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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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2
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Armbruster D, Lesch KP, Strobel A. The long and the short of it: 5-HTTLPR and moral judgement. Behav Brain Res 2023; 452:114524. [PMID: 37269929 DOI: 10.1016/j.bbr.2023.114524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/28/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Differences in moral sentiments are widespread. Increasingly, their biological correlates are investigated to elucidate potential sources of divergent moral attitudes and choices. Serotonin is one such potential modulator. We investigated the effects of a functional serotonergic polymorphism, 5-HTTLPR, which was previously linked to moral choices albeit with inconsistent findings. N = 157 healthy young adults completed a set of congruent and incongruent moral dilemmas. In addition to the traditional moral response score, this set allows by using a process dissociation (PD) approach an estimation a deontological and a utilitarian parameter. While there was no main effect of 5-HTTLPR on any of the three moral judgement parameters, there was an interaction effect between 5-HTTLPR and endocrine status on PD parameters, which was mainly due to the deontological but not the utilitarian parameter. In men and free cycling women, LL homozygotes showed reduced deontological tendencies compared to S allele carriers. Contrariwise, in women using oral contraceptives, LL homozygotes had increased deontology parameter scores. Furthermore, LL genotypes in general reported less difficulty in making harmful choices, which were in addition associated with less negative emotions. The findings suggest that 5-HTTLPR might be involved in modulating cognitive and emotional processes contributing to moral decisions.
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Affiliation(s)
- Diana Armbruster
- Personality Psychology and Assessment, Institute of Psychology, Chemnitz University of Technology, Chemnitz, Germany.
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, Russia; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Alexander Strobel
- Personality and Individual Differences, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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3
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Bao C, Hu X, Zhang D, Lv Z, Chen J. Predicting Moral Elevation Conveyed in Danmaku Comments Using EEGs. CYBORG AND BIONIC SYSTEMS 2023; 4:0028. [PMID: 37351325 PMCID: PMC10284275 DOI: 10.34133/cbsystems.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/13/2023] [Indexed: 06/24/2023] Open
Abstract
Moral elevation, the emotion that arises when individuals observe others' moral behaviors, plays an important role in determining moral behaviors in real life. While recent research has demonstrated the potential to decode basic emotions with brain signals, there has been limited exploration of affective computing for moral elevation, an emotion related to social cognition. To address this gap, we recorded electroencephalography (EEG) signals from 23 participants while they viewed videos that were expected to elicit moral elevation. More than 30,000 danmaku comments were extracted as a crowdsourcing tagging method to label moral elevation continuously at a 1-s temporal resolution. Then, by employing power spectra features and the least absolute shrinkage and selection operator regularized regression analyses, we achieved a promising prediction performance for moral elevation (prediction r = 0.44 ± 0.11). Our findings indicate that it is possible to decode moral elevation using EEG signals. Moreover, the small-sample neural data can predict the continuous moral elevation experience conveyed in danmaku comments from a large population.
