Publications by authors named "Rudi De Raedt"

214 Publications

Are Emotion Regulation Strategies Associated With Visual Attentional Breadth for Emotional Information in Youth?

Front Psychol 2021 9;12:637436. Epub 2021 Dec 9.

Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium.

Attentional deployment is currently considered as one of the most central mechanisms in emotion regulation (ER) as it is assumed to be a crucial first step in the selection of emotional information. According to the broaden-and-build theory, positive emotions are associated with attentional broadening and negative emotions with attentional narrowing toward emotional information. Given that ER strategies relying on attentional deployment (i.e., rumination, cognitive reappraisal and distraction) have the possibility to influence positive and negative emotions by (re)directing one's attention, there could be an association with one's attentional scope. The current study investigated the association between the general (trait) use of three specific ER strategies and visual attentional breadth for positive, negative, and neutral information in a selected sample of 56 adolescents ( = 12.54, = 1.72; 49% girls) at risk for developing psychopathology. First, participants self-reported on their overall use of different ER strategies. Next, the previously validated Attentional Breadth Task (ABT) was used to measure visual attention breadth toward emotional information. No evidence was found for the relationship between 2 specific ER strategies (i.e., cognitive reappraisal and rumination) and visual attentional breadth for neutral, positive and negative emotional information. Surprisingly, "distraction" was associated with visual attentional narrowing, which was unrelated to the valence of the emotion. These unexpected results indicate the multifaceted relationship between trait ER, distraction specifically, and visual attentional breadth for emotional information. Future research, especially in younger age groups, could further elaborate on this research domain.
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http://dx.doi.org/10.3389/fpsyg.2021.637436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8696011PMC
December 2021

Treatment experiences during a cognitive behaviour therapy group intervention targeting repetitive negative thinking: A qualitative study.

Psychol Psychother 2021 Dec 22. Epub 2021 Dec 22.

Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium.

Objectives: Treatment of repetitive negative thinking (RNT) focuses rather on individual than group cognitive behaviour therapy (CBT) treatment. Additionally, little is known on how clients experienced these interventions. This study investigates clients' experiences on participating in a CBT group intervention targeting RNT (RNT-G).

Design: Of the 80 participants, 11 were randomly selected for an in-depth, semi-structured interview after treatment. Interviews focused on what participants experienced as important on group aspects, offered interventions, homework tasks, and possible changes.

Methods: All participants were adults, diagnosed with major depressive disorder and/or generalized anxiety disorder and being currently in mental health care treatment. After transcribing the interviews, analyses were performed according to the guidelines of thematic analysis.

Results: Four major themes were identified. First, the group format itself was experienced as an important factor of change. The experiences about the different offered interventions during the group formed a second theme. A third theme related to changes in family or professional life and dealing with RNT as a result of the intervention. Finally, group participation, social interactions, and mental health care treatment were experienced as mutually influencing during the intervention.

Conclusions: The results of this study shed some light on which treatment interventions were perceived as beneficial during the RNT-G and should therefore be emphasized in treatment. Further, they indicate that the treatment in a group format was experienced as helpful by the participants. Finally, a positive mutual influence between the group intervention and the ongoing individual treatment was experienced.
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http://dx.doi.org/10.1111/papt.12378DOI Listing
December 2021

Attenuated beta-adrenergic response to stress and increased anticipation and perception of social threat in women high on perceived criticism.

Psychoneuroendocrinology 2021 11 20;133:105421. Epub 2021 Sep 20.

Department of Psychology, Harvard University, USA.

A large amount of literature has demonstrated that Perceived Criticism (PC)-that is, how critical a person believes a given relative is of him or her-is associated with negative clinical outcomes in a broad range of psychiatric disorders (e.g., relapse or recurrence of symptoms). A possible mechanism behind the predictive value of PC might be its association with the stress regulation process. This is the first study to investigate differences in the psychophysiological response to a social stress task in young women (mean age = 21.66, SD = 4.33) with high (n = 40) and low (n = 39) PC. The physiological response was investigated by measuring two markers of sympathetic activity mediated by acetylcholine (skin conductance levels; SCL) and adrenaline (pre-ejection period; PEP) levels, respectively, and one marker of the vagally-mediated parasympathetic system (heart rate variability; HRV). Moreover, we investigated the anticipation and perception of social threat, in the form of criticism, during the stressor. No differences in HRV and SCL were observed. However, individuals high in PC mobilized fewer cardiovascular resources to deal with the stressor, reflected in an attenuated beta-adrenergic response (i.e., lower PEP response). Women high in PC also expected and perceived more criticism during the stress task. Together, our results indicate that women high in PC make heightened social threat anticipation and interpretations, and they tend to engage in less active coping when exposed to socially evaluated stressful events. Our findings indicate that PC is associated with underlying stress-related psychobiological vulnerabilities that may contribute to its association with negative clinical outcomes.
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http://dx.doi.org/10.1016/j.psyneuen.2021.105421DOI Listing
November 2021

Prefrontal tDCS Attenuates Self-Referential Attentional Deployment: A Mechanism Underlying Adaptive Emotional Reactivity to Social-Evaluative Threat.

Front Hum Neurosci 2021 17;15:700557. Epub 2021 Aug 17.

Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium.

