Attentional networks in co-occurring generalized anxiety disorder and major depression disorder: Towards a staging approach to the executive control deficits.

INTRODUCTION: Major Depression Disorder (MDD) and Generalized Anxiety Disorder (GAD) often co-occur, but the neurocognitive mechanisms of this co-occurrence remain unknown. Prominent views have pointed to attentional processes as potent mechanisms at play in MDD and GAD, respectively. Yet uncertainty remains regarding the very nature of attentional impairments in patients with co-occurring MDD and GAD. METHODS: Inspired by contemporary models of attentional networks, we compared the three main attentional networks, namely the orienting, alerting, and executive networks of the Attention Network Task's model, in four groups of patients with, respectively, co-occurring DSM-5 MDD and GAD (n = 30), DSM-5 MDD only (n = 30), DSM-5 GAD only (n = 30), or free from any DSM-5 diagnosis (n = 30). To capture the multivariate nature of our data, we examined between-group differences in the attentional networks through a multivariate analysis of variance. RESULTS: Patients with co-occurring MDD and GAD exhibited more severe impairments in the executive control network than those with only one of the disorders. Although patients with MDD or GAD solely did not differ in terms of attentional impairments, both groups showed significantly more impairments in the executive control network than those free from any DSM-5 diagnosis (all Bonferonni-corrected post-hoc ps < 0.05). CONCLUSIONS: Our findings align with a longstanding staging approach to comorbidity whereby, via synergistic effects, co-occurring disorders produce more damages than the sum of each disorder. Here, for the first time, we extended this approach to the executive network of attention in the context of the co-occurrence between MDD and GAD.

Unfolding the Complex Dynamic Interplay Between Attentional Processes and Anxiety: A Commentary on Ghassemzadeh, Rothbart, and Posner.

Theories about the involvement of attention in feelings of fear and anxiety have been debated in philosophical circles since long before the foundation of experimental psychology and cognitive neuroscience. In this issue, Ghassemzadeh, Rothbart, and Posner (2019) provide a much-needed historical and conceptual review of the relations between attention and anxiety disorders. Throughout their paper, they argue that insights from the study of brain networks of attention offer a particularly viable prospect for best clarifying the complex relations between attentional processes and anxiety. We fully share this view. Moreover, we believe that the computational and conceptual tools of network analysis (also known as graph theory) can enable researchers to move even closer to elucidating the complex dynamic interplay between those phenomena. In this commentary, we explain why and how to use network analysis for this purpose.

Mindfulness-Based Cognitive Therapy for Trichotillomania: A Bayesian Case-Control Study.

Over the last years, mindfulness-based interventions combined with habit reversal training have been demonstrated to be particularly suitable for addressing trichotillomania. However, because these studies always combined mindfulness training to habit reversal without including either a mindfulness or habit reversal condition alone, it is still unclear whether clinical benefits are the consequences of mindfulness or merely result from habit reversal training. The primary purpose of the present study was thus to examine whether a mindfulness training procedure without habit reversal could alleviate trichotillomania. Using a Bayesian probabilistic approach for single-case design, client's hair loss severity and level of mindfulness were compared to a normative sample (n = 15) before treatment, after treatment, and at six-month follow-up. Improvement in mindfulness first occurred, and that beneficial effect then transferred to hair-pulling. Indeed, as compared to the normative sample, the client exhibited, from baseline to post-treatment, an improvement in mindfulness. Although a marginal trend to improvement was already evidenced at post-treatment, the mindfulness program only had a significant beneficial effect transferred to hair-loss severity at six-month follow-up. Although it remains particularly difficult to infer generalization from one client, the data from the present case study are the first to suggest that mindfulness training per se might be a suitable clinical intervention for trichotillomania.

Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression.

