Emotions shape memory suppression in trait anxiety

Everything you ever wanted to know about the Think/No-Think task, but forgot to ask

The Think/No-Think (TNT) task has just celebrated 20 years since its inception, and its use has been growing as a tool to investigate the mechanisms underlying memory control and its neural underpinnings. Here, we present a theoretical and practical guide for designing, implementing, and running TNT studies. For this purpose, we provide a step-by-step description of the structure of the TNT task, methodological choices that can be made, parameters that can be chosen, instruments available, aspects to be aware of, systematic information about how to run a study and analyze the data. Importantly, we provide a TNT training package (as Supplementary Material), that is, a series of multimedia materials (e.g., tutorial videos, informative HTML pages, MATLAB code to run experiments, questionnaires, scoring sheets, etc.) to complement this method paper and facilitate a deeper understanding of the TNT task, its rationale, and how to set it up in practice. Given the recent discussion about the replication crisis in the behavioral sciences, we hope that this contribution will increase standardization, reliability, and replicability across laboratories.

Improving mental health by training the suppression of unwanted thoughts

Anxiety, posttraumatic stress, and depression markedly increased worldwide during the COVID-19 pandemic. People with these conditions experience distressing intrusive thoughts, yet conventional therapies often urge them to avoid suppressing their thoughts because intrusions might rebound in intensity and frequency, worsening the disorders. In contrast, we hypothesized that training thought suppression would improve mental health. One hundred and twenty adults from 16 countries underwent 3 days of online training to suppress either fearful or neutral thoughts. No paradoxical increases in fears occurred. Instead, suppression reduced memory for suppressed fears and rendered them less vivid and anxiety provoking. After training, participants reported less anxiety, negative affect, and depression with the latter benefit persisting at 3 months. Participants high in trait anxiety and pandemic-related posttraumatic stress gained the largest and most durable mental health benefits. These findings challenge century-old wisdom that suppressing thoughts is maladaptive, offering an accessible approach to improving mental health.

A mindful approach to controlling intrusive thoughts

Intrusive thoughts of negative experiences can pose a threat to our well-being. To some extent, unwanted memories can be intentionally controlled via an executive control mechanism that downregulates the occurrence of intrusions. Mindfulness training can improve executive control. It is not known whether mindfulness training can be used as an intervention to improve intentional memory control and reduce intrusions. To this end, 148 healthy participants completed a 10-day app-based mindfulness training or an active control task. At baseline, inhibitory control and working memory were assessed as measures of executive functioning. Post-mindfulness training, intrusions were assessed via the Think/No-Think task. It was expected that mindfulness training would reduce intrusions. Furthermore, we hypothesised that this would be moderated by baseline executive functioning. Results revealed that, contrary to our hypothesis, both groups increased equally in dispositional mindfulness between baseline and post-test. As such, our exploratory analysis revealed that higher dispositional mindfulness across both groups resulted in fewer intrusions and enhanced the ability to downregulate intrusions over time. Furthermore, this effect was moderated by inhibitory control at baseline. These results provide insight into factors that can improve the ability to control unwanted memories, which could have considerable implications for treatments in psychopathologies characterized by the frequent occurrence of intrusive thoughts. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 11th March, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/U8SJN .

Perspective taking in the human brain: complementary evidence from neuroimaging studies with media-based naturalistic stimuli and artificial controlled paradigms

Perception and interpretation of various types of events and information in life crucially depend on one's perspective. A specific perspective can be explicitly adopted, for example, via instructing an experimental subject, implicitly via a priori information given to subjects, and by subjects' personality traits or cultural background. The neural basis of perspective taking has been addressed in a number of recent neuroimaging studies, some of which have used movies and narratives as media-based stimuli to pursue a holistic understanding of the phenomenon under ecologically valid conditions. Results across these studies suggest that the human brain flexibly adapts to support the information-processing needs of different perspectives, however, also that inferior temporal-occipital areas and posterior-medial parietal areas are engaged across different perspectives. These findings are complemented by studies that have investigated specific aspects of perspective taking with highly controlled experimental designs. They have disclosed involvement of the temporoparietal junction in visual perspective taking and the importance of the affective component of the pain matrix when empathizing with others' pain. Identification with the protagonists also seems to matter, as dorsomedial vs. ventromedial prefrontal areas are recruited when the protagonist is dissimilar vs. similar to self. Finally, as a translational aspect, perspective taking can, under certain conditions, serve as an effective emotion regulation technique, wherein lateral and medial regions of the prefrontal cortex seem to support reappraisal processes. Together, findings from studies with media-based stimuli and more traditional paradigms complement each other to gain a comprehensive understanding of the neural basis of perspective taking.

