Affective Reactivity Research Articles

Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults.

Previous research has shown that autistic individuals report high levels of perceived stress and have an increased likelihood of developing mental health difficulties. Increase in individuals' negative emotions in relation to perceived stress (i.e. affective reactivity to stress) is a known risk factor for mental health difficulties. In this study, we investigated perceived daily stress and affective reactivity to stress in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) adolescents and young adults. We used the ecological momentary assessment, a technique that allows to assess individuals repeatedly in their daily life using their smartphone. Moreover, participants filled a questionnaire to evaluate the strategies they use to regulate emotions when faced with difficulties. Finally, a clinical interview and a parent-report questionnaire were used to assess mental health symptoms. Autistic youth reported higher levels of perceived daily stress compared with non-autistic peers. Moreover, they showed increased affective reactivity to stress related to their daily activities. Autistic participants reported more emotion regulation difficulties (e.g. more repetitive thinking of difficulties) compared with non-autistic participants. Difficulties in emotion regulation increased negative emotions in relation to stress and might contribute to the severity of mental health symptoms. We conclude that adolescents and young adults with autism report high perceived stress in their daily lives. To minimize the negative impact of stress and the development of mental health symptoms, people supporting autistic young people could focus on stress management skills and the strategies that the youth use to manage emotions.

A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat

BackgroundIrritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia.MethodsParticipants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations.ResultsAnxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation.ConclusionsAnxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.

Psychometric Evaluation of the Affective Reactivity Index Among Children and Adolescents in China: A Multi-Method Assessment Approach.

The Affective Reactivity Index (ARI) is one of the most studied scales for assessing youth irritability, but little is known about its measurement performance in community populations. This study applied item response theory (IRT), network analysis, and classical test theory (CTT) to examine the psychometric properties of the ARI in a sample of n = 395 community-based children (Mage = 13.44, SD = 2.51) and n = 403 parents. In this sample, the ARI demonstrated good reliability, as well as convergent and concurrent validity. The one-factor structure was supported by both confirmatory factor analysis (CFA) and network analysis. IRT analysis revealed that the ARI effectively distinguished between various levels of irritability within the community population. Network analysis identified "Loses temper easily,""Gets angry frequently," and "Often loses temper" are central aspects of irritability. The findings support the ARI as a brief, reliable, and valid instrument to assess irritability in community children and adolescents.

Cognitive reactivity as a risk factor for non-suicidal self-injury in young adults

Objectives Non-suicidal self-injury (NSSI) risk in young adults is impacted by both affective and cognitive responses to stress. While previous research shows affective reactivity (AR) increases risk for NSSI, less research has examined the role of cognitive reactivity (CR). The current study examined how individual differences in CR to stress relate to NSSI. Participants The sample included 192 college students (M = 19.84 years, SD = 2.51, 82% women). Methods Participants completed a baseline questionnaire followed by a laboratory visit involving measures before and after stress induction. Results Analyses indicated that individuals who engage in NSSI reported more affective and cognitive reactivity to stress. Additionally, higher levels of affective and cognitive reactivity uniquely predicted NSSI. A combined model yielded mixed results. Higher levels of AR led to lower levels of CR, while higher levels of CR predicted more NSSI. Conclusion In sum, results demonstrated significant but unique effects of affective and cognitive reactivity to stress on NSSI.

Mediating effect of amygdala activity on response to fear vs. happiness in youth with significant levels of irritability and disruptive mood and behavior disorders.

