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Despite alarming prevalence rates, surprisingly little is known about neural mechanisms underlying eating behavior in juveniles with obesity. To simulate reactivity to modern food environments, event-related potentials (ERP) to appetizing food images (relative to control images) were recorded in adolescents with obesity and healthy adolescents.Thirty-four adolescents with obesity (patients) and 24 matched healthy control adolescents watched and rated standardized food and object images during ERP recording. Personality (impulsivity) and eating styles (trait craving and dietary restraint) were assessed as potential moderators.Food relative to object images triggered larger early (P100) and late (P300) ERPs. More impulsive individuals had considerably larger food-specific P100 amplitudes in both groups. Controls with higher restraint scores showed reduced food-specific P300 amplitudes and subjective palatability ratings whereas patients with higher restraint scores showed increased P300 and palatability ratings.This first ERP study in adolescents with obesity and controls revealed impulsivity as a general risk factor in the current obesogenic environment by increasing food-cue salience. Dietary restraint showed paradoxical effects in patients, making them more vulnerable to visual food-cues. Salutogenic therapeutic approaches that deemphasize strict dietary restraint and foster healthy food choice might reduce such paradoxical effects.

Smartphone usage has tremendously increased and most users keep their smartphones close throughout the day. Smartphones have a broad variety of sensors, that could automatically map and track the user’s life and behaviour. In this work we investigate whether automatically collected smartphone usage and sensor data can be employed to predict the experienced stress levels of a user using a customized brief version of the Perceived Stress Scale (PSS). To that end we have conducted a user study in which smartphone data and stress (as measured by the PSS seven times a day) were recorded for two weeks. We found significant correlations between stress scores and smartphone usage as well as sensor data, pointing to innovative ways for automatic stress measurements via smartphone technology. Stress is a prevalent risk factor for multiple diseases. Thus accurate and efficient prediction of stress levels could provide means for targeted prevention and intervention.

Background and objectives Cognitive behavioral therapy (CBT) combines cognitive restructuring with exposure to feared stimuli in the treatment of anxiety disorders. Due to the complexities of cognition–emotion interactions during ongoing CBT, the underlying mechanisms remain unclear, which hinders treatment optimization. Methods We created a laboratory analogue by combining reappraisal, a key ingredient of cognitive restructuring, with Pavlovian conditioning, a key ingredient in behavioral treatments. The novel differential Pavlovian acquisition and extinction task featured social stimuli as conditioned and unconditioned stimuli under unregulated and reappraisal instructions. Results Findings indicated that reappraising the conditioned stimuli attenuated acquisition (Study 1) and facilitated extinction (Study 2) of conditioned negative valence. In Study 3, highly socially anxious individuals showed deficient extinction learning relative to low socially anxious individuals but compensated for this by using reappraisal. Limitations Diagnostic status of participants was not assessed in structured clinical interviews. Conclusions Reappraisal of feared stimuli could be useful in prevention and treatment of social anxiety.

Although emotional intensity powerfully challenges regulatory strategies, its influence remains largely unexplored in affective-neuroscience. Accordingly, the present study addressed the moderating role of emotional intensity in two regulatory stagesimplementation (during regulation) and pre-implementation (prior to regulation), of two major cognitive regulatory strategiesdistraction and reappraisal. According to our framew ork, 10 because distraction implementation involves early attentional disengagement from emotional information before it gathers force, in high-intensity it should be more effective in the short-term, relative to reappraisal, which modulates emotional processing only at a late semantic meaning phase. Supporting findings showed that in high (but not low) intensity, distraction implementation resulted in stronger modulation of negative experience, reduced neural emotional processing (centro-parietal late positive potential, LPP), with suggestive evidence for less cognitive effort (frontal-LPP), relative to reappraisal. Related pre-implementation findings confirmed that anticipating regulation of high-intensity stimuli resulted in distraction 15 (over reappraisal) preference. In contrast, anticipating regulation of low-intensity stimuli resulted in reappraisal (over distraction) preference, which is most beneficial for long-term adaptation. Furthermore, anticipating cognitively demanding regulation, either in cases of regulating counter to these preferences or via the more effortful strategy of reappraisal, enhanced neural attentional resource allocation (Stimulus Preceding Negativity). Broad implications are discussed.

Our current environment is characterized by the omnipresence of food cues. The sight and smell of real foods, but also graphically depictions of appetizing foods, can guide our eating behavior, for example, by eliciting food craving and influencing food choice. The relevance of visual food cues on human information processing has been demonstrated by a growing body of studies employing food images across the disciplines of psychology, medicine, and neuroscience. However, currently used food image sets vary considerably across laboratories and image characteristics (contrast, brightness, etc.) and food composition (calories, macronutrients, etc.) are often unspecified. These factors might have contributed to some of the inconsistencies of this research. To remedy this, we developed food-pics, a picture database comprising 568 food images and 315 non-food images along with detailed meta-data. A total of N = 1988 individuals with large variance in age and weight from German speaking countries and North America provided normative ratings of valence, arousal, palatability, desire to eat, recognizability and visual complexity. Furthermore, data on macronutrients (g), energy density (kcal), and physical image characteristics (color composition, contrast, brightness, size, complexity) are provided. The food-pics image database is freely available under the creative commons license with the hope that the set will facilitate standardization and comparability across studies and advance experimental research on the determinants of eating behavior. Read F

Highlights • Cardiac vagal control (CVC) was measured during an extended standardized baseline. • Subjective and polysomnographic variables of sleep quality were assessed. • Higher CVC was found to be associated with better subjective and objective sleep quality., Cardiac vagal control (CVC) has been linked to both physical and mental health. One critical aspect of health, that has not received much attention, is sleep. We hypothesized that adults with higher CVC – operationalized by high-frequency heart rate variability (HF-HRV) – will exhibit better sleep quality assessed both subjectively (i.e., with Pittsburgh Sleep Quality Index) and objectively (i.e., with polysomnography). HF-HRV was measured in 29 healthy young women during an extended neutral film clip. Participants then underwent full polysomnography to obtain objective measures of sleep quality and HF-HRV during a night of sleep. As expected, higher resting HF-HRV was associated with higher subjective and objective sleep quality (i.e., shorter sleep latency and fewer arousals). HF-HRV during sleep (overall or separated by sleep phases) showed less consistent relationships with sleep quality. These findings indicate that high waking CVC may be a key predictor of healthy sleep.

