Expressive suppression is defined as the inhibition of emotion displays. Most studies among European Americans have found expressive suppression to be associated with poorer mental health. However, cross-cultural studies have shown that these associations are mixed for Asian Americans, with some studies finding negative associations, non-significant associations, and positive associations between expressive suppression and poorer mental health. As such, an investigation of within-group variability in the function of expressive suppression across emotion valence (i.e., negative vs. positive emotions) and suppression targets (i.e., with unfamiliar others vs. close others) among this group may help unpack these findings. The current study examined the relationships between daily expressive suppression and negative affect by emotion valence and relationship types, and whether these relationships were moderated by interdependent values among a sample of Asian American college students. Seventy-eight Asian Americans completed a 14-day daily diary study. There was no significant main effect of daily expressive suppression with close others on negative affect. Interdependent values moderated the relationship between daily expressive suppression of negative emotions, but not positive emotions, and same-day negative affect in close relationships, such that individuals who suppressed negative emotions with close others tended to experience greater negative affect among those who endorsed low interdependent values. Findings highlighted the importance of emotion valence and relationship types. Further, the findings demonstrated the potential protective role of interdependent values in buffering the maladaptive link between expressive suppression of both positive and negative emotions in close relationships and negative affect.
Anxiety disorders are chronic, pervasive, and debilitating; characterised by a persistent or exaggerated response to distal or abstract threats. Impaired threat discrimination (distinguishing safe from threatening stimuli) and impaired threat extinction (learning a once threatening stimulus is now safe), are known risk factors in the development and persistence of anxiety disorders. These effects can be experimentally elicited through fear conditioning. First, repeated trials of paired aversive and neutral stimuli are delivered during a fear acquisition phase, followed by repeated trials with no aversive stimuli in a fear extinction phase. The effects are typically measured through comparison of end-phase data points, or simple descriptive or statistical models. Computational modelling, by contrast, can offer a hypothesis-driven, trial-by-trial mechanistic account of fear conditioning. This unmasks within subject task variance by estimating the rate of threat learning, safety learning, and threat extinction, examining individual differences in the cognitive mechanisms behind anxiety. A normative sample (n = 145) underwent a differential fear conditioning task on a bespoke smartphone app, in addition to completing an anxiety severity measure (GAD-7). Computational models fitted to task data estimated learning rates. Whilst the threat learning rate showed no association, the threat extinction and safety learning rates showed small negative associations with anxiety severity (ρ = –0.22, p = 0.01 & ρ = –0.21, p = 0.01 respectively). These findings are in keeping with prior studies using traditional analytical approaches, and indicate that anxious individuals are not quicker to develop fear of a stimulus, but take more time than their non-anxious counterparts to learn that a stimulus is safe. This study strengthens the evidence for impairments in fear extinction in those with anxiety, and the importance of learning rates as an index of anxiety severity, a previously hidden cognitive mechanism underlying anxiety persistence.
Why some surgical participants experience pain that extends beyond the original site of injury while others do not remains poorly understood. Both pain intensity and widespread pain contribute to recovery and quality of life, yet their psychosocial correlates are often examined separately. Using data from two large pre-surgical cohorts-participants preparing for knee replacement or thoracic surgery-we examined associations between sociodemographic and psychosocial factors, pain intensity at surgical and non-surgical sites, and widespread chronic pain. Across cohorts and outcomes, fatigue showed the strongest and most consistent associations with pain intensity and widespread pain, independent of other measured factors. Fatigue also occupied a central position in statistical association networks and accounted for substantial shared variance among multiple psychosocial variables, including sleep disturbance, depression, stress, and socioeconomic disadvantage. Pain at non-surgical sites was strongly associated with widespread pain and frequently accounted for observed associations between surgical-site pain and widespread pain. Together, these findings highlight robust patterns of association linking fatigue, pain intensity, and widespread pain in pre-surgical populations.
Cognitive neuroscience has advanced significantly due to the availability of openly shared datasets. Large sample sizes, large amounts of data per person, and diversity in tasks and data types are all desirable, but are difficult to achieve in a single dataset. Here, we present an open dataset with N = 101 participants and 6 hours of scanning per participant, including 6 multifaceted functional tasks, 2 hours of naturalistic movie viewing, structural T1 images and multi-shell diffusion imaging as well as autonomic physiological data. This dataset’s combination of sample size, extensive data per participant (>600 iso-hours of data), and a wide range of experimental conditions — including cognitive, affective, social, and somatic/interoceptive tasks — positions it uniquely for probing important questions in cognitive neuroscience.