Prefrontal-hippocampal interactions supporting the extinction of emotional memories: the retrieval stopping model

Neuroimaging has revealed robust interactions between the prefrontal cortex and the hippocampus when people stop memory retrieval. Efforts to stop retrieval can arise when people encounter reminders to unpleasant thoughts they prefer not to think about. Retrieval stopping suppresses hippocampal and amygdala activity, especially when cues elicit aversive memory intrusions, via a broad inhibitory control capacity enabling prepotent response suppression. Repeated retrieval stopping reduces intrusions of unpleasant memories and diminishes their affective tone, outcomes resembling those achieved by the extinction of conditioned emotional responses. Despite this resemblance, the role of inhibitory fronto-hippocampal interactions and retrieval stopping broadly in extinction has received little attention. Here we integrate human and animal research on extinction and retrieval stopping. We argue that reconceptualising extinction to integrate mnemonic inhibitory control with learning would yield a greater understanding of extinction's relevance to mental health. We hypothesize that fear extinction spontaneously engages retrieval stopping across species, and that controlled suppression of hippocampal and amygdala activity by the prefrontal cortex reduces fearful thoughts. Moreover, we argue that retrieval stopping recruits extinction circuitry to achieve affect regulation, linking extinction to how humans cope with intrusive thoughts. We discuss novel hypotheses derived from this theoretical synthesis.

Adult Aging Moderates the Relationship Between Trait Cognitive Anxiety and Subjective Everyday Cognitive Difficulties

The present aim was to determine, across the adult lifespan, the extent to which different dimensions of trait anxiety might affect subjective cognitive difficulties in everyday life. Following Attentional Control Theory (ACT; Eysenck et al., 2007), we predicted that trait anxiety would have a greater effect on attention and verbal abilities than on visual abilities. We also expected trait cognitive anxiety to exhibit more robust relationships with cognition than trait somatic anxiety. Importantly, we predicted that effects of anxiety would be greater in older adults, in line with the Strength and Vulnerability Integration model (SAVI; Charles, 2010). The sample comprised 286 United Kingdom-based adults aged 18–93 years. Participants completed self-report measures of trait cognitive and somatic anxiety (the State-Trait Inventory for Cognitive and Somatic Anxiety; STICSA, Ree et al., 2008) and everyday cognitive difficulties (the Multiple Abilities Self-Report Questionnaire; MASQ, Seidenberg et al., 1994). Moderated regression models were constructed, including trait cognitive or somatic anxiety as a predictor of cognitive difficulties, and age as the moderator variable. Covariates included depression, stress (the Depression Anxiety Stress Scales—short form; DASS-21, Lovibond and Lovibond, 1995), gender, current mental health treatment status, and physical health status. When cognitive anxiety was the predictor variable, somatic anxiety was also included as a covariate, and vice-versa. Trait cognitive anxiety and age interacted to predict all MASQ subscales other than visual-perceptual ability. Difficulties with attention, verbal memory, and language abilities were significantly greater at higher levels of anxiety for all age groups, with the effect greatest in older adults. Difficulties with visual-spatial memory were significantly greater at higher levels of anxiety in middle-aged and older adults only. Higher trait somatic anxiety predicted difficulties with verbal memory and language ability independently of age, and interacted with age to predict language difficulties. Interestingly, age also significantly predicted less subjective difficulty with attention, independently of anxiety level. The results show that trait cognitive and somatic anxiety are both related to subjective, everyday cognitive difficulties. However, effects of trait cognitive anxiety are more robust across cognitive domains and tend to increase, or first appear, over the course of the adult lifespan.

Functional connectivity between right-lateralized ventrolateral prefrontal cortex and insula mediates reappraisal's link to memory control

BACKGROUND

Memory control (MC) ability is critical for people's mental and physical health. Previous research had conceptually demonstrated that MC ability has close relationship with reappraisal. However, experimental evidence supporting the relationship was limited. Thus, in the present study, we investigated how MC and reappraisal are linked, both in behavior and in the brain.