Highlights • Intrusive memories can be seen as conditioned responses to trauma reminders. • Novel conditioned-intrusion paradigm models both fear conditioning and intrusions. • Low estradiol is related to higher conditioned responses during fear extinction. • Low estradiol is related to higher intrusive memory strength in daily life. • Conditioned responding during extinction partially explains the latter relationship., Posttraumatic stress disorder (PTSD) can be conceptualized as a disorder of emotional memory showing strong (conditioned) responses to trauma reminders and intrusive memories among other symptoms. Women are at greater risk of developing PTSD than men. Recent studies have demonstrated an influence of ovarian steroid hormones in both fear conditioning and intrusive memory paradigms. However, although intrusive memories are considered non-extinguished emotional reactions to trauma reminders, none of the previous studies has investigated effects of ovarian hormones on fear conditioning mechanisms and intrusive memories in conjunction. This may have contributed to an overall inconsistent picture of the role of these hormones in emotional learning and memory. To remedy this, we exposed 37 healthy women with a natural menstrual cycle (during early follicular or luteal cycle phase) to a novel conditioned-intrusion paradigm designed to model real-life traumatic experiences. The paradigm included a differential fear conditioning procedure with short violent film clips as unconditioned stimuli. Intrusive memories about the film clips were assessed ambulatorily on subsequent days. Women with lower levels of estradiol displayed elevated differential conditioned skin conductance responding during fear extinction and showed stronger intrusive memories. The inverse relationship between estradiol and intrusive memories was at least partially accounted for by the conditioned responding observed during fear extinction. Progesterone levels were not associated with either fear acquisition/extinction or with intrusive memories. This suggests that lower levels of estradiol might promote stronger symptoms of PTSD through associative processes.

Rapid eye movement (REM) sleep has been postulated to facilitate emotional processing of negative stimuli. However, empirical evidence is mixed and primarily based on self-report data and picture-viewing studies. This study used a full-length aversive film to elicit intense emotion on one evening, and an emotionally neutral control film on another evening while psychophysiological and experiential responses were measured. Subsequent sleep was monitored polysomnographically, and specific film scenes were presented again on the next morning. Correlation analyses revealed that participants with longer late-night REM sleep after the aversive film showed higher increase of electrodermal reactivity and less reduction of facial corrugator muscle reactivity to negative film scenes on the next morning. This indicates that REM sleep may be associated with attenuated emotional processing of prolonged and intense emotional stimuli from pre- to postsleep.

In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

In our current obesogenic environment, exposure to visual food-cues can easily lead to craving and overeating because short-term, pleasurable effects of food intake dominate over the anticipated long-term adverse effects such as weight gain and associated health problems. Here we contrasted these two conditions during food-cue presentation while acquiring event-related potentials (ERPs) and subjective craving ratings. Female participants (n = 25) were presented with either high-calorie (HC) or low-calorie (LC) food images under instructions to imagine either immediate (NOW) or long-term effects (LATER) of consumption. On subjective ratings for HC foods, the LATER perspective reduced cravings as compared to the NOW perspective. For LC foods, by contrast, craving increased under the LATER perspective. Early ERPs (occipital N1, 150-200 ms) were sensitive to food type but not to perspective. Late ERPs (late positive potential, LPP, 350-550 ms) were larger in the HC-LATER condition than in all other conditions, possibly indicating that a cognitive focus on negative long-term consequences induced negative arousal. This enhancement for HC-LATER attenuated to the level of the LC conditions during the later slow wave (550-3000 ms), but amplitude in the HC-NOW condition was larger than in all other conditions, possibly due to a delayed appetitive response. Across all conditions, LPP amplitudes were positively correlated with self-reported emotional eating. In sum, results reveal that regulation effects are secondary to an early attentional analysis of food type and dynamically evolve over time. Adopting a long-term perspective on eating might promote a healthier food choice across a range of food types.

Emotional eating, a trait-like style of food intake in response to negative emotion states, represents an important aspect of overeating and eating related psychopathology. The mechanisms of emotional eating both on experiential and neuronal levels are not well delineated. We recorded event related potentials (ERPs) while individuals with high or low emotional eating style (HEE, n = 25; LEE, n = 20) viewed and rated pictures of high-caloric food during neutral state vs. negative idiosyncratic emotion induction. Craving ratings increased in HEE and decreased in LEE during negative relative to neutral states. ERPs to food pictures showed an enhanced late positive potential (LPP) over parieto-occipital regions for HEE compared to LEE. Emotional state modulated food picture evoked ERPs over right frontal regions in HEE only. This suggests that appetitive food processing is susceptible to both concurrent emotion and habitual eating style which is of relevance for overeating in healthy and abnormal eating.

