Emotion Regulation In Patients Research Articles

Neural mechanism of non-adaptive cognitive emotion regulation in patients with non-suicidal self-injury

BackgroundThe incidence of non-suicidal self-injury (NSSI) has been on the rise in recent years. Studies have shown that people with NSSI have difficulties in emotion regulation and cognitive control. In addition, some studies have investigated the cognitive emotion regulation of people with NSSI which found that they have difficulties in cognitive emotion regulation, but there was a lack of research on cognitive emotion regulation strategies and related neural mechanisms. MethodsThis study included 117 people with NSSI (age = 19.47 ± 5.13, male = 17) and 84 non-NSSI participants (age = 19.86 ± 4.14, male = 16). People with NSSI met the DSM-5 diagnostic criteria, and non-NSSI participants had no mental or physical disorders. The study collected all participants' data of Cognitive Emotion Regulation Questionnaire (CERQ) and functional magnetic resonance imaging (fMRI) to explore the differences in psychological performance and brain between two groups. Afterwards, Machine learning was used to select the found differential brain regions to obtain the highest correlation regions with NSSI. Then, Allen's Human Brain Atlas database was used to compare with the information on the abnormal brain regions of people with NSSI to find the genetic information related to NSSI. In addition, gene enrichment analysis was carried out to find the related pathways and specific cells that may have differences. ResultsThe differences between NSSI participants and non-NSSI participants were as follows: positive refocusing (t = −4.74, p < 0.01); refocusing on plans (t = −4.11, p < 0.01); positive reappraisal (t = −9.22, p < 0.01); self-blame (t = 6.30, p < 0.01); rumination (t = 3.64, p < 0.01); catastrophizing (t = 9.10, p < 0.01), and blaming others (t = 2.52, p < 0.01), the precentral gyrus (t = 6.04, pFDR < 0.05) and the rolandic operculum (t = −4.57, pFDR < 0.05). Rolandic operculum activity was negatively correlated with blaming others (r = −0.20, p < 0.05). Epigenetic results showed that excitatory neurons (p < 0.01) and inhibitory neurons (p < 0.01) were significant differences in two pathways, “trans-synaptic signaling” (p < −log108) and “modulation of chemical synaptic transmission” (p < −log108) in both cells. ConclusionsPeople with NSSI are more inclined to adopt non-adaptive cognitive emotion regulation strategies. Rolandic operculum is also abnormally active. Abnormal changes in the rolandic operculum of them are associated with non-adaptive cognitive emotion regulation strategies. Changes in the excitatory and inhibitory neurons provide hints to explore the abnormalities of the neurological mechanisms at the cellular level of them.Trial registration number NCT04094623

Training in Cognitive Reappraisal Normalizes Whole-Brain Indices of Emotion Regulation in Borderline Personality Disorder

BackgroundBorderline personality disorder (BPD) is the prototypical disorder of emotion dysregulation. We have previously shown that patients with BPD are impaired in their capacity to engage cognitive reappraisal, a frequently employed adaptive emotion regulation strategy. MethodsHere, we report on the efficacy of longitudinal training in cognitive reappraisal to enhance emotion regulation in patients with BPD. Specifically, the training targeted psychological distancing, a reappraisal tactic whereby negative stimuli are viewed dispassionately as though experienced by an objective, impartial observer. At each of 5 sessions over 2 weeks, 22 participants with BPD (14 female) and 22 healthy control participants (13 female) received training in psychological distancing and then completed a widely used picture-based reappraisal task. Self-reported negative affect ratings and functional magnetic resonance imaging data were acquired at the first and fifth sessions. In addition to behavioral analyses, we performed whole-brain pattern expression analyses using independently defined patterns for negative affect and cognitive reappraisal implementation for each session. ResultsPatients with BPD showed a decrease in negative affect pattern expression following reappraisal training, reflecting a normalization in neural activity. However, they did not show significant change in behavioral self-reports. ConclusionsTo our knowledge, this study represents the first longitudinal functional magnetic resonance imaging examination of task-based cognitive reappraisal training. Using a brief, proof-of-concept design, the results suggest a potential role for reappraisal training in the treatment of patients with BPD.