METHODS

The habitual use of reappraisal was assessed by Emotion Regulation Questionnaire, and memory control ability was measured through directed forgetting task. Resting-state functional magnetic resonance imaging was used to test the seed-based functional connectivity in 181 healthy subjects.

RESULTS

Behavioral results revealed that more frequent reappraisal was associated with an enhanced ability to control negative memories. Resting-state seed-based functional connectivity showed that habitual use of reappraisal was positively related to the strength of functional connectivity between the right ventrolateral prefrontal cortex (VLPFC) and right insula. Most importantly, this functional connectivity mediated the effect of habitual use of reappraisal on control over negative memories.

LIMITATIONS

Present results mainly showed the habitual use of reappraisal was related with MC ability in negative items. Future study could further explore the relationship between MC ability of different categories of negative emotional memories and other kinds of ER strategies.

CONCLUSIONS

Our results support the notion that reappraisal provides opportunities for individuals to practice and enhance inhibitory control-a relationship underpinned by connectivity between the right VLPFC and right insula.

Retrieval orientation for memories encoded in emotional contexts: An ERP study

Retrieval orientation, which is involved in recognition cue processing, optimizes goal-directed memory retrieval. However, whether the emotionality of encoding context affects subsequent retrieval orientation remains unclear. To clarify this, neutral objects were paired with either emotional or neutral background scenes during the study phase. During recognition test, only neutral objects were presented. The ERP analysis on the correctly rejected new items indicated that at least two processes were modulated by the emotionality of memory: 1) the arousal-modulated effect on the right-frontal scalp, and 2) the posterior-distributed effect, which was found to differentiate between memories with positive and negative valence. Furthermore, the magnitude of posterior-distributed effect was correlated with affective rating. The topographical distribution indicated that retrieval orientation for positive memories involves at least partially different neural circuitries from neutral or negative memories. Our results suggest that the emotionality of encoding context affects subsequent retrieval orientation.

Forgetting Unwanted Memories: Active Forgetting and Implications for the Development of Psychological Disorders

Intrusive memories are a common feature of many psychopathologies, and suppression-induced forgetting of unwanted memories appears as a critical ability to preserve mental health. In recent years, biological and cognitive studies converged in revealing that forgetting is due to active processes. Recent neurobiological studies provide evidence on the active role of main neurotransmitter systems in forgetting, suggesting that the brain actively works to suppress retrieval of unwanted memories. On the cognitive side, there is evidence that voluntary and involuntary processes (here termed "intentional" and "incidental" forgetting, respectively) contribute to active forgetting. In intentional forgetting, an inhibitory control mechanism suppresses awareness of unwanted memories at encoding or retrieval. In incidental forgetting, retrieval practice of some memories involuntarily suppresses the retrieval of other related memories. In this review we describe recent findings on deficits in active forgetting observed in psychopathologies, like post-traumatic stress disorder, depression, schizophrenia, and obsessive-compulsive disorder. Moreover, we report studies in which the role of neurotransmitter systems, known to be involved in the pathogenesis of mental disorders, has been investigated in active forgetting paradigms. The possibility that biological and cognitive mechanisms of active forgetting could be considered as hallmarks of the early onset of psychopathologies is also discussed.

Investigating the mediating effect of working memory on intentional forgetting in dysphoria

Our aim was to determine if deficits in intentional forgetting that are associated with depression and dysphoria (subclinical depression) could be explained, at least in part, by variations in working memory function. Sixty dysphoric and 61 non-dysphoric participants completed a modified version of the think/no-think (TNT) task and a measure of complex working memory (the operation span task). The TNT task involved participants learning a series of emotional cue-target word pairs, before being presented with a subset of the cues and asked to either recall the associated target (think) or to prevent it from coming to mind (no think) by thinking about a substitute target word. Participants were subsequently asked to recall the targets to all cues (regardless of previous recall instructions). As expected, after controlling for anxiety, we found that dysphoric individuals exhibited impaired forgetting relative to the non-dysphoric participants. Also as expected, we found that superior working memory function was associated with more successful forgetting. Critically, in the dysphoric group, we found that working memory mediated the effect of depression on intentional forgetting. That is, depression influenced forgetting indirectly via its effect on working memory. However, under conditions of repeated suppression, there was also a direct effect of depression on forgetting. These findings represent an important development in the understanding of impaired forgetting in depression and also suggest that working memory training might be a viable intervention for improving the ability of depressed individuals to prevent unwanted memories from coming to mind.

