REM Sleep Preserves Affective Response to Social Stress-Experimental Study.

Sleep's contribution to affective regulation is insufficiently understood. Previous human research has focused on memorizing or rating affective pictures and less on physiological affective responsivity. This may result in overlapping definitions of affective and declarative memories and inconsistent deductions for how rapid eye movement sleep (REMS) and slow-wave sleep (SWS) are involved. Literature associates REMS theta (4-8 Hz) activity with emotional memory processing, but its contribution to social stress habituation is unknown. Applying selective sleep stage suppression and oscillatory analyses, we investigated how sleep modulated affective adaptation toward social stress and retention of neutral declarative memories. Native Finnish participants (N = 29; age, M = 25.8 years) were allocated to REMS or SWS suppression conditions. We measured physiological (skin conductance response, SCR) and subjective stress response and declarative memory retrieval thrice: before laboratory night, the next morning, and after 3 d. Linear mixed models were applied to test the effects of condition and sleep parameters on emotional responsivity and memory retrieval. Greater overnight increase in SCR toward the stressor emerged after suppressed SWS (intact REMS) relative to suppressed REMS (20.1% vs 6.1%; p = 0.016). The overnight SCR increase was positively associated with accumulated REMS theta energy irrespective of the condition (r = 0.601; p = 0.002). Subjectively rated affective response and declarative memory recall were comparable between the conditions. The contributions of REMS and SWS to habituation of social stress are distinct. REMS theta activity proposedly facilitates the consolidation of autonomic affective responses. Declarative memory consolidation may not have greater dependence on intact SWS relative to intact REMS.

Differential modulation of resting-state functional connectivity between amygdala and precuneus after acute physical exertion of varying intensity: indications for a role in affective regulation.

Introduction: Physical activity influences psychological well-being. This study aimed to determine the impact of exercise intensity on psychological well-being and alterations in emotion-related brain functional connectivity (FC). Methods: Twenty young, healthy, trained athletes performed a low- and high-intensity interval exercise (LIIE and HIIE) as well as a control condition in a within-subject crossover design. Before and after each condition, Positive And Negative Affect Scale (PANAS) was assessed as well as resting-state functional MRI (rs-fMRI). Voxel-wise FC was examined for bilateral amygdala seed region to whole-brain and emotion-related anatomical regions (e.g., insula, temporal pole, precuneus). Data analyses were performed using linear mixed-effect models with fixed factors condition and time. Results: The PANAS Positive Affect scale showed a significant increase after LIIE and HIIE and a significant reduction in Negative Affect after the control condition. In rs-fMRI, no significant condition-by-time interactions were observed between the amygdala and whole brain. Amygdala-precuneus FC analysis showed an interaction effect, suggesting reduced post-exercise anticorrelation after the control condition, but stable, or even slightly enhanced anticorrelation for the exercise conditions, especially HIIE. Discussion: In conclusion, both LIIE and HIIE had positive effects on mood and concomitant effects on amygdala-precuneus FC, particularly after HIIE. Although no significant correlations were found between amygdala-precuneus FC and PANAS, results should be discussed in the context of affective disorders in whom abnormal amygdala-precuneus FC has been observed.

What's in the mind's eye of individuals with bipolar disorders: an exploration of the content and characteristics of mental images in different thymic phases.

BACKGROUND: Mental imagery, or 'seeing with the mind's eye' (Kosslyn et al. ), provokes strong emotional responses (Ji et al., ). To date, there is a lack of data on the content and clinical characteristics (e.g. vividness, likelihood, emotional effects) of spontaneous mental images (MI) in people with bipolar disorder (BD) according to their thymic states. AIM: The current study sought to assess the characteristics associated with the contents of MI in people with BD. METHOD: Forty-two euthymic individuals diagnosed with BD (American Psychiatric Association, ) were asked to self-report their MI during depression, (hypo)mania and euthymia. Participants also rated levels of vividness, likelihood and emotional activation related to MI (i.e. valence, arousal, type of emotion). RESULTS: The contents of the MI revealed phenomenological aspects of BD. Different themes were associated with each thymic phase. In (hypo)mania and in euthymia, the mental images were assessed as being as vivid as probable (p>.05). (Hypo)manic and euthymic-related MI activated more pleasure than displeasure (p<.001) and were mainly associated with joy. In depression, MI were assessed as more vivid than likely (p<.05). In depression, MI activated more displeasure than pleasure (p<.0001) and induced mainly sadness. DISCUSSION: Overall, a congruence between the contents of images and the three thymic phases was found. The content of the MI was related to self-reported emotional effects that were congruent with the thymic phases concerned. The results add new clinical information for the use of imagery-based cognitive therapy in individuals with BD.

