Affective Cognitive Processes Research Articles

'I became the nurse I dreamed to be': Posttraumatic growth of hospital nurses during COVID-19

Abstract Background The unexpected COVID-19 pandemic outbreak has shaken the personal and professional lives of people worldwide. Nurses, as the largest healthcare workforce and in the closest proximity to patients, are at high risk of being infected, facing life-threatening situations while being exposed to secondary traumatic stress from direct care of others who are also experiencing traumatic events. Aim To explore the lived experiences of frontline hospital nurses as direct caregivers of COVID-19 patients, during four waves of the pandemic. Methods The grounded theory approach was employed to generate a theory of nurses’ lived experiences during four waves of the pandemic using the constant comparative method of analysis. Semi-structured interviews were conducted with 23 nurses from nine tertiary hospitals in Israel, between August and September 2021. Interviews were video recorded and transcribed verbatim. Criteria for establishing trustworthiness were applied. Results Nurses experienced the COVID-19 pandemic as (1) A direct and secondary threatening event; unexpected, uncertain with poor conditions and resources; (2) Paradoxical negative and positive changes were experienced such as threats to life vs. valuing life; social distancing vs. improved relations; and professional challenges vs. growth; (3) Nurses gained meaningful professional growth such as awareness of their professional strengths and limitations; choosing the optimal career path, and restructuring their nursing identity and image. Conclusions This study shed some light on nurses’ positive experiences during their struggle during the COVID-19 pandemic without neglecting the impact of adverse experiences on nurses. The phenomenon of secondary traumatization in nursing is still undervalued and needs to be explored and addressed. The pandemic provided nurses with a rare opportunity to redefine the meaning of being a nurse and experience professional growth. Key messages • Nursing leadership should consider nurses’ emotional needs and include affective-cognitive processing of traumatic events as part of the professional curricula in nursing education and at workplace. • Public recognition of the added value of nurses strengthened nurses’ professional identity and image. This process of developing the future state of the nursing image must be continued internationally.

Posttraumatic growth in colorectal cancer survivors: A systematic review.

The diagnosis of cancer is an adverse event; nevertheless, it can also exert positive changes on survivors, such as posttraumatic growth (PTG). This review aims to integrate researches on PTG in colorectal cancer (CRC) survivors, including manifestations and prevalence of PTG, factors associated with PTG and interventions on PTG. A systematic search was implemented on six databases to identify studies on PTG in CRC survivors published in English or Chinese from October 1995 to May 2022. We also performed a manual search for additional studies from the article reference lists. Thirty-one studies were included. The results were integrated based on the PTG theoretical framework and PTG affective-cognitive processing model. PTG manifests in CRC survivor-caregiver dyads in five domains, including personal growth, appreciation of life, relating to others, new possibilities and spiritual change. Factors correlated with PTG can be integrated into levels of personality, event cognitions, appraisal mechanisms, emotional states, coping and social environmental context. Elements of interventions can be integrated according to the affective-cognitive processing PTG model. Existing interventions are effective in promoting PTG in CRC survivors. We provide a systematic perspective on studies targeting PTG in CRC survivors. PTG manifested in survivor-caregiver dyads. Factors associated with PTG in CRC survivors are significant, and the interventions are effective. An intervention programme based on the affective-cognitive processing model and focused on CRC survivor-caregiver dyads would be significant for the dyads facing cancer.

Can Yoga Boost Access to the Bodily and Emotional Self? Changes in Heart Rate Variability and in Affective Evaluation Before, During and After a Single Session of Yoga Exercise With and Without Instructions of Controlled Breathing and Mindful Body Awareness in Young Healthy Women.

