Impaired regulation of emotion: Neural correlates of reappraisal and distraction in bipolar disorder and unaffected relatives

Deficient emotion regulation has been proposed as a crucial pathological mechanism in bipolar disorder (BD). We therefore investigated emotion regulation impairments in BD, the related neural underpinnings and their etiological relevance for the disorder. Twenty-two euthymic patients with bipolar-I disorder and 17 unaffected first-degree relatives of BD-I patients, as well as two groups of healthy gender-, age- and education-matched controls (N=22/17, respectively) were included. Participants underwent functional magnetic resonance imaging while applying two different emotion regulation techniques, reappraisal and distraction, when presented with emotional images. BD patients and relatives showed impaired downregulation of amygdala activity during reappraisal, but not during distraction, when compared with controls. This deficit was correlated with the habitual use of reappraisal. The negative connectivity of amygdala and orbitofrontal cortex (OFC) observed during reappraisal in controls was reversed in BD patients and relatives. There were no significant differences between BD patients and relatives. As being observed in BD patients and unaffected relatives, deficits in emotion regulation through reappraisal may represent heritable neurobiological abnormalities underlying BD. The neural mechanisms include impaired control of amygdala reactivity to emotional stimuli and dysfunctional connectivity of the amygdala to regulatory control regions in the OFC. These are, thus, important aspects of the neurobiological basis of increased vulnerability for BD

Lay theories of grandiose and vulnerable narcissism

In public discourse, narcissism is often portrayed one-sidedly and overly negative, rendering a picture of narcissistic individuals as “toxic people” or “evil characters”. Beyond these salient associations, psychological theories point to a more complex phenomenon, and different developmental mechanisms are being discussed in relation to it. We investigated the prevalence of different implicit theories on narcissism including beliefs about its developmental antecedents. We put forward the question whether grandiose and vulnerable narcissistic behaviors are regarded as congruent or incongruent expressions of underlying feelings and motives, that is whether grandiose behavior is attributed to underlying grandiosity or underlying vulnerability, and vice versa. Results of an online survey (N = 177) show higher agreement with congruent rather than incongruent theories (i.e., grandiose narcissism is attributed to feelings of superiority rather than inferiority, vulnerable narcissism is attributed to inferiority rather than superiority). In line with this, participants displayed predominant beliefs in parental overvaluation as a developmental antecedent of grandiose narcissism/parental coldness as an antecedent of vulnerable narcissism. With higher self-reported prior knowledge of narcissism, endorsement of theories assuming incongruencies increased. The likability of narcissism was not associated with endorsement of the different implicit theories, but instead with perceivers’ own narcissism levels. Results suggest that laypeople employ an “it is what it seems” – heuristic facing both grandiose and vulnerable narcissistic behaviors and are less likely to attribute grandiose or vulnerable behavior to incongruent motivational states. Findings might help to better understand the public image of narcissism and its social consequences

Bipolar disorder: A neural network perspective on a disorder of emotion and motivation

Bipolar disorder (BD) is a severe, chronic disease with a heritability of 60–80%. BD is frequently misdiagnosed due to phenomenological overlap with other psychopathologies, an important issue that calls for the identification of biological and psychological vulnerability and disease markers. Altered structural and functional connectivity, mainly between limbic and prefrontal brain areas, have been proposed to underlie emotional and motivational dysregulation in BD and might represent relevant vulnerability and disease markers. In the present laboratory review we discuss functional and structural neuroimaging findings on emotional and motivational dysregulation from our research group in BD patients and healthy individuals at risk to develop BD. As a main result of our studies, we observed altered orbitofrontal and limbic activity and reduced connectivity between dorsal prefrontal and limbic brain regions, as well as reduced integrity of fiber tracts connecting prefrontal and subcortical brain structures in BD patients and high-risk individuals. Our results provide novel insights into pathophysiological mechanisms of bipolar disorder. The current laboratory review provides a specific view of our group on altered brain connectivity and underlying psychological processes in bipolar disorder based on our own work, integrating relevant findings from others. Thereby we attempt to advance neuropsychobiological models of BD

Medication-enhanced psychotherapy for posttraumatic stress disorder: Recent findings on oxytocin’s involvement in the neurobiology and treatment of posttraumatic stress disorder

Background: Traumatic experiences may result in Posttraumatic Stress Disorder (PTSD), which is characterized as an exaggerated fear response that cannot be extinguished over time or in safe environments. What are beneficial psychotherapeutic treatment options for PTSD patients? Can oxytocin (OXT), which is involved in the stress response, and safety learning, ameliorate PTSD symptomatology and enhance psychotherapeutic effects? Here, we will review recent studies regarding OXT’s potential to enhance psychotherapeutic therapies for PTSD treatment. Method: We conducted a literature review on the neurobiological underpinnings of PTSD especially focusing on OXT’s involvement in the biology and memory formation of PTSD. Furthermore, we researched successful psychotherapeutic treatments for PTSD patients and discuss how OXT may facilitate observed psychotherapeutic effects. Results: For a relevant proportion of PTSD patients, existing psychotherapies are not beneficial. OXT may be a promising candidate to enhance psychotherapeutic effects, because it dampens responses to stressful events and allows for a faster recovery after stress. On a neural basis, OXT modulates processes that are involved in stress, arousal and memory. OXT effectively counteracts memory impairments caused by stress and facilitates social support seeking which is a key resilience factor for PTSD and which is beneficial in psychotherapeutic settings. Conclusion: OXT has many characteristics that are promising to positively influence psychotherapy for PTSD patients. It potentially reduces intrusions, but preserves memory of the event itself. Introducing OXT into psychotherapeutic settings may result in better treatment outcomes for PTSD patients. Future research should directly investigate OXT’s effects on PTSD, especially in psychotherapeutic settings

Narcissism in independent and interdependent cultures

Narcissism can manifest in a grandiose form – admiration-seeking, exhibitionism, and dominance – or a vulnerable form – anxiety, withdrawal, and hypersensitivity. While grandiose narcissism is conceptually in line with an independent self-construal, as prevalent in Western countries, the vulnerable form can be assumed to relate more to an interdependent self-construal, as prevalent in Eastern countries. We studied both forms of narcissism in Germany and Japan (Ns = 258, 280), which differ fundamentally in their independent and interdependent self-construal, yet are similar regarding global developmental standards. We tested whether (1) mean differences in both narcissism forms would conform to the predominant self-construal, (2) self-construal would explain variance in narcissism beyond broad personality traits, and (3) there would be stronger mental health tradeoffs for culturally incongruent forms of narcissism. Our results largely confirm these expectations for vulnerable narcissism, which is (1) more prevalent in Japan than Germany, (2) related to self-construal beyond broad traits, and, (3) more strongly related to mental health problems in Germany than Japan. For grandiose narcissism, data analyses indicated that construct equivalence can only be assumed for the entitlement factor, and internal structure and nomological networks differ substantially between cultural contexts

Deficits in explicit emotion regulation in bipolar disorder: A systematic review

Background: This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods: To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results: In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion: We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders