Posttraumatic reexperiencing and alcohol use: mediofrontal theta as a neural mechanism for negative reinforcement.

Objective: Over half of US military veterans with posttraumatic stress disorder (PTSD) use alcohol heavily, potentially to cope with their symptoms. This study investigated the neural underpinnings of PTSD symptoms and heavy drinking in veterans. We focused on brain responses to salient outcomes within predictive coding theory. This framework suggests the brain generates prediction errors (PEs) when outcomes deviate from expectations. Alcohol use might provide negative reinforcement by reducing the salience of negatively-valenced PEs and dampening experiences like loss. Methods: We analyzed electroencephalography (EEG) responses to unpredictable gain/loss feedback in veterans of Operations Enduring and Iraqi Freedom. We used time-frequency principal components analysis of event-related potentials to isolate neural responses indicative of PEs, identifying mediofrontal theta linked to losses (feedback-related negativity, FRN) and central delta associated with gains (reward positivity, RewP). Results: Intrusive reexperiencing symptoms of PTSD were associated with intensified mediofrontal theta signaling during losses, suggesting heightened negative PE sensitivity. Conversely, increased hazardous alcohol use was associated with reduced theta responses, implying a dampening of these negative PEs. The separate delta-RewP component showed associations with alcohol use but not PTSD symptoms. Conclusions: Findings suggest a common neural component of PTSD and hazardous alcohol use involving altered PE processing. We suggest that reexperiencing enhances the intensity of salient negative PEs, while chronic alcohol use may reduce their intensity, thereby providing negative reinforcement by muting emotional disruption from reexperienced trauma. Modifying the mediofrontal theta response could address the intertwined nature of PTSD symptoms and alcohol use, providing new avenues for treatment.

Mindfulness-Oriented Recovery Enhancement remediates anhedonia in chronic opioid use by enhancing neurophysiological responses during savoring of natural rewards.

BACKGROUND: Neuropsychopharmacologic effects of long-term opioid therapy (LTOT) in the context of chronic pain may result in subjective anhedonia coupled with decreased attention to natural rewards. Yet, there are no known efficacious treatments for anhedonia and reward deficits associated with chronic opioid use. Mindfulness-Oriented Recovery Enhancement (MORE), a novel behavioral intervention combining training in mindfulness with savoring of natural rewards, may hold promise for treating anhedonia in LTOT. METHODS: Veterans receiving LTOT (N = 63) for chronic pain were randomized to 8 weeks of MORE or a supportive group (SG) psychotherapy control. Before and after the 8-week treatment groups, we assessed the effects of MORE on the late positive potential (LPP) of the electroencephalogram and skin conductance level (SCL) during viewing and up-regulating responses (i.e. savoring) to natural reward cues. We then examined whether these neurophysiological effects were associated with reductions in subjective anhedonia by 4-month follow-up. RESULTS: Patients treated with MORE demonstrated significantly increased LPP and SCL to natural reward cues and greater decreases in subjective anhedonia relative to those in the SG. The effect of MORE on reducing anhedonia was statistically mediated by increases in LPP response during savoring. CONCLUSIONS: MORE enhances motivated attention to natural reward cues among chronic pain patients on LTOT, as evidenced by increased electrocortical and sympathetic nervous system responses. Given neurophysiological evidence of clinical target engagement, MORE may be an efficacious treatment for anhedonia among chronic opioid users, people with chronic pain, and those at risk for opioid use disorder.

Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse.

BACKGROUND: Opioid misuse is hypothesized to compromise the ability to regulate negative emotions, as manifested through visceral and peripheral physiological signals. However, neurophysiological impairment of top-down cognitive emotion regulation in opioid misuse has not previously been shown. METHODS: Patients with chronic pain who had been taking opioids for 90 days or longer (N = 149; female, n = 98) underwent a negative emotion regulation task with electroencephalography. Participants were instructed to view or reappraise negative images presented for 3 seconds. Using a validated cutoff score on the Current Opioid Misuse Measure, participants were classified as exhibiting aberrant drug-related behavior consistent with opioid misuse (MISUSE+) or as being low risk for opioid misuse (MISUSE-). Participants reported their craving in response to negative emotions over the past week. RESULTS: We observed a group × condition interaction (p = .003) such that the MISUSE- group decreased the late positive potential of the electroencephalography during reappraisal, whereas the MISUSE+ group showed increased late positive potential during reappraisal. This deficit in negative emotion regulation remained significant after controlling for an array of potential confounding variables, including opioid dose, pain, and depression. Heightened late positive potential during reappraisal was associated with more severe opioid craving. CONCLUSIONS: Opioid misuse may occasion top-down deficits in emotional regulation that begin as early as 400 ms after presentation of negative stimuli. It remains unknown whether emotion dysregulation is the cause, correlate, or consequence of opioid misuse. Nonetheless, targeting emotion dysregulation in opioid misuse with reappraisal-focused interventions may represent an important treatment approach.

How Racial Identity and Worry About Discrimination Impact Coping Responses to Racial Discrimination Among Black American Community Members.