An investigation into the abnormal dynamic connection mechanism of generalized anxiety disorders based on non-homogeneous Markov models

BackgroundThe dynamic and hierarchical nature of the functional brain network. The neural dynamical systems tend to converge to multiple attractors (stable fixed points or dynamical states) in long run. Little is known about how the changes in this brain dynamic “long-term” behavior of the connectivity flow of brain network in generalized anxiety disorder (GAD). MethodsThis study recruited 92 patients with GAD and 77 healthy controls (HC). We applied a reachable probability approach combining a Non-homogeneous Markov model with transition probability to quantify all possible connectivity flows and the hierarchical structure of brain functional systems at the dynamic level and the stationary probability vector (10-step transition probabilities) to describe the steady state of the system in the long run. A random forest algorithm was conducted to predict the severity of anxiety. ResultsThe dynamic functional patterns in distributed brain networks had larger possibility to converge in bilateral thalamus, posterior cingulate cortex (PCC), right superior occipital gyrus (SOG) and smaller possibility to converge in bilateral superior temporal gyrus (STG) and right parahippocampal gyrus (PHG) in patients with GAD compared to HC. The abnormal transition probability pattern could predict anxiety severity in patients with GAD. LimitationsSmall samples and subjects taking medications may have influenced our results. Future studies are expected to rule out the potential confounding effects. ConclusionOur results have revealed abnormal dynamic neural communication and integration in emotion regulation in patients with GAD, which give new insights to understand the dynamics of brain function of patients with GAD.

The Emotion Regulation of Acupuncture in Chronic Low Back Pain: A Clinical Neuroimaging Protocol.

Acupuncture is effective for patients with chronic low back pain (CLBP), which can relieve pain intensity and regulate negative emotional states such as pain-related anxiety and depression. Previous studies mainly discuss the analgesic mechanism of acupuncture treatment of CLBP, but there are multiple dimensions to pain, including sensation, emotion and cognition. Therefore, this study aims to investigate the central mechanism of acupuncture for CLBP from the perspective of emotional regulation by functional magnetic resonance imaging (fMRI). A total of 72 patients with CLBP will be recruited in the study and randomly assigned to the verum acupuncture group or the sham acupuncture group. The trail will last for 18 weeks including a 2-week baseline, a 4-week treatment and a 12-week for follow-up period. The primary outcomes are the visual analog scale (VAS) and the Japanese Orthopaedic Association Scores (JOA) score. The secondary outcomes are the 12-item short form health survey (SF-12), the state trait anxiety inventory (STAI), the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The VAS, JOA, STAI SAS and SDS will be collected at baseline, week 2, week 4, and after follow-up. The SF-12 will be evaluated at baseline, week 2 and week 4. Functional magnetic resonance imaging (MRI) data will be collected at baseline and the end of treatment. Emotion-related brain regions will be chosen as regions of interest (ROIs). The gray matter volume (GMV), amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), functional connectivity (FC), and large-scale functional brain network based on these ROIs will be analyzed within and between the two groups. This study will verify the emotional regulation of acupuncture and explore the mechanism of acupuncture for emotion regulation in patients with CLBP. https://www.chictr.org.cn/showproj.html?proj=195486, identifier: ChiCTR2300070557.

Impaired implicit emotion regulation in patients with panic disorder: An event-related potential study on affect labeling.

