Neural correlates of emotion regulation deficits in remitted depression: The influence of regulation strategy, habitual regulation use, and emotional valence

Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany.
NeuroImage (Impact Factor: 6.36). 07/2012; 61(3):686-93. DOI: 10.1016/j.neuroimage.2012.03.089
Source: PubMed


Regulating emotions through reappraisal has been shown to elicit abnormal neural activation patterns in currently depressed patients. It is, however, unclear if this deficit generalizes to other emotion regulation strategies, if it persists when patients recover, and if it is related to habitual use of reappraisal strategies. Therefore, we measured the neural responses to emotional images with functional magnetic resonance imaging in remitted patients with previous episodes of major depression and healthy controls. While viewing the images participants regulated the elicited emotions using either a reappraisal or a distraction strategy. Habitual reappraisal use was measured with the Cognitive Emotion Regulation Questionnaire. Depressed patients showed a selective deficit in down-regulating amygdala responses to negative emotional stimuli using reappraisal. This down-regulation of amygdala activity was strongest in participants high in habitual reappraisal use. Activity in the regulating control-network including anterior cingulate and lateral orbitofrontal cortex was increased during both emotion regulation strategies. The findings in remitted patients with previous episodes of major depression suggest that altered emotion regulation is a trait-marker for depression. This interpretation is supported by the relation of habitual reappraisal use to amygdala down-regulation success.

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    • "rally not significant for male participants , although ANOVA results were significant , may suggest that the listening task was less determinant of males ' mPFC activation than other factors , including Discharge use , which would be in line with previous research showing neural responses differences based on habitual emotion regulation strategy ( Kanske et al . , 2012 ) . However , because here we only used questionnaires rather than an experimental manipulation , it cannot be concluded whether these neural underpinnings are caused by repeated Discharge , anxiety and Neuroticism , or some other factor common to all three ."
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    ABSTRACT: Music therapists use guided affect regulation in the treatment of mood disorders. However, self-directed uses of music in affect regulation are not fully understood. Some uses of music may have negative effects on mental health, as can non-music regulation strategies, such as rumination. Psychological testing and functional magnetic resonance imaging (fMRI) were used explore music listening strategies in relation to mental health. Participants (n = 123) were assessed for depression, anxiety and Neuroticism, and uses of Music in Mood Regulation (MMR). Neural responses to music were measured in the medial prefrontal cortex (mPFC) in a subset of participants (n = 56). Discharge, using music to express negative emotions, related to increased anxiety and Neuroticism in all participants and particularly in males. Males high in Discharge showed decreased activity of mPFC during music listening compared with those using less Discharge. Females high in Diversion, using music to distract from negative emotions, showed more mPFC activity than females using less Diversion. These results suggest that the use of Discharge strategy can be associated with maladaptive patterns of emotional regulation, and may even have long-term negative effects on mental health. This finding has real-world applications in psychotherapy and particularly in clinical music therapy.
    Frontiers in Human Neuroscience 08/2015; 9. DOI:10.3389/fnhum.2015.00466 · 3.63 Impact Factor
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    • "Relevant for the applicability to clinical conditions, one might expect that using reappraisal to regulate emotional personal memories in affective disorders might be a costly strategy and more difficult to apply, due to overall decreased cognitive/ executive abilities in these patient populations (Kanske et al., 2012). Therefore, it would be important to explore whether manipulation of attentional deployment, which has been shown to have immediate beneficial effects in reducing the emotional impact of viewing emotional images and to have clinical utility (Kanske et al., 2012), is also effective in down-regulating the subjective emotional re-experiencing of AMs and the associated activity in emotion-related regions. The main goal of the present study was to investigate the neural correlates of focusing away from emotion during autobiographical recollection, by manipulating the attentional focus during AM retrieval . "
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    ABSTRACT: Remembering emotional autobiographical memories (AMs) is important for emotional well-being, and investigation of the role of emotion regulation (ER) during AM recollection has relevance for understanding mental health issues. Although significant progress has been made in understanding the brain mechanisms underlying ER and AM, less is known about the role of ER during AM recollection. The present study investigated how focusing away (or ‘distracting’) from the emotional response during AM recollection influences the subjective re-experiencing of emotions and the associated neural correlates, by manipulating the retrieval focus of participants who remembered emotional AMs while fMRI data were recorded. Analyses revealed that focusing away from emotion led to decreased self-reported emotional responses, along with increased engagement of ER-related regions (ventro-medial prefrontal cortex-vmPFC), and reduced activity in emotion-related regions (amygdala-AMY). Moreover, mediation analysis identified vmPFC as a functional hub integrating affective signals from AMY and mediating their impact on the subjective re-experiencing of emotion, according to the current retrieval focus. Collectively, these findings shed light on the neural mechanisms underlying the ability to effectively switch attentional focus away from emotions during AM recollections, and have direct relevance for understanding, preventing, and treating affective disorders, characterized by reduced ability to regulate emotions.
    Social Cognitive and Affective Neuroscience 02/2015; DOI:10.1093/scan/nsu039 · 7.37 Impact Factor
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    • "Differential prefrontal cortical influence on amygdala activation in MDD has been observed during regulation of both negative and positive emotions (Greening et al., 2014), although not all studies have found evidence of altered frontolimbic indicators of regulation in MDD (Dillon and Pizzagalli, 2013). Altered frontolimbic activation during emotion regulation is also observed in euthymic individuals with a history of MDD (Kanske et al., 2012), and increases in dlPFC and ventral medial prefrontal cortex (vmPFC) activation during emotion regulation are associated with symptom improvement during treatment with antidepressant medications (Heller et al., 2013), further emphasizing the importance of emotion regulation on the trajectory of changes in depressive symptoms. "
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    ABSTRACT: Mood disorders are characterized by impaired emotion regulation abilities, reflected in alterations in frontolimbic brain functioning during regulation. However, little is known about differences in brain function when comparing regulatory strategies. Reappraisal and emotional acceptance are effective in downregulating negative affect, and are components of effective depression psychotherapies. Investigating neural mechanisms of reappraisal versus emotional acceptance in remitted major depressive disorder (rMDD) may yield novel mechanistic insights into depression risk and prevention. Thirty-seven individuals (18 rMDD, 19 controls) were assessed during an fMRI task requiring reappraisal, emotional acceptance, or no explicit regulation while viewing sad images. Lower negative affect was reported following reappraisal than acceptance, and was lower following acceptance than no explicit regulation. In controls, the acceptance > reappraisal contrast revealed greater activation in left insular cortex and right prefrontal gyrus, and less activation in several other prefrontal regions. Compared to controls, the rMDD group had greater paracingulate and right midfrontal gyrus (BA 8) activation during reappraisal relative to acceptance. Compared to reappraisal, acceptance is associated with activation in regions linked to somatic and emotion awareness, though this activation is associated with less reduction in negative affect. Additionally, a history of MDD moderated these effects. © The Author (2015). Published by Oxford University Press. For Permissions, please email:
    Social Cognitive and Affective Neuroscience 01/2015; 10(9). DOI:10.1093/scan/nsv003 · 7.37 Impact Factor
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