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Affiliation(s)
- Chenhao Bao
- Department of Electronic Engineering,
Tsinghua University, Beijing 100084, China
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD, USA
| | - Xin Hu
- Department of Psychiatry, School of Medicine,
University of Pittsburgh, Pittsburgh, PA, USA
| | - Dan Zhang
- Department of Psychology, School of Social Sciences,
Tsinghua University, Beijing 100084, China
| | - Zhao Lv
- School of Computer Science and Technology,
Anhui University, Hefei 230601, China
| | - Jingjing Chen
- Department of Psychology, School of Social Sciences,
Tsinghua University, Beijing 100084, China
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4
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Baez S, Trujillo-Llano C, de Souza LC, Lillo P, Forno G, Santamaría-García H, Okuma C, Alegria P, Huepe D, Ibáñez A, Decety J, Slachevsky A. Moral Emotions and Their Brain Structural Correlates Across Neurodegenerative Disorders. J Alzheimers Dis 2023; 92:153-169. [PMID: 36710684 PMCID: PMC11181819 DOI: 10.3233/jad-221131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although social cognition is compromised in patients with neurodegenerative disorders such as behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD), research on moral emotions and their neural correlates in these populations is scarce. No previous study has explored the utility of moral emotions, compared to and in combination with classical general cognitive state tools, to discriminate bvFTD from AD patients. OBJECTIVE To examine self-conscious (guilt and embarrassment) and other-oriented (pity and indignation) moral emotions, their subjective experience, and their structural brain underpinnings in bvFTD (n = 31) and AD (n = 30) patients, compared to healthy controls (n = 37). We also explored the potential utility of moral emotions measures to discriminate bvFTD from AD. METHODS We used a modified version of the Moral Sentiment Task measuring the participants' accuracy scores and their emotional subjective experiences. RESULTS bvFTD patients exhibited greater impairments in self-conscious and other-oriented moral emotions as compared with AD patients and healthy controls. Moral emotions combined with general cognitive state tools emerged as useful measures to discriminate bvFTD from AD patients. In bvFTD patients, lower moral emotions scores were associated with lower gray matter volumes in caudate nucleus and inferior and middle temporal gyri. In AD, these scores were associated with lower gray matter volumes in superior and middle frontal gyri, middle temporal gyrus, inferior parietal lobule and supramarginal gyrus. CONCLUSION These findings contribute to a better understanding of moral emotion deficits across neurodegenerative disorders, highlighting the potential benefits of integrating this domain into the clinical assessment.
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Affiliation(s)
| | - Catalina Trujillo-Llano
- Facultad de Psicología, Universidad del Valle, Cali, Colombia
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Leonardo Cruz de Souza
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Departamento de Neurologia Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Forno
- Universidad de los Andes, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department - ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Hernando Santamaría-García
- Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Universidad Javeriana, PhD Program of Neuroscience, Bogotá, Colombia
| | - Cecilia Okuma
- Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurorradiología, Instituto de Neurocirugía Dr. Asenjo, Servicio de Salud Metropolitano Oriente, Santiago, Chile
| | - Patricio Alegria
- Servicio de Radiología, Hospital Barros Luco Trudeau, San Miguel, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Agustín Ibáñez
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
| | | | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department - ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Center, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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5
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Israel B, Wiprovnick AE, Belcher AM, Kleinman MB, Ramprashad A, Spaderna M, Weintraub E. Practical Considerations for Treating Comorbid Posttraumatic Stress Disorder in the Addictions Clinic: Approaches to Clinical Care, Leadership, and Alleviating Shame. Psychiatr Clin North Am 2022; 45:375-414. [PMID: 36055729 DOI: 10.1016/j.psc.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
A practical, common-sense framework for recognizing and addressing comorbid posttraumatic stress disorder (PTSD) in the substance use disorder (SUD) clinic is outlined. The article focuses on strategies that can help establish trauma-informed care or augment an existing approach. Interventions are organized around the task of ameliorating shame (or shame sensitivity), which represents a transdiagnostic mediator of psychopathology and, potentially, capacity for change. Countershaming strategies can guide a trauma-responsive leadership approach. Considering the striking rate of underdiagnosis of PTSD among patients with SUD, implementing routine systematic PTSD screening likely represents the single most consequential trauma-informed intervention that SUD clinics can adopt.