Choice behavior is considered the fundamental means by which individuals exert control over their environments. One important choice domain that remains virtually unexplored is that of emotion regulation. This is surprising given that healthy adaptation requires flexibly choosing between regulation strategies in a manner that is responsive to differing situational demands. In the present article, we provide a broad conceptual framework that systematically evaluates the rules that govern the ways individuals choose between different emotion regulation strategies. This conceptual account is buttressed by empirical findings from 6 studies that show the effects of hypothesized emotional, cognitive, and motivational determinants of regulation choice (Studies 1-3) and illuminate the mechanisms that underlie choices between different emotion regulation strategies (Studies 4-6). Broad implications and future directions are discussed.

Previous research on autonomic characteristics of social anxiety in children and adolescents has produced highly inconsistent results which may partially be due to task differences and a limited breadth of autonomic measure- ment. Here we investigated a sample of high (HSA) and low socially anxious (LSA) children, aged 10-12 years before, during and after a standardized evaluated speech task while acquiring a broad set of autonomic and experiential mea- sures. During baseline, we found evidence for tonically higher sympathetic autonomic activity in HSA children, indicated by higher low frequency heart rate variability (LF) and a trend for higher LF to high frequency heart rate vari- ability ratios (LF/HF). In response to the speech task, HSA children showed blunted cardiac responding evidenced by slower increase and delayed recovery of heart rate and a similar significant trend on LF/HF values. Self-reported anxiety, by contrast, showed enhanced reactivity from baseline to anticipation in the HSA compared to the LSA group. The results suggest a restricted cardiac flexibility in HSA children and illustrate that broad autonomic assess- ment during a well-structured, naturalistic task may improve our understanding of the autonomic physiology of socially anxious children. The results have implications for current theories of social anxiety.

Intuitive eating is relevant for adaptive eating, body weight and well-being and impairments are associated with dieting and eating disorders. It is assumed to depend on the ability to recognize one's signs of hunger and fullness and to eat accordingly. This suggests a link to the individual ability to perceive and processes bodily signals (interoceptive sensitivity, IS) which has been shown to be associated with emotion processing and behavior regulation. This study was designed to clarify the relationships between IS as measured by a heartbeat perception task, intuitive eating and body mass index (BMI) in N=111 healthy young women. Intuitive eating was assessed by the Intuitive Eating Scale (IES) with three facets, reliance on internal hunger and satiety cues (RIH), eating for physical rather than emotional reasons (EPR), and unconditional permission to eat when hungry (UPE). IS was not only positively related to total IES score and RIH and EPR, and negatively predicted BMI, but also proved to fully mediate the negative relationship between RIH, as well as EPR and BMI. Additionally, the subjective appraisal of one's interoceptive signals independently predicted EPR and BMI. IS represents a promising mechanism in research on eating behavior and body weight.

Recent studies have begun to carve out a specific role for the rostral part of the dorsal medial prefrontal cortex (dmPFC) and adjacent dorsal anterior cingulate cortex (dACC) in fear/anxiety. Within a novel general framework of dorsal mPFC/ACC areas subserving the appraisal of threat and concomitant expression of fear responses and ventral mPFC/ACC areas subserving fear regulation, the rostral dmPFC/dACC has been proposed to specifically mediate the conscious, negative appraisal of threat situations including, as an extreme variant, catastrophizing. An alternative explanation that has not been conclusively ruled out yet is that the area is involved in fear learning. We tested two different fear expression paradigms in separate fMRI studies (study 1: instructed fear, study 2: testing of Pavlovian conditioned fear) with independent groups of healthy adult subjects. In both paradigms the absence of reinforcement precluded conditioning. We demonstrate significant BOLD activation of an identical rostral dmPFC/dACC area. In the Pavlovian paradigm (study 2), the area only activated robustly once prior conditioning had finished. Thus, our data argue against a role of the area in fear learning. We further replicate a repeated observation of a dissociation between peripheral-physiological fear responding and rostral dmPFC/dACC activation, strongly suggesting the area does not directly generate fear responses but rather contributes to appraisal processes. Although we succeeded in preventing extinction of conditioned responding in either paradigm, the data do not allow us to definitively exclude an involvement of the area in fear extinction learning. We discuss the broader implications of this finding for our understanding of mPFC/ACC function in fear and in negative emotion more generally.

Psychometric studies indicate that anxiety sensitivity (AS) is a risk factor for anxiety disorders such as panic disorder (PD). To better understand the psychophysiological basis of AS and its relation to clinical anxiety, we examined whether high-AS individuals show similarly elevated reactivity to inhalations of carbon dioxide (CO2) as previously reported for PD and social phobia in this task. Healthy individuals with high and low AS were exposed to eight standardized inhalations of 20% CO2-enriched air, preceded and followed by inhalations of room air. Anxiety and dyspnea, in addition to autonomic and respiratory responses were measured every 15 s. Throughout the task, high AS participants showed a respiratory pattern of faster, shallower breathing and reduced inhalation of CO2 indicative of anticipatory or contextual anxiety. In addition, they showed elevated dyspnea responses to the second set of air inhalations accompanied by elevated heart rate, which could be due to sensitization or conditioning. Respiratory abnormalities seem to be common to high AS individuals and PD patients when considering previous findings with this task. Similarly, sensitization or conditioning of anxious and dyspneic symptoms might be common to high AS and clinical anxiety. Respiratory conditionability deserves greater attention in anxiety disorder research.