Irritability, characterized by a tendency to exhibit increased anger, is a common clinical problem in youth. Irritability is a significant clinical issue in youth with various psychiatric diagnoses, especially disruptive behavior, and mood disorders (Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Mood Dysregulation Disorder). Although there have been previous studies focusing on functional alteration in the amygdala related to irritability, there is no comprehensive model between emotional, neuronal, and behavioral characteristics. Using an functional magnetic resonance imaging (fMRI) procedure, we investigated the relationships between behavioral irritability, selective impairments in processing facial emotions and the amygdala neural response in youth with increased irritability. Fifty-nine youth with disruptive mood and behavior disorder completed a facial expression processing task with an event-related fMRI paradigm. The severity of irritability was evaluated using the Affective Reactivity Index. In the result of behavioral data, irritability, and reaction time (RT) differences between interpreting negative (fear) and positive (happiness) facial expressions were positively correlated. In the fMRI result, youth showed higher activation in the right cingulate gyrus, bilateral cerebellum, right amygdala, right precuneus, right superior frontal gyrus, right middle occipital gyrus, and middle temporal gyrus, during the happiness condition vs. fear condition. No brain region exhibited greater activation in the fear than in the happiness conditions. In the result of the mediator analysis, increased irritability was associated with a longer RT toward positive vs. negative facial expressions. Irritability was also positively associated with the difference in amygdala blood oxygen level-dependent responses between the two emotional conditions (happiness > fear). This difference in amygdala activity mediated the interaction between irritability and the RT difference between negative and positive facial expressions. We suggest that impairment in the implicit processing of facial emotional expressions with different valences causes distinct patterns of amygdala response, which correlate with the level of irritability. These results broaden our understanding of the biological mechanism of irritability at the neural level and provide information for the future direction of the study.

Affective reactivity to daily stressors and immune cell gene expression in the MIDUS study

Affective reactivity to stress is a person-level measurement of how well an individual copes with daily stressors. A common method of measuring affective reactivity entails the estimation of within-person differences of either positive or negative affect on days with and without stressors present. Individuals more reactive to common stressors, as evidenced by affective reactivity measurements, have been shown to have increased levels of circulating pro-inflammatory markers. While affective reactivity has previously been associated with inflammatory markers, the upstream mechanistic links underlying these associations are unknown. Using data from the Midlife in the United States (MIDUS) Refresher study (N = 195; 52% female; 84% white), we quantified daily stress processes over 10 days and determined individuals’ positive and negative affective reactivities to stressors. We then examined affective reactivity association with peripheral blood mononuclear cell (PBMC) gene expression of the immune-related conserved transcriptional response to adversity. Results indicated that individuals with a greater decrease in positive affect to daily stressors exhibited heightened PBMC JUNB expression after Bonferroni corrections (p-adjusted < 0.05). JUNB encodes a protein that acts as a transcription factor which regulates many aspects of the immune response, including inflammation and cell proliferation. Due to its critical role in the activation of macrophages and maintenance of CD4+ T-cells during inflammation, JUNB may serve as a potential upstream mechanistic target for future studies of the connection between affective reactivity and inflammatory processes. Overall, our findings provide evidence that affective reactivity to stress is associated with levels of immune cell gene expression.

Daily Affective Dynamics in Major Depressive Disorder: The Role of Daily Stressors and Positive Events.

This study examined daily affective dynamic indices among individuals with a major depressive disorder (MDD) diagnosis in the past one year at the time of the interview, focusing on affective variability and change in affect in response to daily events (affective reactivity). Data were from the main survey and daily diary project of the Midlife in the United States (MIDUS) study. Participants (N = 1,970; nMDD = 202; nnon-MDD = 1,768) completed structured clinical interviews on mental health and telephone interviews about their daily experiences spanning eight consecutive days. Multilevel models revealed that the MDD group experienced greater positive (PA) and negative affect (NA) variability than the non-MDD group. On days that at least one stressful event was reported, the MDD group experienced a greater decrease in PA and a greater increase in NA. On days that at least one positive event was reported, the MDD group experienced a greater increase in PA and a greater decrease in NA. Changes in affect to daily events, particularly the mood brightening effect, may be indicators of depression and potential targets for intervention. Limitations of the study include a community sample, reliance on self-reported measures of daily stressors and positive events, inclusion of remitted and current MDD participants, and the DSM-III-R based criteria for MDD diagnosis.

