Influence of worry on sustained attention to emotional stimuli: evidence from the late positive potential

Trajectories of the Late Positive Potential Across Childhood and Adolescence: A 9-Year Longitudinal Study

The late positive potential (LPP), an event-related potential reflecting affective processing, may exhibit developmental shifts in magnitude and scalp location. In the present longitudinal study, 501 youth (47.3% female; 89.4% White; 12.0% Hispanic) completed the emotion interrupt task to elicit the LPP to neutral, positive, and negative images at approximately 9, 12, 15, and 18 years old (data collected 2010-2022). Multilevel growth models indicated an initial decrease in the occipital LPP and an increase in the parietal and central LPP during late childhood, with rates of change leveling off across adolescence. Trial condition (i.e., valence) significantly impacted trajectories only when the LPP was measured over occipital sites. Results provide novel evidence of stability and change in the LPP across development.

Anxiety Sensitivity and Intolerance of Uncertainty Uniquely Explain the Association of the Late Positive Potential With Generalized Anxiety Disorder Symptoms

Studies suggest that generalized anxiety disorder (GAD) symptoms are related to late positive potential (LPP) responses to negative images, suggesting greater attention. Anxiety sensitivity (AS) and intolerance of uncertainty (IU) are cognitive factors in GAD vulnerability that may be activated by negative stimuli, thereby explaining why the LPP and GAD symptoms are related. We examined whether AS and IU explain the association of the LPP with GAD symptoms. Eighty-seven (77% women) young adults viewed 60 negative and 60 neutral images. The LPP was examined using both frequentist and Bayesian approaches. This revealed unique indirect effects of the LPP on GAD symptoms through AS and IU. Neither indirect effect was stronger, and the indirect effects were present regardless of using frequentist or Bayesian analyses or quantifying the LPP using residual-based scores or difference scores. The indirect effects predicted not only GAD symptoms but social anxiety and depression as well, consistent with the role of AS and IU in transdiagnostic vulnerability. The findings support AS and IU as links that explain how attention to negative stimuli is related not only to GAD symptoms but to other internalizing symptoms as well.

The characteristics of event-related potentials in generalized anxiety disorder: A systematic review and meta-analysis

OBJECTIVES

Previous studies have reported inconsistent findings regarding event-related potentials (ERPs) abnormalities in individuals with generalized anxiety disorder (GAD). This meta-analysis aimed to systematically review and synthesize the existing evidence on ERP alterations in individuals with GAD.

METHODS

A comprehensive literature search was conducted in PubMed, the Cochrane Library, Excerpta Medica Database, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang database, and China Biology Medicine (CBM) databases from inception to November 11, 2024. Gray literature and reference lists were also manually searched. Studies investigating ERP component differences between individuals with GAD and healthy controls were included. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment. Influence and sensitivity analyses were performed to assess the robustness of the pooled results. Effect sizes (SMD, Hedge's g) were calculated for latency and amplitude differences. Heterogeneity was assessed using the I2 statistic. Meta-regression and subgroup analyses were conducted to explore the source of heterogeneity. Trim-and-fill analyses were applied to assess potential publication bias. Data synthesis was performed using R (version 4.2.3) software.

RESULTS

A total of 37 studies involving 1086 individuals with GAD and 1315 healthy controls were included. The overall risk of bias was rated as low for 25 studies and moderate for 12 studies. Ten ERP components were included in the quantitative meta-analysis: P3, N2, N1, P2, Error Related Negativity (ERN), Correction Related Negativity (CRN), Mismatch Negativity (MMN), P1 (amplitude), Pe, and LPP. Pooled results indicated that individuals with GAD exhibited decreased P3 amplitude (g = -0.54, 95% CI: -0.70 to -0.38, I2 = 20%, P = 0.22) and increased ERN amplitude (g = -0.42, 95% CI: -0.72 to -0.12, I2 = 40%, P = 0.11) compared to healthy controls. In addition, delayed latency of P3 (g = 0.43, 95% CI: 0.09 to 0.78, I2 = 75%, P < 0.01), N2 (g = 0.36, 95% CI: 0.11 to 0.62, I2 = 30%, P = 0.20), and MMN (g = 0.63, 95% CI: 0.52 to 0.75, I2 = 0%, P < 0.0001) was observed in individuals with GAD. Due to the limited number of included studies, the results of N170, N1/P2, N270, N400, VPP, BAEP, P1 (latency), P50, EPN and Nf were summarized narratively. Individuals with GAD were reported to have increased N170, N400, and VPP amplitude and delayed P1 latency compared to healthy controls. Age, sex ratio, sample size, diagnostic criteria, task-related modality, and paradigm were identified as potential influencing factors of ERP characteristics.

CONCLUSIONS

Individuals with GAD exhibit increased ERN amplitude and decreased P3 amplitude in contrast with healthy controls. In addition, delayed latency of P3, N2, and MMN is detected in individuals with GAD. The identified ERP components in individuals with GAD are associated with attention, cognition, visual perception, error or conflict monitoring, semantic information integration, and auditory sensory memory processes. Due to the limited number of included studies and high heterogeneity, further studies with high quality are needed to confirm these findings.

Chronic stress in peer relationships moderates the association between pubertal development and neural response to emotional faces in adolescence

Adolescence is a period of heightened risk for multiple forms of psychopathology, partly due to greater exposure to interpersonal stress. One way that interpersonal stress may increase risk for psychopathology is by altering the normative development of neural systems that support socio-affective processing. The late positive potential (LPP) is an event-related potential component that reflects sustained attention to motivationally-salient information and is a promising marker of risk for stress-related psychopathology. However, it is not clear how the LPP to socio-affective information changes across adolescence, nor whether exposure to stress with peers interferes with normative developmental differences in the LPP to socio-affective content during this period. In 92 adolescent girls (10-19 years old), we assessed the LPP to task-irrelevant emotional and neutral faces, as well as behavioural measures of interference following the presentation of these faces. Adolescents at more advanced stages of puberty showed a smaller LPP to emotional faces, but adolescents exposed to greater peer stress exhibited a larger LPP to these stimuli. Additionally, for girls exposed to lower levels of peer stress, more advanced pubertal development was associated with a smaller LPP to emotional faces, whereas for girls exposed to higher levels of peer stress, the association between pubertal development and the LPP to emotional faces was not significant. Neither stress nor pubertal stage was significantly associated with behavioural measures. Combined, these data suggest that one pathway through which stress exposure increases risk for psychopathology during adolescence is by interfering with the normative development of socio-affective processing.

The impacts of anxiety and depressive symptoms on emotional processing in children and their parents: an event-related potential study

BACKGROUND

Anxiety and depressive symptoms are associated with dysregulated emotional processing. However, less is known about the intra-personal and inter-personal impacts of anxiety and depressive symptoms on emotional processing in children and their parents.

METHODS

In a community sample of 36 parent-child dyads (total N = 72), the current study investigated the intra- and inter-personal effects of anxiety and depressive symptoms on the child's and the parent's neurophysiological responses to emotional (i.e., pleasant and unpleasant) stimuli, indexed by the late positive potential (LPP).

RESULTS

The results indicated that children's anxiety symptoms were correlated with their enhanced LPPs to pleasant versus neutral pictures. Additionally, children's depressive symptoms related to their increased LPPs to unpleasant stimuli. Importantly, children's anxiety symptoms were associated with their parents' increased LPPs to both unpleasant and pleasant information.

CONCLUSIONS

These findings suggest that anxiety symptoms in community children were related to their own as well as their parents' emotional processing. The findings contribute to cognitive and family models of anxiety and depression and further highlight the potential role of dyadic interventions for the alleviation of impairing symptoms in children and their caregivers.

Risk for youth anxiety during the COVID-19 pandemic: The interactive impact of financial stress and prepandemic electrocortical reactivity to negative self-referential stimuli

Despite evidence that stress exposure increases risk for internalizing symptoms in youth, it remains unclear which youth are most vulnerable. This study examined whether youth's prepandemic late positive potential (LPP), an electrocortical marker of sustained attention to affective stimuli, exacerbated the impact of stress on prospective increases in depression and anxiety symptoms from before to during the COVID-19 pandemic. Participants were 29 youth (ages 9-16, 82.8% girls) who completed depression and anxiety symptom measures and an affective words task to assess LPP to positive and negative self-referential stimuli prepandemic onset. Postpandemic onset, approximately 16.03 months (SD = 8.86) after their baseline assessments, youth again completed symptom measures as well as the UCLA Life Stress Interview to assess ongoing social and financial chronic stress. Results indicated a significant interaction between youth LPP to negative words and financial stress. Greater exposure to financial stress during the pandemic predicted greater anxiety symptom increases specifically for youth who demonstrated enhanced prepandemic LPP to negative words. Results were specific to the prediction of anxiety, but not depression, symptoms. If replicated in larger studies, findings highlight enhanced LPP to negative stimuli as a promising target for intervention for youth exposed to greater financial stress.