Cognitive models of social phobia (SP) and empirical evidence in adults suggest that affected individuals overestimate arousal symptoms such as heart rate (HR) during social stress and worry about their visibility in public. To date, little is known about these aspects in childhood social anxiety, an important precursor of the disorder. We assessed perception of--and worry about--HR visibility, actual HR, and subjective anxiety during public speaking in high socially anxious (HSA; n = 20) and low socially anxious (LSA; n = 20) Caucasian children, aged 10 to 12 years. Symptom visibility was manipulated by making a nonveridical HR feedback tone audible only to the participant (private condition, HR sounds via headphone) or to participant and observers (public condition, HR sounds via speakers). Further, we assessed interoceptive accuracy in a heartbeat counting task. As expected, HSA children perceived their HR as higher than LSA children in both private and public conditions despite similar actual HR and comparable interoceptive accuracy. Public feedback led to more worry about HR visibility only in HSA but not in LSA children. Biased perception and interpretation of bodily anxiety symptoms during social stress manifests early in social anxiety and might therefore play a crucial role in the aggravation of social anxiety and the development of SP. We discuss implications for current theory, clinical practice, and prevention.

Reports of exaggerated anxiety and physiological hyperreactivity to social-evaluative situations are character- istic of childhood social phobia (SP). However, laboratory research on subjective, autonomic and endocrine function- ing in childhood SP is scarce, inconsistent and limited by small sample sizes, limited breadth of measurements, and the use of non-standardized stressor tasks. We exposed 8- 12-year-old children with DSM-IV SP (n=41) and matched healthy control children (HC; n=40) to the Trier Social Stress Test for Children (TSST-C) while measuring subjec- tive anxiety, heart rate (HR) and salivary alpha-amylase (sAA) as well as salivary cortisol. The SP children showed heightened reactivity to the TSST-C on subjective anxiety compared to the HC children but not a heightened reactivity in HR, sAA or cortisol. However, the SP children showed chronically elevated HR levels throughout the whole laboratory session. Whereas subjective anxiety seems to respond specifically to social-evaluative stress in childhood SP, HR levels may be chronically elevated suggesting a more generalized autonomic hyperreactivity.

Objective To compare the electrocortical processing of food pictures in participants with anorexia nervosa (n = 21), bulimia nervosa (n = 22), and healthy controls (HCs) (n = 32) by measuring the early posterior negativity, an event-related potential that reflects stimulus salience and selective attention. Methods We exposed these three groups to a rapid stream of high- and low-calorie food pictures, as well as standard emotional and neutral pictures. Results Event-related potentials in the time range of 220 milliseconds to 310 milliseconds on posterior electrodes differed between groups: patients with eating disorders showed facilitated processing of both high- and low-calorie food pictures relative to neutral pictures, whereas HC participants did so only for the high-calorie pictures. Subjective palatability of the pictures was rated highest by patients with anorexia nervosa, followed by the HC and bulimia nervosa groups. Conclusions Patients with eating disorders show a generalized attentional bias for food images, regardless of caloric value. This might explain the persistent preoccupation with food in these individuals.

Objective Fear conditionability has been found to be elevated in samples with high trait anxiety or anxiety disorders. Since these studies provide circumstantial evidence for a causal link between anxiety and conditionability we examined fear conditionability after experimental induction of anxiety in two experiments. Method In Experiment 1 , 60 participants were randomized to one of two film conditions inducing an anxious or happy emotional state. They subsequently underwent a differential conditioning acquisition procedure. Two pictures of faces served as conditioned stimuli (CS+ and CS−), and an electric stimulus served as aversive unconditioned stimulus (US). In Experiment 2 , after similar acquisition procedure as used in Experiment 1 , 90 participants watched one of three films (anxious, neutral, happy) prior to an extinction procedure. In both studies, skin conductance response (SCR) served as measure of fearful responding. Results Conditioning was successful in both studies. In Experiment 1 , the anxious group exhibited decreased SCRs to both CS+ and CS− during acquisition. In Experiment 2 , during extinction SCRs to both CSs were highest in the anxious group, intermediate in the neutral, and lowest in the happy group. Discussion State anxiety did not enhance conditionability during acquisition or reduce the extinction procedure. However, individuals in an anxious state show less responding during fear learning, but more responding during unlearning. Thus, our results suggest that state anxiety changes the sensitivity with which individuals react to stimuli presented in different contexts.

Distraction and reappraisal are two widely used forms of emotion regulation. The process model of emotion regulation (Gross, 1998) holds that they differ (1) in when they act on the emotion-generative process, and (2) in their impact on subsequent responses to regulated stimuli. We tested these two predictions by measuring electrocortical responses to neutral and emotional images during two phases. In the regulation phase, images were watched or regulated using distraction or reappraisal. During the re-exposure phase, the same images were passively watched. As predicted, during regulation, distraction reduced the late positive potential (LPP) earlier than reappraisal. Upon re-exposure, images with a distraction (but not reappraisal) history elicited a larger LPP than images with an attend history. This pattern of results suggests that distraction and reappraisal intervene at separate stages during emotion generation, a feature which may have distinct consequences that extend beyond the regulatory episode.

Anticipatory emotional responses play a crucial role in preparing individuals for impending challenges. They do this by triggering a coordinated set of changes in behavioral, autonomic, and neural response systems. In the present study, we examined the biobehavioral impact of varying levels of anticipatory anxiety, using a shock anticipation task in which unpredictable electric shocks were threatened and delivered to the wrist at variable intervals and intensities (safe, medium, strong). This permitted investigation of a dynamic range of anticipatory anxiety responses. In two studies, 95 and 51 healthy female participants, respectively, underwent this shock anticipation task while providing continuous ratings of anxiety experience and electrodermal responding (Study 1) and during fMRI BOLD neuroimaging (Study 2). Results indicated a step-wise pattern of responding in anxiety experience and electrodermal responses. Several brain regions showed robust responses to shock anticipation relative to safe trials, including the hypothalamus, periaqueductal gray, caudate, precentral gyrus, thalamus, insula, ventrolateral PFC, dorsomedial PFC, and ACC. A subset of these regions demonstrated a linear pattern of increased responding from safe to medium to strong trials, including the bilateral insula, ACC, and inferior frontal gyrus. These responses were modulated by individual differences in neuroticism, such that those high in neuroticism showed exaggerated anxiety experience across the entire task, and reduced brain activation from medium to strong trials in a subset of brain regions. These findings suggest that individual differences in neuroticism may influence sensitivity to anticipatory threat and provide new insights into the mechanism through which neuroticism may confer risk for developing anxiety disorders via dysregulated anticipatory responses.

