Emotion regulation through bifocal processing of fear inducing and disgust inducing stimuli.

BACKGROUND: We present first-time evidence for the immediate neural and behavioral effects of bifocal emotional processing via visualized tapping for two different types of negative emotions (fear and disgust) in a sample of healthy participants. RESULTS: Independent of stimulus type, neural activation in the amygdala is increased during regulation, while activation in the ventral anterior cingulate cortex is decreased. Behavioral responses, as well as lateral and medial occipital regions and the dorsolateral prefrontal cortex show differential regulatory effects with respect to stimulus type. CONCLUSIONS: Our findings suggest that emotion regulation through bifocal processing has a neural and behavioral signature that is distinct from previously investigated emotion regulation strategies. They support theoretical models of facilitated access to and processing of emotions during bifocal processing and suggest differential neural and behavioral effects for various types of negative emotions.

Lack of Increase in Sexual Drive and Function After Dopaminergic Stimulation in Women.

Human and animal data indicate that the dopaminergic system plays a crucial role in sexual drive and function. Using a double-blind, placebo-controlled crossover design, this prototype study investigated the effect of the D2 dopamine agonist cabergoline on sexual parameters in 13 healthy women. Cardiovascular and genital parameters were monitored continuously. Sexual drive and function were measured using self-report sexual experience scales. In contrast to previous theories and assumptions, we found that cabergoline did not alter objective and subjective sexual parameters in healthy women. This finding suggests that there may be sex differences in the influence of the dopaminergic system on human sexual functioning.

Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles.

Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc.

Executive Functioning in Pedophilia and Child Sexual Offending.

OBJECTIVES: Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle executive deficits associated with pedophilia (as a deviant sexual preference) from those associated with CSO (as a deviant sexual behavior). METHODS: The German multi-sided research network NeMUP offers the opportunity to overcome these limitations. By applying the Cambridge Automated Neuropsychological Test Battery in four carefully matched groups of men: (1) pedophiles with (N=45) and (2) without (N=45) a history of sexual offending against children; (3) child molesters without pedophilia (N=19), and (4) non-offending controls (N=49), we were able to analyze executive functioning in pedophilia and CSO independently. RESULTS: Both CSO groups as compared to both non-CSO groups exhibited worsened response inhibition ability. However, only non-pedophilic offenders showed additionally disabled strategy use ability. Regarding set-shifting abilities, the P+CSO group showed the best performance. We also found that performances were affected by age: only in pedophiles, response inhibition worsened with age, while age-related deficits in set-shifting abilities were restricted to non-pedophilic participants. The latter also differentiated between both sexual preference groups. CONCLUSIONS: Our results are the first to demonstrate that executive dysfunctions are related to offense status rather than pedophilic preference. Furthermore, there was evidence for differentiating age and performance correlations between pedophiles and non-pedophiles, which warrants further investigation. (JINS, 2017, 23, 460-470).

Finger tapping-related activation differences in treatment-naïve pediatric Tourette syndrome: a comparison of the preferred and nonpreferred hand.

BACKGROUND: Disturbances of motor circuitry are commonly encountered in Tourette syndrome (TS). The aim of this study was to investigate simple motor performance differences between boys with TS and healthy controls. METHODS: We attempted to provide insight into motor network alterations by studying a group of treatment-naïve patients suffering from 'pure' TS, i.e., without comorbid symptomatology at an early stage of disease. We used functional MRI to compare activation patterns during right (preferred) and left (nonpreferred) index finger tapping between 22 TS boys (12.6 ± 1.7 years) and 22 age-matched healthy control boys. RESULTS: Boys with TS revealed altered motor network recruitment for right (dominant) and left (nondominant) index finger tapping. Brain activation patterns in response to index finger tapping of the nonpreferred left hand reflected the most prominent differences, including activation decrease in contralateral sensorimotor cortex while recruiting premotor and prefrontal regions along with the left inferior parietal lobule to a greater extent. CONCLUSIONS: This study demonstrates clear functional differences of simple index finger tapping in early-stage TS. We suggest that this reflects the requirement for additional brain networks to keep a normal performance level during the actual task and adaptive mechanisms due to continuous tic suppression and performance in TS.

