Abnormal Emotional Responses Research Articles

Regulation of negative emotions through directed attention in high-trait-anxious women: Evidence from event-related potentials and eye-tracking

Abnormal emotional responses in high-trait-anxious (HTA) individuals may be related to the use of emotion regulation strategies. Directed attention is a substrategy of attention deployment, which has been proven to be effective in regulating individual negative emotions. The present study investigated whether HTA women can effectively utilize directed attention to decrease negative emotions. Two studies were conducted using the same directed attention paradigm, with one focusing on event-related potentials (ERPs) and the other utilizing eye-tracking techniques. Participants viewed negative and neutral pictures and rated their negative emotions experienced during viewing. During directed attention, attention was directed towards highly arousing aspects, less arousing aspects of negative pictures, or less arousing aspects of neutral pictures. In study 1, late positive potentials (LPP) were recorded in 26 HTA and 24 low-trait-anxious (LTA) women. In study 2, the latency of first fixation, the proportion of gaze duration and fixations in the specific area were recorded in 27 HTA and 23 LTA women. Both the HTA and LTA groups revealed a decrease in negative emotional ratings and LPP amplitudes when their attention was directed towards the less arousing aspects of negative pictures. Furthermore, in this condition, the HTA group had a shorter latency of first fixation on highly arousing aspects and a higher proportion of gaze duration on less arousing aspects of negative pictures compared to the LTA group. These results indicate that when confronted with negative pictures, HTA women are able to regulate their emotional responses through directed attention, which may be accompanied by attentional vigilance and avoidance tendencies.

Altered pattern of theta and gamma oscillation to visual stimuli in patients with postconcussion syndrome.

Although many patients with mild traumatic brain injury (mTBI) suffer from postconcussional syndrome (PCS) including abnormal emotional responses, most conventional imaging studies fail to detect any causative brain lesion. We hypothesized that event-related electroencephalography (EEG) recordings with time-frequency analysis would show a distinguishable pattern in patients with mTBI with PCS compared with normal healthy controls. EEG signals were collected from a total of 18 subjects: eight patients with mTBI with PCS and 10 healthy control subjects. The signals were recorded while the subjects were presented with affective visual stimuli, including neutral, pleasant, and unpleasant emotional cues. Event-related spectral perturbation analysis was performed to calculate frontal midline theta activity and posterior midline gamma activity, followed by statistical analysis to identify whether patients with mTBI with PCS have distinct patterns of theta or gamma oscillations in response to affective stimuli. Compared with the healthy control group, patients with mTBI with PCS did not show a significant increase in the power of frontal theta activity in response to the pleasant stimuli, indicating less susceptibility toward pleasant cues. Moreover, the patient group showed attenuated gamma oscillatory activity, with no clear alteration in gamma oscillations in response to either pleasant or unpleasant cues. This study demonstrates that patients with mTBI with PCS exhibited altered patterns of oscillatory activities in the theta and gamma bands in response to affective visual stimuli compared with the normal control group. The current finding implicates that these distinguishable patterns of brain oscillation may represent the mechanism behind various psychiatric symptoms in patients with mTBI.NEW & NOTEWORTHY Patients with mild traumatic brain injury (mTBI) with postconcussional syndrome (PCS) exhibited altered patterns of changes in oscillatory activities in the theta and gamma bands in response to visual affective stimuli. Distinguishable patterns of brain oscillation may represent the mechanism behind various psychiatric symptoms in patients with mTBI.

