Emotion processing in depression and anxiety disorders in older adults: systematic review

The effect of emotion recognition and mindfulness on depression symptoms: A case-control study

Abnormalities in emotion recognition (ER) are frequently reported in depression, with lower recognition accuracy in patients with major depressive disorder (MDD) when compared to healthy individuals. Mindfulness was found to directly impact the severity of depressive symptoms, by recognizing negative cognitions and dysfunctional reactions. The aims of this study were to compare ER and mindfulness levels between MDD patients and healthy controls (HCs), as well as to examine whether ER and mindfulness are related to symptom severity in MDD patients. Sixty-eight patients with MDD and 93 HCs participated in the study. A sociodemographic form, reading the mind in the eyes test (RMET), five facet mindfulness questionnaire-short form (FFMQ-S) and the Montgomery-Asberg depression scale (MADRS) were administered. Group comparison in ER and mindfulness was performed using the multivariate analysis of covariance (MANCOVA). Bivariate correlations and hierarchical linear regression analyses were performed to assess the associations between depression severity, ER and mindfulness in the patient group. Higher level of mindfulness was found in HCs relative to MDD group, however, no ER difference was present between the groups. A positive association between depression severity and the non-reactivity facet of mindfulness was found. On the other hand, ER was not significantly associated with symptom severity among individuals with MDD. Non-reactivity, unlike other dimensions of mindfulness, seems to increase with the severity of depressive symptoms among MDD patients. A particular focus on this subdimension in mindfulness techniques may yield better outcomes in alleviation of depressive symptoms.

Age-related reductions in arousal-enhanced memory are moderated by trait emotion regulation

Emotional arousal is known to enhance episodic memory in young adults. However, compared to valence, little is known about how healthy aging impacts arousal-enhanced memory effects. Furthermore, while emotion regulation is believed to improve with age, it is unclear how individual differences in emotion regulation influence arousal-enhanced memory. In this large-scale online study, we investigated the impact of age and individual differences in emotion regulation on arousal-enhanced memory. During encoding, participants made arousal ratings about negative, neutral, and positive images, and we compared their subsequent memory of high and low-arousal images. We found the impact of emotional arousal on memory was reduced with age, especially for older adults who habitually suppress their emotions. Our findings show that arousal-related memory benefits are reduced with advancing age, and that individual differences in habitual usage of emotion regulation impact these age-related alterations.

Task-based functional connectivity reveals aberrance with the salience network during emotional interference in late-life depression

OBJECTIVES

Late-life depression (LLD) is a common and debilitating disorder. Previously, resting-state studies have revealed abnormal functional connectivity (FC) of brain networks in LLD. Since LLD is associated with emotional-cognitive control deficits, the aim of this study was to compare FC of large-scale brain networks in older adults with and without a history of LLD during a cognitive control task with emotional stimuli.

METHODS

Cross-sectional case-control study. Twenty participants diagnosed with LLD and 37 never-depressed adults 60-88 years of age underwent functional magnetic resonance imaging during an emotional Stroop task. Network-region-to-region FC was assessed with seed regions in the default mode, the frontoparietal, the dorsal attention, and the salience networks.

RESULTS

FC between salience and sensorimotor network regions and between salience and dorsal attention network regions were reduced in LLD patients compared to controls during the processing of incongruent emotional stimuli. The normally positive FC between these networks were negative in LLD patients and inversely correlated with vascular risk and white matter hyperintensities.

CONCLUSIONS

Emotional-cognitive control in LLD is associated with aberrant functional coupling between salience and other networks. This expands on the network-based LLD model and proposes the salience network as a target for future interventions.

Resting-state frontal, frontlateral, and parietal alpha asymmetry:A pilot study examining relations with depressive disorder type and severity

Introduction

The search for biomarkers has been central to efforts of improving clinical diagnosis and prognosis in psychopathology in the last decades. The main approach has been to validate biomarkers that could accurately discriminate between clinical diagnoses of very prevalent forms of psychopathology. One of the most popular electrophysiological markers proposed for discrimination in depressive disorders is the electroencephalography (EEG)-derived frontal alpha asymmetry. However, the validity, reliability and predictive value of this biomarker have been questioned in recent years, mainly due to conceptual and methodological heterogeneity.

Methods

In the current non-experimental, correlational study we investigated relationship of resting-state EEG alpha asymmetry from multiple sites (frontal, frontolateral, and parietal) with different forms of depressive disorders (varying in type or severity), in a clinical sample.

Results

Results showed that alpha asymmetry in the parietal (P3-P4) was significantly higher than in the frontal (F3-F4) and frontolateral sites (F7-F8). However, we did not find significant relations between alpha asymmetry indices and our depressive disorder measures, except for a moderate positive association between frontolateral alpha asymmetry (eyes-closed only) and depressive disorder severity (determined through clinical structured interview). We also found no significant differences in alpha asymmetry between participants, depending on their depression type.

Discussion

Based on results, we propose the parietal and frontolateral asymmetry indices to form hypotheses that should not be abandoned in the depression markers research, but worth for further experimental research. Methodological and clinical implications of the current findings are discussed.