Panic disorder (PD) involves emotion dysregulation, but its underlying mechanisms remain poorly understood. Previous research suggests that implicit emotion regulation may play a central role in PD-related emotion dysregulation and symptom maintenance. However, there is a lack of studies exploring the neural mechanisms of implicit emotion regulation in PD using neurophysiological indicators. To study the neural mechanisms of implicit emotion regulation in PD with event-related potentials (ERP). A total of 25 PD patients and 20 healthy controls (HC) underwent clinical eva-luations. The study utilized a case-control design with random sampling, selecting participants for the case group from March to December 2018. Participants performed an affect labeling task, using affect labeling as the experimental condition and gender labeling as the control condition. ERP and behavioral data were recorded to compare the late positive potential (LPP) within and between the groups. Both PD and HC groups showed longer reaction times and decreased accuracy under the affect labeling. In the HC group, late LPP amplitudes exhibited a dynamic pattern of initial increase followed by decrease. Importantly, a significant group × condition interaction effect was observed. Simple effect analysis revealed a reduction in the differences of late LPP amplitudes between the affect labeling and gender labeling conditions in the PD group compared to the HC group. Furthermore, among PD patients under the affect labeling, the late LPP was negatively correlated with disease severity, symptom frequency, and intensity. PD patients demonstrate abnormalities in implicit emotion regulation, hampering their ability to mobilize cognitive resources for downregulating negative emotions. The late LPP amplitude in response to affect labeling may serve as a potentially valuable clinical indicator of PD severity.

The efficacy of integrated transdiagnostic treatment in reducing worry, anxiety, depressive and emotional regulation in patients with generalized anxiety disorder

Introduction: Generalized anxiety disorder (GAD) is a prevalent mental health condition, characterized by an individual’s excessive and persistent worry about various social situations. It is a common problem which can induce numerous physical and mental alterations in the person affected. Aim: The current study aimed to evaluate the efficacy of an integrated transdiagnostic treatment approach in alleviating symptoms of worry, anxiety, and depression and improving emotional regulation in patients diagnosed with GAD. Method: In this semi-experimental study, a pretest-posttest, control group design with a follow-up was employed. The research population consisted of all clients aged 18-51 years with GAD in Sanandaj, Iran, during 2018. The research sample comprised 20 patients diagnosed with GAD based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These diagnoses were confirmed through structured interviews conducted by a psychiatrist and a clinical psychologist. The samples were selected via convenience sampling and randomly allocated into experimental and control groups. The research utilized several assessment tools, including the Beck Depression Inventory (1961), the Beck Anxiety Inventory (1988), the Pennsylvania Anxiety Inventory (1990), and the Emotional Regulation Inventory (2008). The collected data were analyzed using the analysis of covariance test in SPSS Version 24 software. Results: According to the results, the integrated transdiagnostic treatment had an impact on reducing anxiety and depression. However, it was not effective in alleviating anxiety and improving emotional regulation in patients with GAD (P≤0.001). Conclusion: The integrated transdiagnostic treatment method utilized in this study proved to be effective in alleviating worry and depression in patients diagnosed with GAD. Consequently, it is recommended for use in the therapeutic management of worry and depression symptoms in individuals suffering from GAD.

High-frequency rTMS over bilateral primary motor cortex improves freezing of gait and emotion regulation in patients with Parkinson's disease: a randomized controlled trial.