We investigated body-related attentional biases in eating disorders by testing whether individuals with anorexia nervosa (AN, n = 19) and bulimia nervosa (BN, n = 18) differ from healthy controls (HC, n = 21) in their bias for attending to a photo of their own body (self-photo) relative to a photo of a matched control participant's body (other photo). In a modified dot-probe task, self- and other photos served as cues on the left and the right of the screen. After 1 of 2 time intervals, 1 of the photos was singled out by a surrounding frame, and participants had to saccade toward it. Saccade latency was used as an index of covert attention to the cue photos. In the AN group, saccades were faster when the self-photo was the target than when the other photo was the target. In the BN group, there was a numerically opposite but nonsignificant pattern. Cues did not affect saccade latencies in healthy controls. The bias for self-photos correlated with body dissatisfaction in the AN group. This is the first evidence of an attentional bias for self-photos over other photos in the AN group and for fundamental attentional differences between AN and BN.

Twenty-five panic disorder (PD) patients, 19 social phobics (SP), and 20 healthy controls (HC) sat quietly for 15 minutes, rating their anxiety and dyspnea every 30 seconds while respiratory, cardiovascular, and electrodermal responses were recorded. No panic attacks were reported. For self-reported anxiety and dyspnea, within-subject variability over time was higher in PD than in SP or HC. In PD within-subject correlations across 30-second epochs were significant for (a) self-reported anxiety versus dyspnea, end-tidal pCO2, minute volume, duty cycle, skin conductance level, and interbeat interval, and for (b) dyspnea versus end-tidal pCO2, minute volume, tidal volume, and inspiratory flow rate. Several positive or negative correlations were greater in PD than in other groups. Thus in PD, experienced anxiety and dyspnea are temporally unstable but are correlated with each other and with fluctuations in respiratory and autonomic variables, even in the absence of panic attacks.

In the aftermath of a distressing social event, adults with social phobia (SP) engage in a review of this event with a focus on its negative aspects. To date, little is known about this post-event processing (PEP) and its relationship with perceived performance in SP children. We measured PEP in SP children (n = 24) and healthy controls (HC; n = 22), aged from 8 to 12 years, after the Trier Social Stress Test for Children (TSST-C). Children also rated their performance immediately after the TSST-C and 2.5 h later. SP children reported more negative and less positive PEP than controls. Regression analyses indicated that negative PEP was associated with social anxiety and perceived task performance independent of comorbid depression. The SP group rated their performance immediately after the TSST-C as worse compared to HCs and ratings remained stable over the following 2.5 h. Results are discussed in relation to current theories of SP.

Previous research has yielded evidence of attentional biases for food-related cues in binge eating disorder (BED) using behavioural measures such as the Stroop and dot probe paradigm. Being a more direct measure of attentional processing, the present study used event related potentials (ERPs) to test reactivity to high caloric and low caloric food pictures in women with BED compared to overweight healthy female controls (HC). In order to detect a possible motivational ambivalence, self-report and psychophysiological measures of the sympathetic and parasympathetic response system were assessed additionally. The main results yielded evidence that in women with BED high caloric food pictures elicit larger long latency ERPs compared to HC. By contrast, no such group difference was found for low caloric food pictures. Peripheral measures did not yield any group differences with respect to the processing of the caloric value of food. The results suggest that for women with BED, high caloric food may have high motivational properties and consume large parts of attentional resources. In the context of an environment in which high caloric food is omnipresent, such an abnormal processing may be relevant for the maintenance of the disorder.

Background The neuroplasticity hypothesis of depression proposes that a dysfunction of neural plasticity—the basic ability of living organisms to adapt their neural function and structure to external and internal cues—might represent a final common pathway underlying the biological and clinical characteristics of the disorder. This study examined learning and memory as correlates of long-term synaptic plasticity in humans to further test the neuroplasticity hypothesis of depression. Methods Learning in three tasks, for which memory consolidation has been shown to depend on local synaptic refinement in areas of interest (hippocampus-dependent declarative word-pair learning, amygdala-dependent fear conditioning, and primary-cortex-dependent visual texture discrimination), was assessed in 23 inpatients who met International Classification of Disease, 10th Revision, criteria for severe unipolar depression and 35 nondepressed comparison subjects. Results Depressed subjects showed a significant deficit in declarative memory consolidation and enhanced fear acquisition as indicated by skin conductance responses to conditioned stimuli, in comparison with nondepressed subjects. Depressed subjects demonstrated impaired visual discrimination at baseline, not allowing for valid group comparisons of gradual improvement, the plasticity-dependent phase of the task. Conclusions The results of the study are consistent with the neuroplasticity hypothesis of depression, showing decreased synaptic plasticity in a dorsal executive network that comprises the hippocampus and elevated synaptic plasticity in a ventral emotional network that includes the amygdala in depression. Evaluation of further techniques aimed at modulating synaptic plasticity might prove useful for developing novel treatments for major depressive disorder.