Brain microstructure mapping in major depressive disorder: a pilot MR study

INTRODUCTION: Major depressive disorder is a common mental health disorder. Alterations in cortical structures have been identified in this disease, but findings have been variable and inconsistent. Previous studies have illustrated that the cingulate and prefrontal gyrus, along with the amygdala, are involved in emotional processing and the development of abnormal emotional responses in depression.OBJECTIVE: Our research aims to investigate the neurological structural differences and alterations in ACC, bilateral amygdala, and dmPFC regions in patients with MDD using quantitative MRI (MPF and Diffusion parameters mapping (DPM), including diffusion kurtosis).MATERIALS AND METHODS: In this study, we utilized advanced quantitative MRI techniques, specifically Diffusion Tensor Imaging, Diffusion Kurtosis Imaging, and Мacromolecular Proton Fraction Mapping, to investigate microstructural differences and alterations in the specific regions in patients diagnosed with major depressive disorder. RESULTS: Our findings revealed no significant interaction between Мacromolecular proton fraction Mapping with depressive disorder. However, patients with major depressive disorder exhibited a statistically significant increase in apparent mean, axial and radial diffusivity (F=6.3, p=0.01, F=5.0, p=0.03, F=7.08, p=0.01, respectively) in the bilateral amygdala compared to healthy controls, as well as in mean and radial diffusivity in the anterior cingulate cortex (F=5.61, p=0.02, F=7.08, p=0.01, respectively).DISCUSSION: These findings suggest that altered molecular diffusion characteristics in the amygdala and the anterior cingulate cortex may be specifically associated with major depressive disorder.CONCLUSIONS: The importance of using new quantitative MRI methods to assess structural changes at the molecular level in the brain is shown, which, ultimately, expands the fundamental understanding of the pathophysiology of depression.

Misophonia Sound Recognition Using Vision Transformer.

Misophonia is a condition characterized by an abnormal emotional response to specific sounds, such as eating, breathing, and clock ticking noises. Sound classification for misophonia is an important area of research since it can benefit in the development of interventions and therapies for individuals affected by the condition. In the area of sound classification, deep learning algorithms such as Convolutional Neural Networks (CNNs) have achieved a high accuracy performance and proved their ability in feature extraction and modeling. Recently, transformer models have surpassed CNNs as the dominant technology in the field of audio classification. In this paper, a transformer-based deep learning algorithm is proposed to automatically identify trigger sounds and the characterization of these sounds using acoustic features. The experimental results demonstrate that the proposed algorithm can classify trigger sounds with high accuracy and specificity. These findings provide a foundation for future research on the development of interventions and therapies for misophonia.

Enhanced fear limits behavioral flexibility in Shank2-deficient mice

BackgroundA core symptom of autism spectrum disorder (ASD) is repetitive and restrictive patterns of behavior. Cognitive inflexibility has been proposed as a potential basis for these symptoms of ASD. More generally, behavioral inflexibility has been proposed to underlie repetitive and restrictive behavior in ASD. Here, we investigated whether and how behavioral flexibility is compromised in a widely used animal model of ASD.MethodsWe compared the behavioral performance of Shank2-knockout mice and wild-type littermates in reversal learning employing a probabilistic classical trace conditioning paradigm. A conditioned stimulus (odor) was paired with an unconditioned appetitive (water, 6 µl) or aversive (air puff) stimulus in a probabilistic manner. We also compared air puff-induced eye closure responses of Shank2-knockout and wild-type mice.ResultsMale, but not female, Shank2-knockout mice showed impaired reversal learning when the expected outcomes consisted of a water reward and a strong air puff. Moreover, male, but not female, Shank2-knockout mice showed stronger anticipatory eye closure responses to the air puff compared to wild-type littermates, raising the possibility that the impairment might reflect enhanced fear. In support of this contention, male Shank2-knockout mice showed intact reversal learning when the strong air puff was replaced with a mild air puff and when the expected outcomes consisted of only rewards.LimitationsWe examined behavioral flexibility in one behavioral task (reversal learning in a probabilistic classical trace conditioning paradigm) using one ASD mouse model (Shank2-knockout mice). Thus, future work is needed to clarify the extent to which our findings (that enhanced fear limits behavioral flexibility in ASD) can explain the behavioral inflexibility associated with ASD. Also, we examined only the relationship between fear and behavioral flexibility, leaving open the question of whether abnormalities in processes other than fear contribute to behavioral inflexibility in ASD. Finally, the neurobiological mechanisms linking Shank2-knockout and enhanced fear remain to be elucidated.ConclusionsOur results indicate that enhanced fear suppresses reversal learning in the presence of an intact capability to learn cue-outcome contingency changes in Shank2-knockout mice. Our findings suggest that behavioral flexibility might be seriously limited by abnormal emotional responses in ASD.

