The protective role of resilience in the reporting of post-concussive symptoms within a non-clinical sample.

Objective: Despite being common following a brain injury, post-concussive symptoms (PCS) are highly prevalent in healthy and non-concussed individuals. Psychosocial factors likely subserve the maintenance of symptoms, and numerous studies have identified prominent risk factors associated with post-concussive symptom reporting (e.g. history of depression). However, few studies have investigated protective factors in this context. The aim of the current study was to examine the relationship between resilience and PCS, and to identify the factors subserving resilience within this relationship. Method: Healthy and non-concussed participants (n = 283, Mage = 22.70 years) completed questionnaires examining PCS (Rivermead Post-Concussion Symptom Questionnaire) and resilience (Resilience Scale for Adults), together with a screener of background demographic/clinical factors. Results: Resilience negatively predicted PCS above and beyond the effect of demographic and clinical factors previously implicated in the reporting of PCS. Interestingly, heightened "perception of self" was the resilience factor uniquely associated with PCS symptoms. The final model accounted for 33% of the variance in PCS. Overall, female gender, a history of headaches, and diagnoses of ADHD and depression, and reduced "perception of self" were all predictive of greater PCS (ps < .05). Conclusion: Resilience, particularly perception of self, is a positive protective factor in the reporting of PCS. These findings highlight the importance of early identification of less resilient individuals following trauma-such as an mTBI and provide a potential rationale for the incorporation of resilience-based rehabilitation programs into the recovery process, particularly those that promote greater self-efficacy and self-competency.

A Biopsychosocial Framework for Apathy Following Moderate to Severe Traumatic Brain Injury: A Systematic Review and Meta-analysis.

Apathy, the deficit of goal-directed behaviour, is well recognised as one of the most debilitating syndromes after moderate-to-severe traumatic brain injury (TBI). However, mechanisms underlying apathy, or at least factors associated with apathy, are sporadically reported. Based on a biopsychosocial framework, this systematic review and meta-analysis synthesised evidence regarding neurobiological, socio-environmental and individual factors associated with apathy. Our searches identified 21 studies satisfying inclusion and exclusion criteria. Results showed that the majority of work has focused on cognitive dysfunction, TBI-related factors, demographic variables and psychological correlates of apathy, while evidence for neural substrates and socio-cultural and premorbid aspects is scant. Overall, the current literature suggests that TBI-related and patient demographic factors did not contribute to apathy after TBI, whereas complex neurocognitive alterations, socio-environmental and cultural factors as well as patients' self-related factors may be important components. The evidence points to the multifaceted interplay of certain biopsychosocial contributors to apathy and suggests future investigations of more complex behavioural traits, cultural elements and pre-injury levels to better characterise the aetiology of this detrimental impairment after TBI.

The effect of tDCS electrode montage on attention and working memory.

The effects of transcranial direct current stimulation (tDCS) for improving attention and working memory have been generally mixed and small, potentially due to variability between studies with montages, stimulus parameters and outcome measures. The tDCS montage is an important parameter which determines the degree and intensity of stimulation in targeted brain regions. This study aimed to examine the effects of using three different montages for modulating attention and working memory performance: Bi-frontal, Broad-frontal and Broad-parietal. Ninety-three healthy adults participated in a counterbalanced cross-over study. Participants received both active and sham tDCS with either the Bi-frontal, Broad-frontal or Broad-parietal montage during performance of both a 1- and 2-back task. TDCS montage moderated 2-back working memory reaction time performance, though not accuracy, with faster reaction times observed for active compared to sham tDCS with the Broad-frontal montage only (F (1,90) = 5.26, p = .024, η2 = 0.06). TDCS montage did not significantly moderate performance on the 1-back task. The cognitive effects of tDCS varied according to montage, task, and outcome measure. TDCS administered with the cathode placed extracephalically in a Broad-frontal montage may be beneficial for improving working memory.

Calling on clinicians to get social and emotional.