Exercise is indispensable for a healthy lifestyle. Yoga exercise can have positive effects on well-being and on cardiac autonomic activity making it an ideal intervention for improving mind-body interactions and resilience to physical and mental stressors. Emotions trigger especially strong bodily and affective-cognitive responses because of their social relevance for the self and their biological relevance of mobilizing the organism for action. This study investigates whether changes in emotion processing related to self-other referential processing and changes in cardiac autonomic activity, reflected by heart rate variability (HRV), occur immediately after already a single session of yoga exercise when yoga postures are practiced with or without breathing- and mindful body awareness instructions. Women, all university students (N = 34, final sample: n = 30, n = 25 naïve to yoga practice) were randomly assigned to two experimental groups who performed the same yoga exercises with or without controlled breathing and mindfulness instructions. Emotional, self-other referential processing, awareness of bodily signals and HRV indicators were investigated before and after the exercise using standardized experimental tasks, standardized questionnaires, and mobile recording devices. Exercising for 30 minutes changed cardiac activity significantly. HRV measures showed adaptability of cardiac activity during the exercise as well as during the affective task post- to pre-exercise. Exercising with breathing instructions and mindful body awareness had no superior effects on cardiac, particularly parasympathetic activity, compared to practicing the same movements without such explicit instructions. Self-referential processing did not change; however, participants were faster and more accurate in their affective judgments of emotional stimuli [regardless of their reference (self/other)], and showed better awareness of bodily signals after compared to before the exercise session. The results support immediate, adaptive effects of yoga exercise on cardiac and affective-cognitive processing in an all-female healthy sample. Therefore, yoga exercise could be recommended as a physical activity for boosting cardiac and emotional resilience in this target group.

Association between pain, anxiety, and pain relief in patients receiving emergent endodontic treatment

The experience of pain relief is closely associated with the affective-cognitive processing of hedonic value. Higher pain relief plays a key role in patients' satisfaction with treatment and higher motivation to receive treatment. Previous studies focused on pain and anxiety of endodontic treatment. However, the association between pain relief, pain, and anxiety has not been investigated. We investigated 35 patients (20 females and 15 males, with mean age 46.3years old) with symptomatic irreversible pulpitis receiving emergent endodontic treatment. Pain-related experience, including pain relief, pain, and anxiety, was assessed before and after treatment, based on an 11-point numerical scale. We found that before treatment, the expected pain relief (median score = 8) that one anticipated was positively correlated with the degree of pain reduction perceived after treatment (two-tailed rho = 0.51, p = 0.002). Expected pain relief was also positively correlated with the post-treatment relief (two-tailed rho = 0.76, p < 0.001) and the relief recalled after 6weeks (two-tailed rho = 0.69, p < 0.001). Moreover, logistic regression models revealed that expected pain relief was a significant predictor of the subgroups of low vs. moderate scores of post-treatment pain (B = - 1.06, p = 0.017) and anxiety (B = - 1.60, p = 0.009), controlled for the condition of pre-treatment medication. The current findings highlight that for patients with symptomatic irreversible pulpitis who received emergent endodontic treatment, their expected pain relief before treatment is a critical factor associated with pain reduction and post-treatment pain/anxiety. Assessment of expected pain relief may be integrated into pre-treatment assessment for painful dental patients.

Posttraumatic growth as a process and an outcome: Vexing problems and paradoxes seen from the perspective of humanistic psychology.

The aim of this article is to discuss the concept of posttraumatic growth (PTG) from the perspective of humanistic psychology. Research findings in PTG have posed what seem to be challenging theoretical questions. Questions that seem perplexing or paradoxical to mainstream research are: whether PTG is a normative process, if it is better described as personality change, what its relationship is with PTSD, if PTG is the same as resilience, if PTG is illusory, and finally, if PTG is actually adaptive. These six questions, I would argue, only seem perplexing or paradoxical when the lens through which they are being examined is the same as when studying illness. There are important differences in how the humanistic growth paradigm approaches the topic of PTG compared to the illness ideology. In this article, I discuss these questions from the perspective of Joseph and Linley’s (2005) organismic valuing process (OVP) theory of growth following adversity. Seen from the humanistic psychology tradition of OVP theory, PTG represents a normative affective-cognitive process of real change toward constructive personality development that leads to resilience and adaptive functioning. I hope to position the topic of growth following adversity more clearly within the field of humanistic psychology and to set a new nonmedicalized research agenda for researchers and clinicians.

