Social vision: sustained perceptual enhancement of affective facial cues in social anxiety

A randomized clinical trial investigating the clinical impact of a game-based digital therapeutic for social anxiety disorder

The objective of this study was to determine if a novel game-based digital therapeutic intervention reduced anxiety symptom severity in adults with clinically elevated symptoms of social anxiety disorder (SAD). Participants were randomly allocated (1:1) to receive four weeks of either the active intervention, a game-based form of attention bias modification (Active ABM) for anxiety, or the sham control training (Control). Between June 2022 to June 2023, 104 participants were enrolled with 93 completing the trial per-protocol and 104 included in the final intention-to-treat analysis (54 intervention, 50 control); mean age was 38.08 (10.56) years and 79 were female. The dependent variable was reduction in SAD symptoms, measured via the Liebowitz SAD Scale (LSAS). Participants were classified as having clinically elevated SAD symptoms only, or both SAD and Generalized Anxiety Disorder (GAD) symptoms (comorbid). The Active condition induced significantly greater reductions in SAD symptoms compared to the Control condition between Baseline and Post-Treatment [Active: M = -29.71, SD = 23.68; Control: M = -14.59, SD = 21.52, d = .67, t(102) = -3.40, p < .001] across the four-week study period. While no significant between-groups differences emerged at each timepoint individually, the Active condition induced significantly greater change over time in SAD symptoms compared to the Control condition. Use of this game-based digital ABM intervention showed benefits in the reduction of anxiety symptoms.

Binocular rivalry in autistic and socially anxious adults

Background

Social anxiousness is a pervasive symptom in both social anxiety disorder and autism spectrum conditions. Binocular rivalry, which occurs when different images are presented to each eye, has been used to explore how visual and cognitive processing differs across various clinical diagnoses. Previous studies have separately explored whether individuals with autism or anxiety experience binocular rivalry in ways that are different from neurotypical individuals.

Methods

We applied rivalry paradigms that are similar to those used in previous studies of autism and general anxiety to individuals experiencing symptoms of social anxiousness at clinical or subclinical levels. We also incorporated rivalrous stimuli featuring neutral and emotional facial valances to explore potential overlap of social processing components in social anxiety and autism.

Results

We hypothesized that higher levels of social anxiousness would increase binocular rivalry switch rates and that higher levels of autistic traits would decrease switch rates. However, stimulus condition did not affect switch rates in either diagnostic group, and switch rate was not significantly predictive of dimensional measures of either autism or social anxiety.

Discussion

This may suggest a common mechanism for atypical visual cognition styles previously associated with social anxiety and autism. Alternatively, differences in switch rates may only emerge at higher trait levels than reported by the participants in our studies. Furthermore, these findings may be influenced by sex differences in our unique sample.

Positive attention bias in high socially anxious individuals: Evidence from an ERP study

The Bivalent Fear of Evaluation (BFEO) model posits that the fear of positive evaluation (FPE) is a core feature of social anxiety. As such, high socially anxious individuals may show attention bias when faced with positive stimuli. However, most of the previous studies focused on the negative attention bias of social anxiety, and less on the attention bias of positive stimuli. Meanwhile, the effect of stimulus presentation time on the attention bias pattern was unclear. In order to investigate this question, we used a dot-probe paradigm with facial expressions (happy, fearful, angry, neutral) presented for 100 ms and 500 ms. The ERP results showed: (1) For high socially anxious group, happy faces elicited a larger N1 for valid than for invalid cued probes, whereas for healthy control group, angry faces elicited a larger N1 for valid than for invalid cued probes. (2) When valid cues following happy faces presented for 500 ms, the N1 amplitude was larger than that of invalid cues. However, when valid cues following angry and fear faces presented for 100 ms, the N1 amplitude was larger than that of invalid cues. The results showed difficulty in attention disengagement of high socially anxious individuals from positive stimuli, as reflected by N1, illustrating the positive attention bias in social anxiety. These results prove that FPE may contribute to maintaining social anxiety.

Relating psychiatric symptoms and self-regulation during the COVID-19 crisis

Disruptions of self-regulation are a hallmark of numerous psychiatric disorders. Here, we examine the relationship between transdiagnostic dimensions of psychopathology and changes in self-regulation in the early phase of the COVID-19 pandemic. We used a data-driven approach on a large number of cognitive tasks and self-reported surveys in training datasets. Then, we derived measures of self-regulation and psychiatric functioning in an independent population sample (N = 102) tested both before and after the onset of the COVID-19 pandemic, when the restrictions in place represented a threat to mental health and forced people to flexibly adjust to modifications of daily routines. We found independent relationships between transdiagnostic dimensions of psychopathology and longitudinal alterations in specific domains of self-regulation defined using a diffusion decision model. Compared to the period preceding the onset of the pandemic, a symptom dimension related to anxiety and depression was characterized by a more cautious behavior, indexed by the need to accumulate more evidence before making a decision. Instead, social withdrawal related to faster non-decision processes. Self-reported measures of self-regulation predicted variance in psychiatric symptoms both concurrently and prospectively, revealing the psychological dimensions relevant for separate transdiagnostic dimensions of psychiatry, but tasks did not. Taken together, our results are suggestive of potential cognitive vulnerabilities in the domain of self-regulation in people with underlying psychiatric difficulties in face of real-life stressors. More generally, they also suggest that the study of cognition needs to take into account the dynamic nature of real-world events as well as within-subject variability over time.

EEG Decoding of Dynamic Facial Expressions of Emotion: Evidence from SSVEP and Causal Cortical Network Dynamics

The neural cognitive mechanism in processing static facial expressions (FEs) has been well documented, whereas the one underlying perceiving dynamic faces remains unclear. In this study, Fourier transformation and time-frequency analysis of Electroencephalography (EEG) data were carried out to detect the brain activation underlying dynamic or static FEs while twenty-one participants were viewing dynamic or static faces flicking at 10 Hz. In particular, steady-state visual evoked potentials (SSVEPs) were quantified through spectral power analysis of EEG recordings. Besides, Granger causality (GC) analysis (GCA) was also performed to capture the causal cortical network dynamics during dynamic or static FEs of emotion. It was discovered that the dynamic (from neural to happy (N2H) or vice versa (H2N)) FEs elicited larger SSVEPs than the static ones. Additionally, GCA demonstrated that the H2N case, in which happy FEs were being gradually changed into neutral ones, exhibited larger GC measure during the late processing stage than that from the early stage. Consequently, enhanced SSVEPs and effective brain connectivity for dynamic FEs illustrated that participants might need consume more attentional resources to process the dynamic faces, particularly for the change from happy to neutral faces. The new neural index might facilitate us to better understand the cognitive processing of dynamic and static FEs.

Smartphone-Detected Ambient Speech and Self-Reported Measures of Anxiety and Depression: Exploratory Observational Study

Background

The ability to objectively measure the severity of depression and anxiety disorders in a passive manner could have a profound impact on the way in which these disorders are diagnosed, assessed, and treated. Existing studies have demonstrated links between both depression and anxiety and the linguistic properties of words that people use to communicate. Smartphones offer the ability to passively and continuously detect spoken words to monitor and analyze the linguistic properties of speech produced by the speaker and other sources of ambient speech in their environment. The linguistic properties of automatically detected and recognized speech may be used to build objective severity measures of depression and anxiety.

Objective

The aim of this study was to determine if the linguistic properties of words passively detected from environmental audio recorded using a participant’s smartphone can be used to find correlates of symptom severity of social anxiety disorder, generalized anxiety disorder, depression, and general impairment.

Methods

An Android app was designed to collect periodic audiorecordings of participants’ environments and to detect English words using automatic speech recognition. Participants were recruited into a 2-week observational study. The app was installed on the participants’ personal smartphones to record and analyze audio. The participants also completed self-report severity measures of social anxiety disorder, generalized anxiety disorder, depression, and functional impairment. Words detected from audiorecordings were categorized, and correlations were measured between words counts in each category and the 4 self-report measures to determine if any categories could serve as correlates of social anxiety disorder, generalized anxiety disorder, depression, or general impairment.

Results

The participants were 112 adults who resided in Canada from a nonclinical population; 86 participants yielded sufficient data for analysis. Correlations between word counts in 67 word categories and each of the 4 self-report measures revealed a strong relationship between the usage rates of death-related words and depressive symptoms (r=0.41, P<.001). There were also interesting correlations between rates of word usage in the categories of reward-related words with depression (r=–0.22, P=.04) and generalized anxiety (r=–0.29, P=.007), and vision-related words with social anxiety (r=0.31, P=.003).

Conclusions

In this study, words automatically recognized from environmental audio were shown to contain a number of potential associations with severity of depression and anxiety. This work suggests that sparsely sampled audio could provide relevant insight into individuals’ mental health.

Functional near-infrared spectroscopy can detect low-frequency hemodynamic oscillations in the prefrontal cortex during steady-state visual evoked potential-inducing periodic facial expression stimuli presentation

Brain oscillations are vital to cognitive functions, while disrupted oscillatory activity is linked to various brain disorders. Although high-frequency neural oscillations (> 1 Hz) have been extensively studied in cognition, the neural mechanisms underlying low-frequency hemodynamic oscillations (LFHO) < 1 Hz have not yet been fully explored. One way to examine oscillatory neural dynamics is to use a facial expression (FE) paradigm to induce steady-state visual evoked potentials (SSVEPs), which has been used in electroencephalography studies of high-frequency brain oscillation activity. In this study, LFHO during SSVEP-inducing periodic flickering stimuli presentation were inspected using functional near-infrared spectroscopy (fNIRS), in which hemodynamic responses in the prefrontal cortex were recorded while participants were passively viewing dynamic FEs flickering at 0.2 Hz. The fast Fourier analysis results demonstrated that the power exhibited monochronic peaks at 0.2 Hz across all channels, indicating that the periodic events successfully elicited LFHO in the prefrontal cortex. More importantly, measurement of LFHO can effectively distinguish the brain activation difference between different cognitive conditions, with happy FE presentation showing greater LFHO power than neutral FE presentation. These results demonstrate that stimuli flashing at a given frequency can induce LFHO in the prefrontal cortex, which provides new insights into the cognitive mechanisms involved in slow oscillation.

Towards a Pragmatic Approach to a Psychophysiological Unit of Analysis for Mental and Brain Disorders: An EEG-Copeia for Neurofeedback

This article proposes what we call an "EEG-Copeia" for neurofeedback, like the "Pharmacopeia" for psychopharmacology. This paper proposes to define an "EEG-Copeia" as an organized list of scientifically validated EEG markers, characterized by a specific association with an identified cognitive process, that define a psychophysiological unit of analysis useful for mental or brain disorder evaluation and treatment. A characteristic of EEG neurofeedback for mental and brain disorders is that it targets a EEG markers related to a supposed cognitive process, whereas conventional treatments target clinical manifestations. This could explain why EEG neurofeedback studies encounter difficulty in achieving reproducibility and validation. The present paper suggests that a first step to optimize EEG neurofeedback protocols and future research is to target a valid EEG marker. The specificity of the cognitive skills trained and learned during real time feedback of the EEG marker could be enhanced and both the reliability of neurofeedback training and the therapeutic impact optimized. However, several of the most well-known EEG markers have seldom been applied for neurofeedback. Moreover, we lack a reliable and valid EEG targets library for further RCT to evaluate the efficacy of neurofeedback in mental and brain disorders. With the present manuscript, our aim is to foster dialogues between cognitive neuroscience and EEG neurofeedback according to a psychophysiological perspective. The primary objective of this review was to identify the most robust EEG target. EEG markers linked with one or several clearly identified cognitive-related processes will be identified. The secondary objective was to organize these EEG markers and related cognitive process in a psychophysiological unit of analysis matrix inspired by the Research Domain Criteria (RDoC) project.

Social aversive generalization learning sharpens the tuning of visuocortical neurons to facial identity cues

Defensive system activation promotes heightened perception of threat signals, and excessive attention to threat signals has been discussed as a contributory factor in the etiology of anxiety disorders. However, a mechanistic account of attentional modulation during fear-relevant processes, especially during fear generalization remains elusive. To test the hypothesis that social fear generalization prompts sharpened tuning in the visuocortical representation of social threat cues, 67 healthy participants underwent differential fear conditioning, followed by a generalization test in which participants viewed faces varying in similarity with the threat-associated face. We found that generalization of social threat sharpens visuocortical tuning of social threat cues, whereas ratings of fearfulness showed generalization, linearly decreasing with decreasing similarity to the threat-associated face. Moreover, individuals who reported greater anxiety in social situations also showed heightened sharpened tuning of visuocortical neurons to facial identity cues, indicating the behavioral relevance of visuocortical tuning during generalization learning.

Expectation Gates Neural Facilitation of Emotional Words in Early Visual Areas

The current study examined whether emotional expectations gate attention to emotional words in early visual cortex. Color cues informed about word valence and onset latency. We observed a stimulus-preceding negativity prior to the onset of cued words that was larger for negative than for neutral words. This indicates that in anticipation of emotional words more attention was allocated to them than to neutral words before target onset. During stimulus presentation the steady-state visual evoked potential (SSVEP), elicited by flickering words, was attenuated for cued compared to uncued words, indicating sharpened sensory activity, i.e., expectation suppression. Most importantly, the SSVEP was more enhanced for negative than neutral words when these were cued. Uncued conditions did not differ in SSVEP amplitudes, paralleling previous studies reporting lexico-semantic but not early visual effects of emotional words. We suggest that cueing mediates re-entrant engagement of visual resources by providing an early “affective gist” of an upcoming word. Consequently, visual single-word studies may have underestimated attentional effects of emotional words and their anticipation during reading.

Sympathetic responding to unconditioned stimuli predicts subsequent threat expectancy, orienting, and visuocortical bias in human aversive Pavlovian conditioning

Threat expectancy is the ability to predict an aversive outcome. What is not known is the influence of initial threat responding on the acquisition of verbal, attentional and perceptual biases towards conditioned threat cues. This study evaluated the extent to which initial unconditioned stimulus (UCS) responding was related to trial-by-trial self-reported expectancy, sensory processing (visuocortical EEG) and orienting (heart rate deceleration) to threat cues during extinction learning. Participants (n = 38) viewed oriented Gabor gratings, associated with the presence (CS+) or absence (CS-) of a 96 dB white noise (UCS), flickering at 12 Hz to elicit steady state visually evoked potentials (ssVEPs). Multivariate multiple regression revealed greater initial UCS skin conductance responding to predict extinction responding: enhanced visuocortical discrimination, greater heart rate deceleration to CS+, and greater threat expectancy endorsements. These results suggest that the motivational intensity of initial threat reactivity (sympathetic UCS responding) drives learning-induced defensive dispositions across multiple response systems.

High Level of Trait Anxiety Leads to Salience-Driven Distraction and Compensation

Individuals with high levels of anxiety are hypothesized to have impaired executive control functions that would otherwise enable efficient filtering of irrelevant information. Pinpointing specific deficits is difficult, however, because anxious individuals may compensate for deficient control functions by allocating greater effort. Here, we used event-related-potential indices of attentional selection (the N2pc) and suppression (the PD) to determine whether high trait anxiety is associated with a deficit in preventing the misallocation of attention to salient, but irrelevant, visual search distractors. Like their low-anxiety counterparts ( n = 19), highly anxious individuals ( n = 19) were able to suppress the distractor, as evidenced by the presence of a PD. Critically, however, the distractor was found to trigger an earlier N2pc in the high-anxiety group but not in the low-anxiety group. These findings indicate that, whereas individuals with low anxiety can prevent distraction in a proactive fashion, anxious individuals deal with distractors only after they have diverted attention.

How the visual brain detects emotional changes in facial expressions: Evidence from driven and intrinsic brain oscillations

The processing of facial expressions is often studied using static pictorial cues. Recent work, however, suggests that viewing changing expressions more robustly evokes physiological responses. Here, we examined the sensitivity of steady-state visual evoked potentials and intrinsic oscillatory brain activity to transient emotional changes in facial expressions. Twenty-two participants viewed sequences of grayscale faces periodically turned on and off at a rate of 17.5 Hz, to evoke flicker steady-state visual evoked potentials (ssVEPs) in visual cortex. Each sequence began with a neutral face (flickering for 2290 msec), immediately followed by a face from the same actor (also flickering for 2290 msec) with one of four expressions (happy, angry, fearful, or another neutral expression), followed by the initially presented neutral face (flickering for 1140 msec). The amplitude of the ssVEP and the power of intrinsic brain oscillations were analyzed, comparing the four expression-change conditions. We found a transient perturbation (reduction) of the ssVEP that was more pronounced after the neutral-to-angry change compared to the other conditions, at right posterior sensors. Induced alpha-band (8-13 Hz) power was reduced compared to baseline after each change. This reduction showed a central-occipital topography and was strongest in the subtlest and rarest neutral-to-neutral condition. Thus, the ssVEP indexed involvement of face-sensitive cortical areas in decoding affective expressions, whereas mid-occipital alpha power reduction reflected condition frequency rather than expression-specific processing, consistent with the role of alpha power changes in selective attention.

Testing the Possibility of Model-based Pavlovian Control of Attention to Threat

Signals for reward or punishment attract attention preferentially, a principle termed value-modulated attention capture (VMAC). The mechanisms that govern the allocation of attention can be described with a terminology that is more often applied to the control of overt behaviors, namely, the distinction between instrumental and Pavlovian control, and between model-free and model-based control. Although instrumental control of VMAC can be either model-free or model-based, it is not known whether Pavlovian control of VMAC can be model-based. To decide whether this is possible, we measured steady-state visual evoked potentials (SSVEPs) while 20 healthy adults took part in a novel task. During the learning stage, participants underwent aversive threat conditioning with two conditioned stimuli (CSs): one that predicted pain (CS+) and one that predicted safety (CS-). Instructions given before the test stage allowed participants to infer whether novel, ambiguous CSs (new_CS+/new_CS-) were threatening or safe. Correct inference required combining stored internal representations and new propositional information, the hallmark of model-based control. SSVEP amplitudes quantified the amount of attention allocated to novel CSs on their very first presentation, before they were ever reinforced. We found that SSVEPs were higher for new_CS+ than new_CS-. This result is potentially indicative of model-based Pavlovian control of VMAC, but additional controls are necessary to verify this conclusively. This result underlines the potential transformative role of information and inference in emotion regulation.

Assessing the relationship between pupil diameter and visuocortical activity

Visuocortical activity and pupil diameter both increase in tasks involving memory, attention, and physiological arousal. Thus, the question arises whether pupil dilation prompts a subsequent increase in visuocortical activity. In this study, we investigated the extent to which changes in visuocortical activity relate to changes in pupil diameter. The amplitude of the sustained visuocortical response to a flickering stimulus (i.e., steady-state visually evoked potential [ssVEP] power) was examined in 39 participants while pupil diameter was measured. To generalize across stimulus conditions, Gabor stimuli varied in brightness and ssVEP driving frequency. As expected, brighter stimuli prompted pupil constriction and larger ssVEP power. To determine whether momentary fluctuations in pupil size contribute to the ssVEP amplitude under conditions of constant luminance and frequency, the single-trial means from each measure were correlated and the shape of the pupil-diameter waveform related to the ssVEP amplitude time course, both within and between participants. Under constant conditions, changes in pupil diameter were not related to changes in ssVEP amplitude, at any luminance level or driving frequency. Findings suggest that pupil dilation does not systematically prompt subsequent changes in visuocortical activity, and thus is not a sufficient cause of visuocortical modulation in cognitive or affective tasks.

Face Perception in Social Anxiety: Visuocortical Dynamics Reveal Propensities for Hypervigilance or Avoidance

BACKGROUND

Theories of aberrant attentional processing in social anxiety, and anxiety disorders more broadly, have postulated an initial hypervigilance or facilitation to clinically relevant threats and consequent defensive avoidance. However, existing objective measurements utilized to explore this phenomenon lack the resolution to elucidate attentional dynamics, particularly covert influences.

METHODS

We utilized a continuous measure of visuocortical engagement, the steady-state visual evoked potential in response to naturalistic angry, fearful, happy, and neutral facial expressions. Participants were treatment-seeking patients with principal diagnoses of social anxiety circumscribed to performance situations (n = 21) or generalized across interaction contexts (n = 42), treatment-seeking patients with panic disorder with agoraphobia (n = 25), and 17 healthy participants.

RESULTS

At the principal disorder level, only circumscribed social anxiety patients showed sustained visuocortical facilitation to aversive facial expressions. Control participants as well as patients with panic disorder with agoraphobia and generalized social anxiety showed no bias. More finely stratifying the sample according to clinical judgment of social anxiety severity and interference revealed a linear increase in visuocortical bias to aversive expressions for all but the most severely impaired patients. This group showed an opposing sustained attentional disengagement.

CONCLUSIONS

Rather than shifts between covert vigilance and avoidance of aversive facial expressions, social anxiety appears to confer a sustained bias for one or the other. While vigilant attention reliably increases with social anxiety severity for the majority of patients, the most impaired patients show an opposing avoidance. These distinct patterns of attentional allocation could provide a powerful means of personalizing neuroscience-based interventions to modify attention bias and related impairment.

What does the dot-probe task measure? A reverse correlation analysis of electrocortical activity

The dot-probe task is considered a gold standard for assessing the intrinsic attentive selection of one of two lateralized visual cues, measured by the response time to a subsequent, lateralized response probe. However, this task has recently been associated with poor reliability and conflicting results. To resolve these discrepancies, we tested the underlying assumption of the dot-probe task-that fast probe responses index heightened cue selection-using an electrophysiological measure of selective attention. Specifically, we used a reverse correlation approach in combination with frequency-tagged steady-state visual potentials (ssVEPs). Twenty-one participants completed a modified dot-probe task in which each member of a pair of lateralized face cues, varying in emotional expression (angry-angry, neutral-angry, neutral-neutral), flickered at one of two frequencies (15 or 20 Hz), to evoke ssVEPs. One cue was then replaced by a response probe, and participants indicated the probe orientation (0° or 90°). We analyzed the ssVEP evoked by the cues as a function of response speed to the subsequent probe (i.e., a reverse correlation analysis). Electrophysiological measures of cue processing varied with probe hemifield location: Faster responses to left probes were associated with weak amplification of the preceding left cue, apparent only in a median split analysis. By contrast, faster responses to right probes were systematically and parametrically predicted by diminished visuocortical selection of the preceding right cue. Together, these findings highlight the poor validity of the dot-probe task, in terms of quantifying intrinsic, nondirected attentive selection irrespective of probe/cue location.

Eye-Tracking Evidence of a Maintenance Bias in Social Anxiety

Background: The mechanisms and triggers of the attentional bias in social anxiety are not yet fully determined, and the modulating role of personality traits is being increasingly acknowledged. Aims: Our main purpose was to test whether social anxiety is associated with mechanisms of hypervigilance, avoidance (static biases), vigilance-avoidance or the maintenance of attention (dynamic biases). Our secondary goal was to explore the role of personality structure in shaping the attention bias. Method: Participants with high vs low social anxiety and different personality structures viewed pairs of faces (free-viewing eye-tracking task) representing different emotions (anger, happiness and neutrality). Their eye movements were registered and analysed for both whole-trial (static) and time-dependent (dynamic) measures. Results: Comparisons between participants with high and low social anxiety levels did not yield evidence of differences in eye-tracking measures for the whole trial (latency of first fixation, first fixation direction, total dwell time), but the two groups differed in the time course of overt attention during the trial (dwell time across three successive time segments): participants with high social anxiety were slower in disengaging their attention from happy faces. Similar results were obtained using a full-sample, regression-based analysis. Conclusion: Our results speak in favour of a maintenance bias in social anxiety. Preliminary results indicated that personality structure may not affect the maintenance (dynamic) bias of socially anxious individuals, although depressive personality structures may favour manifestations of a (static) hypervigilance bias.

