Intolerance of uncertainty and neural measures of anticipation and reactivity for affective stimuli.

Intolerance of uncertainty (IU) is a transdiagnostic construct referring to the aversive interpretation of contexts characterized by uncertainty. Indeed, there is a growing body of research examining individual differences in IU and how these are associated with emotional anticipation and reactivity during periods of certainty and uncertainty, however, how these associations are reflected via neurophysiological indices remain understudied and poorly understood. The present study examined the relationship between self-reported IU and neurophysiological measures of emotional anticipation and reactivity, namely stimulus preceding negativity (SPN) and late positive potential (LPP), and self-report measures of emotional experiences. These measures were captured during an S1-S2 picture viewing tasks in which participants were presented with cues (S1) that either indicated the affective valence of upcoming picture (S2) or provided no information about the valence. Findings here provide evidence for significant associations between SPN amplitude and IU scores during uncertain and certain-positive cueing conditions, and significant associations between LPP amplitude and IU scores during both certain- and uncertain-negative picture viewing conditions that appear driven by prospective IU sub-scores. These positive associations between IU and SPN amplitude are suggestive of heightened emotional anticipation following S1 cues, while positive associations between IU and LPP are suggestive of heightened emotional reactivity following S2 images. These findings are discussed in detail relative to existing IU literature, and potential implications of these findings.

Effects of prepulse format and lead interval on the assessment of automatic and attention-modulated prepulse inhibition.

Prepulse inhibition (PPI) of the acoustic startle response can index automatic and attention-modulated aspects of sensorimotor gating. Automatic sensorimotor gating is typically assessed by a no-task PPI protocol in which participants are presented with discrete white noise prepulse and startle stimuli over continuous background broadband noise at brief short-lead intervals (e.g., 60-120 ms). In contrast, attention-modulated sensorimotor gating is typically assessed through a task-based PPI protocol using continuous format pure tone prepulses and white noise startle stimuli presented over an ambient background at a lead interval of 120 ms. The present study sought to test the extent that the assessment of attention-modulated PPI is dependent on prepulse type and lead interval across two experiments. Experiment 1 assessed attention effects on PPI produced by discrete prepulses at lead intervals of 60 and 120 ms. Experiment 2 examined attention effects on PPI with matched stimulus conditions apart from continuous prepulses. Results indicated that the use of discrete prepulses failed to elicit attentional-modulation of PPI and that assessment therein was dependent on the use of continuous prepulses at a lead interval of 120 ms. These results highlight additional methods to concurrently assess automatic and attention-modulated PPI in a single testing session using a task-based tone counting task.

Attention allocation to subliminally presented affective faces in high and low social anxiety.

Attention bias to affective stimuli, particularly threatening stimuli, has been well documented, with attention bias to affective faces often reported in populations with social anxiety (SA). However, inconsistencies exist in the literature regarding the direction of the bias, with some studies reporting a bias to attend toward social threat, and others reporting a bias to avoid social threat. This variability in the attention bias literature could be related to fluctuations in how attentional resources are allocated toward social stimuli over time. This study aimed to isolate early processing of affective faces using a backward masking paradigm in participants with high and low levels of subclinical SA. We used prepulse inhibition (PPI) of startle to index the amount of early attention allocated to masked affective faces. There was greater PPI to masked angry faces compared to neutral faces across all participants, suggesting that more attention was allocated to threatening faces. This effect was similar across face genders and participant SA levels. There was also a trend for more attention to be allocated to masked affective faces (angry and happy) compared to neutral faces across all participants. These findings demonstrate that attention bias to subliminal affect, and threat specifically, may not be modulated by subclinical levels of SA at very early stages of attention processing.

Flashing a smile: Startle eyeblink modulation by masked affective faces.