The "Efficiency" Effect of Conceptual Referents on the Generation of Happiness: A Cross-National Analysis

This paper analyses how different definitions of happiness affect the individual assessment of subjective wellbeing. Bearing in mind the production theory, we study the impact of definitions of happiness on how efficiently a set of determinants are used and converted into happiness. From a theoretical point of view, we discuss the role of the Conceptual Referent Theory within the affective-cognitive process of personal evaluation of happiness. We use data from the Understanding High Happiness in Latin America survey (2018), which includes a sample of people from Colombia, Costa Rica, Mexico and the USA, to investigate how happiness conceptual referents influence personal assessment using Stochastic Frontier Analysis. This method permits to assess the impact of different definitions of happiness on how a set of standard drivers like income and social relations are used and converted into perceived happiness. To this end, conceptual referents for happiness are treated as (in)efficiency factors. This study shows that the concept of happiness shapes how individuals value the same inputs. “Stoicism”, “virtue” and “enjoyment” emerge as the most efficient referents. Also, we observe that cross-country differences in the level of perceived happiness are associated with differences in the prevalence of conceptual referents. In the USA, where less efficient definitions prevail, people report lower levels of happiness.

Breakdown of the affective-cognitive network in functional dystonia.

Previous studies suggested that brain regions subtending affective‐cognitive processes can be implicated in the pathophysiology of functional dystonia (FD). In this study, the role of the affective‐cognitive network was explored in two phenotypes of FD: fixed (FixFD) and mobile dystonia (MobFD). We hypothesized that each of these phenotypes would show peculiar functional connectivity (FC) alterations in line with their divergent disease clinical expressions. Resting state fMRI (RS‐fMRI) was obtained in 40 FD patients (12 FixFD; 28 MobFD) and 43 controls (14 young FixFD‐age‐matched [yHC]; 29 old MobFD‐age‐matched [oHC]). FC of brain regions of interest, known to be involved in affective‐cognitive processes, and independent component analysis of RS‐fMRI data to explore brain networks were employed. Compared to HC, all FD patients showed reduced FC between the majority of affective‐cognitive seeds of interest and the fronto‐subcortical and limbic circuits; enhanced FC between the right affective‐cognitive part of the cerebellum and the bilateral associative parietal cortex; enhanced FC of the bilateral amygdala with the subcortical and posterior cortical brain regions; and altered FC between the left medial dorsal nucleus and the sensorimotor and associative brain regions (enhanced in MobFD and reduced in FixFD). Compared with yHC and MobFD patients, FixFD patients had an extensive pattern of reduced FC within the cerebellar network, and between the majority of affective‐cognitive seeds of interest and the sensorimotor and high‐order function (“cognitive”) areas with a unique involvement of dorsal anterior cingulate cortex connectivity. Brain FC within the affective‐cognitive network is altered in FD and presented specific features associated with each FD phenotype, suggesting an interaction between brain connectivity and clinical expression of the disease.

Neuronal generator patterns at scalp elicited by lateralized aversive pictures reveal consecutive stages of motivated attention

Event-related potential (ERP) studies have provided evidence for an allocation of attentional resources to enhance perceptual processing of motivationally salient stimuli. Emotional modulation affects several consecutive components associated with stages of affective-cognitive processing, beginning as early as 100–200ms after stimulus onset. In agreement with the notion that the right parietotemporal region is critically involved during the perception of arousing affective stimuli, some ERP studies have reported asymmetric emotional ERP effects. However, it is difficult to separate emotional from non-emotional effects because differences in stimulus content unrelated to affective salience or task demands may also be associated with lateralized function or promote cognitive processing. Other concerns pertain to the operational definition and statistical independence of ERP component measures, their dependence on an EEG reference, and spatial smearing due to volume conduction, all of which impede the identification of distinct scalp activation patterns associated with affective processing. Building on prior research using a visual half-field paradigm with highly controlled emotional stimuli (pictures of cosmetic surgery patients showing disordered [negative] or healed [neutral] facial areas before or after treatment), 72-channel ERPs recorded from 152 individuals (ages 13–68years; 81 female) were transformed into reference-free current source density (CSD) waveforms and submitted to temporal principal components analysis (PCA) to identify their underlying neuronal generator patterns. Using both nonparametric randomization tests and repeated measures ANOVA, robust effects of emotional content were found over parietooccipital regions for CSD factors corresponding to N2 sink (212ms peak latency), P3 source (385ms) and a late centroparietal source (630ms), all indicative of greater positivity for negative than neutral stimuli. For the N2 sink, emotional effects were right-lateralized and modulated by hemifield, with larger amplitude and asymmetry for left hemifield (right hemisphere) presentations. For all three factors, more positive amplitudes at parietooccipital sites were associated with increased ratings of negative valence and greater arousal. Distributed inverse solutions of the CSD-PCA-based emotional effects implicated a sequence of maximal activations in right occipitotemporal cortex, bilateral posterior cingulate cortex, and bilateral inferior temporal cortex. These findings are consistent with hierarchical activations of the ventral visual pathway reflecting subsequent processing stages in response to motivationally salient stimuli.