Active Forgetting: Adaptation of Memory by Prefrontal Control

Over the past century, psychologists have discussed whether forgetting might arise from active mechanisms that promote memory loss to achieve various functions, such as minimizing errors, facilitating learning, or regulating one's emotional state. The past decade has witnessed a great expansion in knowledge about the brain mechanisms underlying active forgetting in its varying forms. A core discovery concerns the role of the prefrontal cortex in exerting top-down control over mnemonic activity in the hippocampus and other brain structures, often via inhibitory control. New findings reveal that such processes not only induce forgetting of specific memories but also can suppress the operation of mnemonic processes more broadly, triggering windows of anterograde and retrograde amnesia in healthy people. Recent work extends active forgetting to nonhuman animals, presaging the development of a multilevel mechanistic account that spans the cognitive, systems, network, and even cellular levels. This work reveals how organisms adapt their memories to their cognitive and emotional goals and has implications for understanding vulnerability to psychiatric disorders.

Reconsidering unconscious persistence: Suppressing unwanted memories reduces their indirect expression in later thoughts

When we seek to forget unwelcome memories, does the suppressed content still exert an unconscious influence on our thoughts? Although intentionally stopping retrieval of a memory reduces later episodic retention for the suppressed trace, it remains unclear the extent to which suppressed content persists in indirectly influencing mental processes. Here we tested whether inhibitory control processes underlying retrieval suppression alter the influence of a memory's underlying semantic content on later thought. To achieve this, across two experiments, we tested whether suppressing episodic retrieval of to-be-excluded memories reduced the indirect expression of the unwanted content on an apparently unrelated test of problem solving: the remote associates test (RAT). Experiment 1 found that suppressed content was less likely than unsuppressed content to emerge as solutions to RAT problems. Indeed, suppression abolished evidence of conceptual priming, even when participants reported no awareness of the relationship between the memory and the problem solving tasks. Experiment 2 replicated this effect and also found that directing participants to use explicit memory to solve RAT problems eliminated suppression effects. Experiment 2 thus rules out the possibility that suppression effects reflect contamination by covert explicit retrieval strategies. Together, our results indicate that inhibitory control processes underlying retrieval suppression not only disrupt episodic retention, but also reduce the indirect influence of suppressed semantic content during unrelated thought processes. Considered with other recent demonstrations of implicit suppression effects, these findings indicate that historical assumptions about the persisting influence of suppressed thoughts on mental health require closer empirical scrutiny and need to be reconsidered.

What doesn't kill you makes you stronger: Psychological trauma and its relationship to enhanced memory control

Control processes engaged in halting the automatic retrieval of unwanted memories have been shown to reduce the later recallability of the targets of suppression. Like other cognitive skills that benefit from practice, we hypothesized that memory control is similarly experience dependent, such that individuals with greater real-life experience at stopping retrieval would exhibit better inhibitory control over unwanted memories. Across two experiments, we found that college students reporting a greater history of trauma exhibited more suppression-induced forgetting of both negative and neutral memories than did those in a matched group who had reported experiencing little to no trauma. The association was especially evident on a test of suppression-induced forgetting involving independent retrieval cues that are designed to better isolate the effects of inhibitory control on memory. Participants reporting more trauma demonstrated greater generalized forgetting of suppressed material. These findings raise the possibility that, given proper training, individuals can learn to better manage intrusive experiences, and are broadly consistent with the view that moderate adversity can foster resilience later in life. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Memory Control: A Fundamental Mechanism of Emotion Regulation

Memories play a ubiquitous role in our emotional lives, both causing vivid emotional experiences in their own right and imbuing perception of the external world with emotional significance. Controlling the emotional impact of memories therefore poses a major emotion-regulation challenge, suggesting that there might be a hitherto unexplored link between the neurocognitive mechanisms underlying memory control (MC) and emotion regulation. We present here a theoretical account of how the mechanisms of MC constitute core component processes of cognitive emotion regulation (CER), and how this observation may help to understand its basic mechanisms and their disruption in psychiatric disorders.

The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.