OBJECTIVE: Disorders of social cognition, such as difficulties with emotion perception, alexithymia, Theory of Mind (ToM), empathy and disorders of emotion regulation, are prevalent and pervasive problems across many neurological, neurodevelopmental and neuropsychiatric conditions. Clinicians are familiar with how these difficulties present but assessment and treatment has lagged behind other traditional cognitive domains, such as memory, language and executive functioning. METHOD: In this paper, we review the prevalence and degree of impairment associated with disorders of social cognition and emotion regulation across a range of clinical conditions, with particular emphasis on their relationship to cognitive deficits and also real-world functioning. We reported effects sizes from published meta-analyses for a range of clinical disorders and also review test usage and available tests. RESULTS: In general, many clinical conditions are associated with impairments in social cognition and emotion regulation. Effect sizes range from small to very large and are comparable to effect sizes for impairments in nonsocial cognition. Socio-emotional impairments are also associated with social and adaptive functioning. In reviewing prior research, it is apparent that the standardized assessment of social cognition, in particular, is not routine in clinical practice. This is despite the fact that there are a range of tools available and accruing evidence for the efficacy of interventions for social cognitive impairments. CONCLUSION: We are using this information to urge and call for clinicians to factor social cognition into their clinical assessments and treatment planning, as to provide rigorous, holistic and comprehensive person-centred care.

Exploring neuropsychological underpinnings of poor communication after traumatic brain injury: The role of apathy, disinhibition and social cognition.

BACKGROUND: Dysarthria, aphasia and executive processes have been examined for their role in producing impaired communicative competence post traumatic brain injury (TBI). Less understood is the role of emotional dysregulation, that is, apathy and disinhibition, and social cognition, that is, reading and interpreting social cues. METHODS & PROCEDURES: In this study, we examined 49 adults with moderate to severe TBI and 18 neurologically healthy adults. We hypothesised that apathy and disinhibition would predict communication outcomes as would social cognition. We also predicted that apathy and disinhibition would influence social cognition. Communication outcomes were measured by the La Trobe Communication Questionnaire (LCQ) and the Social Skills Questionnaire-TBI (SSQ-TBI). Apathy and disinhibition were measured by the Frontal Systems Behavior Scale (FrSBe). We measured four aspects of social cognition: emotion perception and theory of mind using The Awareness of Social Inference Test (TASIT) and the Complex Audio-Visual Evaluation of Affect Test (CAVEAT), empathy using the Questionnaire of Cognitive and Affective Empathy (QCAE) and the Balanced Emotional Empathy Scale (BEES), and alexithymia using the Toronto Alexithymia Scale (TAS-20) and the Bermond-Vorst Alexithymia Questionnaire. OUTCOMES & RESULTS: Consistent with predictions, the LCQ and SSQ-TBI were associated with disinhibition and the LCQ was also associated with apathy. The LCQ was associated with the full range of social cognition constructs although the SSQ-TBI was not. Finally, apathy and disinhibition predicted a number of social cognition measures. CONCLUSIONS AND IMPLICATIONS: These results are discussed in relation to understanding the nature of communication disorders following TBI and how they are measured, as well as the interrelation between emotion dysregulation and social cognition. WHAT THIS STUDY ADDS: What is already known on this subject The role of emotional dysregulation and social cognition in producing impaired communicative competence post traumatic brain injury (TBI) is not well understood. Although most adults with severe TBI have minimal or possibly no language impairment, they often struggle with functional communication in everyday situations. Many have been reported to be overtalkative, insensitive, childish and self-centred, displaying an inappropriate level of self-disclosure and making tangential and irrelevant comments. Conversely, some speakers with TBI have been noted to have impoverished communication, producing little language either spontaneously or in response to the speaker's questions and prompts. What this paper adds to existing knowledge We found that both apathy and disinhibition were strongly associated with the Latrobe Communication Questionnaire both empirically and conceptually, despite the LCQ being developed from a different, pragmatic orientation. Disinhibition was also associated with the Social Skills Questionnaire for TBI. We also found that poor social cognition scores predicted communication difficulties. Finally, we found that behavioural dysregulation itself, i.e., both apathy and disinhibition, predicted poor social cognition. What are the potential or actual clinical implications of this work? Our findings highlight the central role that apathy and disinhibition play in both communication and social cognition. These insights point to the importance of remediation to target behavioural and autonomic dysregulation as a means to improve everyday social function.