Neurotranslations: Interpreting the Human Brain’s Attention System

Our ability to think, create, innovate, and communicate—to survive and thrive—depends on the brain’s attention system: from the reticular activation system that triggers the fight-or-flight response to the cortical and subcortical networks managing familiar and unfamiliar stimuli during the creative process, problem solving, decision making, and related functions that involve interrelated affective cognitive processes. The attention system links key networks of the central and peripheral nervous system, enabling us to be conscious and cognizant of the world of information all human systems and our creations depend on. This article addresses a number of key issues and challenges concerning attentional mechanisms, considering how our nervous systems constantly attend to information needed to perform certain actions that keep us alert, alive and well. The author uses three works of fine art that explore the neural mechanisms of attention underlying the creative process. Like noninvasive imaging tools (EEG, fMRI, PET, SPECT, MEG, VEPs) used to illuminate attention and other key brain functions, these purposeful artworks serve a complementary usefulness: interpreting the ways and means by which the brain tunes into or tunes out information in milliseconds, depending on the level of interest in or connection with the information (i.e., its contents) and the circumstances (i.e., contexts) in which one experiences it. The more personally meaningful and relevant the information is, the more attentive we tend to be in remembering and using it. The metaphorical artworks presented for discussion—“Breaking the Mind Barrier” (1985–86), “Prescience, Foresight” (1986–88), and “Grasping Synapses” (2000–04)—interpret attentional mechanisms that enable us to connect with things our minds are drawn to and care to remember. The hypothesis adventured here is that attention, in addition to its rudimentary functions, is intimately involved in making information personally meaningful and relevant to our lives. Without this fundamental sense of relevance, we neither learn nor remember anything beyond first impressions. The author posits that attentional mechanisms compete to process certain information that interests us, and not just because it’s in our frontal eye fields or immediately relevant to the brain part tasked with processing it, as the biased competition theory suggests.

Naloxone modulates visual judgments of similarity but not dissimilarity

Endogenous opioids have been implicated in mediating (placebo) analgesia, in reward processes, and in the regulation of socially relevant emotions. To explore their potential contributions to higher cognitive functions, we used a novel task with tachistoscopically presented (for 150 ms) pairs of meaningless figures. Healthy right-handed men judged the similarities and dissimilarities between the two figures on a visual analogue scale (VAS) in two separate runs. In a double-blind, between-subjects design, subjects were administered intravenously either 0.2-mg/kg naloxone or placebo 10 min prior to the task, and VAS judgments and response latencies were measured. We found a significant interaction between substance group and type of judgment: The magnitude of the similarity judgments was lower in the naloxone than in the placebo group, while dissimilarity judgments remained uninfluenced by the treatment. Reaction latencies and mood scores, assessed before and after substance administration, did not differ between the two groups, indicating that the findings did not rely on altered motor performance or motivation. We suggest that naloxone decreased the "similarity criterion" in comparative judgments, indicating its potentially modulatory effect on visual cognition. The task introduced here could be used for the implicit study and quantification of subtle affective-cognitive processes beyond the level of mere questionnaire data.

An Affective–Cognitive Processing Model of Post‐Traumatic Growth

A topic that has begun to attract interest from clinical psychologists and psychotherapists is post-traumatic growth. First, we provide a general overview of the field, setting out the historical development, main concepts, measurement issues and research findings. Second, we review evidence showing that the relationship between post-traumatic stress and post-traumatic growth is likely curvilinear. Third, a new affective-cognitive processing model of post-traumatic growth will be introduced in which post-traumatic stress is understood to be the engine of post-traumatic growth. Fourth, points of clinical intervention are described showing the ways in which therapists can facilitate post-traumatic growth.