Freezing of gait (FOG) is a common and disabling phenomenon in patients with Parkinson's disease (PD), but effective treatment approach remains inconclusive. Dysfunctional emotional factors play a key role in FOG. Since primary motor cortex (M1) connects with prefrontal areas via the frontal longitudinal system, where are responsible for emotional regulation, we hypothesized M1 may be a potential neuromodulation target for FOG therapy. The purpose of this study is to explore whether high-frequency rTMS over bilateral M1 could relieve FOG and emotional dysregulation in patients with PD. This study is a single-center, randomized double-blind clinical trial. Forty-eight patients with PD and FOG from the Affiliated Hospital of Xuzhou Medical University were randomly assigned to receive 10 sessions of either active (N = 24) or sham (N = 24) 10 Hz rTMS over the bilateral M1. Patients were evaluated at baseline (T0), after the last session of treatment (T1) and 30 days after the last session (T2). The primary outcomes were Freezing of Gait Questionnaire (FOGQ) scores, with Timed Up and Go Test (TUG) time, Standing-Start 180° Turn (SS-180) time, SS-180 steps, United Parkinson Disease Rating Scales (UPDRS) III, Hamilton Depression scale (HAMD)-24 and Hamilton Anxiety scale (HAMA)-14 as secondary outcomes. Two patients in each group dropped out at T2 and no serious adverse events were reported by any subject. Two-way repeated ANOVAs revealed significant group × time interactions in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14. Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14 at T1 and T2. No significant improvement was found in the sham group. The Spearman correlation analysis revealed a significantly positive association between the changes in HAMD-24 and HAMA-14 scores and FOGQ scores at T1. High-frequency rTMS over bilateral M1 can improve FOG and reduce depression and anxiety in patients with PD.

Comparison of the Effectiveness of Cognitive Behavioral Therapy and Schema Therapy on Cognitive Emotion Regulation in Patients with Major Depressive Disorder

Objective: The aim of this study was to compare the efficacy of cognitive behavioral therapy and schema therapy on cognitive emotion regulation in patients with major depressive disorder. Methods and Materials: The research employed a quasi-experimental pre-test-post-test design with a control group and a one-month follow-up. The study population included all patients visiting Entekhab-e No and Aryaz clinics in Tehran during the period from February 2021 to May 2021, who were diagnosed with major depressive disorder by a psychiatrist. Forty-five individuals were purposively selected and randomly assigned to two experimental groups and one control group (15 per group). The first and second experimental groups underwent 12 and 8 sessions of cognitive behavioral therapy based on the Rosello protocol (2015) and schema therapy based on Young's protocol (2003), respectively. The research instrument was the Cognitive Emotion Regulation Questionnaire (CERQ) (Garnefski &amp; Kraaij, 2006). Data were analyzed using repeated measures ANOVA, Bonferroni test, and SPSS version 24. Findings: Results showed that both cognitive behavioral and schema therapy interventions significantly improved scores of adaptive emotion regulation and decreased scores of maladaptive emotion regulation compared to the control group (P&lt;0.001), with these effects maintained up to the one-month follow-up period. Additionally, there was a difference in the efficacy of the two intervention methods in increasing adaptive emotion regulation scores and decreasing maladaptive emotion regulation scores (P&lt;0.001), with cognitive behavioral therapy being more effective than schema therapy. Conclusion: Thus, utilizing cognitive behavioral therapy and schema therapy can take an important step in reducing the negative outcomes of emotion regulation deficits in depressed patients.

The Effectiveness of Mindfulness-Based Therapy on Reducing Stress and Improving Emotion Regulation in Patients with Post-Traumatic Stress Disorder (PTSD)

Objective: Post-Traumatic Stress Disorder (PTSD) is a significant challenge in the field of mental health, requiring effective and sustainable interventions. Methods and Materials: This study aimed to examine the effectiveness of mindfulness-based therapy in reducing stress and improving emotion regulation in clients with PTSD. The statistical population included clients with PTSD who visited counseling and psychological services centers in Rasht in 2024. From this population, 30 individuals were selected through convenience sampling and divided into experimental and control groups (15 people in each group). The instruments used included the PTSD Checklist (PCL-5), the Perceived Stress Scale (PSS), and the Emotion Regulation Questionnaire (ERQ). Data analysis was performed using SPSS version 26 and statistical methods such as independent t-test, multivariate analysis of variance (MANOVA), and Pearson correlation analysis. Findings: The results indicated that mindfulness-based therapy significantly reduced stress and improved emotion regulation in clients with PTSD. Conclusion: These findings were consistent with previous studies and demonstrated that mindfulness-based therapy could be used as an effective and sustainable method for managing PTSD symptoms. However, limitations such as a limited statistical population, relatively small sample size, and the use of self-report questionnaires should be considered in future research. Suggestions for future research include conducting studies with larger samples and longer follow-up periods, combining mindfulness-based therapy with other therapeutic methods, and using more objective assessment tools.