The effect of ketamine on affective modulation of the startle reflex and its resting-state brain correlates

Ketamine is a rapid-acting antidepressant that also influences neural reactivity to affective stimuli. However, the effect of ketamine on behavioral affective reactivity is yet to be elucidated. The affect-modulated startle reflex paradigm (AMSR) allows examining the valence-specific aspects of behavioral affective reactivity. We hypothesized that ketamine alters the modulation of the startle reflex during processing of unpleasant and pleasant stimuli and weakens the resting-state functional connectivity (rsFC) within the modulatory pathway, namely between the centromedial nucleus of the amygdala and nucleus reticularis pontis caudalis. In a randomized, double-blind, placebo-controlled, cross-over study, thirty-two healthy male participants underwent ultra-high field resting-state functional magnetic resonance imaging at 7 T before and 24 h after placebo and S-ketamine infusions. Participants completed the AMSR task at baseline and one day after each infusion. In contrast to our hypothesis, ketamine infusion did not impact startle potentiation during processing of unpleasant stimuli but resulted in diminished startle attenuation during processing of pleasant stimuli. This diminishment significantly correlated with end-of-infusion plasma levels of ketamine and norketamine. Furthermore, ketamine induced a decrease in rsFC within the modulatory startle reflex pathway. The results of this first study on the effect of ketamine on the AMSR suggest that ketamine might attenuate the motivational significance of pleasant stimuli in healthy participants one day after infusion.

A look through dark-colored glasses: The Dark Tetrad and affective processing.

The Dark Tetrad personality traits (i.e., narcissism, Machiavellianism, psychopathy, and sadism) have been continuously linked to various deficits in affective reactivity. The aim of this study was to examine the relationship of the Dark Tetrad and processing of emotional pictures. A total of 144 participants (56.9% female, Mage = 22.18, SDage = 2.26) completed measures of the Dark Tetrad, and rated pictures selected form the International Affective Picture System (IAPS), classified in accordance with their norms into highly arousing positive and negative. Affective processing measures included participants' valence and arousal ratings, while cognitive processing was measured my means of the response latency for each response. The results showed that the dark traits were related only to valence, but not arousal ratings. Higher narcissism and lower sadism were associated with more positive valence ratings of positive pictures, and higher sadism was associated with more positive ratings of negative pictures. Moreover, higher Machiavellianism predicted faster assessment of valence and arousal of both positive and negative pictures, and higher sadism predicted slower assessment of negative pictures' valence. Obtained results indicate that deficiencies in affective processing are more pronounced in sadism compared to other dark traits, while Machiavellianism is associated with advantages in cognitive processing, highlighting their significance and uniqueness in the Dark Tetrad constellation.

Autistic Symptoms, Irritability, and Executive Dysfunctions: Symptom Dynamics from Multi-Network Models.

Socio-cognitive difficulties in individuals with autism spectrum disorder (ASD) are heterogenuous and often co-occur with irritability symptoms, such as angry/grouchy mood and temper outbursts. However, the specific relations between individual symptoms are not well-represented in conventional methods analyzing aggregated autistic symptoms and ASD diagnosis. Moreover, the cognitive-behavioral mechanisms linking ASD to irritability are largely unknown. This study investigated the dynamics between autistic (Social Responsiveness Scale) and irritability (Affective Reactivity Index) symptoms and executive functions (Cambridge Neuropsychological Test Automated Battery) in a sample of children and adolescents with ASD, their unaffected siblings, and neurotypical peers (N = 345, aged 6-18years, 78.6% male). Three complementary networks across the entire sample were computed: (1) Gaussian graphical network estimating the conditional correlations between symptom nodes; (2) Relative importance network computing relative influence between symptoms; (3) Bayesian directed acyclic graph estimating predictive directionality between symptoms. Networks revealed numerous partial correlations within autistic (rs = .07-.56) and irritability (rs = .01-.45) symptoms and executive functions (rs = -.83 to .67) but weak connections between clusters. This segregated pattern converged in all directed and supplementary networks. Plausible predictive paths were found between social communication difficulties to autism mannerisms and between "angry frequently" to "lose temper easily." Autistic and irritability symptoms are two relatively independent families of symptoms. It is unlikely that executive dysfunctions explain elevated irritability in ASD. Findings underscore the need for researching other mood and cognitive-behavioral bridge symptoms, which may inform individualized treatments for co-occurring irritability in ASD.

