Abstract
Disturbances in emotion regulation (ER) are characteristic of both patients with bipolar disorder (BD) and schizophrenia (SZ). We investigated the temporal dynamics of brain activation during cognitive ER in BD and SZ to understand the contribution of temporal characteristics of disturbed ER to their unique and shared symptomatology. Forty-six participants performed an ER-task (BD, n = 15; SZ, n = 16; controls, n = 15) during functional magnetic resonance imaging, in which they were instructed to use cognitive reappraisal techniques to regulate their emotional responses. Finite impulse response modeling was applied to estimate the temporal dynamics of brain responses during cognitive reappraisal (v. passive attending) of negative pictures. Group, time, and group × time effects were tested using multivariate modeling. We observed a group × time interaction during ER in the ventrolateral prefrontal cortex (VLPFC), supplementary motor area (SMA) and inferior occipital gyrus. Patients with SZ demonstrated initial hyper-activation of the VLPFC and SMA activation that was not sustained in later regulatory phases. Response profiles in the inferior occipital gyrus in SZ showed abnormal activation in the later phases of regulation. BD-patients showed general blunted responsivity in these regions. These results suggest that ER-disturbances in SZ are characterized by an inefficient initialization and failure to sustain regulatory control, whereas in BD, a failure to recruit regulatory resources may represent initial deficits in formulating adequate representations of the regulatory needs. This may help to further understand how ER-disturbances give rise to symptomatology of BD and SZ.
Highlights
Inadequate emotion regulation (ER) poses a threat to personal well-being (Gross, 2002) and is a central part of various psychiatric disorders, including bipolar disorder (BD) (Rowland et al, 2013; Wolkenstein et al, 2014) and schizophrenia (SZ) (Livingstone et al, 2009; van der Meer et al, 2009, 2014)
Given that reappraisal is relevant for the occurrence and treatment of psychosis (Kuipers et al, 2006) that is prevalent in both SZ and BD, the current study focused on reappraisal
All groups were comparable on age, sex, level of education, intelligence and Emotion Regulation Questionnaire (ERQ)-scores, but differed on Quick Inventory of Depressive Symptomatology (QIDS)-score (HC < BD < SZ; ps < 0.01)
Summary
Inadequate emotion regulation (ER) poses a threat to personal well-being (Gross, 2002) and is a central part of various psychiatric disorders, including bipolar disorder (BD) (Rowland et al, 2013; Wolkenstein et al, 2014) and schizophrenia (SZ) (Livingstone et al, 2009; van der Meer et al, 2009, 2014). A direct comparison between BD and SZ suggested a differential neural profile during cognitive ER, with BD-patients showing increased prefrontal involvement compared to SZ-patients (Morris et al, 2012) In this and other studies, lower lateral prefrontal recruitment was observed in SZ-patients compared to controls (Morris et al, 2012; van der Meer et al, 2014), whereas BD has been associated with both lower (Townsend et al, 2013) and higher (Morris et al, 2012) lateral prefrontal activation during ER compared to controls. This may help to further understand how ER-disturbances give rise to symptomatology of BD and SZ
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