Social-evaluative threat (SET) - a situation in which one could be negatively evaluated by others - elicits profound (psycho)physiological reactivity which, if chronically present and not adaptively regulated, has deleterious effects on mental and physical health. Decreased self-awareness and increased other-awareness are understood to be an adaptive response to SET. Attentional deployment - the process of selectively attending to certain aspects of emotional stimuli to modulate emotional reactivity - is supported by fronto-parietal and fronto-limbic networks, with the dorsolateral prefrontal cortex being a central hub. The primary aim of the current study was to investigate the effects of active (versus sham) prefrontal transcranial direct current stimulation (tDCS) on self and other-attentional deployment during the exposure to a SET context. Seventy-four female participants received active or sham tDCS and were subsequently exposed to a rigged social feedback paradigm. In this paradigm a series of social evaluations were presented together with a photograph of the supposed evaluator and a self- photograph of the participant, while gaze behavior (time to first fixation, total fixation time) and skin conductance responses (SCRs; a marker of emotional reactivity) were measured. For half of the evaluations, participants could anticipate the valence (negative or positive) of the evaluation . Analyses showed that participants receiving active tDCS were (a) slower to fixate on their self-photograph, (b) spent less time fixating on their self-photograph, and (c) spent more time fixating on the evaluator photograph. During unanticipated evaluations, active tDCS was associated with less time spent fixating on the evaluation. Furthermore, among those receiving active tDCS, SCRs were attenuated as a function of slower times to fixate on the self-photograph. Taken together, these results suggest that in a context of SET, prefrontal tDCS decreases self-attention while increasing other-attention, and that attenuated self-referential attention specifically may be a neurocognitive mechanism through which tDCS reduces emotional reactivity. Moreover, the results suggest that tDCS reduces vigilance toward stimuli that possibly convey threatening information, corroborating past research in this area.
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http://dx.doi.org/10.3389/fnhum.2021.700557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416079PMC
August 2021

Exposure to Criticism Modulates Left but Not Right Amygdala Functional Connectivity in Healthy Adolescents: Individual Influences of Perceived and Self-Criticism.

Front Psychiatry 2021 6;12:673805. Epub 2021 Jul 6.

Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, Ghent, Belgium.

Frequent exposure to criticism is a known risk factor for various adult psychiatric disorders. Adolescents may be even more vulnerable to (parental) criticism, as their imbalanced brain maturation makes them prone to stronger mood changes and less effective emotional regulation. Identifying which adolescent subgroups are more vulnerable than others could be of great clinical relevance. Perceived criticism (PC) and self-criticism (SC), two related but distinct traits, could well be crucial vulnerability factors. After exposure to criticism during fMRI scanning, rapid changes in amygdalar functional connectivity (FC) with other brain areas involved in emotion regulation and social cognitive processing will occur. These changes will depend on trait moderators, such as the adolescents' proneness to (a) perceive others as critical of them (PC) or (b) perceive themselves positively or negatively (SC). Sixty-four healthy 14-17-year-olds were exposed to a series of auditory comments. Changes in mood states were assessed based on the Profile of Mood States (POMS) prior to and after exposure to these segments. Pre- and post-experiment FC of the left and right amygdalae with other brain areas were also measured. Correlates between FC changes and psychometric measures-including the perceived criticism measure (PCM) and self-perception profile for adolescents (SPPA)-were assessed. First, after being criticized, FC increases of the left amygdala seed region with brain areas related to sustained emotional processing were found, but no right amygdalar FC changes. Second, there was a significant positive partial correlation between individual PCM scores and FC changes between the left amygdala seed region and the left precuneus and left superior parietal cortex, both part of the default mode network. Exposure to criticism resulted in a rapid negative mood change accompanied by an increase in FC between the left amygdala and regions known to be involved in sustained emotional processing, but no right amygdalar FC changes. Furthermore, higher PC but not SC was correlated with stronger left amygdalar FC increases with these regions, suggesting an elevated vulnerability for disturbed emotional processing, as observed in mood disorders, in healthy adolescents with higher PCM scores.
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http://dx.doi.org/10.3389/fpsyt.2021.673805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290839PMC
July 2021

A multi-method assessment of attentional processes in chronic, treatment-resistant depression.

J Psychiatr Res 2021 08 5;140:68-76. Epub 2021 May 5.

Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.

Attentional deficits as well as attentional biases towards negative material are related to major depression and might maintain chronicity. However, studies investigating attentional deficits and attentional biases in chronic, treatment-resistant depressed are lacking. The aim of the current study was to compare measures of attentional deficits and attentional bias between chronic, treatment-resistant depressed outpatients and never-depressed control participants. Attentional deficits were assessed with the attentional control scale (ACS) and the Stroop Color naming task. Attentional bias was measured with the exogenous cueing task (ECT) and an emotional Stroop task. Chronic, treatment-resistant depressed patients (n = 80) showed significantly more attentional deficits than never-depressed controls (n = 113) on the ACS and Stroop color-naming task. However, in contrast with hypotheses, no differences were found between chronic, treatment-resistant depressed patients and never-depressed individuals on the ECT or emotional Stroop task. The current findings indicate that chronic, treatment-resistant depressed patients present attentional deficits. The results however question whether this patient group shows attentional biases for negative material. Future research should include comparisons of chronic, treatment-resistant and non-chronically depressed patients. If replicated, these current results might indicate that focusing on improving attentional deficits could be a more promising target for treatment than addressing attentional biases.
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http://dx.doi.org/10.1016/j.jpsychires.2021.04.030DOI Listing
August 2021

The relationship between affective flexibility, spontaneous emotion regulation and the response to induced stress.

Behav Res Ther 2021 08 1;143:103891. Epub 2021 Jun 1.

Ghent University, Belgium.

