Attention bias modification training aims to alter attentional deployment to symptom-relevant emotionally salient stimuli. Such training has therapeutic applications in the management of disorders including anxiety, depression, addiction and chronic pain. In emotional reactions, attentional biases interact with autonomically-mediated changes in bodily arousal putatively underpinning affective feeling states. Here we examined the impact of attention bias modification training on behavioral and autonomic reactivity. Fifty-eight participants were divided into two groups. A training group (TR) received attention bias modification training to enhance attention to pleasant visual information, while a control group (CT) performed a procedure that did not modify attentional bias. After training, participants performed an evaluation task in which pairs of emotional and neutral images (unpleasant-neutral, pleasant-neutral, neutral-neutral) were presented, while behavioral (eye movements) and autonomic (skin conductance; heart rate) responses were recorded. At the behavioral level, trained participants were faster to orientate attention to pleasant images, and slower to orientate to unpleasant images. At the autonomic level, trained participants showed attenuated skin conductance responses to unpleasant images, while stronger skin conductance responses were generally associated with higher anxiety. These data argue for the use of attentional training to address both the attentional and the physiological sides of emotional responses, appropriate for anxious and depressive symptomatology, characterized by atypical attentional deployment and autonomic reactivity.

The COVID-19 pandemic overwhelmed health facilities and presented healthcare workers (HCWs) with a new infectious disease threat. In addition to a sanitary crisis, Brazil still had to face major political, economic, and social challenges. This study aimed to investigate mental health outcomes in frontline HCWs in different regions of the country and at different epidemic times. We also sought to identify the main risk factors associated with these outcomes.A cross-sectional online survey using respondent-driven sampling was conducted to recruit physicians (n = 584), nurses (n = 997), and nurse technicians (n = 524) in 4 regions of Brazil (North, Northeast, Southeast, and South) from August 2020 to July 2021. We used standardized instruments to screen for common mental disorders (CMD)(SRQ-20), alcohol misuse (AUDIT-C), depression (PHQ-9), anxiety (GAD-7), and post-traumatic stress disorder (PTSD)(PCL-5). Gile's successive sampling estimator was used to produce weighted estimates. We created a three-cluster data set for each HCW category and developed a hierarchical regression model with three levels: individual characteristics; workplace-related aspects; COVID-19 personal experience. The impact of the epidemic moment on the outcomes was also studied.The prevalence of probable CMD was 26.8–36.9%, alcohol misuse 8.7–13.6%, depression 16.4–21.2%, anxiety 10.8–14.2%, and PTSD 5.9–8.0%. We found a stronger association between mental health outcomes and the following factors: history of psychiatric disorders, female gender, and clinical comorbidities (level 1); work overload and family isolation (level 2); sick leave (level 3). Epidemic variables, such as the number of deaths and trend of deaths by COVID-19, had almost no impact on the outcomes.An alarmingly high prevalence of depression and anxiety was found in Brazilian frontline HCWs. Individual factors were the most strongly associated with mental health outcomes. These findings indicate the need to develop programs that provide emotional support, identify professionals at risk and refer them to specialized treatment when necessary.

•Better categorisation of emotion in both central (CV) and peripheral vision (PV).•An opposite pattern of autonomic arousal was observed between CV and PV.•Depression was associated with better categorisation of emotional pictures in CV.•Anxiety was associated with a response bias to unpleasant pictures in PV.

Depression is characterised by attentional bias to emotional information and dysregulated autonomic reactivity. Despite its relevance to understanding depressive mechanisms, the association between attentional bias and autonomic reactivity to emotional information remains poorly characterised. This study compared behavioural and autonomic responses to emotional images in 32 participants in whom subclinical depressive symptomatology was quantified using the Beck Depression Inventory. Pairs of emotional and neutral images (unpleasant-neutral, U-N; pleasant-neutral, P-N; neutral-neutral, N-N) were presented while attentional indices (eye movements) and autonomic activity (skin conductance responses, SCRs; heart rate, HR) were recorded. Results showed that all recorded ocular parameters indicated a preferential orientation and maintenance of attention to emotional images. SCRs were associated with a valence effect on fixation latency: lower fixation latency to pleasant stimuli leads to lower SCRs whereas the opposite was observed for unpleasant stimuli. Finally, stepwise linear regression analysis revealed that latency of fixation to pleasant images and scores of depression predicted SCRs of participants. Thus, our research reveals an association between autonomic reactivity and attentional bias to pleasant information, on the one hand, and depressive symptomatology on the other. Present findings therefore suggest that depressive individuals may benefit from attention training towards pleasant information in association with autonomic biofeedback procedures.