Empathy-Related Responses to Depicted People in Art Works

Existing theories of empathic response to visual art works postulate the primacy of automatic embodied reaction to images based on mirror neuron mechanisms. Arguing for a more inclusive concept of empathy-related response and integrating four distinct bodies of literature, we discuss contextual, and personal factors which modulate empathic response to depicted people. We then present an integrative model of empathy-related responses to depicted people in art works. The model assumes that a response to empathy-eliciting figural artworks engages the dynamic interaction of two mutually interlinked sets of processes: socio-affective/cognitive processing, related to the person perception, and esthetic processing, primarily concerned with esthetic appreciation and judgment and attention to non-social aspects of the image. The model predicts that the specific pattern of interaction between empathy-related and esthetic processing is co-determined by several sets of factors: (i) the viewer's individual characteristics, (ii) the context variables (which include various modes of priming by narratives and other images), (iii) multidimensional features of the image, and (iv) aspects of a viewer's response. Finally we propose that the model is implemented by the interaction of functionally connected brain networks involved in socio-cognitive and esthetic processing.

Competition Effects in Visual Cortex Between Emotional Distractors and a Primary Task in Remitted Depression

BACKGROUND

Attentional biases, particularly difficulty inhibiting attention to negative stimuli, are implicated in risk for major depressive disorder (MDD). The current study examined a neural measure of attentional bias using a continuous index of visuocortical engagement (steady-state visual evoked potentials [SSVEPs]) before and after a negative mood induction in a population at high-risk for MDD recurrence due to a recently remitted MDD (rMDD) episode. Additionally, we examined working memory (WM) capacity as a potential moderator of the link between rMDD and visuocortical responses.

METHODS

Our sample consisted of 27 women with rMDD and 28 never-depressed women. To assess attentional inhibition to emotional stimuli, we measured frequency-tagged SSVEPs evoked from spatially superimposed task-relevant stimuli and emotional distractors (facial displays of emotion) oscillating at distinct frequencies. WM capacity was assessed during a visuospatial memory task.

RESULTS

Women with rMDD, relative to never-depressed women, displayed difficulty inhibiting attention to all emotional distractors before a negative mood induction, with the strongest effect for negative distractors (sad faces). Following the mood induction, rMDD women's attention to emotional distractors remained largely unchanged. Among women with rMDD, lower WM capacity predicted greater difficulty inhibiting attention to negative and neutral distractors.

CONCLUSIONS

By exploiting the phenomenon of oscillatory resonance in the visual cortex, we tracked competition in neural responses for spatially superimposed stimuli differing in valence. Results demonstrated that women with rMDD display impaired attentional inhibition of emotional distractors independent of state mood and that this bias is strongest among those with lower WM capacity.

The interaction between state and dispositional emotions in decision making: An ERP study

In this study, to investigate the influence of incidental emotions on decision making in high-anxious individuals, participants were required to perform a monetary gambling task. Behavioral and electroencephalography responses were recorded to explore the stages of option assessment and outcome evaluation during decision making, respectively. Incidental emotions were elicited by facial expression pictures presented on the background, which included four conditions (control, neutral, fearful, and happy). Results showed smaller feedback-related negativity (FRN) amplitudes in high-anxious participants than low-anxious participants in the control, neutral, and fearful conditions, but not in the happy condition, for small outcomes. The P3 amplitudes were larger in high-anxious participants compared to their counterparts in the fearful and happy conditions, but not in the other conditions. In short, the interaction effects between trait anxiety and facial emotions manifested on the outcome evaluation stage of decision making.

Steady-state visual evoked potentials as a research tool in social affective neuroscience

Like many other primates, humans place a high premium on social information transmission and processing. One important aspect of this information concerns the emotional state of other individuals, conveyed by distinct visual cues such as facial expressions, overt actions, or by cues extracted from the situational context. A rich body of theoretical and empirical work has demonstrated that these socioemotional cues are processed by the human visual system in a prioritized fashion, in the service of optimizing social behavior. Furthermore, socioemotional perception is highly dependent on situational contexts and previous experience. Here, we review current issues in this area of research and discuss the utility of the steady-state visual evoked potential (ssVEP) technique for addressing key empirical questions. Methodological advantages and caveats are discussed with particular regard to quantifying time-varying competition among multiple perceptual objects, trial-by-trial analysis of visual cortical activation, functional connectivity, and the control of low-level stimulus features. Studies on facial expression and emotional scene processing are summarized, with an emphasis on viewing faces and other social cues in emotional contexts, or when competing with each other. Further, because the ssVEP technique can be readily accommodated to studying the viewing of complex scenes with multiple elements, it enables researchers to advance theoretical models of socioemotional perception, based on complex, quasinaturalistic viewing situations.

Driving steady-state visual evoked potentials at arbitrary frequencies using temporal interpolation of stimulus presentation

Background

Steady-state visual evoked potentials have been utilized widely in basic and applied research in recent years. These oscillatory responses of the visual cortex are elicited by flickering stimuli. They have the same fundamental frequency as the driving stimulus and are highly sensitive to manipulations of attention and stimulus properties. While standard computer monitors offer great flexibility in the choice of visual stimuli for driving SSVEPs, the frequencies that can be elicited are limited to integer divisors of the monitor’s refresh rate.

Results

To avoid this technical constraint, we devised an interpolation technique for stimulus presentation, with which SSVEPs can be elicited at arbitrary frequencies. We tested this technique with monitor refresh rates of 85 and 120 Hz. At a refresh rate of 85 Hz, interpolated presentation produced artifacts in the recorded spectrum in the form of additional peaks not located at the stimulated frequency or its harmonics. However, at a refresh rate of 120 Hz, these artifacts did not occur and the spectrum elicited by an interpolated flicker became indistinguishable from the spectrum obtained by non-interpolated presentation of the same frequency.

Conclusions

Our interpolation technique eliminates frequency limitations of the common non-interpolated presentation technique and has many possible applications for future research.