Global stress and daily general and type 1 diabetes stressors and links to daily affect and diabetes outcomes during emerging adulthood.

We examined how global stress and general stressors of daily life relate to emotional well-being and type 1 diabetes (T1D) outcomes and amplify the effects of diabetes stressors in emerging adults. Two-hundred and seven 18-19-year-olds with T1D (duration 8.47 years) completed the Perceived Stress Scale (global stress) and a daily diary assessing daily diabetes and general stressors, positive and negative affect, self-care behaviors, and blood glucose (BG). Multi-level analyses indicated that global stress and within-person daily general and diabetes stressors were associated with more negative and less positive affect. In addition, general stress (between-person) was associated with more negative affect. Global stress amplified the association between daily diabetes stressors and negative affect, with greater affect reactivity to stress for those experiencing higher global stress. Global stress and both within- and between-person diabetes stressors were associated with lower self-care and higher BG. Emerging adults' general stressors in their daily lives relate to poorer well-being beyond the experience of diabetes stressors.

Age and Sex Differences in the Associations Among Socioeconomic Status, Affective Reactivity to Daily Stressors, and Physical Health in the MIDUS Study.

Low socioeconomic status (SES) is robustly associated with increased risks of morbidity and mortality. Affective reactivity to daily stressors has been proposed to be a mediator for this association. However, few longitudinal studies have empirically tested the indirect effect of SES on health through affective reactivity to daily stressors. This study aimed to test the indirect effect of SES on physical health via affective reactivity to daily stressors over a 10-year period and to explore age and sex differences in such indirect effect. Data were drawn from a subsample of 1,522 middle-aged and older adults (34-83 years of age, 57.2% female, 83.5% White) from the Midlife in the United States study. SES (i.e., education, household income, indicators of financial distress) was assessed in 2004-2006. Affective reactivity to daily stressors was computed using data collected during the 8-day daily stress assessment in 2004-2009. Self-reported physical health conditions were assessed in 2004-2006 and 2013-2014. There was a significant indirect effect of lower SES on more physical health conditions via elevated negative affective reactivity to daily stressors among women but not men. The indirect effect of SES on physical health conditions via negative affective reactivity to daily stressors was consistent across the middle and older adulthood. Our findings suggest that negative affective reactivity to daily stressors might be a key intermediate process contributing to persistent SES disparities in physical health, particularly among women.

What Is Rejection? Lexical, Experimental, and Analytical Specificity Is Needed to Drive Developmental Psychopathology Research Forward

There is increasing urgency in the quest to identify prospective risk factors for nonsuicidal self-injury (NSSI), driven by a growing teen mental health crisis. NSSI, which involves deliberately harming one’s physical body without suicidal intent, increases rapidly in early to middle adolescence and is a risk factor for suicidality and other mental illness ( 1 Nock M.K. Joiner Jr., T.E. Gordon K.H. Lloyd-Richardson E. Prinstein M.J. Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006; 144: 65-72 Crossref PubMed Scopus (1014) Google Scholar ). Accumulating research highlights social (e.g., rejection, poor relationships, low support) and affective (e.g., reactivity, lability, dysregulation) risk mechanisms, among others ( 2 Cipriano A. Cella S. Cotrufo P. Nonsuicidal self-injury: A systematic review. Front Psychol. 2017; 8: 1946 Crossref PubMed Scopus (224) Google Scholar ). However, social and affective risk mechanisms can be linked and may interact to confer risk for NSSI as well as mental illness more broadly ( 3 Hsu D.T. Jarcho J.M. Next up for psychiatry: Rejection sensitivity and the social brain. Neuropsychopharmacology. 2021; 46: 239-240 Crossref Scopus (8) Google Scholar ). This is particularly relevant in adolescence, a time of rapid brain development and increases in both mental health struggles and reliance on peer affiliation ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (19) Google Scholar ). Despite the recognition that social difficulties are a common correlate of mental illness, few studies integrate robust measures of real-world peer experience within a neuroscience framework to prospectively predict the emergence of adolescent mental health struggles. Understanding whether neural diatheses confer increased vulnerability to specific stressful peer experiences in adolescence is a critical open question—interventions designed to target neural diatheses or to promote specific types of peer experiences may be critical for prevention efforts in the future ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (19) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 40 SEE CORRESPONDING ARTICLE ON PAGE 40 Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected AdolescentsBiological PsychiatryVol. 94Issue 1PreviewRates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Full-Text PDF