Effective emotion regulation contributes to adapting well to challenging situations. One of the proposed cognitive mechanisms underlying emotion regulation is cognitive flexibility in processing of affective material (i.e. affective flexibility). We investigated (n = 118) effects of affective flexibility on the response to a stressor and on spontaneous use of 'adaptive' and 'maladaptive' emotion regulation strategies. Additionally, we examined how emotion regulation influences stress reactivity and recovery. Affective flexibility was measured with a task-switching paradigm in which participants shift attention between affective and non-affective aspects of emotional material. We investigated changes in emotion and heart rate variability to a stress induction. Affective flexibility did not influence the response to stress, but less efficient shifting of attention towards affective aspects of negative information, and more efficient shifting of attention towards non-affective aspects of positive information were related to more use of maladaptive strategies. Emotion regulation strategy use had limited influence on the perceived and actual physiological response to a stress induction, but especially more use of adaptive regulation strategies reduced negative emotional reactivity. Our findings suggest that individual differences in affective flexibility have limited influence on the (acute) response to a stressful event and recovery afterwards, but do influence spontaneous use of emotion regulation strategies.
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http://dx.doi.org/10.1016/j.brat.2021.103891DOI Listing
August 2021

Prefrontal tDCS attenuates counterfactual thinking in female individuals prone to self-critical rumination.

Sci Rep 2021 06 2;11(1):11601. Epub 2021 Jun 2.

Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), 1K12F, Corneel Heymanslaan 10, 9000, Ghent, Belgium.

The tendency to ruminate (i.e., repetitive negative self-referential thoughts that perpetuate depressive mood) is associated with (a) an elevated propensity to maladaptively experience counterfactual thinking (CFT) and regret, and (b) hypo-activity of the left dorsolateral prefrontal cortex (DLPFC). The goal of this study was to investigate whether anodal transcranial direct current stimulation (tDCS) over the left DLPFC, in function of self-critical rumination tendencies, momentarily reduces counterfactual thinking and regret (assessed via self-report and psychophysiological indices). Eighty healthy participants with different levels of self-critical rumination received either anodal or sham tDCS while performing a decision making task in which they were repeatedly confronted with optimal, suboptimal, and non-optimal choice outcomes. The results showed that among rumination-prone individuals, anodal (versus sham) tDCS was associated with decreased CFT and attenuated psychophysiological reactivity to the differential choice outcomes. Conversely, among low rumination-prone individuals, anodal (versus sham) tDCS was associated with increased CFT and regret, but in absence of any effects on psychophysiological reactivity. Potential working mechanisms for these differential tDCS effects are discussed. Taken together, these results provide initial converging evidence for the adaptive effects of left prefrontal tDCS on CFT and regret to personal choice outcomes among individuals prone to engage in self-critical rumination.
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http://dx.doi.org/10.1038/s41598-021-90677-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172930PMC
June 2021

Early reduction of sensory processing within the visual cortex when switching from internal to external attention.

Biol Psychol 2021 07 18;163:108119. Epub 2021 May 18.

Cognitive & Affective Psychophysiology Laboratory, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

The neurocognitive process underlying attention switches between external (perception-based) and internal (memory-based) attention is poorly characterized. Previous research has found that when participants switch attention either between two perception-based tasks (within-domain switches) or between a memory- and a perception-based task (between-domain switches), a substantial and similar processing cost was observed compared to the repetition of the same task (Verschooren, Schindler, De Raedt, & Pourtois, 2019). Here, we recorded 64-channel EEG while participants carried out within- versus between-domain switches of attention. ERP results showed that during early sensory processing, a marked P1 attenuation was associated with both switch types, suggesting that switching was associated with an early bottleneck during information processing. This early gating effect was stronger when switching from an internal to an external task, compared to switching between external tasks, suggesting different top-down requirements for them. These findings are in line with earlier proposals in the literature.
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http://dx.doi.org/10.1016/j.biopsycho.2021.108119DOI Listing
July 2021

Hostility in medication-resistant major depression and comorbid generalized anxiety disorder is related to increased hippocampal-amygdala 5-HT receptor density.

Eur Arch Psychiatry Clin Neurosci 2021 Oct 27;271(7):1369-1378. Epub 2021 Apr 27.

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are severe and difficult-to-treat psychiatric illnesses with high rates of comorbidity. Although both disorders are treated with serotonergic based psychotropic agents, little is known on the influence of the serotonergic neurotransmitter system on the occurrence of comorbid GAD when clinically depressed. To investigate this poorly understood clinical question, we examined the involvement of frontolimbic post-synaptic 5-HT receptors in 20 medication-resistant depressed (MRD) patients with half of them diagnosed with comorbid GAD with I-5-I-R91150 SPECT. To explore whether 5-HT receptor-binding indices (BI) associated with comorbid GAD could be related to distinct psychopathological symptoms, all were assessed with the symptom Checklist-90-Revised (SCL-90-R). MRD patients with comorbid GAD displayed significantly higher 5-HT receptor BI in the hippocampal-amygdala complex, compared to MRD patients without GAD. Correlation analyses revealed that the 5-HT receptor BI in these areas were significantly related to the SCL-90-R subscale hostility (HOS), especially for those MRD patients with comorbid GAD. Comorbid MRD-GAD may be characterized with increased hippocampal-amygdala 5-HT receptor BI which could represent enhanced levels in hostility in such kinds of patients. Adapted psychotherapeutic interventions may be warranted.
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http://dx.doi.org/10.1007/s00406-021-01243-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429407PMC
October 2021

Effects of combined theta burst stimulation and transcranial direct current stimulation of the dorsolateral prefrontal cortex on stress.

Clin Neurophysiol 2021 05 10;132(5):1116-1125. Epub 2021 Mar 10.

Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium. Electronic address:

Objective: Research suggests that the combination of different non-invasive brain stimulation techniques, such as intermittent theta-burst stimulation (iTBS) and transcranial direct current stimulation (tDCS), could enhance the effects of stimulation. Studies investigating the combination of tDCS and iTBS over the dorsolateral prefrontal cortex (DLPFC) are lacking. In this within-subjects study, we evaluated the additive effects of iTBS with tDCS on psychophysiological measures of stress.