Hippocampal GABA enables inhibitory control over unwanted thoughts

Intrusive memories, images, and hallucinations are hallmark symptoms of psychiatric disorders. Although often attributed to deficient inhibitory control by the prefrontal cortex, difficulty in controlling intrusive thoughts is also associated with hippocampal hyperactivity, arising from dysfunctional GABAergic interneurons. How hippocampal GABA contributes to stopping unwanted thoughts is unknown. Here we show that GABAergic inhibition of hippocampal retrieval activity forms a key link in a fronto-hippocampal inhibitory control pathway underlying thought suppression. Subjects viewed reminders of unwanted thoughts and tried to suppress retrieval while being scanned with functional magnetic resonance imaging. Suppression reduced hippocampal activity and memory for suppressed content. ¹H magnetic resonance spectroscopy revealed that greater resting concentrations of hippocampal GABA predicted better mnemonic control. Higher hippocampal, but not prefrontal GABA, predicted stronger fronto-hippocampal coupling during suppression, suggesting that interneurons local to the hippocampus implement control over intrusive thoughts. Stopping actions did not engage this pathway. These findings specify a multi-level mechanistic model of how the content of awareness is voluntarily controlled.

It is not fully understood how intrusive or unwanted memories are regulated. Here the authors show that hippocampal GABA concentrations, and coupling between the dorsolateral prefrontal cortex and hippocampus, predict how well subjects can suppress unwanted memories when presented with a reminder.

Successfully controlling intrusive memories is harder when control must be sustained

After unpleasant events, people often experience intrusive memories that undermine their peace of mind. In response, they often suppress these unwanted memories from awareness. Such efforts may fail, however, when inhibitory control demands are high due to the need to sustain control, or when fatigue compromises inhibitory capacity. Here we examined how sustained inhibitory demand affected intrusive memories in the Think/No-Think paradigm. To isolate intrusions, participants reported, trial-by-trial, whether their preceding attempt to suppress retrieval had triggered retrieval of the memory they intended to suppress. Such counter-intentional retrievals provide a laboratory model of the sort of involuntary retrieval that may underlie intrusive memories. Using this method, we found that longer duration trials increased the probability of an intrusion. Moreover, on later No-Think trials, control over intrusions suddenly declined, with longer trial durations triggering more relapses of items that had been previously been purged. Thus, the challenges of controlling retrieval appear to cause a decline in control over time, due to a change in state, such as fatigue. These findings raise the possibility that characteristics often true of people with psychiatric disorders - such as compromised sleep, and increased demand on control - may contribute to difficulties in suppressing intrusive memories.

Attempts at memory control induce dysfunctional brain activation profiles in Generalized Anxiety Disorder: An exploratory fMRI study

Suppression of aversive memories through memory control has historically been proposed as a central psychological defense mechanism. Inability to suppress memories is considered a central psychological trait in several psychiatric disorders, including Generalized Anxiety Disorder (GAD). Yet, few studies have attempted the focused identification of dysfunctional brain activation profiles when patients with Generalized Anxiety Disorders attempt memory control. Using a well-characterized behavioral paradigm we studied brain activation profiles in a group of adult GAD patients and well-matched healthy controls (HC). Participants learned word-association pairs before imaging. During fMRI when presented with one word of the pair, they were instructed to either suppress memory of, or retrieve the paired word. Subsequent behavioral testing indicated both GAD and HC were able to engage in the task, but attempts at memory control (suppression or retrieval) during fMRI revealed vastly different activation profiles. GAD were characterized by substantive hypo-activation signatures during both types of memory control, with effects particularly strong during suppression in brain regions including the dorsal anterior cingulate and the ventral prefrontal cortex. Attempts at memory control in GAD fail to engage brain regions to the same extent HC, providing a putative neuronal signature for a well-established psychological characteristic of the illness.

Parallel Regulation of Memory and Emotion Supports the Suppression of Intrusive Memories

Intrusive memories often take the form of distressing images that emerge into a person's awareness, unbidden. A fundamental goal of clinical neuroscience is to understand the mechanisms allowing people to control these memory intrusions and reduce their emotional impact. Mnemonic control engages a right frontoparietal network that interrupts episodic retrieval by modulating hippocampal activity; less is known, however, about how this mechanism contributes to affect regulation. Here we report evidence in humans (males and females) that stopping episodic retrieval to suppress an unpleasant image triggers parallel inhibition of mnemonic and emotional content. Using fMRI, we found that regulation of both mnemonic and emotional content was driven by a shared frontoparietal inhibitory network and was predicted by a common profile of medial temporal lobe downregulation involving the anterior hippocampus and the amygdala. Critically, effective connectivity analysis confirmed that reduced amygdala activity was not merely an indirect consequence of hippocampal suppression; rather, both the hippocampus and the amygdala were targeted by a top-down inhibitory control signal originating from the dorsolateral prefrontal cortex. This negative coupling was greater when unwanted memories intruded into awareness and needed to be purged. Together, these findings support the broad principle that retrieval suppression is achieved by regulating hippocampal processes in tandem with domain-specific brain regions involved in reinstating specific content, in an activity-dependent fashion.