Disinhibited and angry: Investigating the relationship between social disinhibition and the components of aggression following severe TBI.

Social disinhibition and aggression share many similarities. But unlike with aggression, research evidence about social disinhibition following severe traumatic brain injury (TBI) is limited and treatments are missing. Establishing the association between aggression and social disinhibition would facilitate a better conceptualization of these disorders. This study aimed to determine the relationship between social disinhibition and aggression following severe TBI.In this case-control study, 25 individuals with severe TBI and 25 control participants completed the Buss-Perry Aggression Questionnaire (BPAQ), Frontal Systems Behaviour Scale (FrSBe), and Social Disinhibition Interview (SDI).Hierarchical multiple regression analyses revealed that, when controlling for covariates, the inclusion of BPAQ Anger in the model led to a 13% increase in proportion of explained variance of social disinhibition (Adjusted R2 increased from .243 to .363, p < .005). BPAQ Anger was not a significant predictor of SDI scores. Similarly, BPAQ Physical aggression scores did not contribute to the prediction of FrSBe Disinhibition or SDI scores.In conclusion, higher levels of self-reported anger (but no other components of aggression) are associated with higher levels of self-reported social disinhibition. While these findings have potential implications for the treatment of social disinhibition, further research into the possible relationship with aggression should be conducted.

The complex audio visual emotion assessment task (CAVEAT): development of a shorter version for clinical use.

PURPOSE: The Complex Audio Visual Emotion Assessment Task (CAVEAT) is a measure of emotion recognition using dynamic, naturalistic videos to assess recognition of 22 different emotional states (11 positive, 11 negative). It has established construct validity and demonstrated sensitivity to emotion perception impairments in those with moderate-severe traumatic brain injury (TBI). Despite this, its lengthy administration has limited its use in clinical practice and rehabilitation. The current paper aimed to develop shortened versions of the CAVEAT and examine their psychometric properties. METHODS: The CAVEAT-S A and CAVEAT-S B (22 items each) and the CAVEAT-S AB (44 items) were developed using the original data. Comparability, reliability, construct and predictive validity were examined in the original sample (Study 1: 32 people with TBI and 32 demographically matched control participants) and a replication sample (Study 2: 18 adults with TBI and 21 demographically matched controls). RESULTS: All short forms produced comparable accuracy ratings to the full measure, as well as discriminating between people with or without a TBI. Shortened forms all correlated with other measures of emotion perception and social cognition and also predicted psychosocial outcomes in terms of self-reported interpersonal relationships. Internal reliability of the short forms was low relative to the longer forms, especially for the two very short measures. CONCLUSIONS: The new shortened forms of the CAVEAT are promising tools that are sensitive and valid for assessing emotion perception in people with TBI for clinical purposes. Their application in other clinical disorders is yet to be examined.Implications for rehabilitationEmotion perception deficits are present in many clinical populations and an important target for rehabilitation.CAVEAT Short provides ecologically valid emotional stimuli. Such stimuli are important for assessing real world function and to set rehabilitation targets.By having parallel versions of CAVEAT, there is the opportunity to test pre and post intervention while minimising practice effects.Alternatively, one version of CAVEAT-S can be used for assessment, while the other is used for training purposes during remediation.

Social cognition in female adults with Anorexia Nervosa: A systematic review.