Method: Sixty-eight healthy individuals were submitted to a tDCS + iTBS and tDCS + iTBS protocol targeting the DLPFC with a one-week interval. The Maastricht Acute Stress Test was used to activate the stress system after stimulation. Stress reactivity and recovery were assessed using physiological and self-report measures.

Results: The stressor evoked significant psychophysiological changes in both stimulation conditions. However, no evidence was found for differences between them in stress reactivity and recovery. Participants reported more pain and feelings of discomfort to the tDCS + iTBS protocol.

Conclusion: In this study set-up, iTBS plus tDCS was not superior to iTBS in downregulating stress in healthy subjects.

Significance: There is no evidence for an effect of combined tDCS-iTBS of the DLPFC on stress according to the parameters employed in our study. Future studies should explore other stimulation parameters, additive approaches and/or neurobiological markers.
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http://dx.doi.org/10.1016/j.clinph.2021.01.025DOI Listing
May 2021

The impact of the COVID-19 pandemic on wellbeing and cognitive functioning of older adults.

Sci Rep 2021 02 25;11(1):4636. Epub 2021 Feb 25.

Brain & Cognition, KU Leuven, Leuven, Belgium.

COVID-19 took a heavy toll on older adults. In Belgium, by the end of August, 93% of deaths due to COVID-19 were aged 65 or older. Similar trends were observed in other countries. As a consequence, older adults were identified as a group at risk, and strict governmental restrictions were imposed on them. This has caused concerns about their mental health. Using an online survey, this study established the impact of the COVID-19 pandemic on adults aged 65 years or older, and which factors moderate this impact. Participants reported a significant decrease in activity level, sleep quality and wellbeing during the COVID-19 pandemic. Depression was strongly related to reported declines in activity level, sleep quality, wellbeing and cognitive functioning. Our study shows that the COVID-19 pandemic had a severe impact on the mental health of older adults. This implies that this group at risk requires attention of governments and healthcare.
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http://dx.doi.org/10.1038/s41598-021-84127-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907111PMC
February 2021

Cognitive behavioral based group psychotherapy focusing on repetitive negative thinking: Decreased uncontrollability of rumination is related to brain perfusion increases in the left dorsolateral prefrontal cortex.

J Psychiatr Res 2021 04 13;136:281-287. Epub 2021 Feb 13.

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Repetitive negative thinking (RNT) is a core process underlying various psychiatric disorders. 'Uncontrollability of rumination (UOR)' is one the most maladaptive factors of rumination, but little is known on how cognitive behavioral focused RNT psychotherapy may alter brain activity. In a subsample of 47 patients suffering from RNT who also underwent brain imaging (registered RCT trial NCT01983033), we evaluated the effect of cognitive behavioral based group psychotherapy (CBGP) (n = 25) as compared to a delayed treatment control group (DTCG) (n = 22) on frontolimbic brain perfusion with a focus on UOR. This RNT construct was measured using the subscale 'uncontrollability' of the Dutch version of the Rumination on Sadness Scale (LARSS-U). Brain perfusion was assessed with arterial spin labeling (ASL)-fMRI. LARSS-U scale scores significantly decreased in the CBGP cohort whereas no significant changes emerged in the DTCG group. Compared to the DTCG, this decrease on UOR in the CBGP group was related to significant perfusion increases in the left (dorsolateral) prefrontal cortex, part of the executive network. Besides the fact that CBGP significantly reduced RNT, this attenuation of uncontrollable ruminative thoughts was related to brain perfusion increases areas documented to be involved in the top down control of adaptive emotion regulation and the inhibition of ruminative processes.
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http://dx.doi.org/10.1016/j.jpsychires.2021.02.011DOI Listing
April 2021

Looking for carrots, watching out for sticks: A gaze-contingent approach towards training contextual goal-dependent affective attention flexibility.

Behav Res Ther 2021 01 10;136:103787. Epub 2020 Dec 10.

Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.

The ability to flexibly shift between changing goals is crucial to develop an adaptive response to life stressors. Accordingly, lower affective attention flexibility, i.e. the ability to shift attention flexibly between goals, is associated with low reappraisal ability, high levels of rumination, and lower levels of resilience. However, attempts to manipulate affective attention flexibility with current attention training procedures have seen limited success. In the current study, we tested a novel attention flexibility training paradigm using eye-tracking, wherein dysphoric participants had to switch between different context-dependent goals. Attention towards goal-relevant emotional stimuli was reinforced using music and harsh sound. We found that participants in the training condition became significantly faster in switching attention from negative to positive goal-related stimuli pre-to post-training on an attention flexibility task, compared to the control condition. On a transfer task where participants had to give a presentation to an audience, we found that participants in the training condition displayed a more flexible pattern of attending to emotional faces during their presentation, depending upon which goal was activated. Comparatively, participants in the control condition remained rigidly attentive towards negative faces despite the goal activated. Our findings provide preliminary evidence for the role of context-based attention flexibility in dysphoria, and support scope for future clinical applications.
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http://dx.doi.org/10.1016/j.brat.2020.103787DOI Listing
January 2021

Contextual goal-dependent attention flexibility or rule-based learning? An investigation of a new attention flexibility paradigm.

J Behav Ther Exp Psychiatry 2021 06 21;71:101632. Epub 2020 Nov 21.

Department of Experimental, Clinical & Health Psychology, Ghent University, Belgium.

Background & Objectives: Deficits in the ability to process contextual changes have been proposed to be crucial for emotion dysregulation. A recent study found evidence for the role of contextual changes in exacerbating attention switching towards valence-specific goals using a novel attention flexibility paradigm. Despite the task indicating good reliability, the role of rule-based learning has not been clarified in this paradigm. Therefore, we examined whether the novel attention flexibility task is an index of context-based attention switching or does it reflect impact of rule-based learning on attention.

Method: We employed a neutral version of the attention flexibility task. A sample of dysphoric and non-dysphoric participants were introduced to neutral contexts which required them to shift between neutral categories of pictures depending upon the cueing shape.

Results: There was an existence of a switch cost for shifting between different rules owing to the features of the rules. Further, non-dysphorics were faster at set-shifting between different rules as compared to dysphoric individuals. However, unlike in the affective version of the attention flexibility task, we found no significant differences between dysphoric and non-dysphoric individuals in attention switching patterns owing to switching between different rules.

Limitations: Although the current study aimed to replicate the design of the previous study, a depressed patient sample must be employed to further clarify the different aspects of the attention flexibility paradigm.

Conclusion: Our findings were able to clarify the non-existent role of rule-based learning in the attention flexibility paradigm.
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http://dx.doi.org/10.1016/j.jbtep.2020.101632DOI Listing
June 2021

Combined transcranial direct current stimulation and psychological interventions: State of the art and promising perspectives for clinical psychology.

Biol Psychol 2021 01 21;158:107991. Epub 2020 Nov 21.

Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Recent literature shows great heterogeneity in the reported efficacy of transcranial direct current stimulation (tDCS) as a stand-alone psychiatric treatment. Aiming to increase its efficacy, tDCS has been combined with psychological interventions. Our state-of-the-art overview of such combined treatment trials indicates, however, that these usually do not elicit synergistic clinical effects. We therefore explored more basic mechanisms related to the brain state-dependency of tDCS. Importantly, based on our overview, the efficacy of combined interventions may depend on whether individual patients present with endophenotypes that are implicated in the development and maintenance of psychopathology, such as prefrontal-mediated cognitive dysfunction. We discuss how future studies may contribute to the development of personally-tailored dual active treatments by adhering to the Research Domain Criteria (RDoC) framework. RDoC-based mechanistic research may reveal alternative neural circuits that should be functionally targeted by both tDCS and psychological interventions, with promising avenues for clinical psychological science and practice.
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http://dx.doi.org/10.1016/j.biopsycho.2020.107991DOI Listing
January 2021

Combined effects of tDCS over the left DLPFC and gaze-contingent training on attention mechanisms of emotion regulation in low-resilient individuals.

Prog Neuropsychopharmacol Biol Psychiatry 2021 06 13;108:110177. Epub 2020 Nov 13.

Department of Experimental Clinical and Health Psychology, Ghent University, Belgium; Department of Head and Skin, Ghent University, Belgium.

Low resilience is characterized by impairments in attention and emotion regulation mechanisms that depend on prefrontal cortical activity. The aim of this study was to test whether transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) can augment the effectiveness of a new computerized mouse-based (gaze)contingent training (MCAT) to improve attention and emotion regulation processes (improved reappraisal, reduced rumination) in individuals reporting low resilience levels. The study used a full-factorial between-subject design combining active and sham MCAT and tDCS interventions. One hundred participants reporting low resilience levels were randomly assigned to receive either a single session of: tDCS with sham MCAT treatment (tDCS group), MCAT with sham tDCS (MCAT group), a combination of tDCS and MCAT (combined group), or sham tDCS and sham MCAT (control group). Transfer to attention regulation, reappraisal success, and state rumination was evaluated using an eye-tracking disengagement task and an emotion regulation paradigm, respectively. MCAT, either alone or combined with tDCS, resulted in improved attention regulation. Furthermore, the group receiving combined MCAT and tDCS also showed some evidence of increased reappraisal ability and reduced rumination. MCAT in combination with left DLPFC neuromodulation has potential to maximize transfer to emotion regulation capacities and to promote resilience.
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http://dx.doi.org/10.1016/j.pnpbp.2020.110177DOI Listing
June 2021

Children's Attention to Mother and Adolescent Stress Moderate the Attachment-Depressive Symptoms Link.

Psychol Belg 2020 Sep 4;60(1):294-314. Epub 2020 Sep 4.

Experimental Clinical and Health Psychology, Ghent University, Gent, BE.

The breadth of children's attentional field around their mother determines whether securely or insecurely attached children are at risk to develop depressive symptoms when confronted with distress in adolescence. To test this effect longitudinally, we measured children's ( = 10.93; = 109) baseline attentional breadth around their mother, attachment status (combining attachment coherence, secure base script knowledge, and self-reported trust), and self-reported depressive symptoms. One and two years later, we measured self-reported distress and depressive symptoms. We tested three-way interactions between attentional breadth × attachment × distress on changes in depressive symptoms. This three-way interaction was marginally significantly linked with changes in depressive symptoms from baseline to year 1, and significantly with changes in depressive symptoms from baseline to year 2. Results pointed to the protective role of a narrow attentional field around the mother in middle childhood for securely attached children who are confronted with distress later in life.
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http://dx.doi.org/10.5334/pb.550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473194PMC
September 2020

Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression: randomized controlled trail of an intervention for relapse prevention - study protocol.

BMC Psychiatry 2020 09 16;20(1):453. Epub 2020 Sep 16.

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Background: Major depressive episode (MDE) is worldwide one of the most prevalent and disabling mental health conditions. In cases of persistent non-response to treatment, electroconvulsive therapy (ECT) is a safe and effective treatment strategy with high response rates. Unfortunately, longitudinal data show low sustained response rates with 6-month relapse rates as high as 50% using existing relapse prevention strategies. Cognitive side effects of ECT, even though transient, might trigger mechanisms that increase relapse in patients who initially responded to ECT. Among these side effects, reduced cognitive control is an important neurobiological driven vulnerability factor for depression. As such, cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve long-term effects of ECT (i.e., increase remission, and reduce depression relapse).