Comparison of the Effectiveness of Mindfulness-Based Stress Reduction and Compassion-Focused Therapy on the Cognitive Emotion Regulation in Patients with Irritable Bowel Syndrome.

Background: We aimed to compare the effectiveness of mindfulness-based stress reduction and compassion-focused on the cognitive regulation of emotion in patients with irritable bowel syndrome (IBS). The research method was the semi-experimental type, with pre-test, post-test, follow-up, and experimental and control groups. Methods: The population included patients with IBS in Isfahan city; 45 of them were selected by convenience sampling method and randomly assigned to 3 groups (15 in each group). Then, the patients of one experimental group received eight sessions of 90 minutes of a mindfulness-based stress reduction program, while the other experimental group received eight sessions of 90 minutes of compassion-focused therapy. The measurement tools included the Cognitive Emotion Regulation Questionnaire (Garnefski and Kraaij, 2002) and a short clinical interview. Research data were analyzed using variance analysis with repeated measures on one factor (mixed design). Results: Both intervention methods were equally effective in changing the cognitive regulation of adaptive emotion mean scores (P<0.01), but the effect of compassion-focused therapy on improving the mean scores of cognitive regulation of adaptive emotion was more than mindfulness-based stress reduction therapy (P<0.05). Conclusion: It was concluded that both intervention methods can be used as complementary treatment for patients with IBS.

Research on the Characteristics of Emotion Regulation in Obsessive-Compulsive Disorder

The purpose of this research is the characteristics of emotion regulation in patients with obsessive-compulsive disorder, in order to bring more implications to the OCD treatment. This research uses the interviews to explore the characteristics of emotion regulation in patients with OCD. The researchers conducted interviews of OCD patients, and applied the qualitative research paradigm to analyze the emotion regulation characteristics of OCD patients. Individuals with OCD can improve their ability to cope with OCD by improving their ability to regulate their emotions. The therapist can increase coping with OCD by strengthening the ability to regulate emotions.

Effects of Emotional Schema Therapy and Dialectical Behavior Therapy on Cognitive Emotion Regulation in Patients with Bipolar II Disorder

Background: Patients with bipolar disorder suffer from different problems, including emotional disorders, e.g., the loss of emotional self-regulation. Objectives: This study aimed to investigate the effects of emotional schema therapy and dialectical behavior therapy on emotional self-regulation in patients with bipolar II disorder (BP-II). Methods: This was an experimental study with a pretest-posttest design and a control group. The research population comprised patients with BP-II who visited the counseling and psychology centers of Dezful (Iran) in 2022. A sample of 45 eligible patients was purposively selected and randomly allocated to three groups. Each of the two experimental groups received twelve 90-minute sessions of emotional schema therapy and eleven 90-minute sessions of dialectical behavior therapy, while the control group was on the waiting list. The data were collected using the Cognitive Emotion Regulation Questionnaire (CERQ) and analyzed using the analysis of covariance with the Bonferroni post-hoc test in SPSS v. 26. Results: In the emotional schema therapy group, the mean ± standard deviation (SD) of the post-test scores of adaptive and maladaptive emotional self-regulation were 20.60 ± 2.99 and 12.66 ± 2.22, respectively. Moreover, in the dialectical behavior therapy group, the mean ± SD of the post-test scores of adaptive and maladaptive emotional self-regulation were 21.60 ± 3.33 and 14.13 ± 2.35, respectively. Both interventions significantly reduced maladaptive emotional self-regulation and significantly increased adaptive emotional self-regulation in the patients with BP-II, compared to the control group (P &lt; 0.001). Conclusions: Emotional schema therapy and dialectical behavior therapy improved emotional self-regulation in patients with BP-II. Therapists and healthcare professionals can thus administer both methods and other effective methods to improve health-related traits, especially self-regulation, in patients with BP-II.