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Affiliation(s)
- Benjamin Israel
- Division of Consultation-Liaison Psychiatry, Department of Psychiatry, University of Maryland School of Medicine, 4801 Yellowwood Ave, Ste 2E1, Baltimore, MD 21209, USA.
| | - Alicia E Wiprovnick
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Annabelle M Belcher
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Mary B Kleinman
- Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, 4094 Campus Drive, College Park, MD 20742, USA
| | - Avinash Ramprashad
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Max Spaderna
- Division of Addiction Research and Treatment, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Eric Weintraub
- Division of Addiction Research and Treatment, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
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6
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Mancini A, Granziol U, Migliorati D, Gragnani A, Femia G, Cosentino T, Saliani AM, Tenore K, Luppino OI, Perdighe C, Mancini F. Moral Orientation Guilt Scale (MOGS): Development and validation of a novel guilt measurement. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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7
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Eslinger PJ, Anders S, Ballarini T, Boutros S, Krach S, Mayer AV, Moll J, Newton TL, Schroeter ML, de Oliveira-Souza R, Raber J, Sullivan GB, Swain JE, Lowe L, Zahn R. The neuroscience of social feelings: mechanisms of adaptive social functioning. Neurosci Biobehav Rev 2021; 128:592-620. [PMID: 34089764 PMCID: PMC8388127 DOI: 10.1016/j.neubiorev.2021.05.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/31/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023]
Abstract
Social feelings have conceptual and empirical connections with affect and emotion. In this review, we discuss how they relate to cognition, emotion, behavior and well-being. We examine the functional neuroanatomy and neurobiology of social feelings and their role in adaptive social functioning. Existing neuroscience literature is reviewed to identify concepts, methods and challenges that might be addressed by social feelings research. Specific topic areas highlight the influence and modulation of social feelings on interpersonal affiliation, parent-child attachments, moral sentiments, interpersonal stressors, and emotional communication. Brain regions involved in social feelings were confirmed by meta-analysis using the Neurosynth platform for large-scale, automated synthesis of functional magnetic resonance imaging data. Words that relate specifically to social feelings were identfied as potential research variables. Topical inquiries into social media behaviors, loneliness, trauma, and social sensitivity, especially with recent physical distancing for guarding public and personal health, underscored the increasing importance of social feelings for affective and second person neuroscience research with implications for brain development, physical and mental health, and lifelong adaptive functioning.
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Affiliation(s)
- Paul J Eslinger
- Departments of Neurology, Neural & Behavioral Sciences, Pediatrics, and Radiology, Penn State Hershey Medical Center, Hershey, PA, USA.
| | - Silke Anders
- Social and Affective Neuroscience, Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Tommaso Ballarini
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sydney Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Sören Krach
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Annalina V Mayer
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Jorge Moll
- Cognitive Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Tamara L Newton
- University of Louisville, Department of Psychological and Brain Sciences, Louisville, KY, USA
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Ricardo de Oliveira-Souza
- Cognitive Neuroscience Unit, D'Or Institute for Research and Education (IDOR), BR Hospital Universitario, Universidade do Rio de Janeiro, Brazil
| | - Jacob Raber
- Departments of Behavioral Neuroscience, Neurology, and Radiation Medicine, Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA
| | - Gavin B Sullivan
- International Psychoanalytic University, Berlin, Germany, Centre for Trust, Peace and Social Relations, Coventry University, UK
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Psychology and Obstetrics and Gynecology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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8
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Bassil KC, Rutten BPF, Horstkötter D. Biomarkers for PTSD Susceptibility and Resilience, Ethical Issues. AJOB Neurosci 2019; 10:122-124. [PMID: 31361197 DOI: 10.1080/21507740.2019.1632964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Bart P F Rutten
- a Maastricht University.,b Maastricht University Medical Centre
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9