The psychological depression response of Iraqi subfertile wives :a descriptive study

Worldwide about 15% in the childbearing years have subfertility problems. [1] Many studies demonstrated that men and women have abnormal emotional responses, such as stress, anxiety and depression. Around 5% of couples living in the developed countries experience primary subfertility (inability to have any children or secondary subfertility. [1] Experts say that only half of all subfertility cases had a physical origin, the rest were unexplained. But researcher notice that most cases of subfertility attributed to physiological cause in the man or woman. About one-third from those physiological problems is identified in the woman, one-third in the man, and about one-tenth of the time in both. Half of the women and 15% of the men said that infertility was the most upsetting experience of their lives. [2] In Iraq and because of the social regulations and ideas about the female and male thinking the females was under huge psychological pressure towered the pregnancy. In our community less research to examine both men’s and women's reactions to subfertility, men's tend to report experiencing less distress than women. When the problem is diagnosed in their wives, men do not report being as distressed as the women do. Treat infertility by more advanced assisted reproductive technology such as in vitro fertilization (IVF) studies suggest that they may also add to the stress, anxiety, and grief that patients are already experiencing from infertility itself. Aim: The purpose of this study was to evaluate the prevalence of psychological stress (depression) experienced by subfertile wives Material and methods: DESIGN: Cross-sectional prospective study held in between March 2018 until March 2020 SETTING: Face-to-face and online interviews were conducted in study participants PARTICIPANTS:498 subfertile women were interviewed all suffering from primary or secondary infertility only 433 of them were accept to participating in our study and answered the questionnaire they are from subfertility units in maternity hospitals in Kerbala, Najaf and Babylon and in privet clinics and on social media METHODS: A structured questionnaire were used and filled by direct interviewed and/or by social media chatting MAIN OUTCOME MEASURES: The correlation between depression score and subfertility RESULTS: The prevalence of depression was very high among infertile women in Kerbala, Najaf and Babylon/Iraq, where 93.5% were depressed

Activation of 5-HT1A receptor reduces abnormal emotionality in stress-maladaptive mice by alleviating decreased myelin protein in the ventral hippocampus

We previously reported that abnormal emotionality in stress-maladaptive mice was ameliorated by chronic treatment with flesinoxan, a 5-HT1A receptor agonist. Furthermore, the maintenance of hippocampal myelination appeared to contribute to the development of stress adaptation in mice. However, the effects of 5-HT1A receptor activation on myelination under the stress-maladaptive situations and the underlying mechanisms remain unknown. In the present study, we examined using flesinoxan whether activation of 5-HT1A receptor can reduce an abnormal emotional response by acting on oligodendrocytes to preserve myelin proteins in stress-maladaptive mice. Mice were exposed to repeated restraint stress for 4 h/day for 14 days as a stress-maladaptive model. Flesinoxan was given intraperitoneally immediately after the daily exposure to restraint stress. After the final exposure to restraint stress, the emotionality of mice was evaluated by the hole-board test. The expression levels of brain-derived neurotrophic factor (BDNF), phosphorylated-extracellular signal-regulated kinase (p-ERK), phosphorylated-cAMP response element-binding protein (p-CREB), myelin-associated glycoprotein (MAG), myelin basic protein (MBP) and oligodendrocyte transcription factor 2 (olig2) in the hippocampus was assessed by western blotting. Hippocampal oligodendrogenesis were examined by immunohistochemistry. Chronic treatment with flesinoxan suppressed the decrease in head-dipping behaviors in stress-maladaptive mice in the hole-board test. Under this condition, the decreases in MAG and MBP in the hippocampus recovered with increase in BDNF, p-ERK, p-CREB, and olig2. Furthermore, hippocampal oligodendrogenesis in stress-maladaptive mice was promoted by chronic treatment with flesinoxan. These findings suggest that 5-HT1A receptor activation may promote oligodendrogenesis and myelination via an ERK/CREB/BDNF signaling pathway in the hippocampus and reduces abnormal emotionality due to maladaptation to excessive stress.