Neurofeedback as neuroempowerment technique for affective regulation and interoceptive awareness in adolescence: preliminary considerations applied to a psychogenic pseudosyncope case.

Revisions of classical models of acute stress response spectrum and defence cascade process might represent a valuable background for the interpretation of the link between affective reactions, traumatic experiences, and Psychogenic pseudosyncope (PPS) events in childhood and across the lifespan. Indeed, associations between subjective emotional life, early exposure to distressing and/or traumatic events, and PPS have fuelled a debate on potential causes of occurrence and recurrence of such a peculiar clinical manifestation. At the same time, such background suggests that empowering stress management and affective regulation skills could be the target for neurorehabilitation interventions aiming at reducing the severity of symptomatology and/or improving awareness and management of pseudosyncopal spells. Specifically, neuro/biofeedback-based empowerment of self-regulation skills, associated to an increased interoceptive increased awareness, could be a promising complement to classical psychological therapies. Starting from the presentation of a paediatric PPS clinical case, the present work discusses the relevance of assessing affective appraisal and autonomic reactivity in individuals suffering from PPS episodes and introduces a novel potential neuroempowerment protocol aimed at improving self-regulation and stress management skills in adolescence based on a combined neurofeedback and embodied-awareness intervention. By capitalizing available evidence of the effects of neuromodulation and embodied practices on self-awareness/regulation across the life-span, the proposed protocol is based on neurofeedback-supported affective management training, as well as both contemplative and informal awareness exercises devised to be appealing and challenging even for younger patients.

Rol de la oxitocina en patología psiquiátrica / Role of oxytocin in psychiatric pathology

Oxytocin is a neuropeptide that in mammals has important functions on different reproductive stages and socialization behaviors. In humans, its importance has been recognized in processes of social regulation such as social memory, affiliation, mentality and empathy. The objective of this work is to perform an updated review of the evidence about the role of oxytocin in psychiatric disorders. A bibliographic search was carried out on this topic through the Medline / PubMed and SciELO databases. The results show evidence on the possible etiopathogenic role of oxytocin in different clinical conditions. In addition, research has sought answers in this hormone to understand the different symptomatic profiles, such as emotional regulation, the recognition of emotions, the capacity for mentalization and the response to stress, which could operate as targets for possible therapeutic uses of oxytocin. Although the data are still incipient and inconclusive, oxytocin has been positioned as an important focus of neurobiological and therapeutic study in psychiatry for future research.

Rorschach Evaluation of Personality and Emotional Characteristics in Adolescents With Migraine Versus Epilepsy and Controls.

The literature examining primary headache, including migraine, in adolescents, has pointed out the key role played by a wide range of psychiatric disorders in reducing the patients' quality of life. Moreover, pioneering studies showed that preexisting personality characteristics, specific emotion regulation styles and psychological-psychiatric difficulties are likely to increase the risk of the onset, maintenance, and outcome of headache. Still personality issues in migraine have been poorly studied, in particular in children and adolescents. This study aims, therefore, to investigate the specific characteristics of personality, and in particular emotion regulation and coping strategies, in adolescent with migraine, comparing them with age-matched patients with idiopathic epilepsy and healthy adolescents. 52 adolescents (age: 11-17) were assessed using a multi-method test battery, which included a self-report questionnaire (the youth self-report), a proxy-report (child behavior checklist) along with a projective personality test, the Rorschach Test, administered and scored according to the Exner comprehensive system. The results showed specific personality characteristics in adolescents with migraine, revealing a marked difficulty in modulating and regulating affections through thoughts and reflections, resorting instead to impulsive acts and maladaptive coping strategies, thus revealing a vague and immature perception of reality. Differently from adolescents belonging to the general population, but similarly to patients with epilepsy, adolescents with migraine perceive a high situational stress, probably related to the condition of suffering from chronic disease. They have, therefore, a lower self-consideration and self-esteem along with a poorer insight regarding themselves as well as the relations with others. In line with previous findings, these preliminary results suggest the need for further research on ample samples, using also standardized projective test in order to better understand the pathogenesis of psychological difficulties in patients with migraine. As a clinical implication, the results seem to indicate that providing a psychological integrated approach can play a pivotal role in the assessment and treatment of adolescent with migraine, in order to improve the outcome and the quality of life of the young patients.

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem.

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain accompanied by symptoms like depression, anxiety, sleep disturbance and fatigue. In addition, affected patients frequently report cognitive disruption such as forgetfulness, concentration difficulties or mental slowness. Though cognitive deficits in FMS have been confirmed in various studies, not much is known about the mechanisms involved in their origin. This study aimed to investigate the contribution of affect-related variables to cognitive impairments in FMS. For this purpose, 67 female FMS patients and 32 healthy control subjects completed a battery of cognitive tests measuring processing speed, attention, visuospatial and verbal memory, cognitive flexibility and planning abilities. In addition, participants completed self-report questionnaires pertaining to positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Clinical characteristics including pain severity, symptoms of depression and anxiety, insomnia and fatigue were also assessed. FMS patients showed markedly poorer performance than healthy controls in all of the cognitive domains assessed, in addition to greater levels of depression, anxiety, negative affect, alexithymia and pain catastrophizing, and lower self-esteem and positive affect. In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances form a crucial aspect of FMS pathology, whereas strategies aiming to improve emotional regulation may be a beneficial element of psychological therapy in the management of FMS.

Latent classes of trait affect and cognitive affective regulation strategies are associated with depression, non-suicidal self-injury, and well-being.

BACKGROUND: The present study sought to better understand the unique profiles of late adolescents' affective functioning by exploring patterns of trait affect and cognitive affective regulation strategies. The study also examined whether these unique profiles significantly predicted depressive symptoms, non-suicidal self-injury (NSSI), and well-being outcomes. METHODS: Data from a sample of 590 late adolescents were examined (M = 19.14 years, SD = 1.41, 63% Female, 62% Caucasian, 38% African American/Biracial). Participants were followed for an average of 14 months (SD = 2.53) and completed measures of trait affect, cognitive affective regulation, depression, NSSI, and well-being. Data were examined using latent class analysis. RESULTS: Five subgroups with unique patterns of affective functioning were identified. Late adolescents who reported above average levels of negative affect, dampening of positive affect, brooding, and reflection, coupled with below average levels of positive affect and positive rumination, were more likely to report having higher levels of depressive symptoms and greater engagement in NSSI during the one-year period prior to baseline. Similarly, the late adolescents fitting this profile also reported lower levels of well-being and were more likely to report engaging in NSSI at the follow-up. LIMITATIONS: Limitations include a narrow exploration of affective regulation strategies and the addition of key variables after the initiation of the larger study. CONCLUSIONS: These findings shed light on affective regulation factors relevant to the experience of depressive symptoms and NSSI, and the promotion of well-being.

Estudio longitudinal observacional sobre los procesos de regulación afectiva y simbolización a partir de interacciones lúdicas madre-bebé y madre-niño preescolar / Longitudinal observational study of affective regulation and symbolization in mother infant interactions and mother and preschool children