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Teichmann M, Daigmorte C, Funkiewiez A, Sanches C, Camus M, Mauras T, Le Ber I, Dubois B, Levy R, Azuar C. Moral Emotions in Frontotemporal Dementia. J Alzheimers Dis 2019; 69:887-896. [PMID: 31127763 DOI: 10.3233/jad-180991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Emotions, with or without moral valence, appear to be altered in the behavioral variant of frontotemporal dementia (bvFTD) but the relative degree of moral emotion breakdown, which could be a marker of bvFTD diagnosis, remains unexplored. OBJECTIVE To assess moral emotions in bvFTD, to differentiate bvFTD from typical Alzheimer's disease (AD) based on moral emotion processing, and to provide a sensitive and specific assessment tool contributing to bvFTD diagnosis. METHODS We investigated moral emotions in 22 bvFTD patients, 15 patients with typical AD having positive CSF AD biomarkers, and 45 healthy controls. The 'Moral Emotions Assessment' task consisted in 42 scenarios exploring positive and negative moral emotions. To control for moral-specificity, we contrasted the 42 moral scenarios with 18 extra-moral scenarios eliciting the emotions without involving any inter-human moral context. RESULTS bvFTD patients were more impaired in emotion processing than AD patients and healthy controls and had significantly poorer performance in the processing of moral emotions than of emotions without moral valence. ROC analyses of data on moral scenarios showed a high area under the curve (83%), and indicated a cut-off score (< 37/42) for differentiating bvFTD from AD with a sensitivity of 82% and specificity of 73%. CONCLUSION Our findings demonstrate that bvFTD patients have disorders in emotion processing which is mainly related to failure regarding moral emotions. They also show that this deficit is reliably detected by the 'Moral Emotions Assessment' which represents a sensitive and specific diagnostic tool detecting bvFTD and differentiating it from AD.
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Affiliation(s)
- Marc Teichmann
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Chloé Daigmorte
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France
| | - Aurélie Funkiewiez
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Clara Sanches
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France
| | - Maeva Camus
- Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France
| | - Thomas Mauras
- Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France.,Service de Psychiatrie, Hôpital Sainte-Anne, Paris, France
| | - Isabelle Le Ber
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Richard Levy
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Carole Azuar
- Institut du Cerveau et de la Moelle épinière (ICM), FrontLab, Paris, France.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence National 'FTD', Hôpital Pitié Salpêtrière, AP-HP, Paris, France.,Unité de Neuro-Psychiatrie Comportementale (IHU), Hôpital de la Pitié Salpêtrière, Paris, France
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10
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Hennion S, Szurhaj W, Skrobala E, Davière J, Tyvaert L, Derambure P, Delbeuck X. Experiences of self-conscious emotions in temporal lobe epilepsy. Epilepsy Behav 2019; 90:1-6. [PMID: 30476808 DOI: 10.1016/j.yebeh.2018.10.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/09/2018] [Accepted: 10/21/2018] [Indexed: 10/27/2022]
Abstract
Self-conscious emotions (SCEs) with a negative valence (such as shame and guilt) or a positive valence (such as pride) are moral emotions that emerge from self-reflection and self-evaluation processes in social contexts. In some neurologic and psychiatric disorders, experiences of SCEs are dysregulated. The objectives of the present study were to (i) evaluate whether patients with temporal lobe epilepsy (TLE) experience SCEs in the same way as nonclinical (control) participants and (ii) probe the relationships between experiences of SCEs on the one hand and the psychological symptoms frequently diagnosed in patients with TLE (anxiety and depression), the patients' clinical characteristics, and their functional outcomes in everyday life on the other. Sixty-one patients with TLE and 61 matched controls completed a self-questionnaire (the Positive and Negative Affect Schedule (PANAS)) that enabled us to evaluate the extent to which they experienced shame, guilt, and pride. Demographic data, cognitive data, the severity of anxiety symptoms, and the severity of depressive symptoms were recorded for all participants. In patients with TLE, data of clinical characteristics and quality of life were also evaluated. Relative to controls, patients with TLE were more likely to experience negative-valence SCEs to a higher extent and positive SCEs to a lesser extent. The patients who experienced negative-valence SCEs to a higher extent (rather than to a lesser extent) had a higher frequency of seizures, more severe anxiety and depressive symptoms, and a greater prevalence of anxiety and depressive disorders. Furthermore, patients who experienced positive-valence SCEs to a lesser extent (rather than to a higher extent) displayed a higher level of anxiety. Lastly, differences in experiences of SCEs by patients with TLE were associated with a lower quality of life. In conclusion, experiences of SCEs can be dysregulated in patients with TLE. This dysregulation is linked to the patients' clinical and psychological symptoms and quality of life. In this context, SCEs might be a target of interest in the management of epilepsy.