Affective faces are important stimuli with relevance to healthy and abnormal social and affective information processing. The aim of this study was to investigate the effect of brief presentations of affective faces on attention and emotional state across the time course of stimulus processing, as indexed by startle eyeblink response modulation. Healthy adults were presented with happy, neutral, and disgusted male and female faces that were backward masked by neutral faces. Startle responses were elicited at 300, 800, and 3,500 ms following stimulus presentation to probe early and late startle eyeblink modulation, indicative of attention allocation and emotional state, respectively. Results revealed that, at 300 ms, both face expression and face gender modulated startle eyeblink response, suggesting that more attention was allocated to masked happy compared to disgusted female faces, and masked disgusted compared to neutral male faces. There were no effects of either face expression or face gender on startle modulation at 800 ms. At 3,500 ms, target face expression did not modulate startle, but male faces elicited larger startle responses than female faces, indicative of a more negative emotional state. These findings provide a systematic investigation of attention and emotion modulation by brief affective faces across the time course of stimulus processing.

The effects of multiphasic prepulses on automatic and attention-modulated prepulse inhibition.

Prepulse inhibition (PPI) is widely viewed as an operational measure of sensorimotor gating. Previous research has shown that sensorimotor gating can occur automatically and also can be influenced by selective attention. The present research investigated the relationship of the transient detection response (TDR) with automatic and attention-modulated PPI using a novel "multiphasic" prepulse stimulus. Experiment 1 compared discrete versus multiphasic prepulse types in a no-task PPI protocol to validate multiphasic prepulses as effective elicitors of automatic sensorimotor gating. Results revealed that the two prepulse types elicited equivalent levels of PPI. Experiment 2 compared the effectiveness of continuous monophasic versus continuous multiphasic prepulses within a task-based PPI protocol using a lead interval of 120 ms. Results revealed a significant attention effect for monophasic prepulses only. However, robust PPI was produced by the multiphasic prepulses independent of attention as well as over time. These results suggest that multiple influences on PPI can be assessed concurrently depending on prepulse parameters designed to activate the TDR when used in a PPI protocol capable of assessing the effects of selective attention on prepulse processing [corrected]

Anterior cingulate cortex involvement in subclinical social anxiety.

We demonstrated differential activation in the anterior cingulate cortex (ACC) between subjects with high and low social anxiety in response to angry versus neutral faces. Activation in the ACC distinguished between facial expressions in the low, but not the high, anxious group. The ACC's role in threat processing is discussed.

The time course of face processing: startle eyeblink response modulation by face gender and expression.

The purpose of this study was to investigate the effects of both facial expression and face gender on startle eyeblink response patterns at varying lead intervals (300, 800, and 3500ms) indicative of attentional and emotional processes. We aimed to determine whether responses to affective faces map onto the Defense Cascade Model (Lang et al., 1997) to better understand the stages of processing during affective face viewing. At 300ms, there was an interaction between face expression and face gender with female happy and neutral faces and male angry faces producing inhibited startle. At 3500ms, there was a trend for facilitated startle during angry compared to neutral faces. These findings suggest that affective expressions are perceived differently in male and female faces, especially at short lead intervals. Future studies investigating face processing should take both face gender and expression into account.

Publication recommendations for electrodermal measurements.

This committee was appointed by the SPR Board to provide recommendations for publishing data on electrodermal activity (EDA). They are intended to be a stand-alone source for newcomers and experienced users. A short outline of principles for electrodermal measurement is given, and recommendations from an earlier report (Fowles et al., ) are incorporated. Three fundamental techniques of EDA recording are described: (1) endosomatic recording without the application of an external current, (2) exosomatic recording with direct current (the most widely applied methodology), and (3) exosomatic recording with alternating current-to date infrequently used but a promising future methodology. In addition to EDA recording in laboratories, ambulatory recording has become an emerging technique. Specific problems that come with this recording of EDA in the field are discussed, as are those emerging from recording EDA within a magnetic field (e.g., fMRI). Recommendations for the details that should be mentioned in publications of EDA methods and results are provided.

Self-report and startle-based measures of emotional reactions to body image cues as predictors of Drive for Thinness and Body Dissatisfaction in female college students.

The purpose was to compare self-report and psychophysiological assessment techniques in the measurement of emotional response to body image cues. Female college students (n=53; % Caucasian=53.6; M body mass index=26.1 kg/m²) completed the Eating Disorder Inventory (EDI-3) and viewed photos of themselves both unaltered and morphed to simulate weight gain. Response to the photos was assessed by self-report and the affect modulated startle paradigm. EDI-3 Drive for Thinness (DT) and Body Dissatisfaction (BD) scale scores were correlated with startled amplitude for the largest simulated weight gain photo. Startle eye blink amplitude predicted more variance in DT and BD subscales than self-reported response to the image. The affect modulated startle paradigm may provide unique information in the assessment of eating disorder symptomatology that cannot be captured via self-report techniques, and has potential to inform evaluation of treatment outcomes of eating and body image disorders.