Imagination is a principal human capacity, enabling simulation of sensations and situations for planning, learning, and empathy. We examined neural representations of experienced and imagined pain across eight body sites using deep-phenotyping, precision functional MRI with over seven hours of scanning per participant (N = 9). Conventional mapping, pattern classification, and representational similarity analyses converged to show that both imagined and experienced pain activated nociceptive regions (e.g., dorsoposterior insula) and non-nociceptive regions (e.g., supplementary motor area). However, imagined pain did not reliably reactivate body site-selective nociceptive patterns in any region. Instead, imagined and experienced pain shared multivariate representations across widespread cortical and subcortical regions, particularly transmodal cortical areas including dorsomedial and lateral prefrontal cortex, hippocampus, and thalamus. These findings suggest that imagination generates distributed pain-like activity while preserving a neural distinction from verum pain. This distinction may explain the difficulty of vividly imagining pain and underlie its role in empathy, planning, and pain vulnerability. Author Note We are grateful for assistance from Terry Sackett, Maryam Amini, Melanie Kos, Stephanie Sun, Eilis Murphy, Samuel Bergerson, Kristoffer Mansson, Sreekar Kasturi, Jason Davis, and Charles Mazof for assistance in data collection for this study. We thank Byeol Kim, Ben Graul, Li-Bo Zhang, and Zhaoxing Wei for comments on the manuscript, and Luke Chang and Marianne Reddan for insightful discussion. This work was funded by a grant from the Hitchcock Foundation and grant R37MH076136 from the National Institutes of Mental Health. Code for analyses are available at . ### Competing Interest Statement The authors have declared no competing interest. National Institute of Mental Health, https://ror.org/04xeg9z08, R37MH076136 Hitchcock Foundation
ImportanceChronic back pain (CBP) is a leading cause of disability. Placebo treatments often provide as much pain relief as bona fide treatments, such as steroid injections. Open-label (honestly prescribed) placebos (OLPs) may relieve CBP without deception, but OLP mechanisms remain poorly understood. ObjectiveTo investigate the long-term efficacy and neurobiological mechanisms of OLP for CBP. Design, Setting, and ParticipantsA randomized clinical trial of CBP with longitudinal functional magnetic resonance imaging (MRI) comparing OLP with usual care, with 1-year follow-up, was conducted in a university research setting and a community orthopedic clinic. Participants were individuals aged 21 to 70 years with CBP. The trial was conducted from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Data analysis was performed from April 2020 to May 2024. The primary analysis was conducted on an intention-to-treat sample. InterventionsParticipants randomized to OLP received a 1-time subcutaneous lumbar saline injection presented as placebo accompanied by information about the power of placebo to relieve pain, alongside their ongoing care. Usual care participants continued their ongoing care. Main Outcomes and MeasuresThe primary outcome was pain intensity (0-10, with 0 indicating no pain and 10 the most intense) at 1 month posttreatment. Secondary outcomes included pain interference, depression, anxiety, anger, and sleep quality. Functional MRI was performed before and after treatment during evoked and spontaneous back pain. ResultsA total of 101 adults (52 [51.4%] females; mean [SD] age, 40.4 [15.4] years) with moderate severity CBP (mean [SD], 4.10 [1.25] intensity; duration, 9.7 [8.5] years) were enrolled. Compared with usual care, OLP reduced CBP intensity posttreatment (relative reduction, 0.61; Hedges g = 0.45; 95% CI, -0.89 to 0.04; P = .02). Through 1-year follow-up, pain relief did not persist, although significant benefits were observed for depression, anger, anxiety, and sleep disruption (Hedges g = 0.3-0.5; all P < .03). Brain responses to evoked back pain for OLP vs usual care increased in rostral anterior cingulate and ventromedial prefrontal cortex and decreased in somatomotor cortices and thalamus. During spontaneous pain, functional connectivity analyses identified OLP vs usual care increases in ventromedial prefrontal cortex connectivity to the rostral ventral medulla, a pain-modulatory brainstem nucleus. No adverse effects of treatment were reported by participants. Conclusions and RelevanceIn this randomized clinical trial of OLP vs usual care, a single nondeceptive placebo injection reduced CBP intensity for 1 month posttreatment and provided benefits lasting for at least 1 year posttreatment. Brain mechanisms of OLP in a clinical population overlap with those of deceptive placebos in healthy volunteers, including engagement of prefrontal-brainstem pain modulatory pathways. Trial RegistrationClinicalTrials.gov Identifier: NCT03294148
