Lasting Effects of Using Distraction to Manage Responses to Unpleasant Pictures: Electrophysiological Evidence

The immediate and lasting effects of imagery rescripting and their associations with imagery tendency in young adults with childhood maltreatment history: An ERP study

The effectiveness of imagery rescripting (IR) in reducing psychological symptoms associated with aversive memories has been confirmed across various disorders. To better understand the neural mechanisms underlying IR, we assessed the immediate and lasting effects and their associations with imagery tendency by using unpleasant pictures depicting child maltreatment within a population with childhood maltreatment (CM) history. Participants (n = 68) were instructed to engage in two experimental phases while electroencephalogram was recorded. In the rescripting phase, participants viewed neutral or unpleasant pictures and then either imagined the same pictures or rescripted unpleasant ones to assess immediate effect. In the re-exposure phase, participants passively viewed all pictures without instruction to assess lasting effect. Participants rated their subjective valence and imagery vividness in the rescripting phase or intensity of negative feelings in the re-exposure phase. IR led to an attenuation of the late positive potential (LPP) amplitude in the late time window (2000-6000 ms at parietal-occipital electrodes) and a decrease in self-reported unpleasantness during the rescripting phase. After 5-min interval, unpleasant pictures with rescripted history elicited smaller LPP (400-1500 ms at centro-parietal electrodes) and negative feelings than those with imagery history in the re-exposure phase. The higher habitual use of imagery was associated with a greater reduction in late LPP during the rescripting phase and full-time range LPP during the re-exposure phase. The current findings suggest that IR has an immediate effect and a lasting effect on subjective and neural response in the CM population. Individuals with higher imagery tendency are likely to profit more from IR.

Engagement and Disengagement: From the Basic Science of Emotion Regulation to an Anxiety Spectrum

Emotion regulation strategies vary in depth of processing. For instance, reappraisal requires greater engagement than distraction. This affects short-term and long-term response to stimuli. In this review, I describe how the "engagement-disengagement dimension" improves understanding of emotion regulation in normative contexts and in internalizing psychopathology. Part 1 reviews work from my laboratory and others, suggesting that relatively disengaged emotion regulation strategies (e.g., distraction), may have short-term benefits (e.g., faster implementation), but may come with long-term costs (e.g., increased processing of stimuli at subsequent encounter). Therefore, depending on the desired outcome, the adaptive selection of an emotion regulation strategy will be determined by extent of emotional engagement-disengagement. In Part 2, I describe how individuals with more comorbid internalizing psychopathology (e.g., multiple anxiety and depressive diagnoses) are characterized by disengagement from negative stimuli as measured by the late positive potential (LPP). In addition, I introduce a brain profile I have termed, HARM-A (heightened "alarm" and reduced motivated attention), which is characterized by a combination of heightened "alarm" (i.e., increased amygdala) and emotional disengagement (i.e., blunted LPPs) in response to negative stimuli. HARM-A prospectively predicts worse outcomes over 2 years in a mixed internalizing sample. As such, chronic disengagement from negative stimuli appears to contribute to more comorbid and more severe internalizing psychopathology. Overall, emotional disengagement can be beneficial in the short term but may be poorly suited to emotional coping in the longer term.