Mind–body and art therapies impact on emotional regulation in patients with chronic diseases: a pragmatic mixed-methods randomized controlled trial

BackgroundEffective emotional regulation is recognized as essential to a good mental health of people with chronic diseases, and Mind–body and Art Therapies (MBATs) could have a positive effect on emotional regulation skills in this population. Thus, we aimed to evaluate the effect of MBATs on emotional regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) questionnaire.MethodsA convergent mixed approach nested in a pragmatic superiority two arms parallel randomized controlled trial was conducted. French speaking adults with one or more chronic somatic illnesses and not suffering from a chronic psychiatric disorder unrelated to one of their chronic somatic illness were included. At inclusion, non-directive interviews were conducted, followed by an initial DERS assessment. The same combination of evaluation was implemented after 6 months of activity (T1). After inclusion, each participant was randomized within either the intervention group (G1) or the control group (G2) following a controlled wait-list design by use of a pregenerated randomization list. Staff and patient were blinded to this list until the initial evaluation was completed, after which the trial was conducted in an open-label fashion. Participants chose 2 mediations: one creativity-focused (art-therapy, writing workshop, theatre of life, vocal workshop) and one mind–body-focused (mindfulness meditation, Pilates, shiatsu, ayurvedic massages). G1 started their mediations immediately after inclusion, while G2 started 6 months later. Primary outcome was the change in means at 6 months in the overall DERS score compared between each group. Non-directive interviews were carried out at the inclusion and after 6 months of MBATs. A continuous inductive analysis was carried out on gathered material in G1 to explore the participants' experiences regarding their disease and their perceived changes associated to the intervention.ResultsA total of 150 patients was randomized (75 per groups) at the end of the study. At T1, 133 patients filled out the final questionnaire (67 in G1 vs 66 in G2) and 112 interviews were analysed (54 in G1 vs 58 in G2). All 150 patients were analysed (intention to treat) using a multiple imputation approach. The mean DERS score at T0 was equal to 82.8 ± 21.1 and 85.0 ± 20.2 in G1 and G2 respectively. On average, at T1, the score decreased in the G1 (Δ = -4.8, SD = 21.3) and in G2 (Δ = -0.11, SD = 17.8). The difference in decrease, however, was not statistically significant (p = 0.13). Qualitative analysis underlined some MBATs benefits on emotional regulation, especially on regulation strategies. No harms related to the intervention has been observed.ConclusionsThis study only partially supports benefits on MBAT on emotional regulation skills enhancement in patients with chronic disease receiving MBATs, as measured by the DERS scale.Trial registrationThe protocol was registered on Clinical Trials (NCT02911207).

The Effect of Continuous Theta Burst Stimulation over the Right Dorsolateral Prefrontal Cortex on Cognitive Function and Emotional Regulation in Patients with Cerebral Small Vessel Disease.

