Neuronal generator patterns at scalp elicited by lateralized aversive pictures reveal consecutive stages of motivated attention

Feedback negativity and feedback-related P3 in individuals at risk for depression: Comparing surface potentials and current source densities

Blunted responses to reward feedback have been linked to major depressive disorder (MDD) and depression risk. Using a monetary incentive delay task (win, loss, break-even), we investigated the impact of family risk for depression and lifetime history of MDD and anxiety disorder with 72-channel electroencephalograms (EEG) recorded from 29 high-risk and 32 low-risk individuals (15-58 years, 30 male). Linked-mastoid surface potentials (ERPs) and their corresponding reference-free current source densities (CSDs) were quantified by temporal principal components analysis (PCA). Each PCA solution revealed a midfrontal feedback negativity (FN; peak around 310 ms) and a posterior feedback-P3 (fb-P3; 380 ms) as two distinct reward processing stages. Unbiased permutation tests and multilevel modeling of component scores revealed greater FN to loss than win and neutral for all stratification groups, confirming FN sensitivity to valence. Likewise, all groups had greater fb-P3 to win and loss than neutral, confirming that fb-P3 indexes motivational salience and allocation of attention. By contrast, group effects were subtle, dependent on data transformation (ERP, CSD), and did not confirm reduced FN or fb-P3 for at-risk individuals. Instead, CSD-based fb-P3 was overall reduced in individuals with than without MDD history, whereas ERP-based fb-P3 was greater for high-risk individuals than for low-risk individuals for monetary, but not neutral outcomes. While the present findings do not support blunted reward processing in depression and depression risk, our side-by-side comparison underscores how the EEG reference choice affects the characterization of subtle group differences, strongly advocating the use of reference-free techniques.

The Experience of Meaningful Coincidences Is Associated with Stronger Alpha Power Increases during an Eyes-closed Resting Condition: A Bayesian Replication Approach

Recognizing and perceiving meaningful patterns in an ever-changing environment is fundamental to (human) beings. Apophenia, patternicity, and the propensity to perceive meaningful coincidences might result from the human brain working as a prediction machine that constantly matches sensory information to prior expectations. The propensity for Type I errors varies between people and, at its extreme, is associated with symptoms of schizophrenia. However, on a nonclinical level seeing meaning in randomness might be benevolent and was found to be associated with creativity and openness. However, hardly any neuroscientific investigation has examined EEG patterns of the propensity to experience meaningful coincidences in this manner. We hypothesized deviations in brain functions as one potential reason why some people experience more meaning in random arrangements than others. The gating by inhibition theory suggests that alpha power increases represent basic control mechanisms of sensory processes during varying task requirements. We found that people perceiving more meaningful coincidences had higher alpha power during an eyes-closed versus eyes-opened condition compared with people experiencing less meaningful coincidences. This indicates deviations in the sensory inhibition mechanism of the brain, which are critically relevant for higher cognitive functions. Applying Bayesian statistics, we replicated this finding in another independent sample.

Pursuing the epidemiology and familial risks of depression and developing an evidence based psychotherapy

This commentary, as requested, presents the highlights of my research career. The epidemiology of psychiatric disorders study, challenged in a small study, the notion that diagnosis for psychiatric disorders could be made in a community survey. This pilot study was the basis for the Epidemiology Catchment Area Study (ECA) with 18,000 participants and the many more updated surveys, which followed. The families at High and Low Risk for Depression study in its 40th year challenged the notion that children didn't get depressed and showed that parental depression was the major risk for depression, which began in youth and reoccurred over the lifespan. Interpersonal psychotherapy (IPT), now has been tested in over 150 clinical trials, recommended by the World Health Organization (WHO), globally in China, Germany, Ukraine, and many more countries.

More creative ideas are associated with increased right posterior power and frontal-parietal/occipital coupling in the upper alpha band: A within-subjects study

The neurophysiological investigation of creative idea generation is a growing research area. EEG studies congruently reported the sensitivity of upper alpha power (10-12 Hz) for the creative ideation process and its outcome. However, the majority of studies were between-subject design studies and research directly comparing the neurophysiological activation pattern when generating more and less creative ideas within a person are rare. Therefore, the present study was specifically focused on investigating brain activation patterns associated with the generation of more vs. less creative ideas. We applied an alternate uses task (AU-task; i.e., finding original uses for everyday objects such as a brick) in a sample of 74 participants and recorded the brain activation during the AU-task and reference period. A portable EEG system with 21 dry electrodes arranged in the international 10-20 system and linked ear as reference was used. We found a higher increase of upper alpha power during creative ideation (relative to reference period, i.e., task-related power, TRP) over right posterior sites when people generated more compared to less creative ideas. This was accompanied by an increase of functional coupling (i.e., task-related coherence increase) between frontal and parietal/occipital sites, which suggests higher internal attention and more control over sensory processes. Taken together, these findings complement the existing creativity research literature and indicate the importance of alpha power for the creative ideation process also within people.