BACKGROUND: The amygdala is highly implicated in an array of psychiatric disorders but is not accessible using currently available noninvasive neuromodulatory techniques. Low-intensity transcranial focused ultrasound (TFUS) is a neuromodulatory technique that has the capability of reaching subcortical regions noninvasively. METHODS: We studied healthy older adult participants (N = 21, ages 48-79 years) who received TFUS targeting the right amygdala and left entorhinal cortex (active control region) using a 2-visit within-participant crossover design. Before and after TFUS, behavioral measures were collected via the State-Trait Anxiety Inventory and an emotional reactivity and regulation task utilizing neutral and negatively valenced images from the International Affective Picture System. Heart rate and self-reported emotional valence and arousal were measured during the emotional reactivity and regulation task to investigate subjective and physiological responses to the task. RESULTS: Significant increases in both self-reported arousal in response to negative images and heart rate during emotional reactivity and regulation task intertrial intervals were observed when TFUS targeted the amygdala; these changes were not evident when the entorhinal cortex was targeted. No significant changes were found for state anxiety, self-reported valence to the negative images, cardiac response to the negative images, or emotion regulation. CONCLUSIONS: The results of this study provide preliminary evidence that a single session of TFUS targeting the amygdala may alter psychophysiological and subjective emotional responses, indicating some potential for future neuropsychiatric applications. However, more work on TFUS parameters and targeting optimization is necessary to determine how to elicit changes in a more clinically advantageous way.
BackgroundLow intensity, transcranial focused ultrasound (tFUS) is a re-emerging brain stimulation technique with the unique capability of reaching deep brain structures non-invasively. Objective/HypothesisWe sought to demonstrate that tFUS can selectively and accurately target and modulate deep brain structures in humans important for emotional functioning as well as learning and memory. We hypothesized that tFUS would result in significant longitudinal changes in perfusion in the targeted brain region as well as selective modulation of BOLD activity and BOLD-based functional connectivity of the target region. MethodsIn this study, we collected MRI before, simultaneously during, and after tFUS of two deep brain structures on different days in sixteen healthy adults each serving as their own control. Using longitudinal arterial spin labeling (ASL) MRI and simultaneous blood oxygen level dependent (BOLD) functional MRI, we found changes in cerebral perfusion, regional brain activity and functional connectivity specific to the targeted regions of the amygdala and entorhinal cortex (ErC). ResultstFUS selectively increased perfusion in the targeted brain region and not in the contralateral homolog or either bilateral control region. Additionally, tFUS directly affected BOLD activity in a target specific fashion without engaging auditory cortex in any analysis. Finally, tFUS resulted in selective modulation of the targeted functional network connectivity. ConclusionWe demonstrate that tFUS can selectively modulate perfusion, neural activity and connectivity in deep brain structures and connected networks. Lack of auditory cortex findings suggests that the mechanism of tFUS action is not due to auditory or acoustic startle response but rather a direct neuromodulatory process. Our findings suggest that tFUS has the potential for future application as a novel therapy in a wide range of neurological and psychiatric disorders associated with subcortical pathology.
Sleep is an essential physiologic process, and unfortunately, people with gastrointestinal (GI) conditions are more likely than people in the general population to experience poor sleep quality, sleep disorders, and fatigue. Herein, we present information on common sleep disorders, fatigue, and data on these problems in various GI populations. We also discuss several treatments for sleep concerns and emerging research on the use of these treatments in GI populations. Cases that illustrate the GI/sleep relationship are presented, in addition to guidance for your own practice and cultural considerations.
The Pavlovian-Instrumental Transfer (PIT) paradigm examines probabilistic and reinforcement learning. Disruptions in mechanisms that mediate PIT (i.e., cues not triggering adaptive behaviors) are thought to be contributors to psychopathology, making the study of probabilistic and reinforcement learning clinically relevant. The current study evaluated an appetitive PIT effect and its relationship with symptom dimensions spanning depression and anxiety, with a particular focus on anhedonia. Forty young adults ranging in scores across dimensions of depression and anxiety symptoms completed the PIT paradigm and self-report symptom measures. The PIT paradigm consisted of three phases. The instrumental phase consisted of a contingent association in which participants squeezed a handgrip for monetary reward. The Pavlovian phase established a purely predictive association between three visual stimuli (CS + , CS-, baseline) and presence or absence of monetary reward. In the transfer phase, participants’ responses allowed for examination of whether motivational characteristics of Pavlovian predictors influenced the vigor of their handgrip squeezes (instrumental action), which were formerly independent of Pavlovian associations. Analyses revealed a baseline-reward PIT effect, whereby a reward-associated Pavlovian cue enhanced instrumental responding in the transfer phase. However, there were no significant differences between CS + and CS- or CS- and baseline cues, suggesting a disrupted interaction of Pavlovian and instrumental learning. Further, the appetitive PIT effect captured in this paradigm was not associated with anhedonia, fears, or general distress. Future work should investigate the influence of mood states using more specific appetitive PIT paradigms to further understanding of the implications of disrupted reflexive and instrumental responding.
Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect (e.g., negative inferential style) instead of deficits in positive affect (e.g., attenuated reward response) and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality (VR) has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals.
Neuroticism has been associated with depression and anxiety both cross-sectionally and longitudinally. Interpretive bias has been associated with depression and anxiety, primarily in cross-sectional and bias induction studies. The purpose of the current study was to examine the role of interpretive bias as a prospective risk factor and a mediator of the relation between neuroticism and depressive and anxious symptoms in young adults assessed longitudinally. Neuroticism significantly predicted a broad general-distress dimension but not intermediate fears and anhedonia-apprehension dimensions or a narrow social-fears dimension. Neuroticism also significantly predicted negative interpretive bias for social scenarios. Negative interpretive bias for social scenarios did not significantly predict dimension scores, nor did it mediate the relation between neuroticism and general distress or social fears. These results suggest that although neuroticism relates to negative interpretive bias, its risk for symptoms of depression and anxiety is at most weakly conferred through negative interpretive bias.
Posttraumatic stress disorder (PTSD) is often complicated by the after-effects of mild traumatic brain injury (mTBI). The mixture of brain conditions results in abnormal affective and cognitive functioning, as well as maladaptive behavior. To better understand how brain activity explains cognitive and emotional processes in these conditions, we used an emotional N-back task and functional magnetic resonance imaging (fMRI) to study neural responses in US military veterans after deployments to Iraq and Afghanistan. Additionally, we sought to examine whether hierarchical dimensional models of maladaptive personality could account for the relationship between combat-related brain conditions and fMRI responses under cognitive and affective challenge. FMRI data, measures of PTSD symptomatology (PTSS), blast-induced mTBI (bmTBI) severity, and maladaptive personality (MMPI-2-RF) were gathered from 93 veterans. Brain regions central to emotion regulation were selected for analysis, and consisted of bilateral amygdala, bilateral dorsolateral prefrontal (dlPFC), and ventromedial prefrontal/subgenual anterior cingulate (vmPFC-sgACC). Cognitive load increased activity in dlPFC and reduced activity in emotional responding brain regions. However, individuals with greater PTSS showed blunted deactivations in bilateral amygdala and vmPFC-sgACC, and weaker responses in right dlPFC. Additionally, we found that elevated emotional/internalizing dysfunction (EID), specifically low positive emotionality (RC2), accounted for PTSS-related changes in bilateral amygdala under increased cognitive load. Findings suggest that PTSS might result in amygdala and vmPFC-sgACC activity resistant to moderation by cognitive demands, reflecting emotion dysregulation despite a need to marshal cognitive resources. Anhedonia may be an important target for interventions that improve the affective and cognitive functioning of individuals with PTSD.