Personality Vulnerabilities to Psychopathology: Relations between Trait Structure and Affective-Cognitive Processes

Personality Vulnerabilities to Psychopathology: Relations between Trait Structure and Affective-Cognitive Processes

Habits of the heart: life history and the developmental neuroendocrinology of emotion.

The centrality of emotion in cognition and social intelligence as well as its impact on health has intensified investigation into the causes and consequences of individual variation in emotion regulation. Central processing of experience directly informs regulation of endocrine axes, essentially forming a neuro-endocrine continuum integrating information intake, processing, and physiological and behavioral response. Two major elements of life history-resource allocation and niche partitioning-are served by linking cognitive-affective with physiologic and behavioral processes. Scarce cognitive resources (attention, memory, and time) are allocated under guidance from affective co-processing. Affective-cognitive processing, in turn, regulates physiologic activity through neuro-endocrine outflow and thereby orchestrates energetic resource allocation and trade-offs, both acutely and through time. Reciprocally, peripheral activity (e.g., immunologic, metabolic, or energetic markers) influences affective-cognitive processing. By guiding attention, memory, and behavior, affective-cognitive processing also informs individual stances toward, patterns of activity in, and relationships with the world. As such, it mediates processes of niche partitioning that adaptively exploit social and material resources. Developmental behavioral neurobiology has identified multiple factors that influence the ontogeny of emotion regulation to form affective and behavioral styles. Evidence is reviewed documenting roles for genetic, epigenetic, and experiential factors in the development of emotion regulation, social cognition, and behavior with important implications for understanding mechanisms that underlie life history construction and the sources of differential health. Overall, this dynamic arena for research promises to link the biological bases of life history theory with the psychobehavioral phenomena that figure so centrally in quotidian experience and adaptation, particularly, for humans.

Perception de la gêne environnementale en fonction de différents types d’unités urbaines françaises

This paper follows the analysis of a survey conducted on a broad sample of French urban residents. The aim of this secondary analysis was to identify the different dimensions of the perceived urban annoyances. The objective of this secondary analysies is to compare the perception of urban nuisances by city size and their geographical location within the metropolitan area: downtown Paris/provincial France, inner Paris/Parisian suburbs. Responses from 986 urban residents highlight (1) an effect related to the size of the urban unit since in provincial France, the six larger cities stand out against the others in terms of the greatest intensity of discomfort perceived by the residents; (2) a “capital” effect, since in Paris, in spite of the gigantic scale of the space and the very strong density of population involving hard environmental nuisances, the residents have a positive perception of their city compared to the residents of the other big French cities; (3) a heterogeneity of the responses from the residents of the Parisian suburbs according to their department. The results are discussed on the one hand in the light of the logic of sociospatial segregation of the urban territories, and on the other hand by suggesting that affective-cognitive processes could be mediators between the objective characteristics of the urban nuisances and their subjective perception by the residents.

Differences in Low Back Pain Behavior Are Reflected in the Cerebral Response to Tactile Stimulation of the Lower Back

Two groups of patients with chronic low back pain (cLBP) were scanned with functional magnetic resonance imaging during stimulation of the lower back; those showing 4 or 5 positive Waddell signs (WS-H) and those showing 1 or none (WS-L) as an index of pain-related illness behavior. We hypothesized that patients showing good versus poor adjustment to cLBP mobilize cortical affective-cognitive functions differently in response to sensory stimulation and show increased reorganization of somatosensory cortex corresponding to the back. Some patients with cLBP go on to develop significant disability while the majority do not, and physical disease or psychosocial factors alone do not account for the difference. Neuroimaging studies have suggested abnormalities in cortical pain modulation systems can lead to variable pain and behavioral responses, which may account for these differences. METHODS.: Fifteen WS-L and 13 WS-H patients were scanned with functional magnetic resonance imaging while receiving intense tactile stimulation to the lower back. Questionnaire measures of psychosocial function were also collected. There were no significant differences in cLBP duration or lumbar stimulation tolerance threshold between the 2 groups. Significantly more activation was seen in the WS-L versus WS-H group in regions previously associated with normal affective-cognitive processing of sensory input including posterior cingulate and parietal cortices; the magnitude of this activation negatively correlated with catastrophizing scores. WS-H patients showed a modest medial shift in primary somatosensory cortex activation relative to the WS-L group. Successful adjustment to cLBP is associated with a patient's ability to effectively engage a sensory modulation system. In patients in whom such activation does not occur, subjective lack of control maypredispose to altered affective and behavioral responses with poor adjustment to pain. Pain experience may be furthermodified by reorganization of somatosensory cortex, contributing to maintenance of the chronic pain state.