Depression Assessment Method: An EEG Emotion Recognition Framework Based on Spatiotemporal Neural Network

The main characteristic of depression is emotional dysfunction, manifested by increased levels of negative emotions and decreased levels of positive emotions. Therefore, accurate emotion recognition is an effective way to assess depression. Among the various signals used for emotion recognition, electroencephalogram (EEG) signal has attracted widespread attention due to its multiple advantages, such as rich spatiotemporal information in multi-channel EEG signals. First, we use filtering and Euclidean alignment for data preprocessing. In the feature extraction, we use short-time Fourier transform and Hilbert-Huang transform to extract time-frequency features, and convolutional neural networks to extract spatial features. Finally, bi-directional long short-term memory explored the timing relationship. Before performing the convolution operation, according to the unique topology of the EEG channel, the EEG features are converted into 3D tensors. This study has achieved good results on two emotion databases: SEED and Emotional BCI of 2020 WORLD ROBOT COMPETITION. We applied this method to the recognition of depression based on EEG and achieved a recognition rate of more than 70% under the five-fold cross-validation. In addition, the subject-independent protocol on SEED data has achieved a state-of-the-art recognition rate, which exceeds the existing research methods. We propose a novel EEG emotion recognition framework for depression detection, which provides a robust algorithm for real-time clinical depression detection based on EEG.

Dissociating disorders of depression, anxiety, and their comorbidity with measures of emotional processing: A joint analysis of visual brain potentials and auditory perceptual asymmetries

In a multigenerational study of families at risk for depression, individuals with a lifetime history of depression had: 1) abnormal perceptual asymmetry (PA; smaller left ear/right hemisphere [RH] advantage) in a dichotic emotion recognition task, and 2) reduced RH late positive potential (P3_RH) during an emotional hemifield task. We used standardized difference scores for processing auditory (PA sad-neutral) and visual (P3_RH negative-neutral) stimuli for 112 participants (52 men) in a logistic regression to predict history of depression, anxiety or comorbidity of both. Whereas comorbidity was separately predicted by reduced PA (OR = 0.527, p = .042) or P3_RH (OR = 0.457, p = .013) alone, an interaction between PA and P3_RH (OR = 2.499, p = .011) predicted depressive disorder. Follow-up analyses revealed increased probability of depression at low (lack of emotional differentiation) and high (heightened reactivity to negative stimuli) levels of both predictors. Findings suggest that reduced or heightened right-lateralized emotional responsivity to negative stimuli may be uniquely associated with depression.

The effectiveness of emotion cognitive reappraisal as measured by self-reported response and its link to EEG alpha asymmetry

Cognitive reappraisal is an important emotion regulation skill for psychological health and well-being, however, some people cannot use this strategy effectively. We investigated EEG alpha asymmetry by calculating lateral index (LI) when twenty-six healthy participants were instructed to complete the emotion cognitive reappraisal task of viewing neutral pictures, watching negative pictures and reappraising negative pictures. According to self-reported valence and arousal, the participants were divided into effective and ineffective groups. Habitual use of rumination was also assessed using the Cognitive Emotion Regulation Questionnaire (CERQ). EEG alpha asymmetry results demonstrated that, ineffective group showed greater relative right temporal activity than effective group in the early stage of reappraisal, indicating higher subjective arousal. Both groups showed greater relative left frontal alpha activity in the late stages of reappraisal compared with watching negative images, indicating the recruitment of corresponding functions in prefrontal regulatory circuitry during the effort of reappraisal. CERQ analysis results showed that, ineffective group got significantly higher score than effective group in habitual use of rumination. Partial correlation revealed that, in male participants, temporal LI change (negative-reappraisal minus negative-watch) was negatively correlated with self-reported arousal and habitual use of rumination. In addition, by using K-means cluster analysis, temporal LI combined with CERQ-rumination score achieved a classification accuracy of 84.6 %. These findings suggested that, EEG alpha asymmetry as well as the habitual use of rumination accounted for the reappraisal effectiveness.

Neural Indicators of Anhedonia: Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression

BACKGROUND

Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known.

METHODS

We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0-6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) or waitlist.

RESULTS

Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F_1,103 = 10.32, p = .002, partial η² = .09). RewP reward responses increased more (F_1,86 = 5.98, p = .02, partial η² = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = -.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03).