Cognitive impairment in cerebral small vessel disease (CSVD) is a common cause of vascular dementia and is often accompanied by mental disorders. The purpose of this study was to investigate the effect of continuous theta burst stimulation (cTBS) over the right dorsolateral prefrontal cortex (DLPFC) on the cognitive function and Hamilton depression (HAMD) scores in patients with CSVD. A total of 30 CSVD patients who met the inclusion criteria were randomly assigned to either the sham or cTBS group. The patients in both groups received routine cognitive function training. All the patients were under treatment for 14 sessions, with one session per day (each cTBS conditioning session consisted of three-pulse bursts at 50 Hz repeated at 5 Hz, 80% MT, and 600 pulses). Before and after the treatment, the patients in both groups were evaluated using the Montreal Cognitive Assessment (MoCA), Stroop Color-Word Test (SCWT), Trail Marking Test (TMT), Digital Span Test (DST), and HAMD test. The time to complete the SCWT and TMT were recorded. The scores of the MoCA, DST and HAMD test were recorded. The HAMD scores in the cTBS group decreased significantly compared to the control (p < 0.05). There were no significant differences in the MoCA (including the MoCA subitems) or DST scores or in the SCWT or TMT completion times between the two groups (p > 0.05). For the HAMD scores and the MoCA subitem visuospatial/executive scores, the SCWT-B and SCWT-C completion times in the two groups both improved significantly before and after treatment (p < 0.05). For the MoCA scores, the DST-backward scores and the TMT-B completion times in the cTBS group improved significantly before and after treatment (p < 0.05). There was no significant difference in the SCWT-A, TMT-A completion times and MoCA subitems naming, attention, language, abstraction, delayed recall, and orientation scores either before or after treatment in the two groups or between the two groups (p > 0.05). In this study, cTBS over the right DLPFC decreased the HAMD scores significantly in patients with CSVD but had no significant improvement or impairment effects on cognitive function. cTBS over the right DLPFC could be used to treat CSVD patients with depression symptoms.

A Randomized Clinical Trial to Assess the Effect of Medication Therapy Plus tDCS on Problem-solving and Emotion Regulation of Patients with Bipolar Disorder Type I.

This study aims to evaluate the effectiveness of medication therapy combined with transcranial Direct Current Stimulation (tDCS) in improving problem-solving and emotion regulation abilities of patients with bipolar disorder (BD) type I. This is a randomized clinical trial conducted on 30 patients with BD I, randomly assigned into two groups of Medication (n = 15, receiving mood stabilizers including 2-5 tablets of lithium 300 mg, sodium valproate 200 mg, and carbamazepine 200 mg) and Medication + tDCS (n = 15, receiving mood stabilizers plus tDCS with 2 mA intensity over the right dorsolateral prefrontal cortex for 10 days, two sessions per day each for 20 minutes). The Tower of London (TOL) test and Emotion Regulation Questionnaire (ERQ) were used for assessments before, immediately, and 3 months after interventions. There was a significant difference between groups in total ERQ (p = 0.001) and its cognitive reappraisal domain (p = 0.000) which were increased, but the difference was not significant in its expressive suppression domain (p > 0.05). After 3 months, their level decreased. In examining problem-solving variable, the combined therapy could significantly reduce only the total number of errors under TOL test (p = 0.00), but it remained unchanged after 3 months. Medication therapy plus tDCS is effective in improving problem-solving and emotional regulation (cognitive reappraisal) skills of patients with BD I.

Functional Alterations of the Basal Ganglia Are Associated with Voluntary Activation of the Core Stabilizing Muscles in Patients with Chronic Low Back Pain: A Cross-Sectional Study.

Deficits in voluntary activation of the core stabilizing muscles are consistently observed in patients with chronic low back pain (CLBP); however, the underlying neural mechanism remains unclear. This cross-sectional study aimed at testing the hypothesis that the impaired voluntary activation of core stabilizing muscles is associated with structural and functional alterations in the basal ganglia, thalamus, and cortex in patients with CLBP. We obtained structural and resting-state functional magnetic resonance imaging (rs-fMRI) data from 53 patients with CLBP and 67 healthy controls and estimated the alterations in grey matter volume (GMV) and functional and effective connectivity (EC) of regions with altered GMV via whole brain analysis. The voluntary activation of the multifidus (MF) and transversus abdominis (TrA) was evaluated by ultrasound imaging in these patients. Compared with the HCs, they displayed a significant decrease in GMV in the bilateral thalamus and caudate nucleus, a significant increase in GMV in the left middle frontal gyrus, and increased resting-state functional connectivity between the right caudate nucleus and the bilateral precuneus (voxel-level p < 0.005, Gaussian random field-corrected p < 0.05). The patients also showed increased EC from the right caudate nucleus to the bilateral precuneus, which was significantly correlated with voluntary activation of the bilateral MF and TrA (all p < 0.050). Grey matter alterations may be confined to regions responsible for perception, motor control, and emotion regulation in patients with CLBP. The interrupted EC from the basal ganglia to the default mode network might be involved in the impairment of voluntary activation of the core stabilizing muscles.