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Affiliation(s)
- S Hennion
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France.
| | - W Szurhaj
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - E Skrobala
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Memory Resource and Research Center, Lille University Medical Center, Lille, France
| | - J Davière
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Memory Resource and Research Center, Lille University Medical Center, Lille, France
| | - L Tyvaert
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Department of Neurology, Nancy University Medical Center, UMR 7039, CRAN, University of Lorraine, Nancy, France
| | - P Derambure
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - X Delbeuck
- Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Memory Resource and Research Center, Lille University Medical Center, Lille, France
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11
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Fontenelle LF, Frydman I, Hoefle S, Oliveira-Souza R, Vigne P, Bortolini TS, Suo C, Yücel M, Mattos P, Moll J. Decoding moral emotions in obsessive-compulsive disorder. Neuroimage Clin 2018; 19:82-89. [PMID: 30035005 PMCID: PMC6051311 DOI: 10.1016/j.nicl.2018.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 11/20/2022]
Abstract
Background Patients with obsessive-compulsive disorder (OCD) exhibit abnormal neural responses when they experience particular emotions or when they evaluate stimuli with emotional value. Whether these brain responses are sufficiently distinctive to discriminate between OCD patients and healthy controls is unknown. The present study is the first to investigate the discriminative power of multivariate pattern analysis of regional fMRI responses to moral and non-moral emotions. Method To accomplish this goal, we performed a searchlight-based multivariate pattern analysis to unveil brain regions that could discriminate 18 OCD patients from 18 matched healthy controls during provoked guilt, disgust, compassion, and anger. We also investigated the existence of distinctive neural patterns while combining those four emotions (herein termed multiemotion analysis). Results We found that different frontostriatal regions discriminated OCD patients from controls based on individual emotional experiences. Most notably, the left nucleus accumbens (NAcc) discriminated OCD patients from controls during both disgust and the multiemotion analysis. Among other regions, the angular gyrus responses to anger and the lingual and the middle temporal gyri in the multi-emotion analysis were highly discriminant between samples. Additional BOLD analyses supported the directionality of these findings. Conclusions In line with previous studies, differential activity in regions beyond the frontostriatal circuitry differentiates OCD from healthy volunteers. The finding that the response of the left NAcc to different basic and moral emotions is highly discriminative for a diagnosis of OCD confirms current pathophysiological models and points to new venues of research.
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Affiliation(s)
- Leonardo F Fontenelle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
| | - Ilana Frydman
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Sebastian Hoefle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Paula Vigne
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Tiago S Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Chao Suo
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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12
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Santamaría-García H, Baez S, Reyes P, Santamaría-García JA, Santacruz-Escudero JM, Matallana D, Arévalo A, Sigman M, García AM, Ibáñez A. A lesion model of envy and Schadenfreude: legal, deservingness and moral dimensions as revealed by neurodegeneration. Brain 2017; 140:3357-3377. [PMID: 29112719 PMCID: PMC5841144 DOI: 10.1093/brain/awx269] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/21/2017] [Indexed: 12/19/2022] Open
Abstract