CONCLUSIONS

The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.

Gender Role, But Not Sex, Shapes Humans' Susceptibility to Emotion

It is unknown whether the famous sex-related difference in emotion processing is accounted for by biological sex, gender role, or their interaction. To clarify the issue, in Study 1 we recorded event-related potentials in response to negative and positive images of diverse intensities when 47 masculine (26 males) and 47 feminine (22 males) subjects performed a non-emotional task. The occipital P1 and N1 amplitudes were larger in women than in men, while feminine subjects showed larger N1 amplitudes than masculine subjects, regardless of sex. Moreover, feminine subjects showed enhanced frontocentral N2 (210-270 ms) amplitudes for highly and mildly negative than for neutral stimuli, while masculine subjects showed an emotion effect only for highly negative stimuli. The feminine-specific effect for mildly negative stimuli was positively correlated to the feminine score, and this correlation was located to the anterior cingulate and the superior and medial frontal gyri. Furthermore, feminine but not masculine subjects showed enhanced parietal P3 (330-560 ms) amplitudes for highly and mildly positive than for neutral stimuli, an effect positively related to the feminine score and localized to the precuneus, posterior cingulate, and superior temporal gyrus. Machine learning analyses verified that single-trial N2 and P3 amplitudes of feminine subjects reliably discriminated the intensity of negative and positive stimuli, respectively. For ecological considerations, in Study 2 we used an observational approach (n = 300) and confirmed that feminine gender role, rather than biological sex, predicted individual differences in daily experience of emotion-related psychopathological symptoms. These findings provide solid evidence for the critical impact of gender role rather than sex on emotional susceptibility.

Reward-Related Neural Predictors and Mechanisms of Symptom Change in Cognitive Behavioral Therapy for Depressed Adolescent Girls

BACKGROUND

Approximately half of depressed adolescents fail to respond to cognitive behavioral therapy (CBT). Given the variability in response, it is important to identify pretreatment characteristics that predict prognosis. Knowledge of which depressed adolescents are likely to exhibit a positive versus poor outcome to CBT may have important clinical implications (e.g., informing treatment recommendations). Emerging evidence suggests that neural reward responsiveness represents one promising predictor.

METHODS

Adolescents with major depressive disorder (n = 36) received CBT and completed a reward task at 3 time points (pretreatment, midtreatment and posttreatment) while 128-channel electroencephalographic data were acquired. Healthy control participants (n = 29) completed the same task at 3 corresponding time points. Analyses focused on event-related potentials linked to 2 stages of neural processing: initial response to rewards (reward positivity) and later, elaborative processing (late positive potential). Moreover, time-frequency analyses decomposed the reward positivity into 2 constituent components: reward-related delta and loss-related theta activity.

RESULTS

Multilevel modeling revealed that greater pretreatment reward responsiveness, as measured by the late positive potential to rewards, predicted greater depressive symptom change. In addition, a group × condition × time interaction emerged for theta activity to losses, reflecting normalization of theta power in the group with major depressive disorder from baseline to posttreatment.

CONCLUSIONS

An event-related potential measure of sustained (late positive potential)-but not initial (reward positivity)-reward responsiveness predicted symptom improvement, which may help inform which depressed adolescents are most likely to benefit from CBT. In addition to alleviating depression, successful CBT may attenuate underlying neural (theta) hypersensitivity to negative outcomes in depressed youths.

Family Risk for Depression and Prioritization of Religion or Spirituality: Early Neurophysiological Modulations of Motivated Attention

The personal importance of religion or spirituality (R/S) has been associated with a lower risk for major depression (MDD), suicidal behavior, reduced cortical thinning and increased posterior EEG alpha, which has also been linked to antidepressant treatment response in MDD. Building on prior event-related potential (ERP) findings using an emotional hemifield paradigm, this study examined whether abnormal early (preconscious) responsivity to negative arousing stimuli, which is indicative of right parietotemporal dysfunction in both MDD patients and individuals at clinical high risk for MDD, is likewise moderated by R/S. We reanalyzed 72-channel ERP data from 127 individuals at high or low family risk for MDD (Kayser et al., 2017, NeuroImage Clin. 14, 692-707) after R/S stratification (low R/S importance, low/high risk, n = 38/61; high R/S importance, n = 15/13). ERPs were transformed to reference-free current source density (CSD) and quantified by temporal principal components analysis (tPCA). This report focused on N2 sink (peak latency 212 ms), the earliest prominent CSD-tPCA component previously found to be sensitive to emotional content. While overall N2 sink reflected activation of occipitotemporal cortex (prestriate/cuneus), as estimated via a distributed inverse solution, affective significance was marked by a relative (i.e., superimposed) positivity. Statistical analyses employed both non-parametric permutation tests and repeated measures ANOVA for mixed factorial designs with unstructured covariance matrix, including sex, age, and clinical covariates. Participants with low R/S importance, independent of risk status, showed greater ERP responsivity to negative than neutral stimuli, particularly over the right hemisphere. In contrast, early emotional ERP responsivity and asymmetry was substantially reduced for high risk individuals with high R/S importance, however, enhanced for low risk individuals with high R/S importance. Hemifield modulations of these effects (i.e., emotional ERP enhancements with left visual field/right hemisphere stimulus presentations) further corroborated these observations. Results suggest down-regulation of a right-lateralized network for salience detection at an early processing stage in high risk and high R/S importance individuals, presumably to prevent overactivation of ventral brain regions further downstream. These findings may point to a neurophysiological mechanism underlying resilience of families at risk for depression with high R/S prioritization.