Comorbid anxiety and depression: Opposing effects on the electrocortical processing of negative imagery in a focal fear sample

BACKGROUND

Anxiety and depression are highly comorbid and share clinical characteristics, such as high levels of negative emotion. Attention toward negative stimuli in anxiety and depression has been studied primarily using negative pictures. Yet, negative mental imagery-that is, mental representations of imagined negative events or stimuli-might more closely mirror patient experience.

METHODS

The current study presents the first examination of neural response to negative imagery in 57 adults (39 female) who all shared a common "focal fear" diagnosis (i.e., specific phobia or performance-only social anxiety disorder), but varied in levels of comorbid anxiety and depression. After listening to standardized descriptions of negative and neutral scenes, participants imagined these scenes as vividly as possible. Associations between categorical and continuous measures of depression, generalized anxiety disorder (GAD), and social anxiety disorder with electrocortical and subjective responses to negative imagery were assessed.

RESULTS

Individuals who were more depressed showed reduced electrocortical processing of negative imagery, whereas those with GAD showed increased electrocortical processing of negative imagery-but only when controlling for depression. Furthermore, participants with higher levels of depression rated negative imagery as less negative and those with greater social anxiety symptoms rated negative imagery more negatively.

CONCLUSIONS

Depression and GAD are characterized by opposing electrocortical response to negative imagery; moreover, depression may suppress GAD-related increases in the electrocortical processing of negative imagery. Results highlight distinctions between different dimensions of distress-based psychopathology, and reveal the unique and complex contribution of comorbid depression to affective response in anxiety.

Time course of pupillary response to threat words before and after attention bias modification for transdiagnostic anxiety disorders: A randomized controlled trial

INTRODUCTION

Altered attention to threatening stimuli at initial and sustained stages of processing may be dissociable dimensions that influence the development and maintenance of transdiagnostic symptoms of anxiety, such as vigilance, and possibly require distinct intervention. Attention bias modification (ABM) interventions were created to implicitly train attention away from threatening stimuli and have shown efficacy in treating anxiety. ABM alters neurocognitive functioning during initial stages of threat processing, but less is known regarding effects of ABM on neural indices of threat processing at sustained (i.e., intermediate and late) stages, or if ABM-related neural changes relate to symptom response. The current study utilized pupillary response as a temporally sensitive and cost-effective peripheral marker of neurocognitive response to ABM.

MATERIALS AND METHODS

In a randomized controlled trial, 79 patients with transdiagnostic anxiety provided baseline data, 70 were randomized to receive eight sessions of twice-weekly ABM (n = 49) or sham training (n = 21), and 65 completed their assigned treatment condition and returned for post-training assessment.

RESULTS

Among ABM, but not sham, patients, pupillary response to threat words during initial and intermediate stages decreased from pre- to post-training. Pre- to post-training reductions in intermediate and late pupillary response to threat were positively correlated with reductions in patient-reported vigilance among ABM, but not sham, patients.

CONCLUSIONS

All measured stages of threat processing had relevance in understanding the neural mechanisms of ABM, with overlapping yet dissociable roles exhibited within a single neurophysiological marker across an initial-intermediate-late time continuum. Pupillometry may be well suited to measure both target engagement and treatment outcome following ABM.

Evaluation of divided attention using different stimulation models in event-related potentials

Divided attention is defined as focusing on different tasks at once, and this is described as one of the biggest problems of today's society. Default examinations for understanding attention are questionnaires or physiological signals, like evoked potentials and electroencephalography. Physiological records were obtained using visual, auditory, and auditory-visual stimuli combinations with 48 participants-18-25-year-old university students-to find differences between sustained and divided attention. A Fourier-based filter was used to get a 0.01-30-Hz frequency band. Fractal dimensions, entropy values, power spectral densities, and Hjorth parameters from electroencephalography and P300 components from evoked potentials were calculated as features. To decrease the size of the feature set, some features, which yield less detail level for data, were eliminated. The visual and auditory stimuli in selective attention were compared with the divided attention state, and the best accuracy was found to be 88.89% on a support vector machine with linear kernel. As a result, it was seen that divided attention could be more difficult to determine from selective attention, but successful classification could be obtained with appropriate methods. Contrary to literature, the study deals with the infrastructure of attention types by working on a completely healthy and attention-high group. Graphical abstract.