Anxiety and depression are both characterized by dysregulated autonomic reactivity to emotion. However, most experiments until now have focused on autonomic reactivity to stimuli presented in central vision (CV) even if affective saliency is also observed in peripheral vision (PV). We compared autonomic reactivity to CV and PV emotional stimulation in 58 participants with high anxious (HA) or low anxious (LA) and high depressive (HD) or low depressive (LD) symptomatology, based on STAI-B and BDI scores, respectively. Unpleasant (U), pleasant (P), and neutral (N) pictures from IAPS were presented at three eccentricities (0°: CV; -12 and 12°: PV). Skin conductance (SC), skin temperature, pupillary diameter, and heart rate (HR) were recorded. First, HA participants showed greater pupil dilation to emotional than to neutral stimuli in PV than in CV. Second, in contrast to HD, the valence effect indexed by SC and emotional arousal effect indexed by skin temperature were observed in LD. Third, both anxiety and depression lead to a valence effect indexed by pupillary light reflex and heart rate. These results suggest a hyperreactivity to emotion and hypervigilance to PV in anxiety. Depression is associated with an attenuation of positive effect and a global blunted autonomic reactivity to emotion. Moreover, anxiety mostly modulates the early processes of autonomic reactivity whereas depression mainly affects the later processes. The differential impact of emotional information over the visual field suggests the use of new stimulation strategies in order to attenuate anxious and depressive symptoms.

Attentional deficits as well as attentional biases towards negative material are related to major depression and might maintain chronicity. However, studies investigating attentional deficits and attentional biases in chronic, treatment-resistant depressed are lacking. The aim of the current study was to compare measures of attentional deficits and attentional bias between chronic, treatment-resistant depressed outpatients and never-depressed control participants. Attentional deficits were assessed with the attentional control scale (ACS) and the Stroop Color naming task. Attentional bias was measured with the exogenous cueing task (ECT) and an emotional Stroop task. Chronic, treatment-resistant depressed patients (n = 80) showed significantly more attentional deficits than never-depressed controls (n = 113) on the ACS and Stroop color-naming task. However, in contrast with hypotheses, no differences were found between chronic, treatment-resistant depressed patients and never-depressed individuals on the ECT or emotional Stroop task. The current findings indicate that chronic, treatment-resistant depressed patients present attentional deficits. The results however question whether this patient group shows attentional biases for negative material. Future research should include comparisons of chronic, treatment-resistant and non-chronically depressed patients. If replicated, these current results might indicate that focusing on improving attentional deficits could be a more promising target for treatment than addressing attentional biases.

In order to visualize the distribution of chemical elements in arterial walls and atherosclerotic plaque the laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) was applied. As a result, the signals of structural elements in arterial wall and plaque (C, S, P, Ca), as well as trace and toxic elements (Mg, Fe, Mn, Cu, Zn, Co, Sr, Mo, Cd, Ba, Pb) in arterial walls were presented as two-dimensional maps. The bioimaging maps showed heterogeneous distribution of almost all analyzed elements. The elements which build up a plaque (Ca, P, Mg, Sr, Ba) are clearly distinguished from the arterial wall tissue, which in turn is composed mainly of C, S and trace elements. The highest signals of Zn were measured in the area connecting the arterial wall and atherosclerotic plaque which might be due to the presence of increased amount and activity of matrix metalloproteinases in arterial wall. The LA-ICP-MS provided data on the distribution of macro- and microelements, as well as toxic elements, in the soft tissues of arterial wall and the calcified plaque. The statistical analysis of data based on non-parametric tests and principal components analysis was performed, which revealed specific relations in distribution of measured elements.