Emotion regulation after traumatic brain injury: distinct patterns of sympathetic activity during anger expression and recognition

Abstract OBJECTIVE: To assess psychological and psychophysiological correlates of emotion recognition and anger experience in participants with traumatic brain injury (TBI). PARTICIPANTS: Twenty participants with TBI presenting with anger problems and 22 healthy controls. PROCEDURES: Participants were administered tasks assessing emotion recognition (The French Evaluation Task) and anger expression (Anger regulation task). The latter, designed to elicit and modulate anger feelings through verbal recall of a self-experienced event, involved 4 recall conditions that followed a resting period: neutral, uninstructed anger recall, anger rumination, and anger reappraisal. MEASURES: Skin conductance levels during recall and a self-report anger questionnaire between each condition. RESULTS: In the TBI and control groups, self-reported anger was similarly modulated across emotion regulation conditions. However, only in the TBI group did skin conductance levels significantly increase between neutral and uninstructed anger recall conditions. CONCLUSIONS: Impaired emotion regulation in TBI participants could be related to increased levels of autonomic system activity during emotional experience. However, anger feelings in these participants can also be modulated with the use of emotion regulation strategies, including adaptive strategies such as reappraisal. Thus, promoting awareness and management of physiological activation and encouraging cognitive restructuring can be recommended as a component of interventions targeting emotion regulation in TBI patients

Reducing anger outbursts after a severe TBI: A single-case study

Anger outbursts constitute a frequent behavioural issue after a traumatic brain injury (TBI) and have a strong negative impact on the social outcomes resulting from the TBI. However, few studies have examined the efficacy of specific intervention strategies to reduce the frequency and intensity of anger outbursts. We therefore performed a single-case study on this topic by administering two successive and complementary psychological interventions with an AB design with maintenance (first intervention) and an AC design with maintenance plus a one-month follow-up (second intervention) to a patient with a severe TBI. Whereas the first intervention focused on improving the recognition and expression of basic emotions, the second consisted of a self-regulation programme, including various features such as psychoeducation about self-control strategies, relaxation and assertiveness training that aimed to establish adequate behaviours, which were further promoted by an implementation intentions strategy in the patient's daily life. The results indicated that all interventions resulted in a reduced frequency and intensity of anger outbursts, and the data upheld the specificity of these effects. In addition, a meta-analytic integration of the effects of both interventions on the outcomes indicated a medium effect size. Further research is needed on other patients who experience long-standing anger outbursts to examine whether the observed gains can be replicated, sustained on a longer-term basis and improved

Are Fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence.

9nonemixedTESIO, VALENTINA; TORTA, Diana; Colonna F; LEOMBRUNI, Paolo; GHIGGIA, ADA; Fusaro E; GEMINIANI, Giuliano Carlo; TORTA, Riccardo; CASTELLI, LorysTesio, Valentina; Torta, Diana; Colonna, F; Leombruni, Paolo; Ghiggia, Ada; Fusaro, E; Geminiani, Giuliano Carlo; Torta, Riccardo; Castelli, Lory

Determinants of Theory of Mind performance in Alzheimer’s disease: A data-mining study

Whether theory of mind (ToM) is preserved in Alzheimer’s disease (AD) remains a controversial subject. Recent studies have showed that performance on some ToM tests might be altered in AD, though to a lesser extent than in behavioural-variant Frontotemporal Dementia (bvFTD). It is however, unclear if this reflects a genuine impairment of ToM or a deficit secondary to the general cognitive decline observed in AD. Aiming to investigate the cognitive determinants of ToM performance in AD, a data-mining study was conducted in 29 AD patients then replicated in an independent age-matched group of 19 AD patients to perform an independent replication of the results. 44 bvFTD patients were included as a comparison group. All patients had an extensive neuropsychological examination. Hierarchical clustering analyses showed that ToM performance clustered with measures of executive functioning in AD. ToM performance was also specifically correlated with the executive component extracted from a principal component analysis. In a final step, automated linear modelling conducted to determine the predictors of ToM performance showed that 48.8% of ToM performance was significantly predicted by executive measures. Similar findings across analyses were observed in the independent group of AD patients, thereby replicating our results. Conversely, ToM impairments in bvFTD appeared independent of other cognitive impairments. These results suggest that difficulties of AD patients on ToM tests do not reflect a genuine ToM deficit, rather mediated by general (and particularly executive) cognitive decline. They also suggest that executive functioning has a key role in mental state attribution, which support interacting models of ToM functioning. Finally, our study highlights the relevancy of data-mining statistical approaches in clinical and cognitive neurosciences

A Maternal Influence on Reading the Mind in the Eyes Mediated by Executive Function: Differential Parental Influences on Full and Half-Siblings