The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale

Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p < 0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.

Abnormal emotional and neural responses to romantic rejection and acceptance in depressed women

IntroductionResponding adaptively to one's social environment is a key factor predicting the course of major depressive disorder (MDD). Socially rejecting events can exacerbate, whereas socially accepting events can ameliorate depressive symptoms. The neural responses to rejection and acceptance in MDD are relatively unexplored. MethodsWe used functional magnetic resonance imaging (fMRI) to measure neural responses to romantic rejection and acceptance in women diagnosed with current MDD (n = 19) and a matched group of healthy controls (HCs) (n = 19). During fMRI, participants received rejecting, accepting, and neutral feedback from self-selected potential romantic partners. ResultsIn women with MDD but not HCs, rejection significantly increased activity in the right anterior insula relative to neutral feedback. Greater activation during rejection was found in the dorsal anterior cingulate cortex in MDD compared to HCs. Women with MDD reported stronger emotional responses than HCs to both rejection and acceptance. In addition, left and right nucleus accumbens (NAcc) activity mediated the relationship between trait reward responsiveness and increased ratings of feeling “happy and accepted” following acceptance in HCs, but not the MDD group. DiscussionWomen with MDD were behaviorally and neurally hyperresponsive to rejection. Although both groups were behaviorally responsive to acceptance, in MDD this was dissociated from NAcc activity. These findings highlight abnormal behavioral and neural responses to social cues in MDD, with implications for disease prognosis and the development of novel and sensitive biomarkers for MDD focused on neural pathways for social-affective processing. LimitationsConclusions may be limited to depressed women in a romantic context.

Decision-making, somatic markers and emotion processing in opiate users.

Opiate use is associated with deficits in decision-making. A possible explanation for these deficits is provided by the somatic marker hypothesis, which suggests that substance users may experience abnormal emotional responses during decision-making involving reward and punishment. This in turn may interfere with the brief physiological arousal, i.e. somatic markers that normally occur in anticipation of risky decisions. To date, the applicability of the somatic marker hypothesis to explain decision-making deficits has not been investigated in opiate users. This study assessed whether decision-making deficits in opiate users were related to abnormal emotional responses and reduced somatic markers. Opiate users enrolled in an opiate substitute treatment program (n=28) and healthy controls (n=32) completed the Iowa Gambling Task (IGT) while their skin conductance responses (SCRs) were recorded. Participants' emotional responses to emotion-eliciting videos were also recorded using SCRs and subjective ratings. Opiate users displayed poorer decision-making on the IGT than did controls. However, there were no differences between the groups in SCRs; both groups displayed stronger SCRs following punishment than following reward, and both groups displayed stronger anticipatory SCRs prior to disadvantageous decisions than advantageous decisions. There were no group differences in objective or subjective measures of emotional responses to the videos. The results suggest that deficits in emotional responsiveness are not apparent in opiate users who are receiving pharmacological treatment. Thus, the somatic marker hypothesis does not provide a good explanation for the decision-making deficits in this group.

Deletion of the miR-379/miR-410 gene cluster at the imprinted Dlk1-Dio3 locus enhances anxiety-related behaviour.