Cerebral cortex Functional Networks of Transdermal Electrical Stimulation at Daling (PC7) Acupoint

The cerebral cortex functional network of Electroencephalogram (EEG) signals during transcutaneous electrical acupoint stimulation (TEAS) on 21 healthy subjects was constructed by using three modules: standard low-resolution brain electromagnetic tomography (sLORETA), phase-locking value (PLV), and complex network. We investigated the brain functional network triggered by PC7 stimulation by comparing with resting state and non-acupoint stimulation. The results showed that the PC7 stimulation mainly activated frontal lobe and temporal lobe including prefrontal cortex (BA10), insular lobe (BA13), temporal gyrus (BA22), anterior cingulate cortex (BA32), temporal pole (BA38), dorsolateral prefrontal cortex (BA46), and inferior frontal cortex (BA47), which are all closely linked to cognition, spirit, and emotion in brain. Furthermore, the degrees of node in frontal, temporal, and whole brain are increased significantly or extreme significantly with p < 0.05, p < 0.05, and p < 0.01, respectively; clustering coefficient in frontal, temporal, and whole brain are all statistically significant (p < 0.05). The information transmission efficiency of cerebral cortex has been greatly improved. During PC7 stimulation, the topological changes in the activation of cerebral regions and cortical functional networks are consistent with the therapeutic effect, which may provide theoretical support for acupoint stimulation to regulate nerve function.

Sex differences on anxiety and depression in older adults and their relationship with cognitive impairment

INTRODUCTION

Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults.

OBJETIVE

To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center.

METHODS

The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association.

RESULTS

Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs.

CONCLUSIONS

It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment.

Watching with Argus eyes: Characterization of emotional and physiological responding in adults exposed to childhood maltreatment and/or recent adversity

Exposure to adverse experiences is a well-established major risk factor for affective psychopathology. The vulnerability of deleterious sequelae is assumed in maladaptive processes of the defensive system, particularly in emotional processing. More specifically, childhood maltreatment has been suggested to be associated with the recruitment of specific and distinct defensive response profiles. To date, it remains unclear whether these are specific or generalizable to recent adversity in adulthood. This pre-registered study aimed to investigate the impact of exposure to childhood and recent adversity on emotional processing in 685 healthy adults with the "Affective Startle Modulation" Paradigm (ASM). First, we replicated higher trait anxiety and depression levels in individuals exposed to both types of adversity. Second, we observed increased general skin conductance reactivity in individuals exposed to recent adversity. Third, individuals exposed to childhood maltreatment showed reduced, while individuals exposed to recent adversity showed increased discrimination between pictures of negative and neutral valence, compared with non-exposed individuals in SCR. No association between exposure to adversity and fear potentiated startle was observed. Furthermore, explorative analyses revealed moderate dimensional and categorical agreement between two childhood maltreatment questionnaires and provide insight into potential adversity-type specific effects. Our results support experience-dependent plasticity in sympathetic nervous system reactivity and suggest distinct response profiles in affective modulation in individuals exposed to early versus recent adversity. We emphasize the need to further explore distinct adversity profiles to further our understanding on specific psychophysiological profiles and their potential implication for prevention and intervention.

FMRI study of implicit emotional face processing in patients with MDD with melancholic subtype

Introduction

The accurate perception of facial expressions plays a vital role in daily life, allowing us to select appropriate responses in social situations. Understanding the neuronal basis of altered emotional face processing in patients with major depressive disorder (MDD) may lead to the appropriate choice of individual interventions to help patients maintain social functioning during depressive episodes. Inconsistencies in neuroimaging studies of emotional face processing are caused by heterogeneity in neurovegetative symptoms of depressive subtypes. The aim of this study was to investigate brain activation differences during implicit perception of faces with negative and positive emotions between healthy participants and patients with melancholic subtype of MDD. The neurobiological correlates of sex differences of MDD patients were also examined.

Methods

Thirty patients diagnosed with MDD and 21 healthy volunteers were studied using fMRI while performing an emotional face perception task.

Results

Comparing general face activation irrespective of emotional content, the intensity of BOLD signal was significantly decreased in the left thalamus, right supramarginal gyrus, right and left superior frontal gyrus, right middle frontal gyrus, and left fusiform gyrus in patients with melancholic depression compared to healthy participants. We observed only limited mood-congruence in response to faces of differing emotional valence. Brain activation in the middle temporal gyrus was significantly increased in response to fearful faces in comparison to happy faces in MDD patients. Elevated activation was observed in the right cingulate for happy and fearful faces, in precuneus for happy faces, and left posterior cingulate cortex for all faces in depressed women compared to men. The Inventory for Depressive Symptomatology (IDS) score was inversely correlated with activation in the left subgenual gyrus/left rectal gyrus for sad, neutral, and fearful faces in women in the MDD group. Patients with melancholic features performed similarly to controls during implicit emotional processing but showed reduced activation.