The study of moral emotions (i.e. Schadenfreude and envy) is critical to understand the ecological complexity of everyday interactions between cognitive, affective, and social cognition processes. Most previous studies in this area have used correlational imaging techniques and framed Schadenfreude and envy as unified and monolithic emotional domains. Here, we profit from a relevant neurodegeneration model to disentangle the brain regions engaged in three dimensions of Schadenfreude and envy: deservingness, morality, and legality. We tested a group of patients with behavioural variant frontotemporal dementia (bvFTD), patients with Alzheimer’s disease, as a contrastive neurodegeneration model, and healthy controls on a novel task highlighting each of these dimensions in scenarios eliciting Schadenfreude and envy. Compared with the Alzheimer’s disease and control groups, patients with bvFTD obtained significantly higher scores on all dimensions for both emotions. Correlational analyses revealed an association between envy and Schadenfreude scores and greater deficits in social cognition, inhibitory control, and behaviour disturbances in bvFTD patients. Brain anatomy findings (restricted to bvFTD and controls) confirmed the partially dissociable nature of the moral emotions’ experiences and highlighted the importance of socio-moral brain areas in processing those emotions. In all subjects, an association emerged between Schadenfreude and the ventral striatum, and between envy and the anterior cingulate cortex. In addition, the results supported an association between scores for moral and legal transgression and the morphology of areas implicated in emotional appraisal, including the amygdala and the parahippocampus. By contrast, bvFTD patients exhibited a negative association between increased Schadenfreude and envy across dimensions and critical regions supporting social-value rewards and social-moral processes (dorsolateral prefrontal cortex, angular gyrus and precuneus). Together, this study provides lesion-based evidence for the multidimensional nature of the emotional experiences of envy and Schadenfreude. Our results offer new insights into the mechanisms subsuming complex emotions and moral cognition in neurodegeneration. Moreover, this study presents the exacerbation of envy and Schadenfreude as a new potential hallmark of bvFTD that could impact in diagnosis and progression.
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Affiliation(s)
- Hernando Santamaría-García
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia.,Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Grupo de Investigación en Cerebro y Cognición Social, Bogotá, Colombia
| | - Sandra Baez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Grupo de Investigación en Cerebro y Cognición Social, Bogotá, Colombia.,Universidad de los Andes, Bogotá, Colombia
| | - Pablo Reyes
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia
| | | | - José M Santacruz-Escudero
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia.,Departament de Psiquiatria i Medicina Legal, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Diana Matallana
- Centro de Memoria y Cognición. Intellectus-Hospital Universitario San Ignacio, Bogotá Colombia.,Pontificia Universidad Javeriana, Departments of Physiology, Psychiatry and Aging Institute Bogotá, Colombia
| | - Analía Arévalo
- Departamento de Neurologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Mariano Sigman
- Universidad Torcuato di Tella, Laboratorio de Neurociencias, Buenos Aires, Argentina
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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13
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Olatunji BO, Armstrong T, Elwood L. Is Disgust Proneness Associated With Anxiety and Related Disorders? A Qualitative Review and Meta-Analysis of Group Comparison and Correlational Studies. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2017. [DOI: 10.1177/1745691616688879] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Research suggests that disgust may be linked to the etiology of some anxiety-related disorders. The present investigation reviews this literature and employs separate meta-analyses of clinical group comparison and correlational studies to examine the association between disgust proneness and anxiety-related disorder symptoms. Meta-analysis of 43 group comparison studies revealed those high in anxiety disorder symptoms reported significantly more disgust proneness than those low in anxiety symptoms. Although this effect was not moderated by clinical versus analogue studies or type of disorder, larger group differences were observed for those high in anxiety symptoms associated with contagion concerns compared to those high in anxiety symptoms not associated with contagion concerns. Similarly, meta-analysis of correlational data across 83 samples revealed moderate associations between disgust proneness and anxiety-related disorder symptoms. Moderator analysis revealed that the association between disgust proneness and anxiety-related disorder symptoms was especially robust for anxiety symptoms associated with contagion concerns. After controlling for measures of negative affect, disgust proneness continued to be moderately correlated with anxiety-related disorder symptoms. However, negative affect was no longer significantly associated with symptoms of anxiety-related disorders when controlling for disgust proneness. The implications of these findings are discussed in the context of a novel transdiagnostic model.