Deficits in interpersonal and social functioning are well established in females with Anorexia Nervosa (AN), and are thought to be key features involved in the onset and maintenance of the disease. Growing literature suggests these may be attributed to poor social cognitive processes. This systematic review evaluates whether differences in social cognition exist in adult females with AN. A total of 32 studies that compared females with AN against a healthy control group using social cognitive measures and/or questionnaires were analysed. The majority of studies were deemed to have a low or moderate risk of bias. Overall, empathy appears to be intact in AN, however greater emotion regulation difficulties, elevated alexithymia and reduced emotional awareness are evident in AN. Findings relating to emotion recognition and emotional Theory of Mind were inconsistent. The nature of the task appeared to influence the domains of cognitive ToM and social perception, warranting further research. These findings are discussed within the broader context of social cognitive models and AN rehabilitation.

The prevalence, predictors, associated symptoms, and outcomes of social disinhibition following moderate-to-severe TBI: A scoping review of quantitative evidence.

The present study aimed to map existing quantitative evidence of research related to the nature of social disinhibition following moderate-to-severe traumatic brain injury (TBI), with a specific focus on its prevalence, predictors, associated symptoms and outcomes in studies that met minimal methodological criteria. We conducted a scoping review of the literature following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for Scoping Reviews (PRISMA-ScR). Seventeen peer-reviewed articles including 1440 participants met the inclusion criteria and were included in the qualitative synthesis. Results of the study indicate that social disinhibition is a common and significant consequence of moderate-to-severe TBI with its prevalence estimates ranging from 21% to 32%. Inappropriate sexual behavior appears to be more prevalent in men and younger survivors. Rule-breaking/perseverative errors in fluency tests are significantly associated with social disinhibition. The perceived burden of caregivers of people with TBI is a very common outcome. An interesting finding was an association between higher social disinhibition and higher emotional empathy levels. However, similarly to many potential predictors, this was only found in a single study and therefore requires further investigation. Some common methodological flaws are discussed, such as the use of non-probability sampling, lack of sample size justification or not including a control group. Due to the heterogeneity of measures used to assess social disinhibition in the reviewed articles, conducting a meta-analysis was not possible. In conclusion, social disinhibition is a significant consequence of moderate-to-severe TBI, as it impacts both the TBI survivor and their family/caregivers. The present study extends the scope of the prior overview by offering a clearer picture of social disinhibition after surviving moderate-to-severe TBI, as it focuses on studies with strong methodology and validated measures. It also assesses potential predictors other than executive dysfunction, such as demographics and injury characteristics.

Investigating associations between hoarding symptoms and affective and cognitive empathy.

OBJECTIVES: Hoarding is associated with poor interpersonal functioning, such as social isolation and difficulties in forming relationships, but the reasons for these social problems are not well understood. Previous studies have identified empathy as an important precursor to social functioning, particularly for clinical disorders characterized by social deficits. The aim of the current study was therefore to investigate associations between measures of cognitive and emotional empathy and hoarding symptoms. METHOD: A total of 278 participants recruited via MTurk completed online self-report questionnaires on hoarding, empathy (including cognitive and affective components), and depression. All participants subsequently completed The Awareness of Social Inference Test-Short version (TASIT-S), a behavioural measure of theory of mind, a concept used interchangeably with cognitive empathy. RESULTS: Hoarding symptoms were associated with greater self-reported emotional empathy, specifically emotional contagion, and less self-reported cognitive empathy. Emotional empathy predicted hoarding even after controlling for depression symptoms. Hoarding symptoms were also associated with poorer performance on the TASIT-S with respect to both emotion recognition and theory of mind, with theory of mind remaining a unique predictor of hoarding symptoms after controlling for depression. Participants who reported clinically significant hoarding symptoms were impaired in emotion recognition and theory of mind according to TASIT-S norms. CONCLUSIONS: Hoarding symptoms are associated with increased emotional contagion and decreased cognitive empathy. Empathy may be an avenue for understanding and treating interpersonal difficulties in hoarding disorder. PRACTITIONER POINTS: As hoarding increased, self-reported emotional contagion increased As hoarding increased, self-reported and behavioural cognitive empathy decreased Self-reported emotional empathy and behavioural cognitive empathy predicted hoarding even after controlling for depression Empathy may be an avenue for understanding social difficulties in hoarding disorder.

tDCS effects on task-related activation and working memory performance in traumatic brain injury: A within group randomized controlled trial.