En esta comunicación presentamos algunos resultados y reflexiones provenientes de un programa de investigación longitudinal (acreditado con subsidio por UBACyT y la Asociación Psicoanalítica Internacional, IPA), acerca de la relación entre la Regulación Afectiva madre-niño, la Autorregulación de los infantes, el Funcionamiento Reflexivo y los Estilos Maternos de interacción y procesos de simbolización en los primeros 5 años de vida. 48 madres y sus bebés sanos (de 6 meses de edad) fueron filmados en situaciones de juego interactivo. Cuando los mismos niños tenían 4-5 años, 21 de las madres fueron entrevistadas con la Entrevista de Desarrollo Parental en la cual se evaluó el Funcionamiento Reflexivo Parental (Slade y otros, 2005) y 17 díadas fueron filmadas en una interacción de juego libre. Se presentarán instrumentos y resultados obtenidos a partir de la codificación microanalítica del despliegue lúdico madre-niño. A los 6 meses los resultados apuntan a estudiar la regulación diádica y la autorregulación que va logrando el bebé y los posibles indicadores de retraimiento. A los 4-5 años de los niños, encontramos una relación entre el nivel simbólico observado en el niño durante las interacciones lúdicas madre-niño y el modo interactivo convergente, el nivel de funcionamiento reflexivo parental y el estilo materno interactivo facilitante.

In this communication results and reflections are presented from a longitudinal research program (funded by University of Buenos Aires and the International Psychoanalytic Association, IPA), about the relationship between Affective Mother-Child Regulation, Infant Self-Regulation, Reflective Function and Maternal Styles of interaction and processes of symbolization in the first 5 years of life. 48 mothers and their healthy babies (6 months of age) were filmed in interactive play situations. When the same children were 4-5 years old, 21 of the mothers were interviewed with the Parental Development Interview in which Parental Reflective Function was evaluated (Slade et al., 2005) and 17 dyads were filmed in a free play interaction. We will present measurements and results obtained from the micro-analytic coding of the mother-child interactive play situations. At 6 months the results showed relationships betwee dyadic affective regulation and infant self-regulation and the possible signs of withdrawal. At 4-5 years of age, we found a relationship between the convergent interactive mode, the level of parental reflective functioning, the facilitating interactive maternal style on the one hand, and the symbolic level observed in the child during mother-child play interactions.

Affective and Cognitive Conditions are Stronger Predictors of Success with Community Reintegration than Gait and Balance Performance in Veterans with Mild Traumatic Brain Injury.

INTRODUCTION: Optimal community reintegration is an integral part of the clinical management of patients with mild traumatic brain injury. BACKGROUND/OBJECTIVE: We sought the contribution and inter-relation of such variables as balance, executive function, and affective regulation to the community reintegration of veterans with mTBI. METHODS: We examined the statistical relationship among the above variables by conducting a series of objective evaluations to assess the balance, gait, executive function, affective regulation, and scores representing the patients' issues with community reintegration. The data were statistically analyzed for correlation and regression. RESULTS: High correlation was found among scores for balance and gait, executive function and affective regulation. The first and second best predictors of success with patient's community reintegration were data representing affective regulation and cognitive impairments, respectively. However, the data for dynamic balance correlated weakly and insignificantly with scores for the three subsets of community reintegration. CONCLUSIONS: We revealed varying degrees of correlation among balance, executive function and affective regulation, and as they related to the community reintegration success of patients with mTBI. The strongest, intermediate and weakest predictors for these patients' success with community reintegration represented those for affective regulation, executive function, and dynamic balance and gait performance, respectively.

Affective regulation in trichotillomania before and after self-help interventions.