Altered motor network recruitment during finger tapping in boys with Tourette syndrome.

In Tourette syndrome (TS), not only the tics but also the findings on deficits in motor performance indicate motor system alterations. But our knowledge about the pathophysiology of the motor system in TS is still limited. To better understand the neuronal correlates of motor performance in TS, 19 treatment-naïve boys [age 12.5 (SD 1.4) years] with TS without comorbid symptomatology were compared to an age-matched healthy control group [n = 16; age 12.9 (SD 1.6) years] in regard to brain activation during right-hand index finger tapping by means of functional magnetic resonance imaging. Group differences were found mainly in the left (contralateral) precentral gyrus, which was less activated in boys suffering from TS and in caudate nucleus as well as in medial prefrontal cortex, which was more activated compared to healthy boys. These results show that even in the first years after the onset of the disorder, an altered brain network of motor performance is recruited. These alterations in brain regions frequently associated with TS are probably based on functional changes, which are discussed in terms of early compensatory mechanisms of the motor execution network.

ERP evidence for the recognition of emotional prosody through simulated cochlear implant strategies.

BACKGROUND: Emotionally salient information in spoken language can be provided by variations in speech melody (prosody) or by emotional semantics. Emotional prosody is essential to convey feelings through speech. In sensori-neural hearing loss, impaired speech perception can be improved by cochlear implants (CIs). Aim of this study was to investigate the performance of normal-hearing (NH) participants on the perception of emotional prosody with vocoded stimuli. Semantically neutral sentences with emotional (happy, angry and neutral) prosody were used. Sentences were manipulated to simulate two CI speech-coding strategies: the Advance Combination Encoder (ACE) and the newly developed Psychoacoustic Advanced Combination Encoder (PACE). Twenty NH adults were asked to recognize emotional prosody from ACE and PACE simulations. Performance was assessed using behavioral tests and event-related potentials (ERPs). RESULTS: Behavioral data revealed superior performance with original stimuli compared to the simulations. For simulations, better recognition for happy and angry prosody was observed compared to the neutral. Irrespective of simulated or unsimulated stimulus type, a significantly larger P200 event-related potential was observed for happy prosody after sentence onset than the other two emotions. Further, the amplitude of P200 was significantly more positive for PACE strategy use compared to the ACE strategy. CONCLUSIONS: Results suggested P200 peak as an indicator of active differentiation and recognition of emotional prosody. Larger P200 peak amplitude for happy prosody indicated importance of fundamental frequency (F0) cues in prosody processing. Advantage of PACE over ACE highlighted a privileged role of the psychoacoustic masking model in improving prosody perception. Taken together, the study emphasizes on the importance of vocoded simulation to better understand the prosodic cues which CI users may be utilizing.

Lateral frontal cortex volume reduction in Tourette syndrome revealed by VBM.

BACKGROUND: Structural changes have been found predominantly in the frontal cortex and in the striatum in children and adolescents with Gilles de la Tourette syndrome (GTS). The influence of comorbid symptomatology is unclear. Here we sought to address the question of gray matter abnormalities in GTS patients with co-morbid obsessive-compulsive disorder (OCD) and/or attention deficit hyperactivity disorder (ADHD) using voxel-based morphometry (VBM) in twenty-nine adult actually unmedicated GTS patients and twenty-five healthy control subjects. RESULTS: In GTS we detected a cluster of decreased gray matter volume in the left inferior frontal gyrus (IFG), but no regions demonstrating volume increases. By comparing subgroups of GTS with comorbid ADHD to the subgroup with comorbid OCD, we found a left-sided amygdalar volume increase. CONCLUSIONS: From our results it is suggested that the left IFG may constitute a common underlying structural correlate of GTS with co-morbid OCD/ADHD. A volume reduction in this brain region that has been previously identified as a key region in OCD and was associated with the active inhibition of attentional processes may reflect the failure to control behavior. Amygdala volume increase is discussed on the background of a linkage of this structure with ADHD symptomatology. Correlations with clinical data revealed gray matter volume changes in specific brain areas that have been described in these conditions each.