Startle as an objective measure of distress related to teasing and body image.

OBJECTIVE: The startle reflex was used to assess negative emotion in response to body image cues in persons with and without body-related teasing histories. METHOD: Fifty-three female college students viewed photos of themselves both unaltered and morphed to look heavier and thinner. Participants with a teasing history were compared to participants without a teasing history on self-report measures and the affect modulated startle paradigm when viewing the photos. RESULTS: All participants, regardless of teasing history, self-reported that the photo morphed to look heaviest was more unpleasant than the neutral photo. When assessed by the affect modulated startle paradigm, a significant teasing history by photo interaction was found between the neutral and morphed to look heaviest photos and the neutral and morphed to look smallest photo. Those with a teasing history had greater startle response to the morphed images in comparison to the neutral images than did those without a teasing history. DISCUSSION: College-aged women with weight-related teasing histories may have negative emotional reactions to personally relevant body image cues, as measured by the startle reflex, even when they subjectively report no distress. Objective measures, such as the startle reflex should be considered when assessing emotional reactions to body image cues.

Documenting a transfusion: how well is it done?

BACKGROUND: Current practice in transfusion medicine promotes clear documentation of transfusion-related events including the fact that the patient has been informed of the related risks and benefits. STUDY DESIGN AND METHODS: A retrospective review of 1005 patient charts was carried out to determine documentation. RESULTS: Most patients were from general surgery (10.8%) and cardiac surgery (14.1%). In 75 percent of cases the physician had not documented that any discussion had occurred regarding the risks and/or benefits or alternatives. Only 12 percent of charts included information that the patient was subsequently told what blood components were given to them. The discharge summary recorded transfusion information in 32.1 percent of cases whereas the consult note had this information in 26.3 percent. Chart records matched the transfusion medicine records in 60.6 percent of cases. The most common error was in the blood unit identification number. CONCLUSIONS: While accepted in theory, the practice of documenting patient information on transfusion is not well done.

Task switching after stroke.

BACKGROUND AND PURPOSE: Task switching is a cognitive skill that may be compromised after brain damage. The purposes of this study were to examine task-switching abilities in the subacute phase after stroke, to determine whether a switching task under endogenous or internal control is more difficult than a switching task under exogenous or cued control, and to determine whether deficits in switching attenuate in the first few months after stroke. SUBJECTS: The participants in this study were 46 adults with stroke and 38 adults without stroke. METHODS: Subjects performed 2 computer-based switching tasks, an alternating task that relied on endogenous control and a cued task that relied on exogenous control. Testing was done in subjects' homes at 1 and 3 months after stroke and at a 2-month interval for control subjects. Switch costs, or the difference between the no-switch condition and the switch condition, were calculated for accuracy and response time. RESULTS: Subjects in the stroke group had higher switch costs for accuracy than did subjects in the control group. The alternating task was more difficult than the cued task, with higher switch costs for accuracy and response time. The alternating task was particularly difficult for subjects in the stroke group, with high switch costs for accuracy. Both groups showed decreased response time switch costs at the second testing session. DISCUSSION AND CONCLUSION: Task switching, particularly if under endogenous control, is impaired in adults in the subacute phase after stroke. Clinicians should be aware of performance deficits that may relate to task switching.

Infrared reflectance as an alternative to EMG for measuring prepulse inhibition of startle eyeblink.

The "gold standard" measure of the human startle eyeblink response is the ocular electromyogram (EMG). However, EMG measurement is not always feasible, as with special populations or during functional neuroimaging. We evaluated an alternative, nonelectrical, noncontact measure that uses infrared (IR) light reflected from the eye. By simultaneously recording IR and EMG during an acoustic prepulse inhibition of startle paradigm, we were able to directly compare the two measures and evaluate the relative reliability and validity of the IR measure as an index of startle response modulation. Although fewer responses were detected using IR than EMG, both measures were equally sensitive to prepulse modulation of response amplitude, latency, and probability. We conclude that when the goal is simply to assess the effects of a prepulse on the startle response, IR reflectance is an adequate alternative to EMG.