Non-invasive transcranial direct current stimulation (tDCS) has been reported to facilitate working memory in normal adults. There is some evidence in people with Traumatic Brain Injury (TBI) but overall evidence is mixed. This study aimed to address shortcomings of prior study designs in TBI to examine whether a single dose of tDCS would lead to benefits in working memory. Thirty people with severe, chronic TBI were administered a single session of either anodal tDCS (2 mA for 20 min) or sham tDCS (2 mA for 30 s), in a counterbalanced order, over the left parietal cortex while performing 1-back and 2-back working memory tasks. Skin conductance levels were examined as a measure of task activated arousal, a possible functional analogue of cortical excitability. We found that tDCS led to no improvements in accuracy on the working memory tasks. A slight increase in variability and reaction time with tDCS was related to decreased task activated arousal. Overall, this study yielded no evidence that a single session of tDCS can facilitate working memory for people with TBI.

Social and affective neuroscience: an Australian perspective.

While research in social and affective neuroscience has a long history, it is only in the last few decades that it has been truly established as an independent field of investigation. In the Australian region, despite having an even shorter history, this field of research is experiencing a dramatic rise. In this review, we present recent findings from a survey conducted on behalf of the Australasian Society for Social and Affective Neuroscience (AS4SAN) and from an analysis of the field to highlight contributions and strengths from our region (with a focus on Australia). Our results demonstrate that researchers in this field draw on a broad range of techniques, with the most common being behavioural experiments and neuropsychological assessment, as well as structural and functional magnetic resonance imaging. The Australian region has a particular strength in clinically driven research, evidenced by the types of populations under investigation, top cited papers from the region, and funding sources. We propose that the Australian region has potential to contribute to cross-cultural research and facilitating data sharing, and that improved links with international leaders will continue to strengthen this burgeoning field.

Empathy for people with similar experiences: Can the perception-action model explain empathy impairments after traumatic brain injury?

Introduction: A significant proportion of people with traumatic brain injury (TBI) report low levels of empathy, yet there is a paucity of research investigating the mechanisms which underpin this. In this study, we investigated empathy after TBI through the lens of the perception-action model of empathy. Specifically, we looked at the effect of similarity of experience on self-reported empathy and skin conductance in participants with TBI and controls.Method: Thirty people with a traumatic brain injury and 30 matched healthy controls initially recounted three emotional events they had experienced in the past (one happy, one angry and one sad). Then, at a second visit, participants heard three stories which were written to be similar their own stories and three which were based on someone else's stories. We recorded skin conductance while participants listened and then collected self-reported levels of empathy for protagonists in the stories.Results: We found that self-reported empathy, but not skin conductance levels, was greater for similar compared to dissimilar stories. Further, participants with TBI were able to empathise with others despite having markedly reduced autonomic arousal and overall impairment in cognitive functioning.Conclusions: Our results suggest that the PAM has relevance with respect to explaining self-reported empathy for the experiences of others, but cannot explain the role of physiological responses associated with empathy. Further, our results suggest that intact cognitive functioning and physiological responses are not necessary for normal experiences of empathy after TBI.

Psychosocial functioning following moderate-to-severe pediatric traumatic brain injury: recommended outcome instruments for research and remediation studies.

Psychosocial functioning is compromised following pediatric traumatic brain injury (TBI), with the past few decades witnessing a proliferation of research examining the effect of childhood brain insult on a range of psychosocial outcomes. This paper describes the systematic recommendation of outcome instruments to address psychosocial functioning following pediatric TBI.A total of 65 instruments across 11 psychosocial areas (i.e., Global Outcome, Communication, Social Cognition, Behavioural and Executive Function, Other Neuropsychological Functioning, Psychological Status, TBI-related Symptoms, Activities and Participation, Support and Relationships, Sense of Self, and Health-Related Quality of Life) were reviewed using various assessment methods, including working groups, literature searches, comparisons with selection guidelines, and international expert opinion. Each measure was reviewed for its usefulness across early recovery, intervention, and outcome related studies.34 instruments were recommended and classified according to the World Health Organization's International Classification of Functioning, Disability and Health taxonomy and categorised by psychosocial area.This compilation provides a common framework to guide the activities of clinicians and researchers in psychosocial rehabilitation. It is anticipated that these will foster a multidisciplinary approach to psychosocial dysfunction to enhance the evaluation, prediction, and improvement of functional outcomes for those with pediatric TBI.