Discussion and conclusion

This finding suggests that melancholic patients compensate for reduced brain activation when interpreting emotional content in order to perform similarly to controls. Overall, frontal hypoactivation in response to implicit emotional stimuli appeared to be the most robust feature of melancholic depression.

Examining the long-term cognitive effects of exposure to the Canterbury earthquakes in a resilient cohort

BACKGROUND

Although most people do not develop mental health disorders after exposure to traumatic events, they may experience subtle changes in cognitive functioning. We previously reported that 2-3 years after the Canterbury earthquake sequence, a group of trauma-exposed people, who identified as resilient, performed less well on tests of spatial memory, had increased accuracy identifying facial emotions and misclassified neutral facial expressions to threat-related emotions, compared with non-exposed controls.

AIMS

The current study aimed to examine the long-term cognitive effects of exposure to the earthquakes in this resilient group, compared with a matched non-exposed control group.

METHOD

At 8-9 years after the Canterbury earthquake sequence, 57 earthquake-exposed resilient (69% female, mean age 56.8 years) and 60 non-exposed individuals (63% female, mean age 55.7 years) completed a cognitive testing battery that assessed verbal and visuospatial learning and memory, executive functioning, psychomotor speed, sustained attention and social cognition.

RESULTS

With the exception of a measure of working memory (Digit Span Forward), no significant differences were found in performance between the earthquake-exposed resilient and non-exposed groups on the cognitive tasks. Examination of changes in cognitive functioning over time in a subset (55%) of the original earthquake-exposed resilient group found improvement in visuospatial performance and slowing of reaction times to negative emotions.

CONCLUSIONS

These findings offer preliminary evidence to suggest that changes in cognitive functioning and emotion processing in earthquake-exposed resilient people may be state-dependent and related to exposure to continued threat in the environment, which improves when the threat resolves.

Self-Identity and Meaning in Life as Enablers for Older Adults to Self-Manage Depression

Depression is the most common mental illness in older adults and is a leading cause of global disability. Generally, those who have a stronger sense of self-identity and find meaning in their lives tend to manage the symptoms of depression better than those who do not. Little is known about the association between self-identity, meaning in life and self-management of depression in older adults. The aim of this grounded theory study was to explicate how older adults with depression attempted to reclaim self-identity in ways that facilitated self-management. Data collection and analysis were informed by Corbin and Strauss' approach to grounded theory. Thirty-two older adults with a formal diagnosis of moderate depression participated in in-depth, semi-structured interviews. The core problem for participants related to their sense that they were not treated as individuals as they sought to receive and adapt to a depression diagnosis. This challenge was conceptualised as Struggling to maintain personal identity as an older adult with depression. By empowering themselves and striving for a meaningful existence, participants strived to master their current circumstances in ways that strengthened their sense of personal identity. This, in turn, supported their efforts to effectively manage their symptoms of depression and employ adaptive coping strategies that optimise well-being. Our findings identify the need for recovery-oriented models of interdisciplinary practice that enhance self-identity and meaning in life in older adults, in ways that support self-management of depression.

Electroencephalogram Analysis of Magnetic Stimulation at Different Acupoints

Magnetic stimulation has some similarities with acupuncture, and it has broad application prospects because of its non-invasiveness and easy quantification. This paper combines magnetic stimulation technology with electroencephalography to analyze the time-frequency and the brain functional network results elicited by magnetic stimulation at different acupoints. This paper hopes to observe the different effects of stimulating different acupoints on the brain from the perspective of EEG. The EEG signals during magnetic stimulation at ST36, ST40, and GB37 were recorded, respectively. The time-frequency results showed that the magnetic stimulation at ST36 and ST40 on the Foot Yangming Stomach Meridian increased the energy in the left parietal lobe and the right central region, and the energy increased mainly in the theta and alpha bands. However, during the magnetic stimulation at GB37 on the Foot Shaoyang Gallbladder Meridian, the energy in the central region and the frontal lobe increased, and the energy increased mainly in the delta, theta, and alpha bands. Moreover, the energy in the right parietal lobe decreased during magnetic stimulation at GB37. The results of brain functional network were also consistent with time-frequency results. The brain network connections of GB37 stimulation in the central region were significantly less than that of ST36 and ST40 (p < 0.01). In addition, the connections between central region and frontal lobe and the connections between central region and parietal lobe of GB37 stimulation were significantly different from that of ST36 and ST40 (p < 0.01). The above results indicate that ST36 and ST40 on the same meridian have similar effects on the brain, while GB37 on the other meridian has completely different effects from ST36 and ST40. The results of this paper explain the reason why stimulating ST36 and ST40 can treat similar diseases from the perspective of EEG, and also explain that stimulating GB37 has significantly different effects on the brain from that of ST36 and ST40.

Cognition in mood disorders

Cognitive impairment plays a key role in determining the course of illness and functional outcomes in mood disorders. This article summarises and discusses important papers within this thematic series of BJPsych Open that contribute to a greater understanding of the complexity of 'Cognition in Mood Disorders'.