Neural Indicators of Anhedonia: Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression

BACKGROUND

Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known.

METHODS

We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0-6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) treatment or waitlist (WL) control condition.

RESULTS

Analyses included reward positivity (RewP) data from 118 children randomized to PCIT-ED treatment (n = 60) or WL control condition (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 PCIT-ED treatment vs. 55 WL control condition) at baseline. Children in the PCIT-ED group showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,87 = 5.45, p = .02, partial η2 = .06) for PCIT-ED and a greater change in RewP was associated with a greater reduction in major depressive disorder symptoms (r = -.24, p = .05). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in the PCIT-ED group (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03).

CONCLUSIONS

The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures were associated with a greater reduction in depression, suggesting that this ERP measure can predict which children are most likely to respond to treatment.

Central and Divided Visual Field Presentation of Emotional Images to Measure Hemispheric Differences in Motivated Attention

Two dominant theories on lateralized processing of emotional information exist in the literature. One theory posits that unpleasant emotions are processed by right frontal regions, while pleasant emotions are processed by left frontal regions. The other theory posits that the right hemisphere is more specialized for the processing of emotional information overall, particularly in posterior regions. Assessing the different roles of the cerebral hemispheres in processing emotional information can be difficult without the use of neuroimaging methodologies, which are not accessible or affordable to all scientists. Divided visual field presentation of stimuli can allow for the investigation of lateralized processing of information without the use of neuroimaging technology. This study compared central versus divided visual field presentations of emotional images to assess differences in motivated attention between the two hemispheres. The late positive potential (LPP) was recorded using electroencephalography (EEG) and event-related potentials (ERPs) methodologies to assess motivated attention. Future work will pair this paradigm with a more active behavioral task to explore the behavioral impacts on the attentional differences found.

The impact of individuation on the bases of human empathic responding

While there is substantial overlap in the neural systems underlying empathy for people we know as opposed to strangers, social distance has been shown to significantly moderate empathic neural responses towards the negative experiences of others. Intriguingly however, variance in empathic neural responses towards known and unknown targets has not been reflected by behavioral differences as indexed by self-reported empathic ratings. One explanation for this disconnect is that empathic evaluations of known and unknown individuals draw on different bases (e.g. target identity/reactions) within the empathic process. To test this hypothesis, we utilized high density EEG to assess how individuating targets with personal names moderated the link between behavioral pain ratings and attentional processing oriented towards (a) initial target processing and (b) subsequent expressions target discomfort. Consistent with prior findings, no differences in pain ratings between individuated and unindividuated targets was observed. However, individual mean pain rating differences for individuated targets was strongly positively related to attentional processing levels, indexed by the P300, during the initial presentation of those targets, a relationship absent for unindividuated targets. In contrast, pain ratings for unindividuated targets was positively related to levels of attentional processing, indexed by the Late Positive Potential (LPP), during the subsequent discomfort expression stage. Furthermore, the LPP response to individuated target discomfort was positively linked to behavioral measures of emotional expressivity whereas the LPP response to unindividuated target discomfort was positively associated with cognitive appraisal. These findings suggest that individuation can significantly shift the bases of empathic responding.