Understanding how others feel: Evaluating the relationship between empathy and various aspects of emotion recognition following severe traumatic brain injury.

OBJECTIVE: The aim of this study was to use various measures of emotion recognition, such as sensitivity to emotional intensity, accuracy-based emotion labeling, and the ability to differentiate among emotional displays, to examine whether these abilities are associated with emotional and cognitive empathy. We also sought to determine whether these relationships differ between individuals with traumatic brain injury (TBI) and healthy adults. METHOD: TBI participants (n = 28) and healthy adults (n = 29) matched for age, biological sex, and education, were tested on an emotion intensity rating and recognition task. Self-reported emotional and cognitive empathy questionnaires, together with a neuropsychological battery, were also completed. RESULTS: Participants with TBI reported reduced emotional and cognitive empathy. TBI participants also had reduced overall accuracy in recognizing emotion, specifically for happy and sad emotions, although they had no difficulty identifying the intensity or differentiating among emotional displays. Intensity labeling and sensitivity to differentiate among emotions positively correlated with emotional empathy for healthy adults but not for TBI participants. No facet of emotion recognition correlated with cognitive empathy for healthy adults or TBI participants. CONCLUSIONS: The ability to identify the intensity and differentiate among emotions is associated with emotional empathy. Although individuals with severe TBI may be able to differentiate emotions, they may be unable to utilize this information to share and understand the emotions of others, or vice versa. These results could have implications for understanding poor interpersonal relationships and impaired social functioning following TBI. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Subjective emotional experience and physiological responsivity to posed emotions in people with traumatic brain injury.

OBJECTIVE: Although the presence of empathy deficits following traumatic brain injury (TBI) is well established, there is a paucity of research investigating the underpinning mechanisms. This study investigated whether feedback from posed emotional expressions and psychophysiological responsivity, thought to play a role in emotional empathy, are impaired after TBI. METHOD: Thirty adults with TBI and 30 demographically matched healthy controls completed 2 feedback tasks while skin conductance and heart rate were recorded. In Feedback Task 1, participants assumed different emotional postures and rated how this made them feel. In Feedback Task 2, participants held a smile or frown while viewing neutral images and rated the pleasantness of each image. RESULTS: Participants with TBI did not differ from controls in their subjective ratings in response to posed emotional expressions. However, we found reduced skin conductance responses to rapid facial manipulations and some evidence of altered physiological arousal to sad emotional postures in participants with TBI. Finally, there was no relationship between emotional empathy and facial feedback or physiological responsivity. CONCLUSIONS: We failed to replicate past research that demonstrated an impairment in the feedback effect in people with TBI. These normal subjective responses, though, were in the context of reduced psychophysiological responding to the posed expressions, suggesting that another mechanism can contribute to normal feedback effects after TBI. Finally, we did not find the expected relationship between the feedback effect and emotional empathy but may have been limited by the lower than expected rates of low emotional empathy in our sample. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Inhibitory regulation of the prefrontal cortex following behavioral sensitization to amphetamine and/or methamphetamine psychostimulants: A review of GABAergic mechanisms.