SIGNIFICANCE STATEMENT Upsetting events sometimes trigger intrusive images that cause distress and that may contribute to psychiatric disorders. People often respond to intrusions by suppressing their retrieval, excluding them from awareness. Here we examined whether suppressing aversive images might also alter emotional responses to them, and the mechanisms underlying such changes. We found that the better people were at suppressing intrusions, the more it reduced their emotional responses to suppressed images. These dual effects on memory and emotion originated from a common right prefrontal cortical mechanism that downregulated the hippocampus and amygdala in parallel. Thus, suppressing intrusions affected emotional content. Importantly, participants who did not suppress intrusions well showed increased negative affect, suggesting that suppression deficits render people vulnerable to psychiatric disorders.

Suppressing Unwanted Memories Reduces Their Unintended Influences

The ability to control unwanted memories is critical for maintaining cognitive function and mental health. Prior research has shown that suppressing the retrieval of unwanted memories impairs their retention, as measured using intentional (direct) memory tests. Here, we review emerging evidence revealing that retrieval suppression can also reduce the unintended influence of suppressed traces. In particular, retrieval suppression (a) gradually diminishes the tendency for memories to intrude into awareness and (b) reduces memories' unintended expressions on indirect memory tests. We present a neural account in which, during suppression, retrieval cues elicit hippocampally triggered neocortical activity that briefly reinstates features of the original event, which, in turn, are suppressed by targeted neocortical and hippocampal inhibition. This reactivation-dependent reinstatement principle could provide a broad mechanism by which suppressing retrieval of intrusive memories limits their indirect influences.

Cognitive and neural consequences of memory suppression in major depressive disorder

Negative biases in cognition have been documented consistently in major depressive disorder (MDD), including difficulties in the ability to control the processing of negative material. Although negative information-processing biases have been studied using both behavioral and neuroimaging paradigms, relatively little research has been conducted examining the difficulties of depressed persons with inhibiting the retrieval of negative information from long-term memory. In this study, we used the think/no-think paradigm and functional magnetic resonance imaging to assess the cognitive and neural consequences of memory suppression in individuals diagnosed with depression and in healthy controls. The participants showed typical behavioral forgetting effects, but contrary to our hypotheses, there were no differences between the depressed and nondepressed participants or between neutral and negative memories. Relative to controls, depressed individuals exhibited greater activity in right middle frontal gyrus during memory suppression, regardless of the valence of the suppressed stimuli, and differential activity in the amygdala and hippocampus during memory suppression involving negatively valenced stimuli. These findings indicate that depressed individuals are characterized by neural anomalies during the suppression of long-term memories, increasing our understanding of the brain bases of negative cognitive biases in MDD.

Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

Imagining future events conveys adaptive benefits, yet recurrent simulations of feared situations may help to maintain anxiety. In two studies, we tested the hypothesis that people can attenuate future fears by suppressing anticipatory simulations of dreaded events. Participants repeatedly imagined upsetting episodes that they feared might happen to them and suppressed imaginings of other such events. Suppressing imagination engaged the right dorsolateral prefrontal cortex, which modulated activation in the hippocampus and in the ventromedial prefrontal cortex (vmPFC). Consistent with the role of the vmPFC in providing access to details that are typical for an event, stronger inhibition of this region was associated with greater forgetting of such details. Suppression further hindered participants' ability to later freely envision suppressed episodes. Critically, it also reduced feelings of apprehensiveness about the feared scenario, and individuals who were particularly successful at down-regulating fears were also less trait-anxious. Attenuating apprehensiveness by suppressing simulations of feared events may thus be an effective coping strategy, suggesting that a deficiency in this mechanism could contribute to the development of anxiety.