Method/design: Eighty-eight patients aged between 18 and 70 years with MDE who start CCT will be included in this randomized controlled trial (RCT). Following (partial) response to ECT treatment (at least a 25% reduction of clinical symptoms), patients will be randomly assigned to a computer based CCT or active placebo control. A first aim of this RCT is to assess the effects of CCT compared to an active placebo condition on depression symptomatology, cognitive complaints, and quality of life. Secondly, we will monitor patients every 2 weeks for a period of 6 months following CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, we will assess patient evaluation of the addition of cognitive remediation to ECT using qualitative interview methods (satisfaction, acceptability and appropriateness). Finally, in order to further advance our understanding of the mechanisms underlying effects of CCT, exploratory analyses will be conducted using video footage collected during the CCT/active control phase of the study.

Discussion: Cognitive remediation will be performed following response to ECT, and an extensive follow-up period will be employed. Positive findings would not only benefit patients by decreasing relapse, but also by increasing acceptability of ECT, reducing the burden of cognitive side-effects.

Trial Registration: The study is registered with ClinicalTrials.gov . Study ID: NCT04383509 Trial registration date: 12.05.2020.
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http://dx.doi.org/10.1186/s12888-020-02856-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493867PMC
September 2020

Manipulating avoidance motivation to modulate attention bias for negative information in dysphoria: An eye-tracking study.

J Behav Ther Exp Psychiatry 2021 03 5;70:101613. Epub 2020 Sep 5.

Department of Experimental Clinical & Health Psychology, Ghent University, Belgium.

Background And Objectives: Instrumentality plays a key role in guiding attention, such that stimuli associated with achieving current goals of an individual prioritize attention. However, in depression, attention is prioritized to negative stimuli even when they are not relevant to current goals. In the current study, we tested whether attention is prioritized to stimuli that are associated with avoidance of imminent negative consequences over negative affective stimuli.

Methods: Using an eye-tracking based attention engagement-disengagement task, we presented pairs of negative faces, and neutral faces associated with avoidance of punishment (white noise and lost money) to a group of dysphoric and non-dysphoric individuals.

Results: First, we replicated previous evidence on difficulties to disengage attention from negative stimuli, when prompted to direct eye-gaze towards simple neutral stimuli, in dysphoric compared to non-dysphoric individuals. Further, we found that both dysphoric and non-dysphoric individuals were faster to disengage their attention from negative pictures when prompted to direct eye-gaze towards punishment avoidance-related neutral stimuli, versus towards simple neutral stimuli.

Limitations: Although we seek to clarify the attention processes underlying depression, the current study employed a sub-clinical sample in order to serve as proof-of-concept study.

Conclusions: Our results indicate that stimuli instrumental to the goal of avoiding negative consequences receive preference in the attention system over simple negative affective stimuli. Our findings suggest that manipulating the instrumentality of avoidance motivation can effectively modulate the attention bias for negative information in dysphoria, and also possibly in depression, akin to the modulation patterns in non-dysphoric individuals.
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http://dx.doi.org/10.1016/j.jbtep.2020.101613DOI Listing
March 2021

The role of cognitive reappraisal and expectations in dealing with social feedback.

Emotion 2020 Sep 3. Epub 2020 Sep 3.

Department of Experimental-Clinical and Health Psychology.

Whereas emotion regulation (ER) in response to distressing events is widely studied, the mechanisms underlying adaptive ER while anticipating these events are still unknown. In this study, we investigated how ER strategies and expectation influence (a) individuals' anticipatory and online processing of self-relevant events, and (b) their affective response to them. Sixty-one healthy female participants were exposed to bogus positive and negative social feedback under reappraisal (regulation) and watch (no regulation) instructions. During the anticipatory period, participants were either expecting negative feedback or they had no expectation regarding the valence of the upcoming self-relevant feedback. Hence, negative feedback was, respectively, expected or unexpected. Participants' affective responses were collected via self-report and electromyographic (EMG) activity over the corrugator muscle. Results showed that participants' negative affect (based on both self-reports and EMG) was reduced by the instructions to reappraise as compared to the watch condition. Yet, such beneficial effect of reappraisal was: (a) not observed during the anticipation phase, and (b) less effective when social feedback was expected (as compared to not expected) prior to its presentation. Possibly, cognitive reappraisal might be less able to overcome the influence of negative forecasting of self-relevant negative emotional stimuli. Research findings are discussed in light of potential mechanisms underlying impaired adaptive ER in patients vulnerable for mood disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/emo0000825DOI Listing
September 2020

Testing the neurocognitive framework for regulation expectation: The relationship between actual/ideal self-esteem and proactive/reactive autonomic stress regulation.

J Behav Ther Exp Psychiatry 2020 12 5;69:101598. Epub 2020 Jul 5.

Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium. Electronic address:

Background And Objectives: According to the Neurocognitive Framework for Regulation Expectation (NFRE), actual and ideal self-esteem are related to how individuals anticipate and respond to a stressful event. Based on this framework, we investigated whether in individuals with low ideal self-esteem (moderator), a positive relationship between actual self-esteem and reactive autonomic regulation would be mediated by the amount of anticipatory autonomic regulation.

Methods: Forty-five healthy females prepared a speech (i.e., anticipation) and performed it in front of a camera (i.e., stressor). Actual and ideal self-esteem were measured with the Implicit Relational Assessment Procedure. Anticipatory and reactive autonomic stress regulation were indexed by heart rate variability, and affective responses were assessed via self-report.

