Cue reactivity to self-harm cues: the development of a systematic treatment intervention for deliberate self-harm

There is increasing awareness of the prevalence of deliberate self-harm (DSH) although the phenomenon is still poorly understood. Those who self-harm often have a poor long-term prognosis, yet systematic focused treatment interventions are scarce. DSH appears to share fundamental characteristics with addictive behaviour, including; impulsive or compulsive urges to act in the presence of triggers, positive and negative reinforcing consequences and endorsement of the diagnostic criteria for clinical dependence. Given this fact, a behavioural mode of DSH may be appropriate. A range of events are anecdotally reported to trigger DSH. This thesis was designed to identify these cues, to develop an understanding of how those who self-harm respond to these cues and the processes by which these cues may operate to maintain DSH. An intervention based on the management of urges to self-harm in the presence of these cues was developed.Study I identified that triggers for DSH (interpersonal, intrapersonal and environmental) were similar to those that reliably predict addictive behaviour. Respondents endorsed the diagnostic criteria for dependency and reported that the act of DSH reduced negative emotions. The second two studies identified self-reported cue reactivity, and generalised hyperarousal to both DSH and neutral stimuli in those who self-harm but no evidence of psychophysiological cue reactivity. Study IV used ERP methodology to evaluate cue reactivity at the CNS level and to evaluate two mechanisms by which cues might operate to maintain DSH. There was some preliminary support for enhanced preconscious attentional bias towards emotional, but not environmental DSH cues, and no support for emotional interference. Study V identified that those who self-harm exhibited enhanced tolerance to physical and psychological stressors, and that priming with interpersonal distress did not impact on this tolerance. Finally, a single case intervention study identified a reduction in DSH, reduced psychophysiological arousal and urges to self-harm and improved clinical symptomatology. However, clinical improvements were not time-locked to targeted exposure intervention phases. The clinical and theoretical implications for these findings are discussed

Epigenetics and endocrinology: new frontiers in motivational science

This thesis explored the role of motivational processes in improved human functioning. There is a large body of evidence supporting the idea that higher quality motivation can have important implications for health and well-being via improved behavioural engagement. However, what is less well understood is whether there is a direct effect of motivation on physiological health beyond that which is explained by engagement with the activity itself. The aim of this thesis was to explore associations between motivational processes and biological markers implicated with improved physical health and human functioning.The programme of research began by systematically reviewing multidimensional theories of motivation and physiological responses associated with activation of the endocrine system. Across several conceptually similar theories of motivation, it was evidenced that higher quality motivation was associated with an attenuated cortisol response in a variety of environments eliciting social-evaluative threat. Furthermore, the needs for power and affiliation were associated with lower and higher levels of salivary secretory immunoglobulin A, respectively. Based on the limitations identified in the systematic review, two subsequent chapters further explored the role of high quality motivation in reducing the cortisol response. Using an experimental design grounded in self-determination theory, Chapter Three explored the effect that manipulating autonomous and controlled motivation had on participants’ cortisol responses, while concurrently measuring self-control exertion. A repeated measures ANCOVA revealed a significant quadratic interaction (F (1, 32) = 5.40, p =.027, ηp2 = .14). Participants in the controlled regulation condition experienced an increased, with autonomy supportive experiencing a decreased, cortisol response. There was also evidence of motivational effects on self-control performance, although the results contradicted the hypothesis. A mixed ANCOVA revealed participants in the controlled regulation condition recorded greater wall sit performance in the first and second wall sits compared with the autonomy-supportive condition (F (1,36) = 4.40, p = .043, ηp2 = .11). This concept was replicated and extended in Chapter Four. Although the cortisol pattern was not replicated, nonetheless a repeated measures ANOVA revealed a significant linear within subject contrast (F (2, 57) = 4.45, p = .016, ηp2 = .14), with a significant linear decline in cortisol observed in the control condition. Furthermore, there was support for the idea of high-quality motivation improving self-control performance. A one-way ANOVA revealed a self-control performance difference between experimental conditions (F (67,2) = 2.88, p = .063, ηp2 = .08), that was driven by autonomy-supportive participants outperforming those exposed to controlled regulation (p = .055). As predicted, this performance difference did not persist to the second self-control task, the plank (F (64,4) = 0.41, p = .664, ηp2 = .03).In the final empirical chapter, the focus shifted from proximal to stable long-term markers of health by exploring a novel area for self-determination theory – epigenetics - specifically, the DNA methylation of the TNF gene associated with expression of the proinflammatory cytokine TNFα. The results further supported the idea that high quality motivation is most important for health-related behaviour and outcomes. Health-related autonomous motivation was weakly but positively associated with TNF methylation (β =.18, p =.08); however, health-related introjected regulation was not associated with TNF methylation (β =.13, p =.23). In a subsequent step, path analysis was used to explore whether this relationship persisted when accounting for healthy behaviour, however direct effects of autonomous motivation on TNF methylation did not persist when these indirect effects were included (β =.09, p =.43).Overall, this thesis found support for the value of high-quality motivational processes at the epigenetic and endocrine level. Autonomous motivation was indirectly associated with DNA methylation of TNF, via engagement in healthy behaviour. Furthermore, there were several examples of evidence suggesting that high-quality motivation was associated with attenuated cortisol profiles, and conversely, lower quality motivation was associated with an increased cortisol response. There was also evidence that autonomous motivation was implicated in improved self-control performance, but this was not consistently observed. By extending research into epigenetics and endocrinology, this thesis supports the idea that high-quality motivation has important implications for improved health and well-being .</div