Objective: To assess the external validity of laboratory baselines in panic disorder (PD), frequently associated with respiratory pattern abnormalities like increased respiratory variability and sighing, implying a stable pathophysiologic trait characteristic. Methods: Physical activity and a variety of breath-by-breath volumetric, timing, and variability measures of respiration were recorded in the daily life of 26 patients with PD and 26 healthy controls (HC), using a novel ambulatory monitoring system optimized for reliable assessment of respiratory pattern. Data were stratified for physical activity to eliminate its confounding effects. Results: Groups showed strong and consistent diurnal patterns in almost all respiratory variables. However, patients with PD did not differ from HC regarding any of the respiratory timing, volumetric and variability measures, with negligible group effect sizes for all measures. Patients with fewer self-reported respiratory symptoms of anxiety exhibited more pronounced rapid shallow breathing as well as diminished total breath time and its variability. Conclusions: Despite state-of-the-art ambulatory assessment and sufficient statistical power to detect respiratory alterations previously observed in the laboratory, we found no evidence for such alterations in PD patients' daily life. Neither the total PD group nor patients with particularly pronounced respiratory symptomatology displayed increased respiratory variability. These results caution against interpreting results from laboratory baselines in PD as reflecting a stable trait characteristic. Rather, they likely represent a state-trait interaction due to enhanced reactivity of PD patients to novel environments. These results challenge aspects of respiratory theories of PD that were based on laboratory findings.

To determine the role of social comparison for body dissatisfaction in bulimia nervosa (BN). Previous research suggested that exposure to media content idealizing thin body shape decreases body satisfaction, particularly in women with eating disorder symptoms. This might be due to the negative outcome of social comparisons with media models, and women with eating disorders might be particularly susceptible because they engage in upward social comparison more frequently than women without these symptoms. However, no study has yet explored both upward (i.e., toward more attractive others) and downward (i.e., toward less attractive others) social comparisons and their impact on body dissatisfaction in a clinical eating disorder and healthy controls.We presented patients with BN (n = 20) and healthy controls (HC) (n = 22) with slides comprising a digitized image of their own body alongside comparison bodies with higher and lower body mass indices (BMIs) while measuring their eye movements.As hypothesized, patients with BN fixated longer on comparison bodies with lower BMIs than controls, with the reverse pattern for high BMI bodies. This gaze pattern suggests that upward comparisons were more prevalent in the BN group. Furthermore, upward comparisons were related to a drop in body satisfaction in the BN group.Disadvantageous social comparison strategies might be related to body dissatisfaction and therefore to the maintenance of BN.

We report the first published case study of a suddenly occurring panic attack in a patient with no prior history of panic disorder during combined functional magnetic resonance imaging (fMRI, 1.5 Tesla) and electrocardiogram (ECG) recording. The single case was a 46-year-old woman who developed a panic attack near the planned end of the fMRI acquisition session, which therefore had to be aborted. Correlational analysis of heart rate fluctuations and fMRI data revealed a significant negative association in the left middle temporal gyrus. Additionally, regions-of-interest (ROI) analyses indicated significant positive associations in the left amygdala, and trends towards significance in the right amygdala and left insula.

Inhalation of carbon-dioxide (CO2) enriched air triggers anxiety in panic disorder (PD) patients, which is often interpreted as a sign of biological vulnerability. However, most studies have not measured respiration in these tasks. We compared patients with PD (N=20) and social phobia (SP, N=19) to healthy controls (N=18) during eight inhalations of 20% CO2, preceded and followed by two inhalations of room air, while continuously measuring subjective anxiety and dyspnea as well as autonomic and respiratory variables. PD patients showed increased reactivity and delayed recovery during CO2 inhalations for most measures. Unlike both other groups, the PD group’s tidal volume responses did not habituate across CO2 inhalations. However, PD patients did not differ from SP patients on most other measures, supporting a continuum model of CO2 sensitivity across anxiety disorders. Both patient groups showed continued reactivity during the last air inhalations, which is unlikely to be due to a biological sensitivity.

Restrained eating is a pattern of chronic dietary restriction interspersed with episodes of disinhibited overeating. The present study investigated whether this eating pattern is related to altered electrocortical processing of appetitive food stimuli in two different motivational contexts. Restrained (n = 19) and unrestrained eaters (n = 21) passively viewed high-caloric food pictures, along with normative emotional pictures in a first block. In a second block, food availability was manipulated: participants were told that half of the food items should later be eaten (available food items), whereas the other half of food items was said to be unavailable. While no group differences were obtained during the first block, restrained eaters' event-related potentials (ERPs) were significantly modulated by the availability manipulation: ERPs for available food cues were significantly less positive than ERPs to unavailable food cues. Restrained eaters might down-regulate their reactivity to available food cues to maintain their dietary rules.

Aversive conditioning has been proposed as an important factor involved in the etiology of posttraumatic stress disorder (PTSD). However, it is not yet fully understood exactly which learning mechanisms are characteristic for PTSD. PTSD patients (n=36), and healthy individuals with and without trauma exposure (TE group, n=21; nTE group, n=34), underwent a differential fear conditioning experiment consisting of habituation, acquisition, and extinction phases. An electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures as conditioned stimuli (CS+, paired; CS-, unpaired). Conditioned responses were quantified by skin conductance responses (SCRs), subjective ratings of CS valence and US-expectancy, and a behavioural test. In contrast to the nTE group, PTSD patients showed delayed extinction of SCRs to the CS+. Online ratings of valence and US-expectancy as well as the behavioural test confirmed this pattern. These findings point to a deficit in extinction learning and highlight the role of affective valence appraisals and cognitive biases in PTSD. In addition, there was some evidence that a subgroup of PTSD patients had difficulties in learning the CS-US contingency, thereby providing preliminary evidence of reduced discrimination learning.