Prefrontal-hippocampal pathways underlying inhibitory control over memory

A key function of the prefrontal cortex is to support inhibitory control over behavior. It is widely believed that this function extends to stopping cognitive processes as well. Consistent with this, mounting evidence establishes the role of the right lateral prefrontal cortex in a clear case of cognitive control: retrieval suppression. Retrieval suppression refers to the ability to intentionally stop the retrieval process that arises when a reminder to a memory appears. Functional imaging data indicate that retrieval suppression involves top-down modulation of hippocampal activity by the dorsolateral prefrontal cortex, but the anatomical pathways supporting this inhibitory modulation remain unclear. Here we bridge this gap by integrating key findings about retrieval suppression observed through functional imaging with a detailed consideration of relevant anatomical pathways observed in non-human primates. Focusing selectively on the potential role of the anterior cingulate cortex, we develop two hypotheses about the pathways mediating interactions between lateral prefrontal cortex and the medial temporal lobes during suppression, and their cellular targets: the entorhinal gating hypothesis, and thalamo-hippocampal modulation via the nucleus reuniens. We hypothesize that whereas entorhinal gating is well situated to stop retrieval proactively, thalamo-hippocampal modulation may interrupt an ongoing act of retrieval reactively. Isolating the pathways that underlie retrieval suppression holds the potential to advance our understanding of a range of psychiatric disorders characterized by persistent intrusive thoughts. More broadly, an anatomical account of retrieval suppression would provide a key model system for understanding inhibitory control over cognition.

Intentional forgetting in dysphoria: Investigating the inhibitory effects of thought substitution using independent cues

BACKGROUND

Individuals with clinical and subclinical depression (dysphoria) exhibit problems intentionally forgetting unwanted memories on the think/no-think (TNT) paradigm (Anderson & Green, 2001). However, providing substitute words to think about instead of the to-be-forgotten targets can improve forgetting in depressed patients.

OBJECTIVES

To determine if thought substitution can enhance forgetting in dysphoric participants and to examine the potential mechanisms (blocking or inhibition) that might underpin successful forgetting.

METHODS

Thirty-six dysphoric and 36 non-dysphoric participants learned neutral word-pairs and then practiced responding with the targets to some cues (think trials) and suppressing responses to others (no think trials). Half the participants were provided with substitute words to recall instead of the original targets (aided suppression) and half were simply told to avoid thinking about the targets (unaided suppression). Finally, participants completed two recall tests for the targets; one cued with the original probes and one with independent probes.

RESULTS

Regardless of suppression condition (aided or unaided), dysphoric participants exhibited impaired forgetting, relative to their non-dysphoric counterparts, but only when cued with the original probes. Furthermore, higher depression scores were associated with poorer forgetting. In the aided condition, successful forgetting was observed on both the original and independent probe tasks, which supports the inhibitory account of thought substitution.

LIMITATIONS

Non-clinical status of the dysphoric participants was not confirmed using a validated measure.

CONCLUSIONS

Findings do not support the utility of thought substitution as a method of improving the forgetting in depressed participants, but do support the inhibition account of thought substitution.

Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly

Evaluation of cognitive function in acromegaly has revealed contradictory findings; some studies report normal cognition in patients with long-term cured acromegaly, while others show attention and memory deficits. Moreover, the presence of affective disorders in these patients is common. Our aim was to evaluate memory and decision making in acromegalic patients and explore their relationship with affective disorders like anxiety and depressive symptoms. Thirty-one patients with acromegaly (mean age 49.5 ± 8.5 years, 14 females and 17 males) and thirty-one healthy controls participated in this study. The Iowa Gambling Task (IGT), Rey Auditory Verbal Learning Test, State-Trait Anxiety Inventory, and Beck Depression Inventory-II (BDI-II) were used to evaluate decision making, verbal memory, anxiety, and depressive symptoms, respectively. Acromegalic patients showed impairments in delayed verbal memory (p < 0.05) and more anxiety and depressive symptoms (p < 0.05) than controls. In the IGT, acromegalic patients presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (p < 0.05) and higher number of the riskier cards (p < 0.05). Moreover, multiple correlations between anxiety and depressive symptoms and performance in memory and decision making were found. Impaired delayed memory and decision making observed in acromegalic patients are related to anxiety and depressive symptoms. Providing emotional support to the patients could improve their cognitive function. A key clinical application of this research is the finding that depressive symptoms and anxiety are essentially modifiable factors.