BACKGROUND: Parent-of-origin effects have been found to influence the mammalian brain and cognition and have been specifically implicated in the development of human social cognition and theory of mind. The experimental design in this study was developed to detect parent-of-origin effects on theory of mind, as measured by the 'Reading the mind in the eyes' (Eyes) task. Eyes scores were also entered into a principal components analysis with measures of empathy, social skills and executive function, in order to determine what aspect of theory of mind Eyes is measuring. METHODOLOGY/PRINCIPAL FINDINGS: Maternal and paternal influences on Eyes scores were compared using correlations between pairs of full (70 pairs), maternal (25 pairs) and paternal siblings (15 pairs). Structural equation modelling supported a maternal influence on Eyes scores over the normal range but not low-scoring outliers, and also a sex-specific influence on males acting to decrease male Eyes scores. It was not possible to differentiate between genetic and environmental influences in this particular sample because maternal siblings tended to be raised together while paternal siblings were raised apart. The principal components analysis found Eyes was associated with measures of executive function, principally behavioural inhibition and attention, rather than empathy or social skills. CONCLUSIONS/SIGNIFICANCE: In conclusion, the results suggest a maternal influence on Eye scores in the normal range and a sex-specific influence acting to reduce scores in males. This influence may act via aspects of executive function such as behavioural inhibition and attention. There may be different influences acting to produce the lowest Eyes scores which implies that the heratibility and/or maternal influence on poor theory of mind skills may be qualitatively different to the influence on the normal range

Social cognitive deficits and their neural correlates in progressive supranuclear palsy

Although progressive supranuclear palsy is defined by its akinetic rigidity, vertical supranuclear gaze palsy and falls, cognitive impairments are an important determinant of patients’ and carers’ quality of life. Here, we investigate whether there is a broad deficit of modality-independent social cognition in progressive supranuclear palsy and explore the neural correlates for these. We recruited 23 patients with progressive supranuclear palsy (using clinical diagnostic criteria, nine with subsequent pathological confirmation) and 22 age- and education-matched controls. Participants performed an auditory (voice) emotion recognition test, and a visual and auditory theory of mind test. Twenty-two patients and 20 controls underwent structural magnetic resonance imaging to analyse neural correlates of social cognition deficits using voxel-based morphometry. Patients were impaired on the voice emotion recognition and theory of mind tests but not auditory and visual control conditions. Grey matter atrophy in patients correlated with both voice emotion recognition and theory of mind deficits in the right inferior frontal gyrus, a region associated with prosodic auditory emotion recognition. Theory of mind deficits also correlated with atrophy of the anterior rostral medial frontal cortex, a region associated with theory of mind in health. We conclude that patients with progressive supranuclear palsy have a multimodal deficit in social cognition. This deficit is due, in part, to progressive atrophy in a network of frontal cortical regions linked to the integration of socially relevant stimuli and interpretation of their social meaning. This impairment of social cognition is important to consider for those managing and caring for patients with progressive supranuclear palsy

Cognitive-behavioural therapy: a tool to facilitate emotional adjustment to brain disorders

Nous avons investigué si les thérapies cognitivo-comportementales sont adaptées pour améliorer la régulation émotionnelle chez les patients cérébrolésés et diminuer le stress chez les proches. Les quatre études de la thèse ont montré que: 1) les manifestations psychophysiologiques durant les réactions émotionnelles chez les patients cérébrolésés peuvent être détectées et apaisées; 2) les patients ont la possibilité d'être conscients de leurs manifestations émotionnelles et de leurs modulations; 3) il est possible de promouvoir auprès de ces patients des techniques de régulation émotionnelle basées sur un travail sur les pensées, et ce malgré la présence de troubles cognitifs; 4) intervenir auprès des proches contribue non seulement à diminuer les effets physiologiques du stress, mais également à diminuer les manifestations neurocomportementales chez les patients. Malgré la nécessité d'études supplémentaires dans le domaine, les thérapies cognitivo-comportementales peuvent être un outil avantageux pour faciliter l'ajustement émotionnel à la nouvelle réalité induite par l'atteinte cérébrale

Effects of group psychotherapy on anger management following acquired brain injury

To assess the effects of an anger management group programme for patients with acquired brain injury (ABI) on self-reported anger and to identify specific effects of intervention components at different time-points

Prefrontal transcranial direct current stimulation facilitates affective flexibility

Performance on paradigms involving switching between emotional and non-emotional task-sets (affective flexibility) predicts emotion regulation abilities and is impaired in patients with different emotional disorders. A better understanding of how neurostimulation techniques such as transcranial direct current stimulation (tDCS) influence affective switching may provide support for the improvement of rehabilitation programs. In the current study healthy volunteers received anodal tDCS over the right dorsolateral prefrontal cortex (DLPFC), the left DLPFC or sham stimulation while performing an affective-switching task. Participants had to repeat or switch between facial judgments of emotional expressions (emotional task-set) or gender (non-emotional task-set). Right tDCS resulted in faster responses in the gender task only when it followed a judgment of emotion. These effects were not observed following left tDCS. Further, switching away from emotion was easier for the right compared to left tDCS group (reduced switch costs for gender), while switching away from gender toward emotion was easier for the left compared to the right group (reduced switch-costs for emotion). In sum, tDCS over the DLPFC may modulate affective flexibility and right stimulation may be particularly helpful to facilitate disengagement from emotional task-sets. The usefulness of tDCS-trained affective switching may be further investigated on larger therapeutic protocols targeting emotional disorders