The Effects of Worry in Daily Life: An Ecological Momentary Assessment Study Supporting the Tenets of the Contrast Avoidance Model

The contrast avoidance model (CAM) suggests that worry increases and sustains negative emotion to prevent a negative emotional contrast (sharp upward shift in negative emotion) and increase the probability of a positive contrast (shift toward positive emotion). In Study 1, we experimentally validated momentary assessment items (N = 25). In Study 2, participants with generalized anxiety disorder (N = 31) and controls (N = 37) were prompted once per hour regarding their worry, thought valence, and arousal 10 times a day for 8 days. Higher worry duration, negative thought valence, and uncontrollable train of thoughts predicted feeling more keyed up concurrently and sustained anxious activation 1 hr later. More worry, feeling keyed up, and uncontrollable train of thoughts predicted lower likelihood of a negative emotional contrast in thought valence and higher likelihood of a positive emotional contrast in thought valence 1 hr later. Findings support the prospective ecological validity of CAM. Our findings suggest that naturalistic worry reduces the likelihood of a sharp increase in negative affect and does so by increasing and sustaining anxious activation.

Protracted amygdalar response predicts efficacy of a computer-based intervention targeting attentional patterns in transdiagnostic clinical anxiety

Individuals with clinical anxiety demonstrate an attention bias toward threatening information, which is thought to be partially driven by heightened amygdala activity to perceived threat. Attention Bias Modification (ABM) is a computer-based treatment that trains attention toward neutral stimuli and away from threatening stimuli. Alterations in initial processing of threat have been linked to ABM responses, but the impact of protracted processing in the aftermath of neutral and threatening information on ABM outcomes has not been well studied. Our study tested whether sustained activity in the amygdala, which occurred after neutral and threatening stimuli had been removed, could predict which individuals would respond well to ABM. Unmedicated anxious individuals underwent a baseline fMRI assessment during performance of a task sensitive to protracted emotional processing. Afterward, they were randomized to complete eight sessions of ABM (n = 38) or a sham training (n = 19). ABM patients who displayed greater sustained bilateral amygdalar response in the aftermath of neutral stimuli displayed the least improvement in self-reported (but not clinician-rated) vigilance symptoms. In contrast, amygdalar response did not predict improvement in sham patients. Results suggest that in certain anxious individuals, the amygdala may have a robust protracted response even to subjectively neutral cues, which could make these individuals a poor fit for ABM because of its focus on repeatedly retraining attention toward neutral cues. Findings may help elucidate neural mechanisms of ABM and promote the identification of a subset of anxious patients who would be good candidates for this intervention.

Interindividual neural differences in moral decision-making are mediated by alpha power and delta/theta phase coherence

As technology in Artificial Intelligence has developed, the question of how to program driverless cars to respond to an emergency has arisen. It was recently shown that approval of the consequential behavior of driverless cars varied with the number of lives saved and showed interindividual differences, with approval increasing alongside the number of lives saved. In the present study, interindividual differences in individualized moral decision-making at both the behavioral and neural level were investigated using EEG. It was found that alpha event-related spectral perturbation (ERSP) and delta/theta phase-locking - intertrial coherence (ITC) and phase-locking value (PLV) - play a central role in mediating interindividual differences in Moral decision-making. In addition, very late alpha activity differences between individualized and shared stimuli, and delta/theta ITC, where shown to be closely related to reaction time and subjectively perceived emotional distress. This demonstrates that interindividual differences in Moral decision-making are mediated neuronally by various markers - late alpha ERSP, and delta/theta ITC - as well as psychologically by reaction time and perceived emotional distress. Our data show, for the first time, how and according to which neuronal and behavioral measures interindividual differences in Moral dilemmas can be measured.

Electrocortical consequences of image processing: The influence of working memory load and worry

Research suggests that worry precludes emotional processing as well as biases attentional processes. Although there is burgeoning evidence for the relationship between executive functioning and worry, more research in this area is needed. A recent theory suggests one mechanism for the negative effects of worry on neural indicators of attention may be working memory load, however few studies have examined this directly. The goal of the current study was to document the influence of both visual and verbal working memory load and worry on attention allocation during processing of emotional images in a cued image paradigm. It was hypothesized that working memory load will decrease attention allocation during processing of emotional images. This was tested among 38 participants using a modified S1-S2 paradigm. Results indicated that both the visual and verbal working memory tasks resulted in a reduction of attention allocation to the processing of images across stimulus types compared to the baseline task, although only for individuals low in worry. These data extend the literature by documenting decreased neural responding (i.e., LPP amplitude) to imagery both the visual and verbal working memory load, particularly among individuals low in worry.