescent interbeat interval); random (noncontingent on cardiac cycle). Outcomes were judged on phobic and anxiety measures and physiological data (skin conductance). Individuals were also rated on interoceptive accuracy.

Results: MANCOVA analysis showed that timing group affected the outcome measures (F(10,80) = 2.405, p = .015) and there was a group interaction with interoception ability (F(15,110) = 1.808, p = .045). Subjective symptom reduction was greatest in the systolic group relative to the other two groups (diastolic (t = 3.115, ptukey = .009); random (t = 2.438, ptukey = .048)), with greatest reductions in those participants with lower interoceptive accuracy. Behavioral aversion reduced more in cardiac-contingent groups than the noncontingent (random) group (diastolic (t = 3.295, ptukey = .005); systolic (t = 2.602, ptukey = .032)). Physiological (skin conductance response) responses remained strongest for spider stimuli presented at cardiac systole.

Conclusions: Interoceptive information influences exposure benefit. The reduction in the subjective expression of fear/phobia is facilitated by "bottom-up" afferent signals, whereas improvement in the behavioral expression is further dependent on "top-down" representation of self-related physiology (heart rhythm). Individual interoceptive differences moderate these effects, suggesting means to personalize therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PSY.0000000000000646DOI Listing
January 2019

Network abnormalities in generalized anxiety pervade beyond the amygdala-pre-frontal cortex circuit: Insights from graph theory.

Psychiatry Res Neuroimaging 2018 11 27;281:107-116. Epub 2018 Sep 27.

Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy. Electronic address:

Generalized anxiety disorder (GAD) has excessive anxiety and uncontrollable worry as core symptoms. Abnormal cerebral functioning underpins the expression and perhaps pathogenesis of GAD:. Studies implicate impaired communication between the amygdala and the pre-frontal cortex (PFC). Our aim was to longitudinally investigate whether such network abnormalities are spatially restricted to this circuit or if the integrity of functional brain networks is globally disrupted in GAD. We acquired resting-state functional magnetic resonance imaging data from 16 GAD patients and 16 matched controls at baseline and after 1 year. Using network modeling and graph-theory, whole-brain connectivity was characterized from local and global perspectives. Overall lower global efficiency, indicating sub-optimal brain-wide organization and integration, was present in patients with GAD compared to controls. The amygdala and midline cortices showed higher betweenness centrality, reflecting functional dominance of these brain structures. Third, lower betweenness centrality and lower degree emerged for PFC, suggesting weakened inhibitory control. Overall, network organization showed impairments consistent with neurobiological models of GAD (involving amygdala, PFC, and cingulate cortex) and further pointed to an involvement of temporal regions. Such impairments tended to progress over time and predict anxiety symptoms. A graph-analytic approach represents a powerful approach to deepen our understanding of GAD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pscychresns.2018.09.006DOI Listing
November 2018

The verbal nature of worry in generalized anxiety: Insights from the brain.

Neuroimage Clin 2018 14;17:882-892. Epub 2017 Dec 14.

Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy. Electronic address:

Background: The Cognitive Avoidance Theory of Worry argues that worry is a cognitive strategy adopted to control the physiological arousal associated with anxiety. According to this theory, pathological worry, as in Generalized Anxiety Disorder (GAD), is verbal in nature, negative and abstract, rather than concrete. Neuroimaging studies link the expression of worry to characteristic modes of brain functional connectivity, especially in relation to the amygdala. However, the distinctive features of worry (verbal, abstract, negative), and their relationship to physiological arousal, have not so far been mapped to brain function.

Methods: We addressed this omission by undertaking a resting-state functional magnetic resonance neuroimaging study of 19 patients with GAD and 21 controls, before and after induction of perseverative cognitions, while measuring emotional bodily arousal from heart rate (HR). Seed-based analyses quantified brain changes in whole brain functional connectivity from the amygdala.

Results: In GAD, the induction increased negative thoughts and their verbal content. In line with predictions, the verbal expression of worry in GAD was associated with higher HR at baseline and attenuated HR increases after induction of perseverative cognitions. Within brain, the increased use of words during worry, and the associated dampening of HR after induction were mediated by the strength of functional connectivity between the amygdala and default mode network 'hubs' and the opercular cortex. The negative content of worry was further related to functional communication between amygdala and cingulo-opercular and temporal cortices.