BACKGROUND: Major Depression Disorder (MDD) and Generalized Anxiety Disorder (GAD) often co-occur, but uncertainty remains regarding the neurocognitive mechanisms linked to this co-occurrence. In this study, we applied network analytic methods to characterize the associations of the attention control (AC) components, as assessed using laboratory-based measurement tools, with MDD and GAD symptoms. Of critical interest was identifying whether AC components were primarily associated with symptoms unique or common to MDD and GAD. METHODS: We computed a regularized partial correlation network to examine the associations between attention control with symptoms specific to MDD, specific to GAD, and symptoms common to MDD and GAD (n = 371). RESULTS: Symptoms that are common to MDD and GAD emerged as highly influential nodes in the network. In particular, our findings pointed to sleep problems as a hub bridging attention control components to hallmark symptoms of MDD and GAD. LIMITATIONS: The present results should not be interpreted as definitive but instead as hypothesis-generating and highlighting the utility of rethinking the conceptualization of the associations between attention control, MDD, and GAD through the lens of sleep problems. Future studies would especially want to consider the temporal unfolding of the network structure. CONCLUSIONS: To our knowledge, this is the first study to identify sleep problems as a potential pathway bridging together components of attention control with symptoms of GAD and MDD.

On the Measurement of Climate Change Anxiety: French Validation of the Climate Anxiety Scale.

The notion of climate change anxiety has gained traction in the last years. Clayton & Karazsia (2020) recently developed the 22-item Climate Change Anxiety Scale (CAS), which assesses climate change anxiety via a four-factor structure. Yet other research has cast doubts on the very structure of the CAS by calling either for a shorter (i.e. 13 items) two-factor structure or for a shorter single-factor structure (i.e. 13 items). So far, these three different models have not yet been compared in one study. Moreover, uncertainty remains regarding the associations between the CAS and other psychological constructs, especially anxiety and depression. This project was designed to overcome these limitations. In a first preregistered study (n = 305), we translated the scale into French and tested, via confirmatory factor analyses (CFA), whether the French version would better fit with a four-, two-, or single-factor structure, as implied by previous works. We also examined how the CAS factors related to depression, anxiety, and environmental identity. In a second preregistered study, we aimed at replicating our comparison between the three CFA models in a larger sample (n = 905). Both studies pointed to a 13-item version of the scale with a two-factor structure as the best fitting model, with one factor reflecting cognitive and emotional features of climate change anxiety and the other reflecting the related functional impairments. Each factor exhibited a positive association with depression and environmental identity but not with general anxiety. We discuss how this two-factor structure impacts the conceptualization of climate change anxiety.

A network approach to the five-facet model of mindfulness.

Despite the large-scale dissemination of mindfulness-based interventions, debates persist about the very nature of mindfulness. To date, one of the dominant views is the five-facet approach, which suggests that mindfulness includes five facets (i.e., Observing, Describing, Nonjudging, Nonreactivity, and Acting with Awareness). However, uncertainty remains regarding the potential interplay between these facets. In this study, we investigated the five-facet model via network analysis in an unselected sample (n = 1704). We used two distinct computational network approaches: a Gaussian graphical model (i.e., undirected) and a directed acyclic graph, with each model determining the relations between the facets and their relative importance in the network. Both computational approaches pointed to the facet denoting Acting with Awareness as playing an especially potent role in the network system. Altogether, our findings offer novel data-driven clues for the field's larger quest to ascertain the very foundations of mindfulness.

The Impact of Anodal tDCS on the Attentional Networks as a Function of Trait Anxiety and Depressive Symptoms: A Preregistered Double-Blind Sham-Controlled Experiment.

OBJECTIVE: Attention is a multifaceted construct, including three distinct attentional networks: the alerting, orienting, and executive conflict networks. Recently, researchers have started to envision strategies to enhance the attentional networks, and transcranial Direct Current Stimulation (tDCS) has emerged as a promising tool to do so, especially regarding the executive conflict network. On the other hand, other research lines have suggested that anodal tDCS might yield more substantial impacts among depressive and anxious participants. METHOD: In this preregistered study, we thus examined two questions. First, we wanted to replicate previous observations and tested whether anodal tDCS does improve the executive conflict network's efficiency. Second, we set out to clarify the impact of anxiety and depressive symptoms on this effect. To do so, we adopted a double-blind within-subject protocol in an unselected sample (n = 50) and delivered a single session of anodal- applied over the dorsolateral part of the left prefrontal cortex-versus sham tDCS during the completion of a task assessing the attentional networks. We assessed anxiety and depressive symptoms at baseline. RESULTS AND CONCLUSIONS: Although there were no significant direct effects of tDCS on the attentional networks, we found that the higher the levels of depression and trait anxiety, the larger the executive conflict network's enhancement during tDCS. By highlighting the importance of trait anxiety and depression when considering the impact of tDCS on the attentional networks, this study fulfills a valuable niche in clinical neuroscience, wherein preclinical data provide critical clues for larger, more definitive future translational efforts.