Categorical and dimensional approaches to the developmental relationship between ADHD and irritability.

Attention deficit hyperactivity disorder (ADHD) and irritability commonly co-occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co-occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability. A community sample of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow-up after 18-months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity-impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability. Irritability was significantly higher among the ADHD group than controls; however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive-impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability; however, baseline irritability did not significantly predict change in ADHD symptoms. ADHD symptoms-particularly hyperactive-impulsive symptoms-predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain-specific measures provides additional insight into this relationship.

Increased affective reactivity among depressed individuals can be explained by floor effects: An experience sampling study

Experience sampling studies into daily-life affective reactivity indicate that depressed individuals react more strongly to both positive and negative stimuli than non-depressed individuals, particularly on negative affect (NA). Given the different mean levels of both positive affect (PA) and NA between patients and controls, such findings may be influenced by floor/ceiling effects, leading to violations of the normality and homoscedasticity assumptions underlying the used statistical models. Affect distributions in prior studies suggest that this may have particularly influenced NA-reactivity findings. Here, we investigated the influence of floor/ceiling effects on the observed PA- and NA-reactivity to both positive and negative events. Data came from 346 depressed, non-depressed, and remitted participants from the Netherlands Study of Depression and Anxiety (NESDA). In PA-reactivity analyses, no floor/ceiling effects and assumption violations were observed, and PA-reactivity to positive events, but not negative events, was significantly increased in the depressed and remitted groups versus the non-depressed group. However, NA-scores exhibited a floor effect in the non-depressed group and naively estimated models violated model assumptions. When these violations were accounted for in subsequent analyses, group differences in NA-reactivity that had been present in the naive models were no longer observed. In conclusion, we found increased PA-reactivity to positive events but no evidence of increased NA-reactivity in depressed individuals when accounting for violations of assumptions. The results indicate that affective-reactivity results are very sensitive to modeling choices and that previously observed increased NA-reactivity in depressed individuals may (partially) reflect unaddressed assumption violations resulting from floor effects in NA.

A daily diary study of minority stressors, suicidal ideation, nonsuicidal self-injury ideation, and affective mechanisms among sexual and gender minority youth.

Sexual and gender minority youth (SGMY) are at greater risk than their heterosexual and cisgender counterparts for suicidal thoughts and behaviors (STB) and nonsuicidal self-injury (NSSI). Unique stressors (i.e., minority stressors) specific to SGMY's stigmatized identities such as discrimination or concealment of one's identity are posited to explain these disparities. However, there is limited research examining the associations among minority stressors, affective mediating processes, and STB and NSSI in SGMY's daily lives. We conducted a 28-day daily diary study to test the mediating effects of daily negative and positive affect and emotion dysregulation between minority stressors and STB and NSSI among SGMY who were recruited from clinical and community settings. Participants were 92 SGMY, aged 12-19 years old (M = 16.45; SD = 1.81; 64% cisgender; 69% White). Results indicated that on days SGMY experienced external and internalized minority stressors, they reported greater intensity of suicidal and nonsuicidal self-injurious ideation and affective distress (i.e., greater negative affect, lower positive affect, and more emotion dysregulation). Greater affective reactivity processes were associated with greater suicidal and nonsuicidal self-injurious ideation intensity on the same day. Most of the within-person associations between external and internalized minority stressors and ideation intensity were mediated by heightened negative affect and emotion dysregulation but not lower positive affect. Our results provide the first evidence of these associations among SGMY, advance the minority stress model, and have implications for clinical interventions as we identified modifiable affective mechanisms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Resilience to substance use disorder following childhood maltreatment: association with peripheral biomarkers of endocannabinoid function and neural indices of emotion regulation