Enhanced conditionability has been proposed as a crucial factor in the etiology and maintenance of panic disorder (PD). To test this assumption, the authors of the current study examined the acquisition and extinction of conditioned responses to aversive stimuli in PD. Thirty-nine PD patients and 33 healthy control participants took part in a differential aversive conditioning experiment. A highly annoying but not painful electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures were used as either the paired conditioned stimulus (CS+) or the unpaired conditioned stimulus (CS-). Results indicate that PD patients do not show larger conditioned responses during acquisition than control participants. However, in contrast to control participants, PD patients exhibited larger skin conductance responses to CS+ stimuli during extinction and maintained a more negative evaluation of them, as indicated by valence ratings obtained several times throughout the experiment. This suggests that PD patients show enhanced conditionability with respect to extinction.

Advances in biosignal acquisition and processing have provided an effective window to the complex peripheral physiology related to human emotions. Numerous cardiovascular measures have been used for assessing the activity of the sympathetic and parasympathetic branches of the autonomic nervous system. More recently, respiratory parameters have shown promise for the assessment of anxiety. Current theoretical accounts of anxiety recommend a broad assessment of anxiety responses involving measures from the physiological, behavioral and verbal-cognitive domain. However, practical and statistical considerations put restrictions on the number of dependent variables used in studies on emotion. In a laboratory experiment we assessed a large number of psychophysiological parameters to identify their relative utility for differentiating between a neutral (quiet sitting) and an anxious state induced by threat of shock. High effect sizes were found in all psychophysiological systems with electrodermal and behavioral responses demonstrating the highest, and respiratory and cardiovascular responses yielding medium and small effect sizes. A linear combination of the six most powerful variables was highly significant in distinguishing the neutral from the anxious state and resulted in 83.3% correct classification. Results demonstrate the necessity to include measures from multiple response domains for an adequate assessment of anxiety states. Furthermore, our results point to the significance of respiratory parameters in anxiety assessment.

Objectives. It has been suggested that temperaments such as ‘hypomanic personality’ (HYP) have an explanatory role in affective disorders. Similarly, the impulsive nonconformity scale, originally designed to assess psychosis proneness, was recently found to augment the prediction of manic episodes. Conversely, research indicates that ‘rigidity’, a central feature of Typus Melancholicus (TMEL; von Zerssen, 1996), may characterize the premorbid personality of depressives. Design. The present study combines these three scales to prospectively predict manic and depressive symptoms diagnosed 2 years later in a non-college student population. Method. Structured clinical interviews for DSM-IV were conducted with 114 individuals (60% female, mean age =19.9 years), 2 years after an initial screening. Results. It was found that none of the predictors predicted purely depressive symptoms. As expected, HYP emerged as the strongest predictor of (hypo-)manic symptoms. Conclusions. While rigidity did not predict depression, people with a hypomanic temperament are at risk of developing symptoms of bipolar disorder, especially (hypo-)manic ones. It is noteworthy that this was evident in our young sample, still in the earlier stages of the high-risk period.

Background: Schizophrenia is associated with attentional dysfunctions. In bipolar disorder, there is also evidence for sustained attention deficits. Therefore, we hypothesized that risk for bipolar disorder but not for unipolar depression might be associated with attentional abnormalities as well. Method: Using the Hypomanic Personality Scale (HPS) and the Rigidity Scale, we defined three groups: bipolar at-risk (n=42), unipolar at-risk (n=34), and control (n=37). All completed the d2 Test and the Continuous Performance Test (CPT). Results: There was no evidence for overall attentional deficits in people at risk for affective disorders. However, reduced sensitivity, i.e., less discrimination between targets and nontargets, was observed in people at risk for bipolar disorders who also displayed schizotypy. Limitations: We only looked at selective and sustained attention and did not assess other factors such as memory or executive functions. Additionally, the risk status was only defined by a psychometric indicator and did not include other approaches of defining risk (e.g., first-degree relatives). Conclusions: Despite some limitations, our results support on one hand the idea that vulnerability for bipolar disorder can be associated with cognitive impairments, but they also highlight that this is not generally the case. Vulnerability for bipolar disorder and schizotypy might be correlated but are not the same. D 2004 Elsevier B.V. All rights reserved.

Social anxiety disorder (SAD) is marked by persistent fear of being scrutinized by others. This and most diagnostic symptoms relate to some form of fear of negative evaluation (FNE). More recent accounts of SAD, such as the Bivalent Fear of Evaluation Model, however, complement FNE with fear of positive evaluation (FPE), described as distress and avoidance of positive feedback. An explicit test of the incremental validity of FPE in discriminating SAD patients from controls – over and on top of the explanatory power of FPE – is currently missing and generally, well controlled laboratory experiments with positive and negative social stimuli in this patient group are rare. To fill this gap, we exposed 35 patients with SAD and healthy controls (HCs) to short social-evaluative video clips with actors expressing negative and positive as well as neutral statements while recording reactivity on experiential measures (valence, arousal, and approval ratings) as well as on facial electromyography and electrocardiography. In addition, participants completed questionnaire measures of FNE and FPE. Results revealed that FPE questionnaire scores as well as experiential (valence and appreciation) and electromyographical reactivity measures to positive videos improved prediction of group membership beyond the predictive power of FNE questionnaires scores and reactivity to negative videos. Results document the importance of FPE to more fully characterize and understand social anxiety and SAD. Implications include amendments to future diagnostic criteria, theoretical models, and treatment approaches for SAD.