Bifocal emotion regulation through acupoint tapping in fear of flying.

Very few studies have investigated the neural underpinnings of bifocal-multisensory interventions such as acupoint tapping (tapping) despite their well-documented efficacy. The present study aims to investigate the neural and behavioral responses to tapping during the perception of phobic and generally fear-inducing stimulation in a group of participants with fear of flying. We studied 29 flight-phobic participants who were exposed to phobia-related, fear-inducing and neutral stimulation while undergoing fMRI and a bifocal-multisensory intervention session consisting of tapping plus cognitive restructuring in a within-subject design. During tapping we found an up-regulation of neural activation in the amygdala, and a down-regulation in the hippocampus and temporal pole. These effects were different from automatic emotion regulatory processes which entailed down-regulation in the amygdala, hippocampus, and temporal pole. Mean scores (±SD) on the Fear of Flying scale dropped from 2.51(±0.65) before the intervention to 1.27(±0.68) after the intervention (p <.001). The proportion of participants meeting the criteria for fear of flying also dropped from 89.7 percent before the intervention to 24.0 percent after the intervention (p <.001). Taken together, our results lend support to the effectiveness of tapping as a means of emotion regulation across multiple contexts and add to previous findings of increased amygdala activation during tapping, as opposed to amygdala down-regulation found in other emotion regulation techniques. They expand on previous knowledge by suggesting that tapping might modulate the processing of complex visual scene representations and their binding with visceral emotional reponses, reflected by the down-regulation of activation in the hippocampus and temporal pole. Bifocal emotion regulation was useful in ameliorating aversive reactions to phobic stimuli in people with fear of flying.

Conflict adaptation and related neuronal processing in Parkinson's disease.

Non-motor symptoms like cognitive impairment are a huge burden for patients with Parkinson's disease. We examined conflict adaptation by using the congruency sequence effect as an index of adaptation in 17 patients with Parkinson's disease and 18 healthy controls with an Eriksen flanker task using functional magnet resonance imaging to reveal possible differences in executive function performance. We observed overall increased response times in patients with Parkinson's disease compared to healthy controls. A flanker interference effect and congruency sequence effect occurred in both groups. A significant interaction of current and previous trial type was revealed, but no effect of response sequence concerning left or right motor responses. Therefore, top-down conflict monitoring processes are likely the main contributors leading to the congruency sequence effect in our paradigm. In both groups incongruent flanker events elicited activation in the middle temporal gyrus, inferior parietal cortex, dorsolateral prefrontal cortex and the insula in contrast to congruent flanker events. A psychophysiological interactions analysis revealed increased functional connectivity of inferior parietal cortex as a seed to the left prefrontal thalamus during incongruent vs. congruent and neutral stimuli in patients with Parkinson's disease that may reflect compensatory facilitating action selection processes. We conclude that patients with Parkinson's disease exhibit conflict adaptation comparable to healthy controls when investigated while receiving their usual medication.

Intertemporal choice in Parkinson's disease.

The administration of dopamine agonists in Parkinson's disease has been associated with impulse control disorders, in particular, pathological gambling. In the present investigation, 17 patients with Parkinson's disease without impulse control disorders and 17 matched control participants were offered choices between monetary rewards (ranging between 11 and 80 euros) available immediately and larger rewards (between 25 and 85 euros) available after delays ranging from 7 to 186 days. Participants had a 1-in-6 chance of winning a reward that they chose on 1 randomly selected trial. Assuming a hyperbolic discounting model, k values were estimated from the pattern of participants' choices. Patients were tested twice, once on dopamine agonist medication and once after 12 hours without medication. Patients showed a considerably steeper discounting function than healthy controls independent of medication status, with k values more than 3 times larger than those of controls. This study shows that patients with Parkinson's disease without clinically apparent impulse control disorders nevertheless tend to make impulsive decisions in intertemporal monetary choice. The lack of difference between sessions could be a result either of the persistent effects of dopaminergic therapy or hint at a genuine medication-independent change in intertemporal choice behavior in Parkinson's disease. This needs to be addressed in further studies. The paradigm used is easy to apply and should be used more extensively to describe decision behavior in Parkinson's disease.

