Cognitive reappraisal attenuates the association between depressive symptoms and emotional response to stress during adolescence

Depression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents (M-age?=?15.28; 49% female, 47% Caucasian), at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recovery from the stressor. Findings suggested that cognitive reappraisal was associated with an attenuated impact of depressive symptoms on trait and state emotional recovery. These results provide evidence that cognitive reappraisal may be an effective strategy for improving some aspects of emotional responding in relation to depressive symptoms among adolescents.     

Skin conductance responses as predictor of emotional responses to stressful life events

Preferential preattentive processing towards threat has been proposed to play a casual role in the development of anxiety, mainly because it reliably predicts emotional responding to stressful events. However, in the investigation of the predictive value of preferential preattentive processing towards threat, the emotional Stroop task has exclusively being used. This study was designed to prospectively investigate the predictive value of skin conductance reactivity in response to masked (i.e., preattentively perceived) threatening pictures on emotional responding following stressful life events. To collect skin conductance data, the picture perception task was administered to 136 police recruits due to enroll into active duty within 2-4 months. To assess psychological distress following emotionally stressful life events, the impact of event scale were administered approximately 24 months later. Controlling for trait anxiety, analyses indicated that enhanced skin conductance reactivity in response to masked threatening pictures (relative to neutrals) was a strong predictor of emotional responding to stressful life events. This finding support preferential preattentive processing towards threat as a relatively independent factor predictive of emotional responding.     

Malleability of attentional bias for positive emotional information and anxiety vulnerability

Recent research supports a causal link between attentional bias for negative emotional information and anxiety vulnerability. However, little is known about the role of positive emotional processing in modulating anxiety reactivity to stress. In the current study, we used an attentional training paradigm designed to experimentally manipulate the processing of positive emotional cues. Participants were randomly assigned to complete a computerized probe detection task designed to induce selective processing of positive stimuli or to a sham condition. Following training, participants were exposed to a laboratory stressor (i.e., videotaped speech), and state anxiety and positive affect in response to the stressor were assessed. Results revealed that individual variability in the capacity to develop an attentional bias for positive information following training predicted subsequent emotional responses to the stressor. Moreover, individual differences in social anxiety, but not depression, moderated the effects of the attentional manipulation, such that, higher levels of social anxiety were associated with diminished attentional allocation toward positive cues. The current findings point to the potential value of considering the role of positive emotional processing in anxiety vulnerability.     

Stress-response-dampening effects of alcohol: attention as a mediator and moderator

The present study sought to characterize alcohol's stress-response-dampening (SRD) effects on multiple measures of stress and whether these effects are mediated by reductions in sustained attention and, further, whether baseline levels of sustained attention moderate SRD. One hundred six men consumed either an alcohol (0.70 g/kg) or a placebo beverage prior to learning that they would deliver a self-disclosing speech. Structural equation models controlling for multiple baseline periods indicated that alcohol directly reduced self-reported anxiety and skin conductance levels in response to the stressor. Alcohol's effect on reducing heart rate response, in contrast, was indirect and mediated by effects on prestress baseline. As hypothesized, differences in sustained attention partially mediated the effects of alcohol on skin conductance (but not heart rate or self-reported anxiety) and served as a moderator of alcohol's effects on skin conductance response. Findings are discussed in terms of theoretical links among alcohol consumption, specific cognitive abilities, and stress reactivity.     

Social Anxiety–Linked Attention Bias to Threat Is Indirectly Related to Post-Event Processing Via Subjective Emotional Reactivity to Social Stress

Attention bias to threat (e.g., disgust faces) is a cognitive vulnerability factor for social anxiety occurring in early stages of information processing. Few studies have investigated the relationship between social anxiety and attention biases, in conjunction with emotional and cognitive responses to a social stressor. Elucidating these links would shed light on maintenance factors of social anxiety and could help identify malleable treatment targets. This study examined the associations between social anxiety level, attention bias to disgust (AB-disgust), subjective emotional and physiological reactivity to a social stressor, and subsequent post-event processing (PEP). We tested a mediational model where social anxiety level indirectly predicted subsequent PEP via its association with AB-disgust and immediate subjective emotional reactivity to social stress. Fifty-five undergraduates (45% female) completed a passive viewing task. Eye movements were tracked during the presentation of social stimuli (e.g., disgust faces) and used to calculate AB-disgust. Next, participants gave an impromptu speech in front of a video camera and watched a neutral video, followed by the completion of a PEP measure. Although there was no association between AB-disgust and physiological reactivity to the stressor, AB-disgust was significantly associated with greater subjective emotional reactivity from baseline to the speech. Analyses supported a partial mediation model where AB-disgust and subjective emotional reactivity to a social stressor partially accounted for the link between social anxiety levels and PEP.     