Results: Results were in line with predictions based on the NFRE: when ideal self-esteem was low, higher actual self-esteem was associated with higher reactive autonomic regulation, and this association was mediated by higher anticipatory autonomic regulation.

Limitations: Because only female undergraduates were recruited, replication within a more heterogeneous sample is necessary to further generalize these findings.

Conclusions: These results support the hypothesis, based on the NFRE, that actual and ideal self-esteem interact in predicting the relationship between anticipatory and reactive stress regulation, and are a step forward in the understanding of the mechanisms underlying successful stress regulation.
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December 2020

Flexibility as a Mediator between Personality and Well-Being in Older and Younger Adults: Findings from Questionnaire Data and a Behavioral Task.

Exp Aging Res 2020 Oct-Dec;46(5):446-468. Epub 2020 Aug 13.

Department of Experimental Clinical and Health Psychology, Ghent University , Ghent, Belgium.

Background: Personality is a predictor of subjective well-being in older and younger adults, but less is known about the underlying mechanisms. One possible mechanism is psychological flexibility, which is the ability to keep an open mind-set in order to make flexible choices adapted to the situation at hand.

Methods: We recruited 60 younger and 60 older adults and measured personality and well-being by questionnaires. To assess psychological flexibility we used questionnaires and a behavioral task assessing flexibility in information acquisition when making choices.

Results: Based on indirect effect analysis of the questionnaire data, in line with former research, our data show that in both age groups, the relationship between personality and well-being runs through psychological flexibility.

Conclusion: This implies that training psychological flexibility may be a promising approach to increase well-being in both older and younger adults. This effect could not be demonstrated with our choice flexibility task, thus more research is needed to uncover why this could not be measured at the behavioral level.
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http://dx.doi.org/10.1080/0361073X.2020.1805935DOI Listing
January 2021

Effects of HF-rTMS over the left and right DLPFC on proactive and reactive cognitive control.

Soc Cogn Affect Neurosci 2020 Jul 1. Epub 2020 Jul 1.

Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.

Previous research supports the distinction between proactive and reactive control. Although the dorsolateral prefrontal cortex (DLPFC) has been consistently related to these processes, lateralization of proactive and reactive control is still under debate. We manipulated brain activity to investigate the role of the left and right DLPFC in proactive and reactive cognitive control. Using a single-blind, sham-controlled crossover within-subjects design, 25 young healthy females performed the 'AX' Continuous Performance Task after receiving sham versus active High-Frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS) to increase left and right DLPFC activity. RTs and pupillometry were used to assess patterns of proactive and reactive cognitive control and task-related resource allocation respectively. We observed that, compared to sham, HF-rTMS over the left DLPFC increased proactive control. After right DLPFC HF-rTMS, participants showed slower RTs on AX trials, suggesting more reactive control. However, this latter result was not supported by RTs on BX trials (i.e. the trial that specifically assess reactive control). Pupil measures showed a sustained increase in resource allocation after both active left and right HF-rTMS. Our results with RT data provide evidence on the role of the left DLPFC in proactive control and suggest that the right DLPFC is implicated in reactive control.
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http://dx.doi.org/10.1093/scan/nsaa082DOI Listing
July 2020

The effect of HF-rTMS over the left DLPFC on stress regulation as measured by cortisol and heart rate variability.

Horm Behav 2020 08 13;124:104803. Epub 2020 Jun 13.

Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.

The prefrontal cortex, and especially the Dorsolateral Prefrontal Cortex (DLPFC), plays an inhibitory role in the regulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis under stressful situations. Moreover, recent evidence suggests that a sustained DLPFC activation is associated with adaptive stress regulation in anticipation of a stressful event, leading to a reduced stress-induced amygdala response, and facilitating the confrontation with the stressor. However, studies using experimental manipulation of the activity of the DLPFC before a stressor are scarce, and more research is needed to understand the specific role of this brain area in the stress-induced physiological response. This pre-registered study investigated the effect on stress regulation of a single excitatory high frequency (versus sham) repetitive transcranial magnetic stimulation (HF-rTMS) session over the left DLPFC applied before the Trier Social Stress Test in 75 healthy young women (M = 21.05, SD = 2.60). Heart rate variability (HRV) and salivary cortisol were assessed throughout the experimental protocol. The active HF-rTMS and the sham group showed a similar cognitive appraisal of the stress task. No differences in HRV were observed during both the anticipation and the actual confrontation with the stress task and therefore, our results did not reflect DLPFC-related adaptive anticipatory adjustments. Importantly, participants in the active HF-rTMS group showed a lower cortisol response to stress. The effect of left prefrontal HF-rTMS on the stress system provides further critical experimental evidence for the inhibitory role played by the DLPFC in the regulation of the HPA axis.
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August 2020

The link between resting heart rate variability and affective flexibility.

Cogn Affect Behav Neurosci 2020 08;20(4):746-756

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

The neurovisceral integration model aims to account for the complex interplay between physiological, cognitive, and emotion regulation processes through their support by common cortico-subcortical neural circuits. According to the model, vagally mediated heart rate variability (HRV) serves as a peripheral index of the functioning of these circuits, with higher levels of resting HRV reflecting more optimal functioning, to support goal-directed behaviour and adaptability to environmental demands. Although increased cognitive flexibility has been related to higher resting HRV, this has not been assessed in the context of emotional information to examine the interplay between cognition and emotion. Therefore, we investigated (n = 109) the relationship between resting HRV and performance on a task-switching paradigm in which participants shift attention between affective and nonaffective aspects of emotional material. Resting HRV was not associated with flexibility in processing of positive material, but more efficient shifting of attention (greater flexibility) from affective to nonaffective aspects of negative information was related to lower resting HRV. The avoidance theory of worry and anxiety, as well as empirical evidence, links anxiety to attentional avoidance of negative information. Our findings therefore support the neurovisceral integration model such that when greater flexibility can facilitate attentional avoidance of negative information-as seen in anxiety-it is related to lower resting HRV.
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http://dx.doi.org/10.3758/s13415-020-00800-wDOI Listing
August 2020

Mind the social feedback: effects of tDCS applied to the left DLPFC on psychophysiological responses during the anticipation and reception of social evaluations.