OBJECTIVE: Trichotillomania (TTM) is characterized by recurrent hair-pulling behaviours that cause significant distress. Deficits in affective regulation have been reported in individuals with TTM. We aimed to investigate temporal stability of affective regulation in TTM individuals. METHODS: Eighty-one TTM individuals underwent an online intervention. Affective Regulation Scale (ARS), Massachusetts General Hospital Hair-Pulling Scale (MGH-HPS), and Beck Depression Inventory (BDI) scores were obtained at baseline, post-treatment (4 weeks), and follow-up (6 months). We examined the effect of phenotypes including hair-pulling severity and depressive symptoms on absolute and relative stability of affective regulation over time, using multiple linear and hierarchical regression analyses. RESULTS: The ARS total-score from the present TTM sample was significantly lower than the score from non-hair pullers (p < 0.001). ARS total-scores inversely correlated with the MGH-HPS total-scores at baseline (p = 0.001) and post-treatment (p = 0.02), and with BDI total-scores at all time-points (p < 0.001). Although ARS total-scores significantly increased, all ARS sub-scores, except guilt sub-scores, did not change over time, indicating absolute stability. Baseline ARS total-, and sub-scores (except tension) were found to predict their ARS follow-up scores (all p < 0.01), confirming relative stability (i.e., the extent to which the inter-individual differences remained the same over time). The relative stability of ARS total-scores and all but two sub-scores (irritability and guilt) were independent from BDI baseline scores. CONCLUSIONS: Individuals with TTM reported deficits in affective regulation that demonstrated mostly high relative stability and partly absolute stability. Therefore, targeting to improve affective regulation in individuals with TTM during therapy is warranted.

Triadic Interactions in Families of Adolescents with Anorexia Nervosa and Families of Adolescents with Internalizing Disorders.

The latest studies and practice guidelines for the treatment of adolescent patients with anorexia nervosa agree in pointing out the key role played by parents in determining the young patients' therapeutic possibilities and outcomes. Still family functioning has usually been studied using only self-reported instruments. The aim of the present study is therefore to investigate the triadic interactions within the families of adolescents with anorexia nervosa using a semi-standardized observational tool based on a recorded play session, the Lausanne Trilogue Play (LTP). Parents and adolescent daughters, consecutively referred to adolescent neuropsychiatric services, participated in the study and underwent the observational procedure (LTP). The 20 families of adolescent girls with anorexia nervosa (restricting type) were compared with 20 families of patients with internalizing disorders (anxiety and depression). The results showed different interactive patterns in the families of adolescents with anorexia nervosa: they had greater difficulties in respecting roles during the play, maintaining the joint attention and in sharing positive affect, especially in the three-together phase (third phase). The majority of these families (12) exhibited collusive alliances. The parental subsystem appeared frequently unable to maintain a structuring role, i.e., providing help, support and guidance to the daughters, while the girls in turn often found it hard to show independent ideas and develop personal projects. Parents experienced difficulty in carving out a couple-specific relational space, from which the ill daughter was at least temporarily excluded also when they were asked to continue to interact with each other, letting the daughter be simply present in a third-part position (fourth phase). The study of the triadic interactions in the families of adolescents with anorexia nervosa may help to shift the attention from the exclusive mother-daughter relation to the involvement of the father, and of the parental couple as a whole. The family functioning is in fact well established as a maintaining factor of anorexia nervosa or vice versa as a facilitating factor in the therapeutic process.

The cerebellum: its role in language and related cognitive and affective functions.

The traditional view on the cerebellum as the sole coordinator of motor function has been substantially redefined during the past decades. Neuroanatomical, neuroimaging and clinical studies have extended the role of the cerebellum to the modulation of cognitive and affective processing. Neuroanatomical studies have demonstrated cerebellar connectivity with the supratentorial association areas involved in higher cognitive and affective functioning, while functional neuroimaging and clinical studies have provided evidence of cerebellar involvement in a variety of cognitive and affective tasks. This paper reviews the recently acknowledged role of the cerebellum in linguistic and related cognitive and behavioral-affective functions. In addition, typical cerebellar syndromes such as the cerebellar cognitive affective syndrome (CCAS) and the posterior fossa syndrome (PFS) will be briefly discussed and the current hypotheses dealing with the presumed neurobiological mechanisms underlying the linguistic, cognitive and affective modulatory role of the cerebellum will be reviewed.

Measuring self-regulation in a physically active context: Psychometric analyses of scores derived from an observer-rated measure of self-regulation.