Conclusions: Findings provide a neurobiological basis for the impact of verbal worry on HR in GAD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nicl.2017.12.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842731PMC
January 2019

Goal Directed Worry Rules Are Associated with Distinct Patterns of Amygdala Functional Connectivity and Vagal Modulation during Perseverative Cognition.

Front Hum Neurosci 2016 2;10:553. Epub 2016 Nov 2.

Neuroimaging Laboratory, Santa Lucia Foundation Rome, Italy.

Excessive and uncontrollable worry is a defining feature of Generalized Anxiety Disorder (GAD). An important endeavor in the treatment of pathological worry is to understand why some people are unable to stop worrying once they have started. Worry perseveration is associated with a tendency to deploy goal-directed worry rules (known as "as many as can" worry rules; AMA). These require attention to the goal of the worry task and continuation of worry until the aims of the "worry bout" are achieved. This study examined the association between the tendency to use AMA worry rules and neural and autonomic responses to a perseverative cognition induction. To differentiate processes underlying the AMA worry rule use from trait worry, we also examined the relationship between scores on the Penn State Worry Questionnaire (PSWQ) and neural and autonomic responses following the same induction. We used resting-state functional magnetic resonance brain imaging (fMRI) while measuring emotional bodily arousal from heart rate variability (where decreased HRV indicates stress-related parasympathetic withdrawal) in 19 patients with GAD and 21 control participants. Seed-based analyses were conducted to quantify brain changes in functional connectivity (FC) with the amygdala. The tendency to adopt an AMA worry rule was associated with validated measures of worry, anxiety, depression and rumination. AMA worry rule endorsement predicted a stronger decrease in HRV and was positively associated with increased connectivity between right amygdala and locus coeruleus (LC), a brainstem noradrenergic projection nucleus. Higher AMA scores were also associated with increased connectivity between amygdala and rostral superior frontal gyrus. Higher PSWQ scores amplified decreases in FC between right amygdala and subcallosal cortex, bilateral inferior frontal gyrus, middle frontal gyrus, and areas of parietal cortex. Our results identify neural mechanisms underlying the deployment of AMA worry rules. We propose that the relationship between AMA worry rules and increased connectivity between the amygdala and prefrontal cortex (PFC) represents attempts by high worriers to maintain arousal and distress levels in order to feel prepared for future threats. Furthermore, we suggest that neural mechanisms associated with the PSWQ represent effortful inhibitory control during worry. These findings provide unique information about the neurobiological processes that underpin worry perseveration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnhum.2016.00553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5089972PMC
November 2016

'I had a sort of epiphany!' An exploratory study of group mindfulness-based cognitive therapy for older people with depression.

Aging Ment Health 2018 Feb 11;22(2):208-217. Epub 2016 Nov 11.

a Sussex Partnership NHS Foundation Trust , UK.

Objectives: Mindfulness-based cognitive therapy (MBCT) has been successful in reducing depressive symptoms in people with chronic-recurrent depression. However, the research evaluating the efficacy of this approach, and other innovative treatments for mood disorders, has mainly been with people under 65 years. This paper aims to help redress this imbalance by exploring older people's own reflections of their experience of MBCT.

Methods: A qualitative approach was used to explore 13 participants' experiences of MBCT; participants were interviewed pre and post-intervention and again after six months. To see whether the standard course requires any adaptations for older participants, the two MBCT course facilitators were interviewed post-intervention.

Results: Thematic analysis identified five overarching themes and showed that older people reported positive changes in their mental health and well-being and reported being 'released from the past'. The facilitators reported that they needed to be aware of later life issues, such as loneliness and potential physical limitations, but otherwise only minor adaptations were needed to the standard MBCT course for older people.

Conclusion: MBCT is an acceptable approach for people aged 65 years and over and further research should explore potential mechanisms of change including changes in meta-cognitive awareness and self-compassion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13607863.2016.1247415DOI Listing
February 2018

Amygdala functional connectivity as a longitudinal biomarker of symptom changes in generalized anxiety.

Soc Cogn Affect Neurosci 2016 11 30;11(11):1719-1728. Epub 2016 Jun 30.

Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy

Generalized anxiety disorder (GAD) is characterized by excessive worry, autonomic dysregulation and functional amygdala dysconnectivity, yet these illness markers have rarely been considered together, nor their interrelationship tested longitudinally. We hypothesized that an individual's capacity for emotion regulation predicts longer-term changes in amygdala functional connectivity, supporting the modification of GAD core symptoms. Sixteen patients with GAD (14 women) and individually matched controls were studied at two time points separated by 1 year. Resting-state fMRI data and concurrent measurement of vagally mediated heart rate variability were obtained before and after the induction of perseverative cognition. A greater rise in levels of worry following the induction predicted a stronger reduction in connectivity between right amygdala and ventromedial prefrontal cortex, and enhanced coupling between left amygdala and ventral tegmental area at follow-up. Similarly, amplified physiological responses to the induction predicted increased connectivity between right amygdala and thalamus. Longitudinal shifts in a distinct set of functional connectivity scores were associated with concomitant changes in GAD symptomatology over the course of the year. Results highlight the prognostic value of indices of emotional dysregulation and emphasize the integral role of the amygdala as a critical hub in functional neural circuitry underlying the progression of GAD symptomatology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/scan/nsw091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091683PMC
November 2016

Alterations in Amygdala-Prefrontal Functional Connectivity Account for Excessive Worry and Autonomic Dysregulation in Generalized Anxiety Disorder.

Biol Psychiatry 2016 11 28;80(10):786-795. Epub 2015 Oct 28.

Santa Lucia Foundation, Rome, Italy. Electronic address:

Background: Generalized anxiety disorder (GAD) is characterized by the core symptom of uncontrollable worry. Functional magnetic resonance imaging studies link this symptom to aberrant functional connectivity between the amygdala and prefrontal cortex. Patients with GAD also display a characteristic pattern of autonomic dysregulation. Although frontolimbic circuitry is implicated in the regulation of autonomic arousal, no previous study to our knowledge combined functional magnetic resonance imaging with peripheral physiologic monitoring in these patients to test the hypothesis that core symptoms of worry and autonomic dysregulation in GAD arise from a shared underlying neural mechanism.

Methods: We used resting-state functional magnetic resonance imaging and the measurement of parasympathetic autonomic function (heart rate variability) in 19 patients with GAD and 21 control subjects to define neural correlates of autonomic and cognitive responses before and after induction of perseverative cognition. Seed-based analyses were conducted to quantify brain changes in functional connectivity with the right and left amygdala.

Results: Before induction, patients showed relatively lower connectivity between the right amygdala and right superior frontal gyrus, right paracingulate/anterior cingulate cortex, and right supramarginal gyrus than control subjects. After induction, such connectivity patterns increased in patients with GAD and decreased in control subjects, and these changes tracked increases in state perseverative cognition. Moreover, decreases in functional connectivity between the left amygdala and subgenual cingulate cortex and between the right amygdala and caudate nucleus predicted the magnitude of reduction in heart rate variability after induction.

Conclusions: Our results link functional brain mechanisms underlying worry and rumination to autonomic dyscontrol, highlighting overlapping neural substrates associated with cognitive and autonomic responses to the induction of perseverative cognitions in patients with GAD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.biopsych.2015.10.013DOI Listing
November 2016

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder.

Biol Psychol 2016 09 23;119:31-41. Epub 2016 Jun 23.

Department of Psychiatry, Brighton and Sussex Medical School, University of Sussex, Brighton, UK; Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK.

Generalized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within 'default mode' (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.biopsycho.2016.06.009DOI Listing
September 2016

Resolving Ambiguity in Emotional Disorders: The Nature and Role of Interpretation Biases.

Annu Rev Clin Psychol 2016 ;12:281-305

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom; email: , , ,

People with emotional disorders, such as social anxiety disorder (SAD), generalized anxiety disorder (GAD), and depression, demonstrate a consistent tendency, or bias, to generate negative interpretations of ambiguous material. This is different from people without emotional disorders who tend, in general, to make positive interpretations of ambiguity. If central components of an emotional disorder have high levels of inherent ambiguity (e.g., concern about the negative perceptions of others in SAD, or worry in GAD), then interpretive bias may have a causal maintaining role, and this has been demonstrated in studies using cognitive bias modification techniques. This research has also shown that interpretation biases combine with other cognitive processes, such as imagery and memory, which could exacerbate distress. Psychological interventions will benefit from effectively targeting negative interpretations, and future experimental research can inform ways to improve facilitation of more benign inferential processing to maximize amelioration of key components of emotional disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1146/annurev-clinpsy-021815-093436DOI Listing
January 2017

Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety.