Background and objectives: Social interactions inevitably go along with repeated evaluations. Some individuals are particularly sensitive to social evaluations: Psychometric studies suggest stable and distinct individual differences on fear of negative evaluations (FNE) and fear of positive evaluation (FPE). However, little is known about day-to-day correlates of FNE and FPE, particularly their respective contribution to positive/negative affect level and affect reactivity to different stressor types. Design: Two studies naturalistically assessed the level of negative/positive affect and its reactivity to different stressor types (from distant or close social network, work and daily hassles, assessed daily) as a function of FNE/FPE. Method: Ecological Momentary Assessment employed five daily prompts during 12/10 days in convenience samples of 50/59 participants. Results: FNE predicted lower positive affect level only in Study 2. Consistent across studies negative affect reactivity to stressors emanating from the distant social network was increased in individuals high in FNE or FPE. Conclusions: Results document the relevance of both types of evaluation fears (FNE/FPE) for day-to-day affect and stress reactivity. They further specify whose evaluations are well tolerated (close network) or feared (distant network), thereby refining current psycho-evolutionary accounts of FNE/FPE.

Research findings about relationships between trait-like eating behaviors and implicit food evaluations have been inconsistent. This may be partially attributed to the state-dependent nature of implicit food evaluations. In the current studies, relationships between trait and state chocolate craving, current hunger, and implicit evaluation of chocolate were examined. In study 1 (n = 64; 70% females), neither trait nor state chocolate craving were directly associated with implicit evaluation of chocolate. However, higher state chocolate craving was associated with more positive implicit evaluation of chocolate when current hunger was high. A moderated mediation model revealed an indirect effect of trait chocolate craving on implicit evaluation of chocolate via state chocolate craving only in hungry participants. This moderated mediation model was replicated in a sample of female individuals (n = 66; study 2) and in a sample of children and adolescents (n = 146; 47% females; study 3). Results support previous reports in that implicit food evaluations are influenced by state-dependent variables such as current craving and hunger. Moreover, implicit food evaluations are influenced by trait-like eating behaviors as well, inasmuch as these give rise to states of high motivational needs.

Trait impulsivity has been suggested as a risk factor for weight gain. However, it is implausible that a construct that does not cover energy intake or expenditure affects fat mass directly. Instead, it is likely that eating-related variables mediate the effect of impulsivity on body mass. In the current study, a serial mediation model tested two eating-related variables (trait food craving and perceived self-regulatory success in weight regulation) as mediators of the relationship between trait impulsivity and body mass. Participants (n=432, 88% female, 79% students) completed the Barratt Impulsiveness Scale - short form, the Food Cravings Questionnaire-Trait-reduced, and the Perceived Self-Regulatory Success in Dieting Scale (PSRS), in addition to providing sociodemographic and anthropometric data. Trait impulsivity did not correlate with body mass index (BMI), but was indirectly related to BMI via food cravings and PSRS scores. Specifically, higher impulsivity predicted more frequent food cravings, which in turn predicted lower perceived self-regulatory success in eating and weight regulation, which in turn predicted higher BMI. Findings suggest possible mechanisms that mediate the association between impulsivity and BMI. Importantly, they show that impulsivity can indirectly affect BMI via eating-related variables, even in the absence of a total effect. Longitudinal studies are needed that support these assumed causal directions.

In today’s society, obesity rates are rising as food intake is no longer only a response to physiological hunger signals that ensure survival. Eating can represent a reward, a response to boredom, or stress reduction and emotion regulation. While most people decrease food intake in response to stress or negative emotions, some do the opposite. Yet, it is unclear who shows emotional overeating under which circumstances. Emotion regulation theories describe emotional overeating as a learned strategy to down-regulate negative emotions. Cognitive theories, by contrast, attribute emotional overeating to perceived diet breaches in individuals who chronically attempt to diet. After consuming “forbidden foods”, they eat more than individuals who do not restrict their food intake. This laboratory study investigated emotional overeating by exposing individuals to a personalized emotion induction while showing images of palatable foods. Outcome variables indexed cue reactivity to food images through picture ratings (valence, desire to eat), facial expressions (electromyography of the corrugator supercilii muscle), and brain reactivity by detecting event-related potentials (ERPs) by means of electroencephalography (EEG). The influence of emotion condition (negative, neutral) and individual differences (self-reported trait emotional and restrained eating) on outcome variables was assessed. Valence ratings and appetitive reactions of the corrugator muscle to food pictures showed a relative increase in the negative condition for individuals with higher emotional eating scores, with the opposite pattern in lower scores. Desire to eat ratings showed a similar pattern in individuals who showed a strong response to the emotion induction manipulation, indicative of a dose-response relationship. Although no differences between conditions were found for ratings or corrugator activity with restrained eating as a predictor, an ERP at P300 showed increased activation when viewing food compared to objects in the negative condition. Findings support emotion regulation theories: Emotional eaters showed an appetitive reaction in rating patterns and corrugator activity. EEG findings (increased P300) suggest a motivated attention toward food in restrained eaters, which supports cognitive theories. However, this did not translate to other variables, which might demonstrate successful restraint. Future studies may follow up on these findings by investigating eating disorders with emotion regulation difficulties.

It is often assumed that emotional eating occurs when an individual is unable to utilise emotion regulation (ER) to cope with stress. In this stress exposure study, we explored whether manipulating participants’ ER strategies (rumination or self-compassion) influenced their stress-related affect and food consumption. Fifty-three adolescents (Mage = 14.72) were included; half of the participants were instructed to use rumination as their ER strategy, and half were instructed to use self-compassion. We could not demonstrate that the ER strategies differently affected stress-related affect. However, we did find that increased Happiness following ER self-compassion predicted reduced High-Fat Sweet food consumption, whereas increased Happiness following ER rumination instead led to greater High-Fat Sweet food consumption. In participants who ruminated, food consumption reduced feelings of Frustration, but not Boredom or Happiness. Post-hoc exploration revealed that only ER self-compassion, not ER rumination, normalised levels of stress-related affect. The results highlight the need for more research into the complex relationship between ER strategies, affect states, and food types in their effect on emotional eating.