Behavioral sensitization to repeated psychostimulant administration has been proposed to reflect many of the neurochemical and behavioral changes that are characteristic of a range of disorders, including drug addiction and psychoses. While previous studies have examined the role of dopamine and glutamate neurotransmission in mediating sensitization, particularly within the prefrontal cortex (PFC), the role of inhibitory GABAergic processing of the PFC in the expression of sensitization is not well understood. Recent research, however, has proposed an emerging role of GABA synthesis, reuptake, ionotropic and metabotropic receptor regulation, and interneuronal changes following sensitization to methamphetamine and/or amphetamine within the PFC. The aim of this review, therefore, is to synthesize research findings on changes to the GABAergic network following sensitization induced by amphetamines (i.e., amphetamine and/or methamphetamine) in the PFC. In addition to providing an overview of global PFC changes, we also provide evidence of regional specific inhibitory influences on sensitized circuitry, focusing on the prelimbic and orbitofrontal cortices. We propose a neural circuit through which inhibitory PFC GABA changes mediate sensitized disease states, focusing on the interaction between the prelimbic and orbitofrontal cortices with subcortical brain structures and the mesolimbic system. Methodological considerations and avenues for future research are also discussed.

Anxiety sensitivity moderates the subjective experience but not the physiological response to psychosocial stress.

The ability to regulate emotional reactions is a complex process that incorporates both physiological and psychological components. Anxiety sensitivity is a construct associated with the negative and often misinterpretation of bodily sensations, with previous findings suggesting that anxiety sensitivity may regulate an individual's physiological response to an acute stress response. The aim of the current study, therefore, was to identify whether anxiety sensitivity moderates the physiological and subjective experience of acute psychosocial stress. Fifty-eight undergraduate students high and low on anxiety sensitivity (as indexed by the Anxiety Sensitivity Index - Third Edition) had their physiology recorded during a widely-used psychosocial stress induction procedure; the Trier Social Stress Test (TSST). Heart rate and skin conductance, together with self-reported anger and tension on the Profile of Mood States questionnaire, significantly increased in response to the TSST. Conversely, high-frequency heart rate variability (HF-HRV) decreased in response to the TSST. We found that anxiety sensitivity moderated the subjective experience of the TSST, such that those who had greater anxiety sensitivity self-reported elevated tension in response to the TSST compared to those with low anxiety sensitivity. Anxiety sensitivity did not moderate any of the physiological outcomes of the TSST. Consequently, this study provides a physiological profile on how the autonomic nervous system responds to stress. Additionally, these findings suggest that beliefs about body sensations specifically affects the interpretation of stressful experiences rather than augmenting physiological reactions themselves. This may provide insights into how biases subserve the development and maintenance of dysregulated emotional experience.

Preserved rapid conceptual processing of emotional expressions despite reduced neuropsychological performance following traumatic brain injury.

OBJECTIVE: Emotional empathy is critical to successful social interactions and is often compromised after traumatic brain injury (TBI). Using the Emostroop task, we investigated whether adults with moderate to severe TBI (N = 26) have problems with rapid conceptual processing of emotional stimuli compared with controls (N = 30). Further, we investigated whether rapid conceptual processing of emotions relates to emotion recognition and emotional empathy. METHOD: In the Emostroop task, participants categorize emotional words (e.g., joyous, furious, and woeful) into three emotion categories: happy, sad, and angry. Each word is superimposed onto an image of a face, which expresses an emotion that is congruent to the word (congruent condition), incongruent to the word (incongruent condition), or is neutral (neutral condition). Slowed responding in the incongruent condition (interference) and speeded responding in the congruent condition (facilitation) indicates rapid conceptual processing of the faces. Participants also completed an emotion perception task, an empathy questionnaire (the BEES) and neuropsychological tests measuring processing speed, working memory, and executive function. RESULTS: Contrary to our hypotheses, we found that rapid conceptual processing of emotional faces was preserved in people with TBI, despite diminished neuropsychological performance, emotion recognition, emotional empathy, and slowed responding. Further, the Emostroop effect was not correlated with self-reported emotional empathy or with emotion recognition. CONCLUSIONS: We conclude that in people with TBI, reduced empathy may be explained by processes downstream of the initial rapid conceptual processing of emotional information, such as flexibly attending and responding to this information in a goal-directed manner in complex environments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).