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14
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Esperidião-Antonio V, Majeski-Colombo M, Toledo-Monteverde D, Moraes-Martins G, Fernandes JJ, Bauchiglioni de Assis M, Montenegro S, Siqueira-Batista R. Neurobiology of emotions: an update. Int Rev Psychiatry 2017; 29:293-307. [PMID: 28540750 DOI: 10.1080/09540261.2017.1285983] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The 'nature' of emotions is one of the archaic themes of Western thought, thematized in different cultural manifestations - such as art, science, philosophy, myths and religion -, since Ancient times. In the last decades, the advances in neurosciences have permitted the construction of hypotheses that explain emotions, especially through the studies involving the limbic system. To present an updated discussion about the neurobiology of processes relating to emotions - focusing (1) on the main neural structures that relate to emotions, (2) the paths and circuits of greater relevance, (3) the implicated neurotransmitters, (4) the connections that possess neurovegetative control and (5) the discussion about the main emotions - is the objective of this present article.
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Affiliation(s)
| | - Marilia Majeski-Colombo
- b Curso de Graduação em Medicina , Centro Universitário Serra dos Órgãos (UNIFESO) , Teresopolis , Brazil
| | - Diana Toledo-Monteverde
- b Curso de Graduação em Medicina , Centro Universitário Serra dos Órgãos (UNIFESO) , Teresopolis , Brazil
| | - Glaciele Moraes-Martins
- b Curso de Graduação em Medicina , Centro Universitário Serra dos Órgãos (UNIFESO) , Teresopolis , Brazil
| | - Juliana José Fernandes
- b Curso de Graduação em Medicina , Centro Universitário Serra dos Órgãos (UNIFESO) , Teresopolis , Brazil
| | | | - Stefânia Montenegro
- c Núcleo de Estudos em Ciências Médicas , Faculdade Dinâmica do Vale do Piranga (FADIP) , Ponte Nova , Brazil
| | - Rodrigo Siqueira-Batista
- c Núcleo de Estudos em Ciências Médicas , Faculdade Dinâmica do Vale do Piranga (FADIP) , Ponte Nova , Brazil.,d Departamento de Medicina e Enfermagem , Universidade Federal de Viçosa (UFV) , Viçosa , Brazil.,e Postgraduate Program of Bioethics, Ethics and Public Health (PPGBIOS) , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil
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15
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Bomyea J, Allard CB. Trauma-Related Disgust in Veterans With Interpersonal Trauma. J Trauma Stress 2017; 30:149-156. [PMID: 28429858 DOI: 10.1002/jts.22169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 11/25/2016] [Accepted: 01/16/2017] [Indexed: 11/08/2022]
Abstract
Although traditionally conceptualized as an anxiety disorder, variability in posttraumatic stress disorder (PTSD) may be explained by individual differences in peri- or posttraumatic disgust. We examined relationships between disgust reactions and other trauma-related symptoms in 100 veterans with a history of interpersonal trauma and gender differences in these variables. We also evaluated the mediating role of posttraumatic disgust and guilt in the relationship between peritraumatic disgust and PTSD symptoms. Participants completed cross-sectional self-report questionnaires of trauma-related emotions, PTSD, and other psychological symptoms as part of clinical intake procedures. Women and men did not differ on trauma-related emotions or symptoms. However, the relationship between peri- and posttraumatic disgust depended on gender, with men reporting a stronger association between peri- and posttraumatic disgust than women (p = .013, ΔR2 = .04). Posttraumatic disgust and guilt mediated the relationship between peritraumatic disgust and PTSD symptoms, controlling for gender (a1 a2 b1 = 0.18, SE = 0.09, PM = .19). Our results converge with those found in other studies suggesting that disgust is a common trauma-related emotion and that men and women may experience differential relationships between peri- and posttraumatic emotional experiences. Further study of the role of trauma-related emotional responses in PTSD etiology and treatment is warranted.
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Affiliation(s)
- Jessica Bomyea
- VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Carolyn B Allard
- VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, San Diego, California, USA
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