Stress and reward in the maternal brain of mothers with borderline personality disorder: a script-based fMRI study

Borderline personality disorder (BPD) is associated with altered neural activity in regions of salience and emotion regulation. An exaggerated sensitization to emotionally salient situations, increased experience of emotions, and dysfunctional regulative abilities could be reasons for increased distress also during parenting. Mothers with BPD tend to have less reciprocal mother–child interactions (MCI) and reveal altered cortisol and oxytocin reactivity in the interaction with their child, which could indicate altered processing of stress and reward. Here, we studied underlying neural mechanisms of disrupted MCI in BPD. Twenty-five mothers with BPD and 28 healthy mothers participated in a script-driven imagery functional magnetic resonance imaging (fMRI)-paradigm. Scripts described stressful or rewarding MCI with the own child, or situations in which the mother was alone. Mothers with BPD showed larger activities in the bilateral insula and anterior cingulate cortex (ACC) compared to healthy mothers during the imagination of MCI and non-MCI. Already in the precursory phase while listening to the scripts, a similar pattern emerged with stronger activity in the left anterior insula (AINS), but not in the ACC. This AINS activity correlated negatively with the quality of real-life MCI for mothers with BPD. Mothers with BPD reported lower affect and higher arousal. An exaggerated sensitization to different, emotionally salient situations together with dysfunctional emotion regulation abilities, as reflected by increased insula and ACC activity, might hinder sensitive maternal behavior in mothers with BPD. These results underline the importance for psychotherapeutic interventions to improve emotional hyperarousal and emotion regulation in patients with BPD, especially in affected mothers caring for young children.

The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation

BackgroundBulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN.MethodsThis was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175).ResultsDifficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia.ConclusionResults of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.

P-98 Reduced frontal theta oscillatory activity during emotion regulation in patients with borderline personality disorder

P-98 Reduced frontal theta oscillatory activity during emotion regulation in patients with borderline personality disorder

Altered large-scale internetwork functional connectivity in patients with vestibular migraine and migraine without aura

ObjectiveTo investigate large-scale internetwork functional connectivity in patients with vestibular migraine (VM) and migraine without aura (MwoA). MethodsResting-state functional magnetic resonance imaging data from 34 VM patients, 34 MwoA patients, and 33 healthy controls (HCs) were collected and the results were analyzed using independent component analysis (ICA). We also analyzed the correlations between clinical data and internetwork functional connectivity. ResultsIn contrast to HCs, MwoA patients showed decreased functional connectivity between the left frontoparietal network (lFPN) and right frontoparietal network (rFPN), with increased functional connectivity between the sensorimotor network (SMN) and lateral visual network (lVN). When compared to MwoA patients, VM patients demonstrated decreased functional network connectivity between the dorsal attention network (DAN) and posterior medial visual network (pmVN), between the SMN and pmVN, and between the SMN and lVN. Meanwhile, increased functional network connectivity was found between the lFPN and rFPN; however, there was no significant difference in functional network connectivity between VM patients and HCs. In addition, associations were found between clinical data and internetwork functional connectivity. ConclusionFunctional connectivity between the lFPN and rFPN was reduced in patients with MwoA compared with HCs, which may indicate functional impairment in cognitive control, attention, somatosensory perception, and emotion regulation in patients with MwoA. VM patients showed decreased functional connectivity between the DAN, SMN, pmVN and lVN compared to patients with MwoA, which could account for the multisensory integration abnormalities and be the cause of vestibular symptoms in VM patients. These findings offer fresh perspectives on the pathophysiology of VM and MwoA.