Committee report: Guidelines for human startle eyeblink electromyographic studies.

The human startle response is a sensitive, noninvasive measure of central nervous system activity that is currently used in a wide variety of research and clinical settings. In this article, we raise methodological issues and present recommendations for optimal methods of startle blink electromyographic (EMG) response elicitation, recording, quantification, and reporting. It is hoped that this report will foster more methodological validity and reliability in research using the startle response, as well as increase the detail with which relevant methodology is reported in publications using this measure.

Selective and nonselective attention effects on prepulse inhibition of startle: a comparison of task and no-task protocols.

The effects of selective and nonselective attentional processes on prepulse inhibition (PPI) of the acoustic startle response were examined by assessing PPI under intermixed task and no-task conditions. Results for the task condition revealed that greater PPI was produced by an attended than an ignored prepulse at a lead interval of 120 ms (marginally significant in the early trial block and significant in the late trial block), indicating an effect of selective attention at this lead interval. Comparisons between the task and no-task conditions revealed significantly greater PPI in the task than no-task condition at a 60-ms lead interval, during early and late trial blocks, indicating a nonselective attention effect at this lead interval. Overall, these results suggest that PPI is sensitive to selective and nonselective attentional influences and indicate that task and no-task PPI protocols reveal unique aspects of sensorimotor gating ability.

Effects of practice and unpredictable distractors on planning and executing aiming after stroke.

The primary purpose of this study was to examine practice effects on the planning and execution of an aiming movement after right versus left stroke. A secondary purpose was to investigate the effects of a distractor that appeared randomly on motor performance after stroke. Right-hand dominant individuals, 15 with right stroke (right-sided brain damage), 16 with left stroke, and 30 without stroke, performed aiming movements to targets. Those with stroke used the ipsilesional upper extremity (UE). Right and left comparison groups used the right and left UE, respectively. Reaction time (RT) and movement time (MT) were collected to represent movement planning and execution, respectively. Individuals with right stroke improved RT with practice. Individuals with left stroke did not improve RT with practice and made more errors than their comparison group. Those with left stroke achieved faster MT with practice, but MT remained slower than their comparison group. There were no effects of the distractor on RT or MT. Adults with left stroke have persistent deficits in movement planning and execution. Further studies are needed to determine how the performance of older adults, with or without stroke, is affected by an unpredictable visual distractor.

Attentional abilities and functional outcomes following stroke.

Although stroke affects cognitive functioning as well as motor functioning, research on cognitive consequences has lagged behind that focused on motor function. The evidence that is accruing suggests that cognitive function is importantly related to successful rehabilitation. The present study examined two aspects of attentional functioning (divided attention and switching attention) in older adult stroke survivors and healthy older adults. In addition, the authors investigated the relation between attention and functional outcomes following stroke. Results revealed stroke-related deficits in both of the types of attention as well as significant associations between attentional functioning and both physical and social outcome measures. Poorer attentional performance was associated with a more negative impact of stroke on daily functioning. These findings suggest an important role for attention in post-stroke function and provide information that can contribute to improving outcomes following stroke.

Sensory processing in schizophrenia: missing and avoiding information.

The possible coexistence of supersensitivity and overinhibition (Schizophrenia: Origins, Processes, Treatment and Outcome (1993) 335-350) in schizophrenia was studied using the Adult Sensory Profile as a measure of Dunn's (Infants Young Children 9 (1997) 23-25) model of sensory processing. The quadrant model describes sensory sensitivity, sensation avoiding, low registration and sensation seeking as behavioral responses to sensation. Individuals with schizophrenia (N = 27), bipolar disorder (N = 30) and mentally healthy controls (N = 29) were compared using the Adult Sensory Profile. When compared to the mentally healthy group, the results indicated that both the schizophrenia group and the bipolar disorder group had higher scores on sensation avoiding. The schizophrenia group also had higher scores on low registration and lower scores on sensation seeking than the mentally health group. There were no differences between the schizophrenia and bipolar disorder group. According to the findings of this study, individuals with schizophrenia tend to miss available sensory stimuli. When stimuli are indeed detected, they are often avoided.