Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy

Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (SN) reflecting emotion/motivation and the default mode network (DMN) reflecting self-referentiality. Using resting-state functional connectivity (rsFC) analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized anxiety disorder (GAD) patients [with and without major depressive disorder (MDD)] drawn from a larger intervention trial (Renna et al., 2018a), who completed resting state fMRI scans before and after receiving 16 sessions of ERT. We utilized seed-based connectivity analysis with seeds in the posterior cingulate cortex (PCC), right anterior insula, and right posterior insula, to investigate whether ERT was associated with changes in connectivity of nodes of the DMN and SN networks to regions across the brain. Findings revealed statistically significant treatment linked changes in both the DMN and SN network nodes, and these changes were associated with clinical improvement corresponding to medium effect sizes. The results are discussed in light of a nuanced understanding of the role of connectivity changes in GAD and MDD, and begin to provide neural network support for the hypothesized treatment model predicated by ERT

All together now: Utilizing common functional change principles to unify cognitive behavioral and mindfulness-based therapies

Cognitive behavior therapy (CBT) and mindfulness-based interventions (MBI) have made important contributions to resolving the global burden of mental illness. However, response rates are comparatively more modest for the distress disorders. Newer CBTs enriched with MBI components have emerged with promising findings for distress disorders but with a high degree of heterogeneity and, subsequently, an unclear path for determining the unique and synergistic contributions from CBTs and MBIs. We propose that one way to elucidate and improve upon this union is to identify common overarching principles (i.e., attention change; metacognitive change) that guide both approaches and to refine therapeutic processes to optimally reflect these common targets and their interplay (e.g., sequencing and dosing)

Heart rate variability as a potential indicator of positive valence system disturbance: A proof of concept investigation

One promising avenue toward a better understanding of the pathophysiology of positive emotional disturbances is to examine high-frequency heart rate variability (HRV-HF), which has been implicated as a potential physiological index of disturbances in positive emotional functioning. To date, only a few psychopathology relevant studies have systematically quantified HRV-HF profiles using more ecologically valid methods in everyday life. Using an experience-sampling approach, the present study examined both mean levels and intra-individual variability of HRV-HF - as well as comparison measures of cardiovascular arousal, sympathetic activity, and gross somatic movement - in everyday life, using ambulatory psychophysiological measurement across a six-day consecutive period among a spectrum of community adult participants with varying degrees of positive valence system disturbance, including adults with bipolar I disorder (BD; n = 21), major depressive disorder (MDD; n = 17), and healthy non-psychiatric controls (CTL; n = 28). Groups did not differ in mean HRV-HF, but greater HRV-HF instability (i.e., intra-individual variation in HRV-HF) was found in the BD compared to both MDD and CTL groups. Subsequent analyses suggested that group differences in HRV-HF variability were largely accounted for by variations in clinician-rated manic symptoms. However, no association was found between HRV-HF variability and dimensional measures of positive affectivity. This work provides evidence consistent with a quadratic relationship between HRV-HF and positive emotional disturbance and represents a valuable step toward developing a more ecologically valid model of positive valence system disturbances and their underlying psychophysiological mechanisms within an RDoC framework

An experimental examination of worry and relaxation on cardiovascular, endocrine, and inflammatory processes.

BackgroundWorry increases risk for long-term health issues by prolonging the physiological stress response. In contrast, relaxation may ameliorate the psychological and physiological burden resulting from worry. This study examined the impact of experimentally induced worry and relaxation on cortisol, heart rate variability (HRV), and inflammation.MethodParticipants (N = 80) completed both a worry and relaxation induction (presented in a fixed order) while HRV was collected continuously. Three blood samples were taken (at baseline, after the worry induction, and after the relaxation induction) to measure IL-6, IFN-γ, TNF-α and serum cortisol.ResultsThere were significant changes in IL-6 (p < 0.001), IFN-γ (p < 0.01), HRV (p < .001), and cortisol (p <  .001) but not in TNF-α (p = 0.65) across conditions. HRV decreased significantly from baseline to worry and then increased following relaxation. IL-6 was higher during relaxation compared to worry and baseline. Cortisol decreased significantly across conditions. Several patterns of covariance between inflammation and HRV and/or cortisol also emerged.ConclusionsThese findings offer novel insight into how worry influences the immune system and emphasize the utility of a multi-methods approach to understanding the impact of worry on physical health

