Cognitive and physiological dissociations in response to emotional pictures in patients with anorexia

Nandrino, Jean‐Louis; Berna, Guillaume; Hot, Pascal; Dodin, Vincent; Latrée, Julie; Decharles, Sandra; Sequeira, Henrique

doi:10.1016/j.jpsychores.2011.11.003

Cited by 38 publications

(31 citation statements)

References 63 publications

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“…This study adds to a growing body of evidence that AN is associated with altered interoception. For example, AN is associated with reduced heartbeat perception in the ill state (Pollatos et al, 2008) and a dissociation between reported emotional experience and physiological measures (ie, skin conductance response; Nandrino et al, 2012). These findings are generally consistent with a prior fMRI study demonstrating decreased insula activity during pain perception .…”

Section: Discussionsupporting

confidence: 82%

Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa

Kerr

Moseman

Avery

et al. 2015

Neuropsychopharmacol

134

123

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Anorexia nervosa (AN) is a devastating psychiatric illness that is associated with significant morbidity and mortality. Aberrant visceral interoceptive processing within the insula has been hypothesized to be an important mechanism in AN's pathophysiology due to the theoretical link between interoception and emotional experience. We therefore utilized functional magnetic resonance imaging (fMRI) to examine whether altered insula functioning underlies visceral interoception in AN. Fifteen females with restricting-type AN and 15 healthy control females underwent fMRI while performing an interoceptive attention task during which they focused on sensations in their heart, stomach, and bladder. Participants also performed an anxious rumination task while in the scanner. AN participants were weight-restored and free of psychotropic medications. Two distinct regions of the insula-anterior insula and dorsal mid-insula-exhibited a significant (po0.05) interaction between group and interoceptive modality. The post hoc analyses revealed that in the dorsal mid-insula the interaction was driven by group differences during stomach interoception (p = 0.002, Bonferroni corrected), whereas in the anterior insula the interaction was driven by group differences during heart interoception (p = 0.03, Bonferroni corrected). In addition, individuals with AN displayed increased activation during anxious rumination in the dorsal mid-insula, and activation in this region during stomach interoception was correlated with measures of anxiety and psychopathology. This relationship between altered visceral interoception and clinical symptoms in AN suggests an important mechanism for the disorder. Additional research is needed to examine whether interventions targeting visceral interoception may increase the efficacy of treatments for AN.

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Section: Discussionsupporting

confidence: 82%

Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa

Kerr

Moseman

Avery

et al. 2015

Neuropsychopharmacol

134

123

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“…Individuals with alexithymia also present a deficit of imagination and fantasy life, an externally oriented cognitive style (Cochrane et al, 1993; Nandrino et al, 2012) and a difficulty to deal with emotions expressed by others (Taylor et al, 1985). Initially associated with psychosomatic troubles (Nemiah and Sifneos, 1970), alexithymia was later shown to be linked with anxiety (Grynberg et al, 2010, 2012), depression (Hesse and Floyd, 2008; Grynberg et al, 2010), eating disorders (Guilbaud, 2008; Ridout et al, 2010), traumatic experiences (Eichhorn et al, 2014), and autism (Cook et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia

et al. 2017

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Emotional difficulties in alexithymia and their social consequences have been linked to alterations in autonomic nervous system. However, most of previous studies did not take into account the distinction between the affective and the cognitive dimensions of the alexithymia, leading to inconsistent results.Aim: In this study, we compared the effects of both dimensions of alexithymia on the autonomic arousal to emotional and social visual stimulations.Methods: Skin conductance responses (SCRs) to items of the International Affective Pictures System characterized by emotional (unpleasant, neutral, and pleasant), social (with humans) or non-social (without humans) content were recorded in non-alexithymic (NA), affective (AA) and cognitive alexithymic (CA) participants, selected on the basis of the Toronto Alexithymia Scale and the Bermond-Vorst Alexithymia Questionnaire. All participants responded to questionnaires of empathy, social phobia, depression, and anxiety before the experiment and evaluated the arousal of the pictures after it.Results: Cognitive alexithymic group showed lower amplitudes of SCRs to pictures with social than without social relevance whereas the opposite pattern was observed for the NA group. Arousal emotional effects of the pictures on SCRs did not differ among groups. In addition, CA participants showed lower scores than NA in the Personal Taking sub-scale of the empathy questionnaire, while AA showed lower scores than NA in the fantasy sub-scale. The CA group showed higher social phobia, depression and anxiety scores, than the other two groups.Conclusion: This work has two original outcomes: first, affective alexithymics expressed lower empathic affective scores than other groups; second, alexithymia modulated the impact of the social relevance of the stimuli on the autonomic reactivity, this impact vanishing in affective alexithymics and reversing in cognitive alexithymics. Thus, though the groups could not be distinguished on the basis of emotional effect on SCRs, they clearly differed when the empathic characteristics and the autonomic impact of social relevance were considered. Finally, the described autonomic signature to social relevant information could contribute to elucidate the difficulty of alexithymics to deal with emotions during social transactions.

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“…This proposition is however debated, as some authors suggested that emotion systems are only loosely coupled (Bonanno & Keltner, 2004;Izard, 1977), and, more recently, could even be independent (e.g., Ledoux, Ph, & Pine, 2016). Results from past experiments in healthy subjects are inconclusive as they provided evidence either for a moderate association between physiological responses and self-rated experience (Cuthbert, Schupp, Bradley, Birbaumer, & Lang, 2000;Dan-Glauser & Gross, 2013;Franklin et al, 2016;Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005;Nandrino et al, 2012) or were consistent with the hypothesis that there is no emotional coherence between subjective and physiological data (Morris, DeGelder, Weiskrantz, & Dolan, 2001;Vuilleumier, Armony, Driver, & Dolan, 2001;Vuilleumier & Pourtois, 2007).…”

Section: Correlation Between Subjective and Physiological Responsesmentioning

confidence: 99%

The ‘Threat of Scream’ paradigm: A tool for studying sustained physiological and subjective anxiety

Beaurenaut

Tokarski

Dezecache

et al. 2019

Preprint

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Progress in understanding the emergence of pathological anxiety depends on the availability of paradigms effective in inducing anxiety in a simple, consistent and sustained way. Much progress has been made using the Threat-of-Shock paradigm (TOS), which generates anxiety through the delivery of unpredictable electric shocks to participants. However, TOS may be problematic when testing vulnerable populations.Moreover, it is not clear whether anxiety can be sustained throughout experiments of long duration. Here, we bring support for an alternative approach called the Threat-of-Scream paradigm (TOSc), in which the tactile delivery of shocks is replaced by the auditory delivery of distress screams. We report on an onehour long study (plus its replication) in which participants were exposed to blocks before which they were told that they could hear aversive screams at any time (threat blocks), vs. blocks before which they were told that no scream will be heard (safe blocks). Both the experiment and its replication showed higher subjective reports of anxiety, higher skin conductance level, and positive correlation between the two measures, in threat compared to safe blocks. Anxiety measures were sustained throughout the experiments, suggesting little emotional and physiological habituation. Our results suggest that the delivery of low intensity distress screams can be an efficient, stable and cheap methodology to assess the impact of sustained anxiety on a diversity of cognitive functions and populations. We therefore believe the TOSc will become an essential part of the psychological toolkit, particularly so for researchers interested in the emergence of pathological anxiety.

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Cognitive and physiological dissociations in response to emotional pictures in patients with anorexia

Cited by 38 publications

References 63 publications

Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa

Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa

Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia

The ‘Threat of Scream’ paradigm: A tool for studying sustained physiological and subjective anxiety

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