The purpose of this study is to report psychometric properties of scores obtained using a novel observer-rated measure of children's self-regulation, the Response to Challenge Scale (RCS). The RCS was developed to rate children's self-regulatory abilities in a physically active context (e.g., while completing a physical challenge course). The RCS and other study measures were administered in a private school sample of 207 children. Analyses of score distributions indicated that the RCS was able to capture variance among children in self-regulatory abilities; the distribution was normal for the Affective, Cognitive, and Total Self-Regulation scales. Validity analyses revealed significant positive correlations between Cognitive, Affective, Motor, and Total Self-Regulation and executive function task performance; significant negative correlations between Cognitive Regulation and teacher-rated hyperactivity and inattention; significant negative correlations between Affective, Motor, and Total Self-Regulation and teacher ratings of peer problems; and significant positive correlations between Cognitive and Affective Regulation and parent ratings of prosocial behavior. Parent and teacher rated Total Difficulties scores were both negatively correlated with RCS Total Self-Regulation scores. Results suggest that it is possible for observers to rate self-regulatory abilities in the context of physical activities, and that these ratings correspond with performance on tasks requiring executive function as well as teacher and parent ratings of children's difficulties.

Los inicios del juego en la primera infancia y su relación con la regulación afectiva diádica y la autorregulación de los infantes / The beginnings of play in infancy and its relation with dyadic affective regulation and the infant self-regulation

Presentamos un programa de investigación longitudinal sobre 48 díadas madre-niño a los 6 meses y un seguimiento de 24 de las mismas a los 4/5 años que estudia el pasaje de la regulación afectiva diádica a la autorregulación en los niños (UBACyT P806). Se incluye una revisión teórica sobre la función del juego en la estructuración psíquica. El microanálisis de la interacción a los 6 meses mostró diferencias muy marcadas entre interacción cara a cara y juego libre con juguetes en cuanto a los recursos de autorregulación afectiva de los infantes. Se encontró, también una relación entre las variables de autoestima y funcionamiento reflexivo de las madres y las conductas de exploración lúdica con juguetes observada en los infantes. Estos resultados resaltan el lugar del juego con objetos como mediatizador en el logro de la transición de la regulación afectiva diádica a la autorregulación afectiva.

The present program is a follow up research on 48 mother-infant dyads studied when the infants were 6 months old and 24 of the same sample were studied at 4/5 years old about the transition between dyadic affective regulation and infant affective self regulation (UBACyT P806). A theoretical revision on the role of play in psychic development is included. Microanalysis showed differences between face to face interaction and free play interaction at 6 months regarding infant's self-regulatory resources. We also found a relationship between the variables maternal self esteem and reflective function in the mothers, and the exploratory play behaviors observed in the infants. These results underscore the role of play with toys as mediating factor in the transition from dyadic affect regulation to affective self-regulation.

Los inicios del juego en la primera infancia y su relación con la regulación afectiva diádica y la autorregulación de los infantes / The beginnings of play in infancy and its relation with dyadic affective regulation and the infant self-regulation

Presentamos un programa de investigación longitudinal sobre 48 díadas madre-niño a los 6 meses y un seguimiento de 24 de las mismas a los 4/5 años que estudia el pasaje de la regulación afectiva diádica a la autorregulación en los niños (UBACyT P806). Se incluye una revisión teórica sobre la función del juego en la estructuración psíquica. El microanálisis de la interacción a los 6 meses mostró diferencias muy marcadas entre interacción cara a cara y juego libre con juguetes en cuanto a los recursos de autorregulación afectiva de los infantes. Se encontró, también una relación entre las variables de autoestima y funcionamiento reflexivo de las madres y las conductas de exploración lúdica con juguetes observada en los infantes. Estos resultados resaltan el lugar del juego con objetos como mediatizador en el logro de la transición de la regulación afectiva diádica a la autorregulación afectiva.

The present program is a follow up research on 48 mother-infant dyads studied when the infants were 6 months old and 24 of the same sample were studied at 4/5 years old about the transition between dyadic affective regulation and infant affective self regulation (UBACyT P806). A theoretical revision of the role of play in psychic development is included. Microanalysis showed differences between face to face interaction and free play interaction at 6 months regarding infant's self-regulatory resources. We also found a relationship between maternal self esteem and reflective function in the mothers, and the exploratory play behaviors observed in the infants. These results underscore the role of play with toys as mediating factor in the transition from dyadic affect regulation to affective self-regulation.