Mind-wandering and alterations to default mode network connectivity when listening to naturalistic versus artificial sounds

Naturalistic environments have been demonstrated to promote relaxation and wellbeing. We assess opposing theoretical accounts for these effects through investigation of autonomic arousal and alterations of activation and functional connectivity within the default mode network (DMN) of the brain while participants listened to sounds from artificial and natural environments. We found no evidence for increased DMN activity in the naturalistic compared to artificial or control condition, however, seed based functional connectivity showed a shift from anterior to posterior midline functional coupling in the naturalistic condition. These changes were accompanied by an increase in peak high frequency heart rate variability, indicating an increase in parasympathetic activity in the naturalistic condition in line with the Stress Recovery Theory of nature exposure. Changes in heart rate and the peak high frequency were correlated with baseline functional connectivity within the DMN and baseline parasympathetic tone respectively, highlighting the importance of individual neural and autonomic differences in the response to nature exposure. Our findings may help explain reported health benefits of exposure to natural environments, through identification of alterations to autonomic activity and functional coupling within the DMN when listening to naturalistic sounds

Fuzzy Modelling of Human Psycho-Physiological State and Fuzzy Adaptive Control of Automation in Human-Machine Interface

This research aims at proposing a new modelling and control framework that monitors the human operators' psychophysiological state in the human-machine interface to prevent performance breakdown. This research started with the exploration of new psychophysiological state assessment approaches to the adaptive modelling and control method for predicting human task performance and balancing the engagement of the human operator and the automatic system. The results of this research may also be further applied in developing advanced control mechanisms, investigating the origins of human compromised performance and identifying or even remedying operators' breakdown in the early stages of operation, at least. A summary of the current human psychophysiological studies, previous human-machine interface simulation and existing biomarkers for human psychophysiological state assessment was provided for simulation experiment design of this research. The use of newly developed facial temperature biomarkers for assessing the human psychophysiological state and the task performance was investigated. The research continued by exploring the uncertainty of the human-machine interface system through the use of the complex fuzzy logic based offline modelling approach. A new type-2 fuzzy-based modelling approach was then proposed to assess the human operators' psychophysiological states in the real-time human-machine interface. This new modelling technique integrated state tracking and type-2 fuzzy sets for updating the rule base with a Bayesian process. Finally, this research included a new type-2 fuzzy logic-based control algorithm for balancing the human-machine interface systems via adjusting the engagement of the human operators according to their psychophysiological state and task performance. This innovative control approach combined the state estimation of the human operator with the type-2 fuzzy sets to maintain the balance between the task requirements (i.e. difficulty level) and the human operator feasible effort (i.e. psychophysiological states). In addition, the research revealed the impacts of multi-tasking and general fatigue on human operator's performance