Prolegomena zu einer Psychopathologie der Verzweiflung

Despair as a phenomenon has not received much attention from psychopathologists, which is difficult to grasp in the clinical context. This paper is an attempt to elaborate upon despair as a key concept and thus open up a new field in psychopathology. The historical approach leads to a twofold view on despair, namely as an affect and as a cognitive structure. The paper therefore follows both the affect theories developed since the onset of the modern era and the cognitive theories on doubt at risk of progressing into despair. Using current approaches of cognitive emotional psychology, despair is defined as an oscillating, affective-cognitive process: the oscillation of doubt is reflected in the alternation of various single affects such as hope, fear, anxiety, anger, shame, guilt, and sadness and then moves towards the negative pole of increasing affect diffusion, loss of object relation, hopelessness, and suicidality. On the basis of this model it is possible to elaborate specific types of despair in individual psychiatric disorders, assessments of the stage of the process, and possible therapeutic strategies.

Effects of induced rumination and distraction on mood and overgeneral autobiographical memory in adolescent Major Depressive Disorder and controls.

In adults there is evidence that the affective-cognitive processes of rumination and overgeneral autobiographical memory retrieval may play a part in maintaining depression. This study investigated the effects of induced rumination as compared to distraction on mood and categoric overgeneral memory in adolescents with first episode Major Depressive Disorder (MDD), and the specificity of any effects to MDD. Three subject groups; adolescents with first episode MDD (N = 75), non-depressed psychiatric participants (N = 26) and community controls (N = 33) were recruited. An experimental design was used, with repeated measures of 'in the moment' depressed mood and categoric overgeneral memory before and after rumination and distraction, induced on separate occasions and counterbalanced in order across participants. In adolescents with MDD, induced rumination as compared to distraction differentially increased depressed mood. There were no significant differences in this effect between full current MDD participants and those in partial remission. This differential effect was also seen in community controls but was absent in non-MDD psychiatric participants. In addition, rumination as compared to distraction increased overgeneral memories to negative cues in MDD participants, but this increase was not significantly related to mood change, and was specific to MDD, being absent in non-MDD psychiatric and community control groups. Experimentally induced rumination as compared to distraction increases depressed mood and negative categoric memories in adolescents with first episode MDD. These results suggest that rumination has a deleterious effect on mood and memory retrieval processes in adolescents with first episode MDD. Increased negative overgeneral memories with rumination may be a process of particular importance for adolescents with MDD rather than psychiatric disorder in general. The findings imply that strategies to interrupt ruminative processes may be helpful in minimising persistence of first episode MDD in adolescence.

Recent undesirable life events: their influence on subsequent psychopathology.

Life events appear to exert a range of effects on subsequent behaviour through their impact on affective-cognitive processes. Their effects on those physiological processes pertinent to psychopathology have yet to be investigated. Single events do not exert much risk for subsequent disorder. It is the pattern of adverse life experiences, of which recent life events is frequently a component, that determines the degree of risk and the mechanisms and processes that may lead to subsequent psychopathology. Recall of events that occurred in the recent past may be influenced independently by the age of the individual and a previous episode of psychiatric disorder. Longitudinal studies determining the impact of life events on subsequent behaviour will need to take these features into account. There remains no specificity between particular types of recent undesirable life events and anxious or depressive disorders. Future longitudinal research should employ modern methods of life event data collection and measurement. The goal of future longitudinal research should be to determine the relative contribution of undesirable and desirable recent life events in the presence and absence of other putative casual factors from different domains. This should necessarily include social (e.g. long-term difficulties), psychological (e.g, temperament (18) or self esteem) and physiological (e.g. hypercortisolaemia in adolescent major depression (14, 11) elements. It is only through this combination of longitudinal design, together with sensitive and concurrent multiple repeat measurements that a greater understanding of the mechanisms and processes that determine psychopathology over the course of development will occur.