Speech anxiety and rapid emotional reactions to angry and happy facial expressions

The aim was to explore whether people high as opposed to low in speech anxiety react with a more pronounced differential facial response when exposed to angry and happy facial stimuli. High and low fear participants were selected based on their scores on a fear of public speaking questionnaire. All participants were exposed to pictures of angry and happy faces while facial electromyographic (EMG) activity from the Corrugator supercilii and the Zygomaticus major muscle regions was recorded. Skin conductance responses (SCR), heart rate (HR) and ratings were also collected. Participants high as opposed to low in speech anxiety displayed a larger differential corrugator responding, indicating a larger negative emotional reaction, between angry and happy faces. They also reacted with a larger differential zygomatic responding, indicating a larger positive emotional reaction, between happy and angry faces. Consistent with the facial reaction patterns, the high fear group rated angry faces as more unpleasant and as expressing more disgust, and further rated happy faces as more pleasant. There were no differences in SCR or HR responding between high and low speech anxiety groups. The present results support the hypothesis that people high in speech anxiety are disposed to show an exaggerated sensitivity and facial responsiveness to social stimuli.     

Psychological stress,appraisal, emotion and Cardiovascular response in a public speaking task

Forty-three undergraduates (30 males, 13 females) prepared and performed a speech task (stressor) or a reading task (no-stressor control). Preparing to speak led to greater threat appraisal, negative emotion, and cardiovascular (CV) response than preparing to read aloud, particularly in speech anxious individuals. Delivering the speech, however, did not result in an increment in CV response over and above preparation. Although threat appraisals could not explain the effect of stress on CV response during task preparation, negative emotion accounted for over half of the effect. These data support the hypothesis that CV response in these studies is at least partially accounted for by psychological processes (stressor-specific anxiety and negative emotional response) and suggests that these processes may be best studied during a period of stressor anticipation.     

The worried mind: autonomic and prefrontal activation during worrying

To study the psychophysiological correlates of worrying, the authors recorded heart rate, respiratory sinus arrhythmia (RSA), skin conductance level, and alpha electroencephalographic asymmetry in healthy males during baseline, relaxation, worry induction, and anticipation of an impromptu speech task. Compared with baseline, relaxation, and anticipation, worrying was associated with greater heart rate and lower RSA. Worrying was further characterized by higher skin conductance levels compared with baseline but lower levels than during anticipation. Finally, worrying was associated with relatively greater left frontal activity compared with anticipation. Trait public speaking anxiety was positively correlated with left frontal activity during worrying. These results support the notion that worrying is a unique emotional state that is different from fearful anticipation.     

Associations between emotional avoidance,anxiety sensitivity,and reactions to an observational fear challenge procedure

Research has shown that emotional avoidance and anxiety sensitivity are associated with more self-reported fear and distress in response to laboratory fear challenge procedures. The present study aimed to expand upon this work and examined how emotional avoidance and anxiety sensitivity are related to emotional and physiological responses to an observational fear challenge procedure. To accomplish this aim, a carefully screened, non-clinical sample (N = 43) was administered the Acceptance and Action Questionnaire (AAQ), a measure of emotional avoidance, and the Anxiety Sensitivity Index (ASI). Participants then engaged in an observational fear challenge paradigm. During the fear challenge, participants watched mock panic attacks while emotional (e.g., fear and panic) and skin conductance levels were assessed. Consistent with expectation, emotional avoidance and anxiety sensitivity were positively associated with more self-reported fear and more severe panic symptoms to the challenge procedure. However, anxiety sensitivity was more highly associated with self-reported fear and panic symptoms in response to the challenge procedure than emotional avoidance. Emotional avoidance and anxiety sensitivity were not associated with levels of physiological arousal to the observational fear challenge procedure. Discussion focuses on the interplay between emotional avoidance, anxiety sensitivity, and the development of vicarious fear responses and how these constructs may contribute to the pathogenesis of anxiety disorders.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

Relationship of Mindfulness to Distress and Cortisol Response in Adolescent Girls At-Risk for Type 2 Diabetes

Altered stress response theoretically contributes to the etiology of cardiometabolic disease. Mindfulness may be a protective buffer against the effects of stress on health outcomes by altering how individuals evaluate and respond to stress. We engaged adolescent girls at risk for developing Type 2 diabetes in a cold-pressor test in order to determine the relationship of dispositional mindfulness to cortisol response and subjective stress, including perceived pain and unpleasantness during the stressor, and negative affect following the stressor. We also evaluated mindfulness as a moderator of psychological distress (depressive/anxiety symptoms) and stress response. Participants were 119 girls age 12–17 years with overweight/obesity, family history of diabetes, and mild-to-moderate depressive symptoms. Greater mindfulness was associated with less perceived pain and negative affect, but was unrelated to cortisol response to the stressor. Regardless of mindfulness, greater depressive/anxiety symptoms related to a more blunted cortisol response. Mindfulness might promote better distress tolerance in adolescents at risk for diabetes by altering how youth perceive and relate to acute stress, rather than through altering the physiological stress response. At all levels of mindfulness, depressive/anxiety symptoms relate to greater blunting of cortisol response. Findings contribute to emerging literature on the role of mindfulness in promoting the mental and physical health and well-being of individuals at risk for Type 2 diabetes.     