Every year, most Black Americans report experiencing racial discrimination, which has been shown to have a variety of negative consequences. Aspects of racial identity, particularly holding a positive perception of one's racial group (private regard), may buffer the impact of negative experiences including racial discrimination through differential coping strategy use. The current study (1) examined whether level of private regard impacted the type of coping strategies used across various forms of perceived experiences of racial discrimination and (2) tested for indirect pathways from perceived experiences of racial discrimination to different coping strategy use. Adults (N = 297) from the community who self-identified as Black American/African American completed several questionnaires on Amazon's Mechanical Turk (MTurk). Four-fifths (80%) of participants reported racial discrimination at least once. Racial identity-particularly private regard-was positively associated with active coping strategy use. Furthermore, results from mediation models demonstrated racial identity was an important predictor of coping strategy use, suggesting high private regard has protective effects against racial discrimination. Worry was an especially robust mediator for pathways from racial discrimination to coping strategies. Altogether, results indicate a need for targeted interventions that promote the development of private regard and address worry about racial discrimination among Black American adults.

Utilizing time-frequency amplitude and phase synchrony measure to assess feedback processing in a gambling task.

The neurophysiological mechanisms involved in the evaluation of performance feedback have been widely studied in the ERP literature over the past twenty years, but understanding has been limited by the use of traditional time-domain amplitude analytic approaches. Gambling outcome valence has been identified as an important factor modulating event-related potential (ERP) components, most notably the feedback negativity (FN). Recent work employing time-frequency analysis has shown that processes indexed by the FN are confounded in the time-domain and can be better represented as separable feedback-related processes in the theta (3-7 Hz) and delta (0-3 Hz) frequency bands. In addition to time-frequency amplitude analysis, phase synchrony measures have begun to further our understanding of performance evaluation by revealing how feedback information is processed within and between various brain regions. The current study aimed to provide an integrative assessment of time-frequency amplitude, inter-trial phase synchrony, and inter-channel phase synchrony changes following monetary feedback in a gambling task. Results revealed that time-frequency amplitude activity explained separable loss and gain processes confounded in the time-domain. Furthermore, phase synchrony measures explained unique variance above and beyond amplitude measures and demonstrated enhanced functional integration between medial prefrontal and bilateral frontal, motor, and occipital regions for loss relative to gain feedback. These findings demonstrate the utility of assessing time-frequency amplitude, inter-trial phase synchrony, and inter-channel phase synchrony together to better elucidate the neurophysiology of feedback processing.

Trait psychopathy, emotional intelligence, and criminal thinking: Predicting illegal behavior among college students.

Research focusing on individuals high on trait psychopathy remains limited. Higher trait psychopathy is associated with lower levels of emotional intelligence and increased participation in illegal behavior. Additionally, research has confirmed significantly higher levels of criminal thinking and lower levels of empathy in the incarcerated psychopathic population. However, the relationships between trait psychopathy and criminal thinking have not been researched in the community or college population. To test for such differences, questionnaires containing relevant measures were administered to 111 college students. Results indicated that higher levels of trait psychopathy were significantly related to less caring for others, intrapersonal understanding, and general mood, and greater interpersonal functioning and stress management. Furthermore, trait psychopathy was a strong predictor of violent, property, drug, and status offenses. Power-oriented criminal thinking was also predictive of violent behaviors, and entitlement predicted property offending. Results suggest emotional intelligence is important for predicting psychopathy, and trait psychopathy is a strong predictor of all types of illegal behaviors among the non-incarcerated population.

Using visual evoked potentials for the early detection of amnestic mild cognitive impairment: a pilot investigation.

OBJECTIVE: Amnesic mild cognitive impairment (MCIa) is often characterized as an early stage of Alzheimer's dementia (AD). The latency of the P2, an electroencephalographic component of the flash visual evoked potential (FVEP), is significantly longer in those with AD or MCIa when compared with controls. The present investigation examined the diagnostic accuracy of several FVEP-P2 procedures in distinguishing people with MCIa and controls. METHODS: The latency of the FVEP-P2 was measured in participants exposed to a single flash condition and five double flash conditions. The double flash conditions had different inter-stimulus intervals between the pair of strobe flashes. RESULTS: Significant group differences were observed in the single flash and two of the double flash conditions. One of the double flash conditions (100 ms) displayed a higher predictive accuracy than the single flash condition, suggesting that this novel procedure may have more diagnostic potential. Participants with MCIa displayed similar P2 latencies across conditions, while controls exhibited a consistent pattern of P2 latency differences. These differences demonstrate that the double stimulation procedure resulted in a measurable refractory effect for controls but not for those with MCIa. CONCLUSIONS: The pattern of P2 group differences suggests that those with MCIa have compromised cholinergic functioning that results in impaired visual processing. Results from the present investigation lend support to the theory that holds MCIa as an intermediate stage between normal healthy aging and the neuropathology present in AD. Measuring the FVEP-P2 during several double stimulation conditions could provide diagnostically useful information about the health of the cholinergic system.