Neuroimage Clin 2016 2;10:172-81. Epub 2015 Dec 2.

Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.

Background: Despite the high prevalence of generalized anxiety disorder (GAD) and its negative impact on society, its neurobiology remains obscure. This study characterizes the neurostructural abnormalities associated with key symptoms of GAD, focusing on indicators of impaired emotion regulation (excessive worry, poor concentration, low mindfulness, and physiological arousal).

Methods: These domains were assessed in 19 (16 women) GAD patients and 19 healthy controls matched for age and gender, using questionnaires and a low demand behavioral task performed before and after an induction of perseverative cognition (i.e. worry and rumination). Continuous pulse oximetry was used to measure autonomic physiology (heart rate variability; HRV). Observed cognitive and physiological changes in response to the induction provided quantifiable data on emotional regulatory capacity. Participants underwent structural magnetic resonance imaging; voxel-based morphometry was used to quantify the relationship between gray matter volume and psychological and physiological measures.

Results: Overall, GAD patients had lower gray matter volume than controls within supramarginal, precentral, and postcentral gyrus bilaterally. Across the GAD group, increased right amygdala volume was associated with prolonged reaction times on the tracking task (indicating increased attentional impairment following the induction) and lower scores on the 'Act with awareness' subscale of the Five Facets Mindfulness Questionnaire. Moreover in GAD, medial frontal cortical gray matter volume correlated positively with the 'Non-react mindfulness' facet. Lastly, smaller volumes of bilateral insula, bilateral opercular cortex, right supramarginal and precentral gyri, anterior cingulate and paracingulate cortex predicted the magnitude of autonomic change following the induction (i.e. a greater decrease in HRV).

Conclusions: Results distinguish neural structures associated with impaired capacity for cognitive, attentional and physiological disengagement from worry, suggesting that aberrant competition between these levels of emotional regulation is intrinsic to symptom expression in GAD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nicl.2015.11.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683456PMC
October 2016

Evaluation of a brief 4-session psychoeducation procedure for high worriers based on the mood-as-input hypothesis.

J Behav Ther Exp Psychiatry 2015 Mar;46:126-32

Background & Objectives: Given the ubiquity of worrying as a consuming and distressing activity at both clinical and sub-clinical levels, it is important to develop theory-driven procedures that address worrying and allow worriers to manage this activity. This paper describes the development and testing of a psychoeducation procedure based on mood-as-input hypothesis, which is a transdiagnostic model that describes a proximal mechanism for perseverative worrying. The study used nonclinical participants meeting IAPT criteria indicating GAD symptomatology.

Methods: In 4 sessions, participants in experimental groups received psychoeducation about the basic principles of the mood-as-input hypothesis and received guidance on how to identify and change worry-relevant goal-directed decision rules and negative moods. Participants in the psychoeducation conditions were compared with participants in a befriending control group.

Results: Psychoeducation about the model significantly reduced PSWQ scores at follow-up compared with the befriending control condition (a between-groups large effect size, Cohen's d = 1.05), and the homework tasks undertaken by the psychoeducation groups raised mood and reduced worry immediately. At follow up 48.2% of participants in the psychoeducation groups were below the recommended cut-off for identifying GAD symptomatology compared with 20% of participants in the control condition.

Limitations: This study was conducted on a small sample, high-worry student population, without a formal diagnosis.

Conclusions: This brief, low-intensity procedure is potentially adaptable to online or self-help procedures, and can be integrated into fuller cognitive therapy packages.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbtep.2014.09.008DOI Listing
March 2015

Does a 'Singing Together Group' improve the quality of life of people with a dementia and their carers? A pilot evaluation study.

Dementia (London) 2013 Mar 31;12(2):157-76. Epub 2011 Oct 31.

Canterbury Christ Church University, UK.