Right brain, left brain in depressive disorders: Clinical and theoretical implications of behavioral, electrophysiological and neuroimaging findings

The right and left side of the brain are asymmetric in anatomy and function. We review electrophysiological (EEG and event-related potential), behavioral (dichotic and visual perceptual asymmetry), and neuroimaging (PET, MRI, NIRS) evidence of right-left asymmetry in depressive disorders. Recent electrophysiological and fMRI studies of emotional processing have provided new evidence of altered laterality in depressive disorders. EEG alpha asymmetry and neuroimaging findings at rest and during cognitive or emotional tasks are consistent with reduced left prefrontal activity in depressed patients, which may impair downregulation of amygdala response to negative emotional information. Dichotic listening and visual hemifield findings for non-verbal or emotional processing have revealed abnormal perceptual asymmetry in depressive disorders, and electrophysiological findings have shown reduced right-lateralized responsivity to emotional stimuli in occipitotemporal or parietotemporal cortex. We discuss models of neural networks underlying these alterations. Of clinical relevance, individual differences among depressed patients on measures of right-left brain function are related to diagnostic subtype of depression, comorbidity with anxiety disorders, and clinical response to antidepressants or cognitive behavioral therapy.

Motivated attention and family risk for depression: Neuronal generator patterns at scalp elicited by lateralized aversive pictures reveal blunted emotional responsivity

Behavioral and electrophysiologic evidence suggests that major depression (MDD) involves right parietotemporal dysfunction, a region activated by arousing affective stimuli. Building on prior event-related potential (ERP) findings (Kayser et al. 2016 NeuroImage 142:337–350), this study examined whether these abnormalities also characterize individuals at clinical high risk for MDD. We systematically explored the impact of family risk status and personal history of depression and anxiety on three distinct stages of emotional processing comprising the late positive potential (LPP). ERPs (72 channels) were recorded from 74 high and 53 low risk individuals (age 13–59 years, 58 male) during a visual half-field paradigm using highly-controlled pictures of cosmetic surgery patients showing disordered (negative) or healed (neutral) facial areas before or after treatment. Reference-free current source density (CSD) transformations of ERP waveforms were quantified by temporal principal components analysis (tPCA). Component scores of prominent CSD-tPCA factors sensitive to emotional content were analyzed via permutation tests and repeated measures ANOVA for mixed factorial designs with unstructured covariance matrix, including gender, age and clinical covariates. Factor-based distributed inverse solutions provided descriptive estimates of emotional brain activations at group level corresponding to hierarchical activations along ventral visual processing stream. Risk status affected emotional responsivity (increased positivity to negative-than-neutral stimuli) overlapping early N2 sink (peak latency 212 ms), P3 source (385 ms), and a late centroparietal source (630 ms). High risk individuals had reduced right-greater-than-left emotional lateralization involving occipitotemporal cortex (N2 sink) and bilaterally reduced emotional effects involving posterior cingulate (P3 source) and inferior temporal cortex (630 ms) when compared to those at low risk. While the early emotional effects were enhanced for left hemifield (right hemisphere) presentations, hemifield modulations did not differ between risk groups, suggesting top-down rather than bottom-up effects of risk. Groups did not differ in their stimulus valence or arousal ratings. Similar effects were seen for individuals with a lifetime history of depression or anxiety disorder in comparison to those without. However, there was no evidence that risk status and history of MDD or anxiety disorder interacted in their impact on emotional responsivity, suggesting largely independent attenuation of attentional resource allocation to enhance perceptual processing of motivationally salient stimuli. These findings further suggest that a deficit in motivated attention preceding conscious awareness may be a marker of risk for depression.

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Emotional hemifield ERP task with 127 individuals at high and low family risk for MDD

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CSD-PCA methods summarized affective modulation of late positive potential (LPP).

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High risk and prior diagnosis of MDD or anxiety disorder independently reduced LPP.

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Suggested hypoarousal (top-down) of right temporoparietal and other emotional regions

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Left hemifield (bottom-up) modulations of early emotional asymmetries were preserved.

Valence and arousal influence the late positive potential during central and lateralized presentation of images

The motivated attention network is believed to be the system that allocates attention toward motivationally relevant, emotional stimuli in order to better prepare an organism for action [Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1997). Motivated attention: Affect, activation, and action. In P. J. Lang, R. F. Simons, M. Balaban, & R. Simons (Eds.), Attention and orienting: Sensory and motivational processes (pp. 97-135). Psychology Press]. The late positive potential (LPP), an event-related potential (ERP) that is a manifestation of the motivated attention network, has not been found to reliably differentiate the valence of emotionally relevant stimuli. In two studies, we systematically varied epoch, stimulus arousal, stimulus valence, and hemisphere of presentation (Study 2) to investigate valence effects in the LPP. Both central and divided visual field presentations of emotional stimuli found the LPP to be sustained in later windows for high-arousing unpleasant images compared to pleasant images. Further, this effect was driven by sustained LPP responses following left hemisphere presentations of unpleasant stimuli compared to right. Findings are discussed regarding hemispheric processing of emotion and how lateralized emotion processes might contribute to psychopathology.