Limited shelf life due to processing associated microbial contamination is one of the major challenging issues with minimally processed ‘Ready to Bake’ (RTB) vegetable products leading to huge post-processing losses. In the current study, three minimally processed vegetables, i.e. tomato, bell pepper and white onion, which are widely used in fast food industries (FFI), such as pizza and burger as well as in households; were studied for their post-processing microbiological profile; and to assess the effect of gamma radiation treatment (0.5–5 kGy) to maintain hygiene during extended storage at low temperature. Prior to radiation treatment, the minimally processed vegetables were packed in low density polyethylene bags (thickness: 50 μm) which is suitable for such agri-produce and compatible to gamma radiation treatment (USA, FDA). Besides, vacuum packaging in multilayered LDPE bags was optimized for shredded onion. Except tomato, which did not contain any detectable presumptive coliform or yeast and mold on day 0, the other two cut vegetables were found to have higher load of microbes, i.e., more than 4.0 log CFUg−1 of total aerobic plate count, 3.0 log CFUg−1of each of yeast and mold counts (YMC) and presumptive coliform (PC) counts. In the radiation treated (2 kGy) vegetables, no PC was detected; even after 20 days of storage; whereas, in the untreated bell pepper, tomato and onion samples PC counts were found to be 4.3 ± 0.1, 3.7 ± 0.2 and 1.7 ± 0.3 log CFUg−1 respectively on day 20 of storage. The data indicated that, the total aerobic plate counts in the 2 kGy irradiated samples were below the permissible limit as per the Food Safety and Standards Authority of India (FSSAI) guidelines. Organoleptic attributes (‘colour’, ‘texture’, ‘flavour’, ‘taste’ and ‘overall acceptability’) of the radiation treated products were found to be well retained even on 20 days of storage. The nutritional adequacy of these products in terms of total energy, fat, protein, carbohydrate, minerals and vitamin content was found to be well retained till the end of the 20 days' storage period. Findings of the study thus establish the efficacy of gamma radiation treatment in ensuring the safety and quality of minimally processed vegetables for their use in FFI as well as domestic kitchens.
Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23-1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.
Our aim was to investigate whether four treatment features (i.e., the inclusion of parental involvement, goal-setting strategies, maintenance/relapse prevention sessions, the addition of booster sessions) were associated with posttreatment and follow-up effect size of youth cognitive behavioral therapies (yCBTs) for anxiety, depression, posttraumatic stress disorder, and obsessive-compulsive disorder in age groups spanning young children to adolescents. We conducted a random-effects meta-analysis of 106 yCBTs tested in 76 randomized clinical trials from the PracticeWise Database to examine average effects of yCBTs posttreatment and at a later follow-up assessment. We coded the use of parental involvement, goal setting, booster sessions, and maintenance/relapse prevention in each yCBT and conducted random-effects meta-regression analyses to investigate whether these treatment features were associated with yCBT effects at posttreatment as well as at follow-up. Overall, yCBTs produced large pre- to posttreatment effects (d = 1.05), 95% confidence interval [0.94, 1.15], and larger pre-to follow-up effects (d = 1.29), 95% confidence interval [1.18, 1.40]. Metaregression results indicated that parental involvement was significantly associated with larger pre- to posttreatment effect sizes as well as pre-to follow-up effect sizes. Booster sessions, goal setting, and maintenance/relapse prevention were not significantly related to effect sizes at posttreatment or follow-up. Parental involvement may be helpful for maximizing long-term effectiveness of yCBT. Future studies should investigate for whom and under what conditions inclusion of yCBT treatment features is related to the durability of treatment gains.
Fear conditioning models key processes related to the development, maintenance and treatment of anxiety disorders and is associated with group differences in anxiety. However, laboratory administration of tasks is time and cost intensive, precluding assessment in large samples, necessary for analysis of individual differences. This study introduces a newly developed smartphone app that delivers a fear conditioning paradigm remotely. Three groups of participants (total n=152) took part in three studies involving a differential fear conditioning experiment to assess the reliability and validity of a smartphone administered fear conditioning paradigm. This comprised of fear acquisition, generalisation, extinction, and renewal phases. We show that smartphone app delivery of a fear conditioning paradigm results in a pattern of fear learning comparable to traditional laboratory delivery, and is able to detect individual differences in performance that show comparable associations with anxiety to the prior group differences literature.
Previous research has shown that the habit of suppressing emotional expressions is associated with long-term, general reductions in social cognitive abilities and interpersonal adjustment. This may be because theoretically, habitual suppression requires the fixation of attention to the self instead of to others. The present research explored the association between the habitual tendency to suppress one’s own emotions and accuracy in recognizing the emotions of others. Emotion recognition accuracy was tested across two tasks, a limited-channel task that presents limited emotional information and a multimodal full-channel task. We further explored cultural differences in this association given that expressive suppression may be normative for individuals of Asian descent due to cultural motivations toward social harmony and interdependence. Our findings revealed few cultural group differences. U.S.-born Asian Americans outperformed foreign-born Asian Americans and European Americans in limited-channel emotion recognition. However, the three groups did not differ in terms of interdependent self-construal, habitual emotion suppression, and full-channel emotion recognition ability. Interdependent self-construal was related to greater habitual suppression and emotion recognition accuracy in the full-channel task. Habitual emotion suppression was negatively related to limited-channel but not full-channel emotion recognition. There was no evidence of cultural differences in the link between habitual suppression and emotion recognition.