Ten people with dementia (PWD) and their family carers participated in a Singing Together Group for 10 weeks and measures of mood, quality of life, PWD's behavioural and psychological problems, activities of daily living and cognitive status were measured at pre, post and 10-week follow-up. Engagement levels were monitored during the sessions and care partners asked to rate each session. Additional qualitative information was obtained through interview pre-post and at follow-up and subjected to thematic analysis. The results showed that PWD were deteriorating slowly over the course of the study on all measures but that they and their carers' quality of life remained relatively stable. Engagement levels during the group were very high and attendance excellent. Qualitative data gave strong support to the group having promoted wellbeing of all participants and Nolan's 'Senses Framework' was used to explore this further. Future research directions are suggested.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1471301211422761DOI Listing
March 2013

Systematic information processing style and perseverative worry.

Clin Psychol Rev 2013 Dec 27;33(8):1041-56. Epub 2013 Aug 27.

University of Sussex, Brighton, UK. Electronic address:

This review examines the theoretical rationale for conceiving of systematic information processing as a proximal mechanism for perseverative worry. Systematic processing is characterised by detailed, analytical thought about issue-relevant information, and in this way, is similar to the persistent, detailed processing of information that typifies perseverative worry. We review the key features and determinants of systematic processing, and examine the application of systematic processing to perseverative worry. We argue that systematic processing is a mechanism involved in perseverative worry because (1) systematic processing is more likely to be deployed when individuals feel that they have not reached a satisfactory level of confidence in their judgement and this is similar to the worrier's striving to feel adequately prepared, to have considered every possible negative outcome/detect all potential danger, and to be sure that they will successfully cope with perceived future problems; (2) systematic processing and worry are influenced by similar psychological cognitive states and appraisals; and (3) the functional neuroanatomy underlying systematic processing is located in the same brain regions that are activated during worrying. This proposed mechanism is derived from core psychological processes and offers a number of clinical implications, including the identification of psychological states and appraisals that may benefit from therapeutic interventions for worry-based problems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cpr.2013.08.007DOI Listing
December 2013

Mood as input and perseverative worrying following the induction of discrete negative moods.

Behav Ther 2012 Jun 1;43(2):393-406. Epub 2011 Oct 1.

School of Psychology, University of Sussex, Brighton, United Kingdom, BN1 9QH.

Previous research has demonstrated that a combination of negative mood and rigorous "as many as can" stop rules can be used to help explain a range of perseverative psychopathologies such as pathological worrying, compulsive checking, and depressive rumination (known as the mood-as-input hypothesis). The aim of the present study was to extend this work and examine whether specific emotions of the same valence will have similar or differential effects on task perseveration. The study experimentally induced discrete moods and manipulated task stop rules in an analog population. Results showed that perseveration at a worry-based interview task conformed to standard mood-as-input predictions in which perseveration was significantly greater when an "as many as can" stop rule was paired with a negative mood or a "feel like continuing" stop rule was paired with a positively valenced mood. The pattern of results revealed no significant inherent differences in processing depending on the type of discrete negative mood being experienced. These findings support a view of mood-as-input effects where overall valency is the important factor in determining perseveration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.beth.2011.08.005DOI Listing
June 2012

Mood-as-input hypothesis and perseverative psychopathologies.

Clin Psychol Rev 2011 Dec 31;31(8):1259-75. Epub 2011 Aug 31.

School of Psychology, University of Sussex, Brighton, UK.

Mood-as-input hypothesis is a theory of task perseveration that has been applied to the understanding of perseveration across psychopathologies such as pathological worrying, compulsive checking, depressive rumination, and chronic pain. We review 10 years of published evidence from laboratory-based analogue studies and describe their relevance for perseveration in clinical populations. In particular, mood-as-input hypothesis predicts that perseveration at a task will be influenced by interactions between the individual's stop rules for the task and their concurrent mood, and that the valency of an individual's concurrent mood is used as information about whether the stop rule-defined goals for the task have been met. The majority of the published research is consistent with this hypothesis, and we provide evidence that clinical populations possess characteristics that would facilitate perseveration through mood-as-input processes. We argue that mood-as-input research on clinical populations is long overdue because (1) it has potential as a transdiagnostic mechanism helping to explain the development of perseveration and its comorbidity across a range of different psychopathologies, (2) it is potentially applicable to any psychopathology where perseveration is a defining feature of the symptoms, and (3) it has treatment implications for dealing with clinical perseveration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cpr.2011.08.002DOI Listing
December 2011