The brain-specific miR-379/miR-410 gene cluster at the imprinted Dlk1-Dio3 domain is implicated in several aspects of brain development and function, particularly in fine-tuning the dendritic outgrowth and spine remodelling of hippocampal neurons. Whether it might influence behaviour and memory-related processes has not yet been explored at the whole organism level. We previously reported that constitutive deletion of the miR-379/miR-410 gene cluster affects metabolic adaptation in neonatal mice. Here, we examined the role of this cluster in adult brain functions by subjecting mice with the constitutive deletion to a battery of behavioural and cognitive tests. We found that the lack of miR-379/miR-410 expression is associated with abnormal emotional responses, as demonstrated by increased anxiety-related behaviour in unfamiliar environments. In contrast, spontaneous exploration, general locomotion, mood levels and sociability remained unaltered. Surprisingly, miR-379/miR-410-deficient mice also showed normal learning and spatial (or contextual) memory abilities in hippocampus-dependent tasks involving neuronal plasticity. Taken together, the imprinted miR-379/miR-410 gene cluster thus emerges as a novel regulator of the two main post-natal physiological processes previously associated with imprinted, protein-coding genes: behaviour and energy homeostasis.

Abnormalities in white matter connections between orbitofrontal cortex and anterior cingulate cortex and their associations with negative symptoms in schizophrenia: A DTI study

IntroductionThe medial orbitofrontal cortex (mOFC) and rostral part of the anterior cingulate cortex (rACC) are brain regions that are important in the neural network involving emotional processing and decision making, as well as playing an important role in social behavior and interaction. Considering the schizophrenia dysconnectivity hypothesis, observed abnormalities in emotional response and social behavior in schizophrenia might be associated with connectivity abnormalities between mOFC and rACC. MethodsTwenty-seven patients with chronic schizophrenia and 26 healthy controls were examined using diffusion tensor imaging (DTI). White matter properties in bilateral mOFC–rACC connections were examined using stochastic tractography, which has been shown to be among the most effective DTI methods for examining tracts between adjacent gray matter regions. ResultsReductions in fractional anisotropy (FA) were observed in left anterior mOFC–rACC connections (p<0.0001), and bilateral posterior mOFC–rACC connections (left: p<0.0001; right: p<0.0001) in patients compared to controls. In addition, reduced FA in left posterior mOFC–rACC connections was associated with more severe anhedonia-asociality (R=−0.396, p=0.041) and avolition-apathy (R=−0.426, p=0.027) using the Scale for the Assessment of Negative Symptoms. DiscussionWhite matter abnormalities within connections between mOFC and rACC are associated with more severe anhedonia-asociality and avolition-apathy, which suggest that these brain regions may be important in understanding abnormal emotional responses and social behavior in patients with schizophrenia.

Autism traits in children and adolescents with Cornelia de Lange syndrome

Cornelia de Lange syndrome (CdLS) is a cohesinopathy causing delayed growth and limb deficits. Individuals with CdLS have mild to profound intellectual disability and autistic features. This study characterizes the behavioral phenotype of children with CdLS, focusing on autistic features, maladaptive behaviors, and impact of age. Children with CdLS (5-18 years) were administered normed instruments to characterize autism features (Childhood Autism Rating Scale, CARS), maladaptive behaviors (Aberrant Behavior Checklist), and adaptive skills (Vineland Adaptive Behaviors Scales). CdLS features and severity were rated with Diagnostic Criteria for CdLS. Forty-one children with CdLS (23 females, 18 males) were classified as having "no autism" (n = 7; 17.1%), "mild autism" (n = 17; 41.4%), and "severe autism" (n = 17; 41.4%), using CARS scores. Characteristic items were abnormal emotional response, stereotypies, odd object use, rigidity, lack of verbal communication, and low intellectual functioning. Verbal communication deficits and repetitive behaviors were higher compared to sensory, social cognition, and behavior abnormalities (P ≤ 0.0001). Maladaptive behaviors associated with autism traits were stereotypies (P = 0.003), hyperactivity (P = 0.01), and lethargy (P = 0.03). Activities of daily living were significantly affected; socialization adaptive skills were a relative strength. However, with advancing age, both socialization (P < 0.0001) and communication (P = 0.001) domains declined significantly. CdLS is characterized by autistic features, notably excessive repetitive behaviors and expressive language deficits. While other adaptive skills are impacted, socialization adaptive skills are less affected. Advancing age can worsen communication and socialization deficits relative to neurotypical peers.