Soc Cogn Affect Neurosci 2020 May 13. Epub 2020 May 13.

Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium.

The left dorsolateral prefrontal cortex (lDLPFC) is implicated in anticipatory (i.e. during anticipation of emotional stimuli) and online (i.e. during confrontation with emotional stimuli) emotion regulatory processes. However, research that investigates the causal role of the lDLPFC in these processes is lacking. In this study, 74 participants received active or sham transcranial direct current stimulation (tDCS) over the lDLPFC. Participants were told strangers evaluated them. These (rigged) social evaluations were presented, and in 50% of the trials, participants could anticipate the valence (positive or negative) of the upcoming social feedback. Pupil dilation (a marker of cognitive resource allocation), and skin conductance responses (a marker of arousal) were measured. The results indicate that active (compared to sham) tDCS reduced arousal during the confrontation with anticipated feedback, but only marginally during the confrontation with unanticipated feedback. When participants were given the opportunity to anticipate the social feedback, tDCS reduced arousal, irrespective of whether one was anticipating or being confronted with the anticipated feedback. Moreover, tDCS reduced cognitive resource allocation during anticipation, which was associated with resource allocation increases during the subsequent confrontation. Altogether, results suggest that the lDLPFC is causally implicated in the interplay between anticipatory and online emotion regulatory processes.
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May 2020

Contributions from neuroscience to the practice of Cognitive Behaviour Therapy: Translational psychological science in service of good practice.

Authors:
Rudi De Raedt

Behav Res Ther 2020 02 7;125:103545. Epub 2020 Jan 7.

Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium. Electronic address:

The integration of neuroscience with multiple disciplines dealing with cognition, behavior and contextual influences holds potential to create new avenues for the application of process oriented interventions and guidelines for clinical psychological practice. In this paper, the main avenues by which neuroscience may readily be used for the clinical practice of Cognitive Behavior Therapy (CBT) are outlined: (1) the selection and optimal use of CBT procedures; (2) the combination of CBT with neurocognitive and neurobiological interventions; (3) tailoring CBT to the neurocognitive characteristics of patients; and (4) the use of neuroscience in psychoeducation. This translational view may facilitate multidisciplinary collaboration in case conceptualization. Moreover, it emphasizes that CBT course programs would benefit from neuroscience training and that continued education to keep track with the latest developments in neuroscience are helpful for good CBT practice.
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http://dx.doi.org/10.1016/j.brat.2019.103545DOI Listing
February 2020

Bifrontal tDCS applied to the dorsolateral prefrontal cortex in heavy drinkers: Influence on reward-triggered approach bias and alcohol consumption.

Brain Cogn 2020 02 18;138:105512. Epub 2019 Dec 18.

Department of Head and Skin, Unit of Psychiatry and Medical Psychology, Ghent University, Belgium.

Even though the ventromedial neural network (reward pathway) has been well documented to be a mediator for increased craving, the prefrontal cortex is receiving ever more attention for craving monitoring. In the current study, we examined whether causal modulation of the prefrontal cortex, and its associated neural network, diminishes reward-triggered approach bias (due to increased cognitive control), alcohol craving and consumption. Using a double-blind within-subjects design in a subclinical group of forty-five heavy drinkers, a single sham controlled session of bilateral transcranial direct current stimulation (tDCS) was applied to the dorsolateral prefrontal cortex (DLPFC). Following real and sham tDCS placing the anode over the right and cathode over the left DLPFC, a rewarded Go/NoGo paradigm was administrated to provoke behavioral biases (irrespective of the task goal) After the cognitive paradigm, alcohol consumption was examined using a beer taste test. Bifrontal tDCS resulted in a reduced reward-triggered approach bias and reduced alcohol consumption, but not self-reported craving. Interestingly, reward-triggered approach bias and alcohol consumption were reliably associated in the sham condition, but not in the tDCS condition. Reward-trigged approach biases might be a cognitive mechanism associated with alcohol prone behavior, and the role of the prefrontal network may be significant.
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http://dx.doi.org/10.1016/j.bandc.2019.105512DOI Listing
February 2020

Cortisol response to stress: The role of expectancy and anticipatory stress regulation.

Horm Behav 2020 01 25;117:104587. Epub 2019 Oct 25.

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

An exacerbated physiological response to stress is associated with the development of stress-related disorders (e.g., depression and anxiety disorders). Recently, it has been proposed that individuals with high expectancies of being able to deal with stressful situations will activate regulatory mechanisms during the anticipation of the stressful event that would improve stress regulation. To test this hypothesis, 52 women in young adulthood (M = 21.06; SD = 2.58) anticipated and performed a laboratory-based stress task after receiving positive or negative bogus feedback on their abilities to deal with stressful events. Heart rate variability and salivary cortisol were assessed throughout the experimental protocol. Participants receiving positive bogus feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress. Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response. Our results indicate that people with positive expectancy initiate mechanisms of anticipatory stress regulation that enhance the regulation of the physiological stress response. Expectancy and anticipatory stress regulation may be key mechanisms in the development and treatment of stress-related disorders.
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January 2020
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