The Effect of Affective Context on Visuocortical Processing of Neutral Faces in Social Anxiety

It has been demonstrated that verbal context information alters the neural processing of ambiguous faces such as faces with no apparent facial expression. In social anxiety, neutral faces may be implicitly threatening for socially anxious individuals due to their ambiguous nature, but even more so if these neutral faces are put in self-referential negative contexts. Therefore, we measured event-related brain potentials (ERPs) in response to neutral faces which were preceded by affective verbal information (negative, neutral, positive). Participants with low social anxiety (LSA; n = 23) and high social anxiety (HSA; n = 21) were asked to watch and rate valence and arousal of the respective faces while continuous EEG was recorded. ERP analysis revealed that HSA showed elevated P100 amplitudes in response to faces, but reduced structural encoding of faces as indexed by reduced N170 amplitudes. In general, affective context led to an enhanced early posterior negativity (EPN) for negative compared to neutral facial expressions. Moreover, HSA compared to LSA showed enhanced late positive potentials (LPP) to negatively contextualized faces, whereas in LSA this effect was found for faces in positive contexts. Also, HSA rated faces in negative contexts as more negative compared to LSA. These results point at enhanced vigilance for neutral faces regardless of context in HSA, while structural encoding seems to be diminished (avoidance). Interestingly, later components of sustained processing (LPP) indicate that LSA show enhanced visuocortical processing for faces in positive contexts (happy bias), whereas this seems to be the case for negatively contextualized faces in HSA (threat bias). Finally, our results add further new evidence that top-down information in interaction with individual anxiety levels can influence early-stage aspects of visual perception.

Sustained attention in context conditioning: Evidence from steady-state VEPs

In classical fear conditioning an aversive event is paired repeatedly with a predictive stimulus, which later elicits fear. Repeated presentation of an aversive event in the absence of a predictive cue however may induce anxiety, and the context may gain a threatening value. As such conditioned anxiety can be considered a sustained reaction compared to phasic fear, it would be interesting to track continuous cortical responses during context conditioning. The present study realized a differential context conditioning paradigm and assessed sustained cortical activations to the threatening and the safe context and how neutral cues are processed within both contexts. Two pictures of different office rooms presented for 20s served as contexts. One room became associated with an unpleasant noise that was presented unpredictably (CTX+) while the other office (CTX-) was never associated with this unpleasant noise. After acquisition, a social agent or an object was presented as a distractor in both contexts. Cortical activations in response to contexts and distractors were assessed separately by steady-state visually evoked potentials (ssVEPs) using frequency tagging. Results revealed enhanced ssVEP-amplitudes for CTX+ compared to CTX- in a lateral occipital cluster during acquisition. Similarly, CTX+ elicited higher ssVEP-amplitudes during the test phase, and these context conditioning effects were not reduced by the simultaneous presentation of novel distractors. These results indicate that context conditioning was successfully implemented and that the anxiety context received facilitated cortical processing across the whole viewing time. We conclude that threatening contexts capture attention over a longer period of time, and are immune to distraction by new objects.

The steady-state visual evoked potential in vision research: A review

Periodic visual stimulation and analysis of the resulting steady-state visual evoked potentials were first introduced over 80 years ago as a means to study visual sensation and perception. From the first single-channel recording of responses to modulated light to the present use of sophisticated digital displays composed of complex visual stimuli and high-density recording arrays, steady-state methods have been applied in a broad range of scientific and applied settings.The purpose of this article is to describe the fundamental stimulation paradigms for steady-state visual evoked potentials and to illustrate these principles through research findings across a range of applications in vision science.

Snake fearfulness is associated with sustained competitive biases to visual snake features: hypervigilance without avoidance

The extent and time course of competition between a specific fear cue and task-related stimuli in early human visual cortex was investigated using electrophysiology. Steady-state visual evoked potentials (ssVEPs) were evoked using random-dot kinematograms that consisted of rapidly flickering (8.57 Hz) dots moving randomly, superimposed upon emotional or neutral distractor pictures. Participants were asked to detect intervals of coherently moving dots, ignoring the distractor pictures that varied in hedonic content. Women reporting high or low levels of snake fear were recruited from a large sample of healthy college students, and snake pictures served as fear-relevant distractors. The time-varying amplitude of the ssVEP evoked by the motion detection task showed significant reduction when viewing emotionally arousing, compared to neutral, distractors, replicating previous studies. For high-fear participants, snake distractors elicited a sustained attenuation of task evoked ssVEP amplitude, greater than the attenuation prompted by other unpleasant arousing content. These findings support a hypothesis that fear cues prompt sustained hypervigilance rather than perceptual avoidance.

Impaired visuocortical discrimination learning of socially conditioned stimuli in social anxiety

In search of causative factors of social anxiety disorder (SAD), classical conditioning has been discussed as a potential trigger mechanism for many years. Recent findings suggest that the social relevance of the unconditioned stimulus (US) might play a major role in learning theories of SAD. Thus, this study applied a social conditioning paradigm with disorder-relevant US to examine the electrocortical correlates of affective learning. Twenty-four high socially anxious (HSA) and 23 age- and gender-matched low socially anxious (LSA) subjects were conditioned to 3 different faces flickering at a frequency of 15 Hz which were paired with auditory insults, compliments or neutral comments (US). The face-evoked electrocortical response was measured via steady-state visually evoked potentials and subjective measures of valence and arousal were obtained. Results revealed a significant interaction of social anxiety and conditioning, with LSA showing highest cortical activity to faces paired with insults and lowest activity to faces paired with compliments, while HSA did not differentiate between faces. No group differences were discovered in the affective ratings. The findings indicate a potentially impaired ability of HSA to discriminate between relevant and irrelevant social stimuli, which may constitute a perpetuating factor of SAD.

Neural response during attentional control and emotion processing predicts improvement after cognitive behavioral therapy in generalized social anxiety disorder

BACKGROUND

Individuals with generalized social anxiety disorder (gSAD) exhibit attentional bias to salient stimuli, which is reduced in patients whose symptoms improve after treatment, indicating that mechanisms of bias mediate treatment success. Therefore, pre-treatment activity in regions implicated in attentional control over socio-emotional signals (e.g. anterior cingulate cortex, dorsolateral prefrontal cortex) may predict response to cognitive behavioral therapy (CBT), evidence-based psychotherapy for gSAD.

METHOD

During functional magnetic resonance imaging, 21 participants with gSAD viewed images comprising a trio of geometric shapes (circles, rectangles or triangles) alongside a trio of faces (angry, fearful or happy) within the same field of view. Attentional control was evaluated with the instruction to 'match shapes', directing attention away from faces, which was contrasted with 'match faces', whereby attention was directed to emotional faces.