Childhood maltreatment (CM) is a risk factor for substance use disorders (SUD) in adulthood. Understanding the mechanisms by which people are susceptible or resilient to developing SUD after exposure to CM is important for improving intervention. This case-control study investigated the impact of prospectively assessed CM on biomarkers of endocannabinoid function and emotion regulation in relation to the susceptibility or resilience to developing SUD. Four groups were defined across the dimensions of CM and lifetime SUD (N = 101 in total). After screening, participants completed two experimental sessions on separate days, aimed at assessing the behavioral, physiological, and neural mechanisms involved in emotion regulation. In the first session, participants engaged in tasks assessing biochemical (i.e., cortisol, endocannabinoids), behavioral, and psychophysiological indices of stress and affective reactivity. During the second session, the behavioral and brain mechanisms associated with emotion regulation and negative affect were investigated using magnetic resonance imaging. CM-exposed adults who did not develop SUD, operationally defined as resilient to developing SUD, had higher peripheral levels of the endocannabinoid anandamide at baseline and during stress exposure, compared to controls. Similarly, this group had increased activity in salience and emotion regulation regions in task-based measures of emotion regulation compared to controls, and CM-exposed adults with lifetime SUD. At rest, the resilient group also showed significantly greater negative connectivity between ventromedial prefrontal cortex and anterior insula compared to controls and CM-exposed adults with lifetime SUD. Collectively, these peripheral and central findings point to mechanisms of potential resilience to developing SUD after documented CM exposure.

227. Does Lifetime Stressor Exposure Predict Greater Affective Reactivity to the Menstrual Cycle? Longitudinal Evidence in a Large Transdiagnostic Sample of Patients with Affective Disorders

227. Does Lifetime Stressor Exposure Predict Greater Affective Reactivity to the Menstrual Cycle? Longitudinal Evidence in a Large Transdiagnostic Sample of Patients with Affective Disorders

47. Affective Reactivity to Reward as a Transdiagnostic Marker of the Severity of Internalizing Psychopathology

47. Affective Reactivity to Reward as a Transdiagnostic Marker of the Severity of Internalizing Psychopathology

Role of individualised homoeopathic medicine in the management of disruptive mood dysregulation disorder - A case report

Disruptive Mood Dysregulation Disorder (DMDD) is a common behavioural dysfunction. The primary features of DMDD are chronic, non-episodic, persistent irritability and temper tantrums disproportionate with the trigger. We present a case of DMDD that was managed with homoeopathic medication and auxiliary measures. A 17-year-old male patient presented to the Psychiatry Outpatient Department of National Homoeopathy Research Institute in Mental Health with symptoms of anger outbursts, abusiveness, persistent irritable mood and laziness. The consultant psychiatrist diagnosed him with DMDD. He was treated with individualised homoeopathic medicine. The outcome was assessed at baseline and further using the Irritability — Parent/Guardian of child age 6–17 affective reactivity index (ARI). The patient’s ARI score reduced drastically within 2 months. His anger, abusiveness, propensity to hurt and irritability also reduced markedly. Behavioural aspects and social interactions showed good outcomes.Individualised homoeopathic medicine is useful in managing of DMDD by improving the susceptibility and modifying the patient’s state of reactivity.