Impact of anticipatory processing versus distraction on multiple indices of anxiety in socially anxious individuals

In models of social phobia, anticipatory processing before a social-evaluative event is a key maintaining factor for the disorder. This study investigated the impact of anticipatory processing versus distraction before a social-evaluative task on affective (self-reported anxiety), psychophysiological (skin conductance), cognitive (self-reported maladaptive self-beliefs) and behavioural (in-situation performance) responses of participants. High and low socially anxious undergraduates were randomly allocated to either an anticipatory processing or distraction condition, and then completed an impromptu speech task. Relative to distraction, anticipatory processing increased self-reported anxiety in all participants, and increased skin conductance and the strength of conditional and high standard beliefs in the high (but not low) socially anxious participants. Unconditional beliefs were not affected. For high socially anxious individuals, anticipatory processing was also indirectly associated with poorer speech performance by increasing self-reported anxiety. Anticipatory processing appears to have multiple adverse effects in socially anxious individuals.     

Evidence for expectancy as a mediator of avoidance and anxiety in a laboratory model of human avoidance learning

A laboratory model was developed to study human avoidance learning. Participants could avoid an electric shock signalled by a 5-s conditioned stimulus (CS) by pressing one of a set of response buttons. Self-reported shock expectancy and skin conductance were recorded during a subsequent 10-s interval before shock. Shock expectancy declined when the correct avoidance response was learned and returned when the response was unavailable. Learning transferred to another shock CS. Parallel effects were observed on skin conductance once performance anxiety was controlled by requiring responding on all trials. Learning was faster when the Pavlovian contingencies were trained before introduction of the instrumental response. The results support a cognitive model of anxiety in which performance of an avoidance response reduces expectancy of an aversive outcome and thereby reduces anxiety.     

Evidence for expectancy as a mediator of avoidance and anxiety in a laboratory model of human avoidance learning

A laboratory model was developed to study human avoidance learning. Participants could avoid an electric shock signalled by a 5-s conditioned stimulus (CS) by pressing one of a set of response buttons. Self-reported shock expectancy and skin conductance were recorded during a subsequent 10-s interval before shock. Shock expectancy declined when the correct avoidance response was learned and returned when the response was unavailable. Learning transferred to another shock CS. Parallel effects were observed on skin conductance once performance anxiety was controlled by requiring responding on all trials. Learning was faster when the Pavlovian contingencies were trained before introduction of the instrumental response. The results support a cognitive model of anxiety in which performance of an avoidance response reduces expectancy of an aversive outcome and thereby reduces anxiety.     

The effects of verbal labelling on psychophysiology: Objective but not subjective emotion labelling reduces skin-conductance responses to briefly presented pictures

Verbally labelling emotional stimuli has been shown to reliably decrease emotional responding. The present study compared the use of identical emotional labels during two types of verbal labelling: subjective labelling of one's own emotional response and objective labelling of the stimulus. We recorded skin conductance responses (SCRs) to emotional pictures presented at four brief durations preceding a backward mask. We observed that as the exposure duration increased, SCRs decreased during objective labelling of the stimuli. However, when participants subjectively labelled their own emotional state, SCRs increased as exposure duration increased. In addition, subjective labelling produced larger SCRs than objective labelling at a shorter exposure duration when the presented stimuli were biologically prepared. These results indicate that only objective labelling results in decreased emotional responding, and describe a novel interaction between bottom-up stimulus characteristics and top-down cognitive effects on physiological responses.     

Transdiagnostic processes in emotional disorders and insomnia: results from a sample of adult outpatients with anxiety and mood disorders

Conceptual similarities between recent models of insomnia and emotional disorders suggest there may be common factors that underlie or maintain these difficulties. Maladaptive cognitive and behavioral processes similar to those described in connection with emotional disorders have been cited as key mechanisms in the maintenance of primary insomnia. Unfortunately, research on this potential overlap is lacking. The present study examined the relationship among anxiety sensitivity (AS), dysfunctional beliefs, fatigue, safety behaviors, and insomnia severity in 59 outpatients with anxiety and mood disorders. Key insomnia processes (dysfunctional beliefs, fatigue, safety behaviors) were all related to insomnia severity in the comorbid sample, although AS was not. However, as hypothesized, AS did moderate the relationship of both dysfunctional beliefs and fatigue with insomnia severity. The relationships between key insomnia processes and insomnia severity was strongest among individuals high in AS. Results support the hypothesis that common mechanisms are involved for insomnia and emotional disorders. AS might function as a mechanism for the maintenance of sleep disturbance in the context of anxiety and mood disorders, suggesting a promising avenue for future research.     