EPA-1004 - SENSO: A new framework for the study of neural correlates of social cognition in depression

Objectives To describe a new framework ‘SENSO’ (sensitivity to social signal) that emphasizes that acute depressed patients show abnormal cognitive, emotional and biological responses to positive and negative social signals with impaired monitoring of social acceptance. Methods We will review evidence that Major Depression is associated with increasing vulnerability to social rejection and social stress. We will also discuss a recent meta-analysis realized by our group evaluating neural correlates of social exclusion tasks in healthy subjects. Results Major Depression is clearly precipitated by major social life-events. These social events increase the need for subjects to monitor their level of social acceptance and induce stress response. Self-propagatory processes (i.e. excessive reassurance seeking, negative feedback seeking) generate in depressed patients a vicious circle leading to increase sensitivity to social rejection. Social exclusion tasks in healthy subjects induce increased activation in ventromedial prefrontal cortex, subgenual cortex and insula, regions implicated in self-processing and production of negative emotion. Conclusion Results of our literature review and of our meta-analysis stress the importance of studying interpersonal processes and their neural correlates in depressive phenomena. They emphasize the role of salient and default mode networks in the pathophysiology of major depression.

Erbb4 Deletion from Fast-Spiking Interneurons Causes Schizophrenia-like Phenotypes

Genetic variation in neuregulin and its ErbB4 receptor has been linked to schizophrenia, although little is known about how they contribute to the disease process. Here, we have examined conditional Erbb4 mouse mutants to study how disruption of specific inhibitory circuits in the cerebral cortex may cause large-scale functional deficits. We found that deletion of ErbB4 from the two main classes of fast-spiking interneurons, chandelier and basket cells, causes relatively subtle but consistent synaptic defects. Surprisingly, these relatively small wiring abnormalities boost cortical excitability, increase oscillatory activity, and disrupt synchrony across cortical regions. These functional deficits are associated with increased locomotor activity, abnormal emotional responses, and impaired social behavior and cognitive function. Our results reinforce the view that dysfunction of cortical fast-spiking interneurons might be central to the pathophysiology of schizophrenia.

Venlafaxine facilitates between-session extinction and prevents reinstatement of auditory-cue conditioned fear

Anxiety disorders, characterized by anxiety and fearfulness, are found to be able to cause abnormal emotional responses’ associated with memories of negative events, which implicate pressure on society with an increasingly large burden. Better treatment has been of concern to the community. Venlafaxine (VEN), a nonclassical antidepressant agent, is applied in the treatment of social phobia, major depression (MD) and general anxiety disorder (GAD) and, to a certain extent, posttraumatic stress disorder (PTSD), which improves working memory and spatial memory as well as ameliorates emotion by affecting specified brain regions. In this study, we committed to seek a new way for using VEN on treatment of anxiety disorders. To investigate the effect of VEN on extinction of auditory-cue conditioned fear, conditioned rats received a treatment with VEN before extinction training and tests for freezing level of within-session and between-session extinction. To investigate the effect of VEN on reinstatement, all conditioned rats received a treatment with VEN over a period for 21 days. After a rest for 7 days, two tests for freezing level were conducted. We found that: (1) VEN (40mg/kg) treatment at 30min prior to extinction training significantly facilitated the between-session extinction, but not the within-session extinction; (2) chronic administration with VEN (40mg/kg) prevented the return of extinguished auditory-cue fear. These data elucidate the critical role of VEN in auditory-cue fear memory, suggesting that VEN may be an ideal choice for the exposure-based drug treatment and maintenance treatment in patients with GAD, SAD and PTSD.