On emotional conflict: interference resolution of happy and angry prosody reveals valence-specific effects.

To comprehend emotional prosodic cues in speech is a critical function of human social life. However, it is common in everyday communication that conflicting information in emotional prosody and semantic content co-occur. Here, we sought to specify brain regions involved in conflict monitoring of these interfering communication channels. By means of functional magnetic resonance imaging, we obtained signal increases in the right dorsal anterior cingulate cortex and right superior temporal gyrus (STG) and superior temporal sulcus when participants listened to incongruous compared with congruous sentences. Moreover, valence-specific effects were found in the left inferior frontal gyrus and left STG for happily intoned sentences expressing a negative content. The left caudate nucleus along with the thalamus was active when angrily intoned sentences were coupled with positive semantic content. Our results suggest a brain network that monitors conflict in emotional prosody and emotional semantic content comprising of medial prefrontal areas that have previously been associated with cognitive conflict processing. Furthermore, our study extends the knowledge of these processes by suggesting valence-specific differences of emotional conflict processing.

How the brain resolves high conflict situations: double conflict involvement of dorsolateral prefrontal cortex.

Executive control is a human ability that allows to overcome automatic stimulus-response mappings and to act appropriate in the context of a task where the selection of relevant stimuli and the suppression of interfering information are crucial. In order to address the question which brain areas are involved in the detection and processing of two simultaneously operating sources of interference derived from a spatial incompatibility task, we used functional MRI to contrast neural activity related to a double conflict situation to single incompatibility conditions. Results show signal increase of left dorsolateral prefrontal cortex when monitoring simultaneously presented conflict. There was no additional activity in the medial prefrontal cortex or anterior cingulate cortex although these regions are expected to play an important role in all types of conflict monitoring. Further analyses of conflict resolution and post-error adaptation pointed to different underlying functional mechanisms. While the resolution of high conflict was associated with rostral ACC activation, the post-error adaptation reflecting activity during post-error trials suggests a specific medial and lateral prefrontal network which was functionally distinct from conflict-related activity. Our results also suggest a major role for the basal ganglia during error detection and resolution.

Empathy in pedophilia and sexual offending against children: A multifaceted approach.

Empathy is regarded as dynamic risk factor of child sexual offending. However, empathy research in the context of child sexual abuse suffers from various problems. First, prior studies failed to differentiate between pedophilic and nonpedophilic sexual offenders. Second, there is no distinction made between cognitive and affective empathy. Third, cognitive and affective empathy toward emotional states of specific age groups (children and adults) has not been adequately addressed. The current study tackles these shortcomings investigating offending and nonoffending pedophiles and multiple aspects of empathy using self-reports and objective behavioral measures. Participants included 85 pedophilic men who committed hands-on child sexual offenses (P+CSO), 72 pedophilic men who never committed hands-on child sexual offenses (P-CSO), and 128 nonoffending teleiophilic male controls (TC). Several affective and cognitive aspects of empathy were assessed using the Multifaceted Empathy Test (MET) and the Interpersonal Reactivity Index (IRI). Whereas in self-reports (IRI) P+CSO scored lower than TC (P-CSO intermediate) in cognitive perspective-taking abilities, a performance-based measure (MET) revealed evidence for a better differentiation of emotional states in P-CSO as compared with P+CSO (TC intermediate). In addition, P+CSO and P-CSO showed significantly higher affective resonance while observing children (MET), which was paralleled by higher self-reported levels of personal distress in social situations (IRI). The results indicate evidence for higher general affective empathic resonance to children in pedophilic men but superior cognitive empathy abilities in nonoffending pedophiles only, which may act as a protective factor in the prevention of sexual offending. Together, these findings underline the importance of accounting for multiple facets of empathy when targeting pedophilia and child sexual offending. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The influence of response conflict on error processing: evidence from event-related fMRI.