RESULTS

Whole-brain voxel-wise analyses showed that symptom improvement was predicted by enhanced pre-treatment activity in the presence of emotional face distractors in the dorsal anterior cingulate cortex and dorsal medial prefrontal cortex. Additionally, CBT success was foretold by less activity in the amygdala and/or increased activity in the medial orbitofrontal gyrus during emotion processing.

CONCLUSIONS

CBT response was predicted by pre-treatment activity in prefrontal regions and the amygdala. The direction of activity suggests that individuals with intact attentional control in the presence of emotional distractors, regulatory capacity over emotional faces and/or less reactivity to such faces are more likely to benefit from CBT. Findings indicate that baseline neural activity in the context of attentional control and emotion processing may serve as a step towards delineating mechanisms by which CBT exerts its effects.

Neural rhythmic symphony of human walking observation: Upside-down and Uncoordinated condition on cortical theta, alpha, beta and gamma oscillations

Biological motion observation has been recognized to produce dynamic change in sensorimotor activation according to the observed kinematics. Physical plausibility of the spatial-kinematic relationship of human movement may play a major role in the top-down processing of human motion recognition. Here, we investigated the time course of scalp activation during observation of human gait in order to extract and use it on future integrated brain-computer interface using virtual reality (VR). We analyzed event related potentials (ERP), the event related spectral perturbation (ERSP) and the inter-trial coherence (ITC) from high-density EEG recording during video display onset (−200–600 ms) and the steady state visual evoked potentials (SSVEP) inside the video of human walking 3D-animation in three conditions: Normal; Upside-down (inverted images); and Uncoordinated (pseudo-randomly mixed images). We found that early visual evoked response P120 was decreased in Upside-down condition. The N170 and P300b amplitudes were decreased in Uncoordinated condition. In Upside-down and Uncoordinated conditions, we found decreased alpha power and theta phase-locking. As regards gamma oscillation, power was increased during the Upside-down animation and decreased during the Uncoordinated animation. An SSVEP-like response oscillating at about 10 Hz was also described showing that the oscillating pattern is enhanced 300 ms after the heel strike event only in the Normal but not in the Upside-down condition. Our results are consistent with most of previous point-light display studies, further supporting possible use of virtual reality for neurofeedback applications.

Raised middle-finger: electrocortical correlates of social conditioning with nonverbal affective gestures

Humans form impressions of others by associating persons (faces) with negative or positive social outcomes. This learning process has been referred to as social conditioning. In everyday life, affective nonverbal gestures may constitute important social signals cueing threat or safety, which therefore may support aforementioned learning processes. In conventional aversive conditioning, studies using electroencephalography to investigate visuocortical processing of visual stimuli paired with danger cues such as aversive noise have demonstrated facilitated processing and enhanced sensory gain in visual cortex. The present study aimed at extending this line of research to the field of social conditioning by pairing neutral face stimuli with affective nonverbal gestures. To this end, electro-cortical processing of faces serving as different conditioned stimuli was investigated in a differential social conditioning paradigm. Behavioral ratings and visually evoked steady-state potentials (ssVEP) were recorded in twenty healthy human participants, who underwent a differential conditioning procedure in which three neutral faces were paired with pictures of negative (raised middle finger), neutral (pointing), or positive (thumbs-up) gestures. As expected, faces associated with the aversive hand gesture (raised middle finger) elicited larger ssVEP amplitudes during conditioning. Moreover, theses faces were rated as to be more arousing and unpleasant. These results suggest that cortical engagement in response to faces aversively conditioned with nonverbal gestures is facilitated in order to establish persistent vigilance for social threat-related cues. This form of social conditioning allows to establish a predictive relationship between social stimuli and motivationally relevant outcomes.

Dissociation of part-based and integrated neural responses to faces by means of electroencephalographic frequency tagging

In order to isolate the repetition suppression effects for each part of a whole-face stimulus, the left and right halves of face stimuli were flickered at different frequency rates (5.88 or 7.14 Hz), changing or not changing identity at every stimulation cycle. The human electrophysiological (electroencephalographic) responses to each face half increased in amplitude when different rather than repeated face half identities were presented at every stimulation cycle. Contrary to the repetition suppression effects for whole faces, which are usually found over the right occipito-temporal cortex, these part-based repetition suppression effects were found on all posterior electrode sites and were unchanged when the two face halves were manipulated by separation, lateral misalignment, or inversion. In contrast, intermodulation components (e.g. 7.14-5.88 = 1.26 Hz) were found mainly over the right occipito-temporal cortex and were significantly reduced following the aforementioned manipulations. In addition, the intermodulation components decreased substantially for face halves belonging to different identities, which form a less coherent face than when they belong to the same face identity. These observations provide objective evidence for dissociation between part-based and integrated (i.e. holistic/configural) responses to faces in the human brain, suggesting that only responses to integrated face parts reflect high-level, possibly face-specific, representations.

Understanding individual face discrimination by means of fast periodic visual stimulation

This paper reviews a fast periodic visual stimulation (FPVS) approach developed recently to make significant progress in understanding visual discrimination of individual faces. Displaying pictures of faces at a periodic frequency rate leads to a high signal-to-noise ratio (SNR) response in the human electroencephalogram, at the exact frequency of stimulation, a so-called steady-state visual evoked potential (SSVEP, Regan in Electroencephalogr Clin Neurophysiol 20:238-248, 1966). For fast periodic frequency rates, i.e., between 3 and 9 Hz, this response is reduced if the exact same face identity is repeated compared to the presentation of different face identities, the largest difference being observed over the right occipito-temporal cortex. A 6-Hz stimulation rate (cycle duration of ~170 ms) provides the largest difference between different and repeated faces, as also evidenced in face-selective areas of the ventral occipito-temporal cortex in functional magnetic resonance imaging. This high-level discrimination response is reduced following inversion and contrast-reversal of the faces and can be isolated without subtraction thanks to a fast periodic oddball paradigm. Overall, FPVS provides a response that is objective (i.e., at an experimentally defined frequency), implicit, has a high SNR and is directly quantifiable in a short amount of time. Although the approach is particularly appealing for understanding face perception, it can be generalized to study visual discrimination of complex visual patterns such as objects and visual scenes. The advantages of the approach make it also particularly well-suited to investigate these functions in populations who cannot provide overt behavioral responses and can only be tested for short durations, such as infants, young children and clinical populations.