The Structural Connectivity Pattern of the Default Mode Network and Its Association with Memory and Anxiety

The default mode network (DMN) is one of the most widely studied resting state functional networks. The structural basis for the DMN is of particular interest and has been studied by several researchers using diffusion tensor imaging (DTI). Most of these previous studies focused on a few regions or white matter tracts of the DMN so that the global structural connectivity pattern and network properties of the DMN remain unclear. Moreover, evidences indicate that the DMN is involved in both memory and emotion, but how the DMN regulates memory and anxiety from the perspective of the whole DMN structural network remains unknown. We used multimodal neuroimaging methods to investigate the structural connectivity pattern of the DMN and the association of its network properties with memory and anxiety in 205 young healthy subjects with age ranging from 18 to 29 years old. The Group ICA method was used to extract the DMN component from functional magnetic resonance imaging (fMRI) data and a probabilistic fiber tractography technique based on DTI data was applied to construct the global structural connectivity pattern of the DMN. Then we used the graph theory method to analyze the DMN structural network and found that memory quotient (MQ) score was significantly positively correlated with the global and local efficiency of the DMN whereas anxiety was found to be negatively correlated with the efficiency. The strong structural connectivity between multiple brain regions within DMN may reflect that the DMN has certain structural basis. Meanwhile, the results we found that the network efficiency of the DMN were related to memory and anxiety measures, indicated that the DMN may play a role in the memory and anxiety.

Why Forget? On the Adaptive Value of Memory Loss

Is forgetting mostly a positive force in human life? On the surface, this seems to not be the case, and people often associate memory loss with frustration in their everyday lives. Yet, forgetting does not have exclusively negative consequences; it also serves valuable, indeed vital, functions. In this article, I review and reflect on evidence from various areas of research, and I argue that forgetting serves at least three broad purposes. First, it is part of emotion regulation, and it promotes subjective well-being by limiting access to negative memories and by reducing unpleasant affect. Forgetting thereby allows for positivity and painlessness. Second, it is involved in knowledge acquisition, and it provides a basis for obtaining semantic and procedural knowledge by allowing for abstraction and automatization. Third, forgetting is part of context attunement, and it orients information processing for the present and the future by facilitating environmental sensitivity and by ensuring that knowledge is current, which enables timeliness and updating. Overall, I suggest that forgetting helps people to be happy, well-structured, and context sensitive, and thereby that it serves fundamentally adaptive functions.

Failing to forget: inhibitory-control deficits compromise memory suppression in posttraumatic stress disorder

Most people have experienced distressing events that they would rather forget. Although memories of such events become less intrusive with time for the majority of people, those with posttraumatic stress disorder (PTSD) are afflicted by vivid, recurrent memories of their trauma. Often triggered by reminders in the daily environment, these memories can cause severe distress and impairment. We propose that difficulties with intrusive memories in PTSD arise in part from a deficit in engaging inhibitory control to suppress episodic retrieval. We tested this hypothesis by adapting the think/no-think paradigm to investigate voluntary memory suppression of aversive scenes cued by naturalistic reminders. Retrieval suppression was compromised significantly in PTSD patients, compared with trauma-exposed control participants. Furthermore, patients with the largest deficits in suppression-induced forgetting were also those with the most severe PTSD symptoms. These results raise the possibility that prefrontal mechanisms supporting inhibitory control over memory are impaired in PTSD.

Neural mechanisms of motivated forgetting

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Motivated forgetting of unwanted memories shapes what we retain of our personal past.

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Motivated forgetting is achieved in part by inhibitory control over encoding or retrieval.

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Prefrontal cortex reduces hippocampal and cortical activity to suppress memories.

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Electrophysiological activity during motivated forgetting implicates active inhibition.

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A neurobiological model of memory control can inform disordered control over memory.

Not all memories are equally welcome in awareness. People limit the time they spend thinking about unpleasant experiences, a process that begins during encoding, but that continues when cues later remind someone of the memory. Here, we review the emerging behavioural and neuroimaging evidence that suppressing awareness of an unwelcome memory, at encoding or retrieval, is achieved by inhibitory control processes mediated by the lateral prefrontal cortex. These mechanisms interact with neural structures that represent experiences in memory, disrupting traces that support retention. Thus, mechanisms engaged to regulate momentary awareness introduce lasting biases in which experiences remain accessible. We argue that theories of forgetting that neglect the motivated control of awareness omit a powerful force shaping the retention of our past.