The ability to detect errors is a crucial prerequisite for the appropriate adjustment of behavior to future situations. In the present event-related fMRI study, we provide evidence for the existence of different error-related networks within the human brain using a Simon task based on coherent motion perception. While errors related to incompatible trials were mainly associated with activation of the rostral anterior cingulate cortex (rACC) and the precuneus/posterior cingulate, errors related to trials without pre-response conflict showed specific activation in the right inferior parietal cortex. Despite this functional dissociation of brain networks, conjunction analysis revealed common clusters of activation in the medial wall (dorsal anterior cingulate cortex (dACC) and medial superior frontal cortex (msFC)), and bilateral inferior frontal gyrus/insula, consistent with earlier reports of error-related BOLD-signal increases. The present data support the view that despite of an overlapping core system of error processing, additional brain areas come into play depending on the existence or absence of cognitive conflict.

Two Simon tasks with different sources of conflict: an ERP study of motion- and location-based compatibility effects.

Behavioral and electrophysiological correlates of two Simon tasks were examined using comparable stimuli but different task-irrelevant and conflict-inducing stimulus features. Whereas target shape was always the task-relevant stimulus attribute, either target location (location-based task) or motion direction within the target stimuli (motion-based task) was used as a source of conflict. Data from ten healthy participants who performed both tasks are presented. In the motion-based task the incompatible condition showed smaller P300 amplitudes at Pz than the compatible condition and the location-based task yielded a trend towards a reduced P300 amplitude in the incompatible condition. For both tasks, no P300 latency differences between the conditions were found at Pz. The results suggest that the motion-based task elicits behavioral and electrophysiological effects comparable with regular Simon tasks. As all stimuli in the motion-based Simon task were presented centrally the present data strongly argue against the attention-shifting account as an explanatory approach.

Multimodal neuroimaging measures and intelligence influence pedophile child sexual offense behavior.

Pedophilia is a heterogeneous disorder for which the neurobiological correlates are not well established. In particular, there are no biological markers identifying individuals with high risk to commit child sexual offense (CSO). Pedophiles with CSO (P+CSO; N = 73), pedophiles without CSO (P-CSO; N = 77), and non-pedophilic controls (NPC; N = 133) were assessed using multimodal structural neuroimaging measures including: cortical thickness (CT), surface area (SA), and white matter fractional anisotropy (FA), as well as full scale IQ (FSIQ) performance. Cortex-wise mediation analyses were used to assess the relationships among brain structure, FSIQ and CSO behavior. Lower FSIQ performance was strongly predict with P+CSO (Wald Chi2 = 13.0, p = 3.1 × 10-5). P+CSO had lower CT in the right motor cortex and pronounced reductions in SA spanning the bilateral frontal, temporal, cingulate, and insular regions (PFWE-corrected < 0.05). P+CSO also had lower FA particularly in the corpus callosum (PFWE-corrected < 0.05). The relationship between SA and P+CSO was significantly mediated by FSIQ, particularly in the prefrontal and anterior insular cortices (PFWE-corrected < 0.05). Within P+CSO, left prefrontal and right anterior cingulate SA negatively correlated with number of CSOs (PFWE-corrected < 0.05). This study demonstrates converging neurobiological findings in which P+CSO had lower FSIQ performance, reduced CT, reduced SA, and reduced FA, compared to P-CSO as well as NPC. Further, FSIQ potentially mediates abuse by pedophiles via aberrant SA, whereas the CT and FA associations were independent of FSIQ differences. These findings suggest aberrant neuroanatomy and lower intelligence as a potential core feature underlying child sexual abuse behavior by pedophiles.