Fearful faces heighten the cortical representation of contextual threat

Perception of facial expressions is typically investigated by presenting isolated face stimuli. In everyday life, however, faces are rarely seen without a surrounding visual context that affects perception and interpretation of the facial expression. Conversely, fearful faces may act as a cue, heightening the sensitivity of the visual system to effectively detect potential threat in the environment. In the present study, we used steady-state visually evoked potentials (ssVEPs) to examine the mutual effects of facial expressions (fearful, neutral, happy) and affective visual context (pleasant, neutral, threat). By assigning two different flicker frequencies (12 vs. 15Hz) to the face and the visual context scene, cortical activity to the concurrent stimuli was separated, which represents a novel approach to independently tracking the cortical processes associated with the face and the context. Twenty healthy students viewed flickering faces overlaid on flickering visual scenes, while performing a simple change-detection task at fixation, and high-density EEG was recorded. Arousing background scenes generally drove larger ssVEP amplitudes than neutral scenes. Importantly, background and expression interacted: When viewing fearful facial expressions, the ssVEP in response to threat context was amplified compared to other backgrounds. Together, these findings suggest that fearful faces elicit vigilance for potential threat in the visual periphery.

Reduced processing of facial and postural cues in social anxiety: insights from electrophysiology

Social anxiety is characterized by fear of evaluative interpersonal situations. Many studies have investigated the perception of emotional faces in socially anxious individuals and have reported biases in the processing of threatening faces. However, faces are not the only stimuli carrying an interpersonal evaluative load. The present study investigated the processing of emotional body postures in social anxiety. Participants with high and low social anxiety completed an attention-shifting paradigm using neutral, angry and happy faces and postures as cues. We investigated early visual processes through the P100 component, attentional fixation on the P2, structural encoding mirrored by the N170, and attentional orientation towards stimuli to detect with the P100 locked on target occurrence. Results showed a global reduction of P100 and P200 responses to faces and postures in socially anxious participants as compared to non-anxious participants, with a direct correlation between self-reported social anxiety levels and P100 and P200 amplitudes. Structural encoding of cues and target processing were not modulated by social anxiety, but socially anxious participants were slower to detect the targets. These results suggest a reduced processing of social postural and facial cues in social anxiety.

Fear of negative evaluation and attentional bias for facial expressions: an event-related study

Numerous studies have shown an exacerbation of attentional bias towards threat in anxiety states. However, the cognitive mechanisms responsible for these attentional biases remain largely unknown. Further, the authors outline the need to consider the nature of the attentional processes in operation (hypervigilance, avoidance, or disengagement). We adapted a dot-probe paradigm to record behavioral and electrophysiological responses in 26 participants reporting high or low fear of evaluation, a major component of social anxiety. Pairs of faces including a neutral and an emotional face (displaying anger, fear, disgust, or happiness) were presented during 200 ms and then replaced by a neutral target to discriminate. Results show that anxious participants were characterized by an increased P1 in response to pairs of faces, irrespective of the emotional expression included in the pair. They also showed an increased P2 in response to angry-neutral pairs selectively. Finally, in anxious participants, the P1 response to targets was enhanced when replacing emotional faces, whereas non-anxious subjects showed no difference between the two conditions. These results indicate an early hypervigilance to face stimuli in social anxiety, coupled with difficulty in disengaging from threat and sustained attention to emotional stimuli. They are discussed within the framework of current models of anxiety and psychopathology.

Automatic neural processing of disorder-related stimuli in social anxiety disorder: faces and more

It has been proposed that social anxiety disorder (SAD) is associated with automatic information processing biases resulting in hypersensitivity to signals of social threat such as negative facial expressions. However, the nature and extent of automatic processes in SAD on the behavioral and neural level is not entirely clear yet. The present review summarizes neuroscientific findings on automatic processing of facial threat but also other disorder-related stimuli such as emotional prosody or negative words in SAD. We review initial evidence for automatic activation of the amygdala, insula, and sensory cortices as well as for automatic early electrophysiological components. However, findings vary depending on tasks, stimuli, and neuroscientific methods. Only few studies set out to examine automatic neural processes directly and systematic attempts are as yet lacking. We suggest that future studies should: (1) use different stimulus modalities, (2) examine different emotional expressions, (3) compare findings in SAD with other anxiety disorders, (4) use more sophisticated experimental designs to investigate features of automaticity systematically, and (5) combine different neuroscientific methods (such as functional neuroimaging and electrophysiology). Finally, the understanding of neural automatic processes could also provide hints for therapeutic approaches.

Neural response to the observable self in social anxiety disorder

BACKGROUND

Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others. Method Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping.

RESULTS

Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range.

CONCLUSIONS

Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.

Emotional perception: correspondence of early and late event-related potentials with cortical and subcortical functional MRI

This research examines the relationship between brain activity recorded with functional magnetic resonance imaging (fMRI) and event related potentials (ERP) as these responses varied over a series of emotionally evocative and neutral pictures. We investigate the relationship of early occipitotemporal and later centroparietal emotion-modulated ERPs in one sample to fMRI estimates of neural activity in another sample in a replicated experiment. Using this approach, we aimed to link effects found in time-resolved electrocortical measures to specific neural structures across individual emotional and nonemotional picture stimuli. The centroparietal late positive potential (LPP) showed covariation with emotion-modulated regions of hemodynamic activation across multiple dorsal and ventral visual cortical structures, while the early occipitotemporal potential was not reliably associated. Subcortical and corticolimbic structures involved in the perception of motivationally relevant stimuli also related to modulation of the LPP, and were modestly associated to the amplitude of the early occipitotemporal potential. These data suggest that early occipitotemporal potentials may reflect multiple sources of modulation including motivational relevance, and supports the perspective that the slow-wave LPP represents aggregate cortical and subcortical structures involved in emotional discrimination.