Associations between Alexithymia and Executive Function in Younger and Older Adults

The prevalence of alexithymia, a condition characterized by difficulties identifying and verbalizing one’s emotions, increases across the lifespan, with older adults reporting greater alexithymic features than young and middle-aged adults. This late-life increase in alexithymia may be the product of age-related decline in prefrontal brain circuitry implicated in emotional awareness and executive processes, notably in the anterior cingulate cortex (ACC). There is a dearth of research on the link between executive function and alexithymia in healthy adults. This study determined associations between alexithymia and executive function in healthy younger and older adults. Higher alexithymia scores were predicted to be associated with poorer performance on measures of executive function, specifically one that taps into ACC function (i.e., verbal fluency). Sixty-five young adults and 44 older adults completed the 20-item Toronto Alexithymia Scale, three executive function tasks (Verbal Fluency, Design Fluency, and Trail Making), assessments of memory and verbal ability, and a self-report measure of depressive symptoms. Greater total alexithymia and difficulties describing feelings (a dimension of alexithymia) were associated with poorer verbal fluency, accounting for age, gender, and depressive symptoms, in the full sample and in older adults, but not in young adults. Findings support the theoretical model that alexithymia is associated with age-related decline in frontal circuitry – possibly specific to declines in ACC functioning. Results provide insight into the possible origins of emotion self-awareness deficits in older adulthood

Emotional Response to Negative Mood Induction in Mild Cognitive Impairment and Cognitively-intact Older Adults

Older adults with mild cognitive impairment (MCI) report greater rates of psychiatric symptoms than cognitively-intact older persons. This may be associated with emotion dysregulation, which is prevalent in cognitively-impaired populations. No research to date has investigated responses to emotionally-provocative stimuli in persons with MCI. Aim 1 of this study determined differences in emotional reactivity to and recovery from negative mood induction in older persons with amnestic MCI (aMCI) and cognitively-healthy older adults. Moreover, emotion dysfunction in MCI may be linked to impairment in executive function (EF), a common feature of MCI. Theoretical models postulate that EF is essential to the active regulation of emotions. Aim 2 of this study determined associations between EF and emotion outcomes. Twenty older adults with aMCI and 25 cognitively-intact older adults watched a video depicting interpersonal loss to induce negative mood. Self-reported emotions were assessed prior to and immediately after the video, and after 3- and 6-minute recovery periods. Participants completed neuropsychological and behavioral measures of EF. Persons with aMCI and cognitively-intact older participants did not significantly differ in sadness or pleasantness reactivity to and recovery from the negative film clip. An association between poorer performance on an EF measure of behavioral inhibition and greater sadness reactivity was significantly stronger for individuals with aMCI compared to cognitively-intact older adults. Results lend support to theoretical models of EF and emotion regulatory abilities, and – with replication – may lead to better psychosocial interventions for persons with MCI who experience psychological distress

Better Memory for a Negative Event Associated with Better Emotion Regulation

Cognitive resources in older adults may promote psychological well-being. Our data add a novel dimension to this work by demonstrating that superior memory for negative mood induction stimuli is associated with better emotion recovery over time. Older (n = 11) and younger (n = 14) participants were shown film clips depicting themes of loss to induce negative emotions and reduce positive emotions. Self-report emotions were assessed prior to the videos, immediately after the videos, and after 10-minutes of emotion recovery. Results indicated that Positive Affect, Joviality, and Attentiveness significantly (ps \u3c .05) decreased and Negative Affect, Sadness, and Hostility significantly (ps \u3c .05) increased from pre- to post-video. Changes in Guilt were significantly (p \u3c .05) different by age group; scores for younger adults decreased whereas scores for older adults increased. Free recall and recognition memory for the film stimuli were tested. There was a trend for younger adults to have better recognition memory for the negative film stimuli than older adults (p \u3c 0.10). Poorer recognition memory was associated with less efficient emotion recovery for several negative emotions. Specifically, poorer recognition memory was associated with less efficient recovery as a trend for Fear (r = -.35, p \u3c .10) and Sadness (r = -.36, p \u3c .10) and significantly for Guilt (r = -.66, p \u3c .05). Better memory for an event that causes negative emotions may facilitate emotion regulation and emotion recovery. Implications for emotion dysregulation in memory disorders are discussed

A Web-Disseminated Self-Help and Peer Support Program Could Fill Gaps in Mental Health Care: Lessons From a Consumer Survey

Background: Self-guided mental health interventions that are disseminated via the Web have the potential to circumvent barriers to treatment and improve public mental health. However, self-guided interventions often fail to attract consumers and suffer from user nonadherence. Uptake of novel interventions could be improved by consulting consumers from the beginning of the development process in order to assess their interest and their preferences. Interventions can then be tailored using this feedback to optimize appeal. Objective: The aim of our study was to determine the level of public interest in a new mental health intervention that incorporates elements of self-help and peer counseling and that is disseminated via a Web-based training course; to identify predictors of interest in the program; and to identify consumer preferences for features of Web-based courses and peer support programs. Methods: We surveyed consumers via Amazon’s Mechanical Turk to estimate interest in the self-help and peer support program. We assessed associations between demographic and clinical characteristics and interest in the program, and we obtained feedback on desired features of the program. Results: Overall, 63.9% (378/592) of respondents said that they would try the program; interest was lower but still substantial among those who were not willing or able to access traditional mental health services. Female gender, lower income, and openness to using psychotherapy were the most consistent predictors of interest in the program. The majority of respondents, although not all, preferred romantic partners or close friends as peer counselors and would be most likely to access the program if the training course were accessed on a stand-alone website. In general, respondents valued training in active listening skills. Conclusions: In light of the apparent public interest in this program, Web-disseminated self-help and peer support interventions have enormous potential to fill gaps in mental health care. The results of this survey can be used to inform the design of such interventions

Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ):Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis

This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.</p