Helping your patients cope with a cancer diagnosis

Q: How do I assess and manage my patients’ emotional response to their cancer diagnosis? A: A cancer diagnosis is a life-altering event. Patients often experience anxiety at the time of diagnosis, at the onset of new treatment regimens, when transitioning from active treatment to follow-up care, and at annual follow-up visits with their healthcare provider once in remission. Additionally, patients may develop symptoms of depression during or following any of the phases of the cancer experience. It isn’t uncommon for nurses caring for patients and their families to feel unprepared to assist them through the emotional reactions to this experience. A comprehensive nursing assessment of the oncology patient includes assessing for a history of depression, anxiety, or posttraumatic stress reactions before the cancer diagnosis. A patient with these histories may be at higher risk for a depressive or anxiety response to the cancer experience. Ongoing assessment of the patient for current symptoms of depression or anxiety is essential. Keep in mind that patients may not directly report these symptoms to you; rather, they may verbalize physical complaints or a decreased ability to function on some level. Additionally, patients may present with complaints of insomnia, fatigue, anorexia, nausea, weakness, and palpitations. They may report decreased interest in usual activities, isolating at home, feeling like a burden to their caregivers, or a feeling of worthlessness or hopelessness. You may observe patients being irritable, nervous, sad, angry, uncooperative, or noncompliant with treatment. Caregivers may directly or casually report that patients are having diffi culty coping when at home, despite their presentation in the outpatient clinical setting. Although many of these symptoms may be expected responses to cancer treatments, it’s important to further assess and evaluate if the severity of the patient’s symptoms or the decreased functioning in everyday activities may be an abnormal emotional response to the cancer experience. It’s important to recognize symptoms of anxiety and depression in oncology patients and seek to differentiate symptoms that might respond to additional supportive care from those that would be most effectively treated with medication and professional counseling. Nursing interventions that may be effective in bringing relief to patients and families experiencing emotional distress related to the cancer experience include: • providing education regarding the patient’s diagnosis, treatments, and expected physiologic responses to help alleviate fear of the unknown • providing time for the patient to ask questions and for listening to the patient’s stories • validating the patient’s experiences, feelings, thoughts, and emotions • sitting quietly with the patient • assessing the patient’s perceived strengths to access and build on for coping with this diffi cult time • assessing for the presence or lack of a support system • assessing the willingness, availability, and resilience of the patient’s family and friends to serve as supportive caregivers • seeking information and making the patient and family aware of support groups • promoting socialization and support from other patients and families in infusion room or clinical practice areas to decrease isolation during treatments • advocating for the patient and family while collaborating with the treatment team if a psychiatric consultation is indicated. A cancer diagnosis is never easy, but you’re here to help.

WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders.

This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide.

VISUAL ATTENTION, EMOTIONAL AND BEHAVIORAL RESPONSES TO FACIAL EXPRESSION IN YOUNG CHILDREN WITH AUTISM

The current study investigated the differential attentive, emotional and behavioral responses to facial expressions in toddlers with autism (N = 37) and healthy controls (N = 40) using a task capturing visual attention, emotional response and joint attention behavior to facial expression. The findings showed that autistic children’s performances were significantly worse than healthy children. These preliminary findings suggest that children with autism not only show less visual attention to facial expression than healthy children but also have impairments in social attention. A fine-grained analysis showed that children with autism, but not healthy children, showed abnormal emotional responses to the negative facial expressions. The results are discussed in terms of cognitive deficits in facial expression in young children of autism.

Non-Idiographic Emotional Script-Driven Imagery in Posttraumatic Stress Disorder

Abnormal emotional responses to standardized emotional stimuli in posttraumatic stress disorder (PTSD) implicate problems in emotional processing less obviously linked to traumatic experiences. However, the personal meaningfulness and association of standardized emotional stimuli with specific episodic memories in PTSD participants has not been investigated. This paper takes the position that emotional processing of standardized stimuli cannot be divorced from the personal meaning these stimuli are ascribed, such as via the priming of episodic memory. Women with PTSD reported greater priming of episodic memories within the context of emotional imagery of standardized scripts, and episodic recall predicted emotional responses to script-driven imagery. Furthermore, greater priming of episodic recall during imagery of fear-anxiety scripts was associated with less response within the ventral medial prefrontal cortex. Clinical, theoretical, and methodological issues are discussed.