Physiological effects of heart rate variability biofeedback during laboratory induced congnitive stress

Includes bibliographical references.Heart rate variability (HRV) biofeedback is effective in reducing stress as well as managing chronic disease. It facilitates easy manipulation of HRV, and, therefore, potentially provides a valuable intervention for altering the activity of the autonomic nervous system. The aim of this thesis was to examine the effects of a single 10 minute episode of HRV biofeedback on measures of HRV and EEG during and immediately after the intervention, measures of HRV and cognitive performance during laboratory induced cognitive stress and subjective feelings of anxiety and relaxation states after testing. Eighteen healthy male volunteers (34 ± 6 years) exposed to work-related stress, were randomised into an HRV biofeedback intervention (BIO) and a comparative intervention group (COM)

Anger Induction and Ambient Interventions: Effects on Cardiovascular Activity and Frontal EEG Asymmetry

Background and aims: The experience of anger could affect cardiovascular (CV) and electro-encephalographic (EEG) parameters but such parameters could vary within the motivational context. Although models of motivational contexts were proposed by CV literature as challenge/threat (Blascovich & Tomaka, 1996) and by frontal EEG asymmetry literature as approach/avoidance (Harmon-Jones, 2004a) little is known whether a negative emotion such as anger could be indexed by CV and EEG responses within motivational contexts. Anger in a threat context may be particularly detrimental for health due to low control compared to anger in a challenge context, where control is high. Hence, the aim of the research was twofold: 1. to investigate how a motivational context (challenge vs. threat) influences the cardiovascular system and frontal EEG asymmetry during anger induction protocols and 2. to analyse the efficacy of ambient interventions (music, light) to reduce the impact of anger on cardiovascular responses. Affective computing through the use of ambient intelligence technology could be used to promote positive emotion or to ameliorate negative moods. Method: There were two anger induction protocols within the thesis. Firstly, anger was manipulated using an experimenter effect (i.e., rude vs. polite experimenter). Participants were exposed to a computer-based problem-solving task under conditions of control and no control which represented the motivational contexts of challenge/threat. Secondly, anger was induced by exposing participants to a time constrained driving schedule on a simulated route with financial penalties for any delays to arrive to the destination. Motivation was manipulated by exposing participants to traffic delays at an early (challenge) and later point (threat) on a simulated driving route. STAXI-2 (Spielberg, 1999) was used to measure anger states and motivation was measured by Confidence and Perceived Control Scale from Dundee Stress State Questionnaire (Matthews & Desmond, 1998). Psychophysiological variables included: blood pressure (BP), cardiovascular impedance (ICG), frontal EEG asymmetry, and facial electromyography (fEMG). Results: The cardiovascular and EEG results of the present thesis pointed to a circumplex model of anger with quadruplet facets along cardiovascular responses to challenge/threat contexts in conjunction with approach/avoidance tendencies where a threat motivation with avoidance was indexed by increased blood pressure and cardiac output and by greater right frontal activation. The difference in the approach-threat responses was the activation of the left hemisphere. The challenge-avoidance state was defined by increased total peripheral resistance (TPR), systolic blood pressure (SBP), heart rate (HR), mean arterial pressure (MAP) and greater right frontal hemisphere activation. No frontal asymmetric activity was identified in the challenge-approach, but increased TPR, SBP, HR and MAP were observed. The ambient intervention results suggested that cardiovascular responses (e.g., SBP) could be reduced by low activation music or blue ambient light. Discussion and conclusions: Anger in the context of challenge can be distinguished from anger in the context of threat via a specific pattern of CV (systolic BP) and EEG measures (frontal peripheral brain site). Ambient interventions (low activation music or blue light) could be factors in modulating physiological reactions while driving; discrepancies between self-report measures and physiological responses, low sensitivity of impendence data to manipulations and low impact of various colour ambient lights on cardiovascular responses were addressed within a theoretical and methodological