Clinical characteristics associated with paedophilia and child sex offending - Differentiating sexual preference from offence status.

Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paedophiles with a history of CSO. The aim of this study was to distinguish between factors associated with sexual preference (paedophile versus non-paedophile) and offender status (with versus without CSO). Accordingly, a 2 (sexual preference) × 2 (offender status) factorial design was used for a comprehensive clinical assessment of paedophiles with and without a history of CSO (n = 83, n = 79 respectively), child sex offenders without paedophilia (n = 32) and healthy controls (n = 148). Results indicated that psychiatric comorbidities, sexual dysfunctions and adverse childhood experiences were more common among paedophiles and child sex offenders than controls. Offenders and non-offenders differed in age, intelligence, educational level and experience of childhood sexual abuse, whereas paedophiles and non-paedophiles mainly differed in sexual characteristics (e.g., additional paraphilias, onset and current level of sexual activity). Regression analyses were more powerful in segregating offender status than sexual preference (mean classification accuracy: 76% versus 68%). In differentiating between offence- and preference-related factors this study improves clinical understanding of both phenomena and may be used to develop scientifically grounded CSO prevention and treatment programmes. It also highlights that some deviations are not traceable to just one of these two factors, thus raising the issue of the mechanism underlying both phenomena.

Valence-specific conflict moderation in the dorso-medial PFC and the caudate head in emotional speech.

Emotional speech comprises of complex multimodal verbal and non-verbal information that allows deducting others' emotional states or thoughts in social interactions. While the neural correlates of verbal and non-verbal aspects and their interaction in emotional speech have been identified, there is very little evidence on how we perceive and resolve incongruity in emotional speech, and whether such incongruity extends to current concepts of task-specific prediction errors as a consequence of unexpected action outcomes ('negative surprise'). Here, we explored this possibility while participants listened to congruent and incongruent angry, happy or neutral utterances and categorized the expressed emotions by their verbal (semantic) content. Results reveal valence-specific incongruity effects: negative verbal content expressed in a happy tone of voice increased activation in the dorso-medial prefrontal cortex (dmPFC) extending its role from conflict moderation to appraisal of valence-specific conflict in emotional speech. Conversely, the caudate head bilaterally responded selectively to positive verbal content expressed in an angry tone of voice broadening previous accounts of the caudate head in linguistic control to moderating valence-specific control in emotional speech. Together, these results suggest that control structures of the human brain (dmPFC and subcompartments of the basal ganglia) impact emotional speech differentially when conflict arises.

Attachment representation modulates oxytocin effects on the processing of own-child faces in fathers.

Oxytocin (OT) plays a crucial role in parental-infant bonding and attachment. Recent functional imaging studies reveal specific attachment and reward related brain regions in individuals or within the parent-child dyad. However, the time course and functional stage of modulatory effects of OT on attachment-related processing, especially in fathers, are poorly understood. To elucidate the functional and neural mechanisms underlying the role of OT in paternal-child attachment, we performed an event-related potential study in 24 healthy fathers who received intranasal OT in a double-blind, placebo-controlled, within-subject experimental design. Participants passively viewed pictures of their own child (oC), a familiar (fC) and an unfamiliar child (ufC) while event-related potentials were recorded. Familiarity of the child's face modulated a broad negativity at occipital and temporo-parietal electrodes within a time window of 300-400ms, presumably reflecting a modulation of the N250 and N300 ERP components. The oC condition elicited a more negative potential compared to the other familiarity conditions suggesting different activation of perceptual memory representations and assignment of emotional valence. Most importantly, this familiarity effect was only observed under placebo (PL) and was abolished under OT, in particular at left temporo-parietal electrodes. This OT induced attenuation of ERP responses was related to habitual attachment representations in fathers. In summary, our results demonstrate an OT-specific effect at later stages of attachment-related face processing presumably reflecting both activation of perceptual memory representations and assignment of emotional value.