Explicit memory in anxiety disorders

Two experiments were conducted to study selective memory bias favoring anxiety-relevant materials in patients with anxiety disorders. In the 1st experiment, 32 patients with generalized anxiety disorder (GAD), 30 with social phobia (speaking anxiety), and 31 control participants incidentally learned GAD-relevant words, speech anxiety-relevant words, strongly pleasant words, and words with a neutral valence. Participants did not show any explicit memory bias for threatening materials. Thirty patients suffering from panic disorder (PD) with agoraphobia and 30 controls took part in the 2nd experiment. The design was similar to the 1st experiment. This time a highly specific selective memory bias for threatening words was found. Words describing symptoms of anxiety were better recalled by PD patients. Results are consistent with previous findings but are inexplicable by existing theories.     

The Links Between Social Anxiety Disorder,Insomnia Symptoms,and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States

Social anxiety disorder (SAD) is associated with increased risk of developing an alcohol use disorder (AUD). Most of the current literature has focused on the role of acute stress responding in this relation; however, both SAD and AUDs also are linked to insomnia symptoms (i.e., difficulty falling or staying asleep). As adolescence is a sensitive period for the onset of these disorders, the present study examined if insomnia symptoms might partially account for the SAD-AUD link in a large sample of adolescents. Data from the National Comorbidity Survey–Adolescent Supplement were examined. Participants (N = 10,140) completed interviews to assess past 12-month SAD and AUD diagnostic status as well as insomnia symptoms. Analyses tested whether insomnia symptoms accounted for a significant proportion of the SAD-AUD relation. Results indicated that insomnia symptoms were positively related to both SAD and AUD status, and the relation between SAD and AUD status was significantly reduced when insomnia symptoms were included in the model. Findings remained significant after controlling for the effects of age, gender, posttraumatic stress disorder, major depressive disorder, and other drug dependence status. Experimental examination and intensive longitudinal assessment of these relationships are needed before strong conclusions can be inferred about causality and temporal relationships. The current findings do indicate insomnia may be an important indirect and stigma-free treatment target to address in prevention and treatment efforts for SAD, AUDs, and their co-occurrence.     

Distinguishing youths at risk for anxiety disorders from self‐reported BIS sensitivity and its psychophysiological concomitants

The aim of the study was to explore the psychophysiological concomitants of self‐reported behavioral inhibition system (BIS) sensitivity in adolescents (12 to 17 years old) supposed to be at risk for anxiety disorders. Twenty participants with high scores in self‐reported BIS sensitivity (at‐risk group) were matched in age and sex to 20 participants scoring in the normal range in BIS sensitivity (control group). Negative affect, negative emotion regulation style, and anxiety symptomatology were assessed by means of self‐reported measures. Cardiac and electrodermal response signals were recorded during baseline, paced breathing, exposure to an attentional task with response cost and fear‐relevant slides conditions. The at‐risk group exhibited higher scores on measures of negative affect, negative emotion regulation style, and anxiety symptomatology than their control counterparts. After controlling for negative styles of emotion regulation, groups did not differ in skin conductance reactivity during the attentional task with response cost, but participants at risk exhibited more nonspecific skin conductance responses than the control group during baseline recording. Regarding the cardiac concomitants, participants at risk presented lower vagal tone at resting conditions as compared to participants in the control group. Additionally, at‐risk participants exhibited lower flexibility across experimental conditions in heart rate and cardiac sample entropy measures than participants in the control group. These findings add knowledge on psychophysiological concomitants of BIS sensitivity and are discussed in light of associations between temperament and development of anxiety disorders in youth. They show how psychophysiological patterns observed in resting conditions could be useful endophenotypes to reliably detect individuals at risk before the disorder onset.     

Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders

The present investigation compared the subjective and physiological effects of emotional suppression and acceptance in a sample of individuals with anxiety and mood disorders. Sixty participants diagnosed with anxiety and mood disorders were randomly assigned to one of two groups. One group listened to a rationale for suppressing emotions, and the other group listened to a rationale for accepting emotions. Participants then watched an emotion-provoking film and applied the instructions. Subjective distress, heart rate, skin conductance level, and respiratory sinus arrhythmia were measured before, during, and after the film. Although both groups reported similar levels of subjective distress during the film, the acceptance group displayed less negative affect during the post-film recovery period. Furthermore, the suppression group showed increased heart rate and the acceptance group decreased heart rate in response to the film. There were no differences between the two groups in skin conductance or respiratory sinus arrhythmia. These findings are discussed in the context of the existing body of research on emotion regulation and current treatment approaches for anxiety and mood disorders.