Does Change in Attention Control Mediate the Impact of tDCS on Attentional Bias for Threat? Limited Evidence from a Double-blind Sham-controlled Experiment in an Unselected Sample.

Neurocognitive models of attentional bias for threat posit that attentional bias may result from a decreased activation of the left prefrontal cortex, and especially of its dorsolateral part (dlPFC), resulting in an impaired attention control. Consequently, a transient increase of neural activity within the left dlPFC via non-invasive brain stimulation reduces attentional bias among both anxious and nonanxious participants. Yet, it is still unclear whether the impact of dlPFC activation on attentional bias is mediated by improvement in attention control. In this experiment, we sought to test this hypothesis in an unselected sample (n = 20). Accordingly, we adopted a double-blind within-subject protocol in which we delivered a single-session of anodal versus sham transcranial Direct Current Stimulation (tDCS) over the left dlPFC during the completion of a task assessing attention control. We also assessed its subsequent impact on attentional bias. Neither attention control nor attentional bias did significantly improve following anodal tDCS. Although our results do not support our main hypothesis, we believe the present null results to be particularly useful for future meta-research in the field. We also formulated a series of methodological recommendations for future research aiming at testing the tDCS-induced modification of attentional bias.

[Transcranial direct current stimulation: new clinical roadmaps for psychiatric research]. / La stimulation transcrânienne à courant continu en psychiatrie - Vers de nouvelles perspectives d'interventions.

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has undergone intensive research over the past decade with promising results. tDCS is based on the application of weak, direct current over the scalp, leading to cortical hypo- or hyperpolarization according to the specified parameters. Recent studies have shown that tDCS is able to induce potent changes in cortical excitability as well as to elicit long-lasting modifications in brain activity. Over the last decade, tDCS physiological mechanisms of action have been intensively investigated. This research has given support for the investigation of tDCS applications in a wide range of clinical populations, including patients with post-stroke motor and language deficits, chronic pain, and tinnitus. Recently, its efficacy to treat psychiatric conditions has been explored increasingly. In this review, we will gather clinical studies involving tDCS to ameliorate psychiatric symptoms and discuss reasonable next steps in this direction.

Untangling attention bias modification from emotion: A double-blind randomized experiment with individuals with social anxiety disorder.

BACKGROUND: Uncertainty abounds regarding the putative mechanisms of attention bias modification (ABM). Although early studies showed that ABM reduced anxiety proneness more than control procedures lacking a contingency between cues and probes, recent work suggests that the latter performed just as well as the former did. In this experiment, we investigated a non-emotional mechanism that may play a role in ABM. METHODS: We randomly assigned 62 individuals with a DSM-IV diagnosis of social anxiety disorder to a single-session of a non-emotional contingency training, non-emotional no-contingency training, or control condition controlling for potential practice effects. Working memory capacity and anxiety reactivity to a speech challenge were assessed before and after training. RESULTS: Consistent with the hypothesis of a practice effect, the three groups likewise reported indistinguishably significant improvement in self-report and behavioral measures of speech anxiety as well as in working memory. Repeating the speech task twice may have had anxiolytic benefits. LIMITATIONS: The temporal separation between baseline and post-training assessment as well as the scope of the training sessions could be extended. CONCLUSIONS: The current findings are at odds with the hypothesis that the presence of visuospatial contingency between non-emotional cues and probes produces anxiolytic benefits. They also show the importance of including a credible additional condition controlling for practice effects.