An experimental examination of worry and relaxation on cardiovascular, endocrine, and inflammatory processes

Background: Worry increases risk for long-term health issues by prolonging the physiological stress response. In contrast, relaxation may ameliorate the psychological and physiological burden resulting from worry. This study examined the impact of experimentally induced worry and relaxation on cortisol, heart rate variability (HRV), and inflammation. Method: Participants (N = 75) completed both a worry and relaxation induction (presented in a fixed order) while HRV was collected continuously. Three blood samples were taken (at baseline, after the worry induction, and after the relaxation induction) to measure IL-6, IFN-γ, TNF-α and serum cortisol. Results: There were significant changes in IL-6 (p < 0.001), IFN-γ (p < 0.001), HRV (p < .001), and cortisol (p < .001) but not in TNF-α (p = 0.19) across conditions. HRV decreased significantly from baseline to worry and then increased following relaxation. IL-6 changed significantly between worry and relaxation and continued to increase following relaxation. Cortisol decreased significantly across conditions. Several patterns of covariance between inflammation and HRV and/or cortisol also emerged. Conclusions: These findings offer novel insight into how worry influences the immune system and emphasize the utility of a multi-methods approach to understanding the impact of worry on physical health

Using bodily displays to facilitating approach action outcomes within the context of a personally relevant task

Abstract Background Considerable attention has been paid to the effect of bodily (expansive and contractive) displays on affective, behavioral, and hormonal outcomes. However, the majority of past studies are limited by a lack of control groups with neutral displays and low personal relevance of the experimental tasks employed. The present study aimed to investigate the effect of adopting different bodily displays, including neutral displays, within the context of a personally relevant task. Methods In an experiment with healthy participants (N = 90), we investigated the effects of two different bodily manipulations (i.e., expansive and contractive), compared to a control group (i.e., neutral displays). Effects were evaluated in terms of completed valued action in addition to processes considered potentially helpful in preparing and motivating the individual to take valued action, including a change in emotion experience, action tendencies, and appraisals. Results Several main effects were detected and only few significant interaction effects were revealed. In case of group differences, results showed that expansive bodily displays outperformed the control group, leading to more positive emotions, more approach action tendencies, less negative emotion variability, and less avoidance action tendencies toward threat. Discussion These results mainly suggest that identifying a valued action and explicating the underlying motivational conflict may be beneficial regardless of bodily displays. This conclusion runs somewhat counter both to our hypotheses and to findings in recent meta‐analytic work. However, previous experiments have not evaluated the effect of bodily displays within a personally relevant context

The Impact of Emotion Regulation On the Relationship Between Momentary Negative Affect and End-of-Day Worry and Rumination

Background: Negative self-referential processing (NSRP), including worry and rumination, is a hallmark feature of generalized anxiety disorder (GAD). Negative affect relates to NSRP, and emotion regulation skills (e.g., reappraisal and acceptance) may attenuate this relationship. This ecological momentary assessment study explored whether increased emotion regulation skills use would alter associations between daily fluctuations of negative affect and end-of-day NSRP. Methods: Participants were 99 young adults (Mage = 19.94; SD = 1.81), diagnosed with GAD (n = 48) and healthy controls (n = 51). They provided twice daily ratings of negative affect, reappraisal, and acceptance over 14 days, and end-of-day ratings of NSRP. Mixed linear models adjusted for covariates, including state-level worry and rumination. Results: Individuals with GAD reported higher levels of negative than controls, and high negative affect corresponded to greater end-of-day NSRP across all participants. Increased emotion regulation skills altered the relationship between increased negative affect and higher NSRP, though this did not differ by group. Acceptance and reappraisal differentially affected associations between negative affect and NSRP. Conclusions: Findings suggest that emotion regulation skills moderate the relationship between negative affect and end-of-day NSRP, highlighting the utility of using reappraisal and acceptance in daily life. This could eventually lead to improvements in treating GAD