[Domestic violence and its psychological consequences during the COVID-19 pandemic-key findings from German-speaking countries]. / Häusliche Gewalt und ihre psychischen Folgen während der COVID-19-Pandemie ­ Zentrale Befunde aus dem deutschsprachigen Raum.

The impact of traumatic experiences on mental health during the COVID-19 pandemic has been insufficiently discussed in the German-speaking countries. Against this background, a working group of scientifically and clinically active colleagues was formed on behalf of the German-Speaking Society for Psychotraumatology (DeGPT). The aim of the working group was to summarize central research findings on the incidence of domestic violence and associated psychological distress during the COVID-19 pandemic in German-speaking countries and to discuss their implications. In addition, associations between pre-existing childhood trauma and psychological distress during the pandemic should be illuminated. The present narrative review was prepared for this purpose.The results of the studies conducted indicate high prevalences of domestic violence during the COVID-19 pandemic, which, however, predominantly correspond to pre-pandemic prevalences. Adults with current or pre-existing interpersonal traumatic experiences during childhood or adolescence reported increased psychological distress during the pandemic compared with adults without such experiences. A number of risk factors (e.g., female gender, lower frequency of social contacts) increased the risk of psychological distress and posttraumatic stress disorder symptoms during the pandemic. According to these findings, people with current or past interpersonal trauma exposure represent a vulnerable group with special support needs during pandemic contexts.

Childhood Traumatic Experiences and Dimensional Models of Personality Disorder in DSM-5 and ICD-11: Opportunities and Challenges.

PURPOSE OF REVIEW: Childhood trauma is an important risk factor for the development of personality disorders (PDs), yet most research has been devoted to categorical models of personality pathology. Considering the introduction of a dimensional PD model with ICD-11, we review current findings related to various forms of childhood trauma, and PDs, operationalized in the form of personality functioning and maladaptive traits. We focus on the magnitude of associations and examine specific relationships between emotional and physical trauma with areas of personality functioning and single traits. RECENT FINDINGS: Two studies showed a strong association between childhood trauma and personality dysfunction. Seven studies, including clinical and forensic samples, demonstrated heterogeneous associations between various forms of childhood trauma and maladaptive traits. Overall, four studies indicated a slightly stronger association between personality dysfunction, maladaptive trait expression, and higher levels of emotional trauma than for physical or sexual trauma. Regarding specific trait domains and childhood trauma, most studies yielded the strongest associations for either psychoticism or detachment. Research on childhood trauma and dimensional PD models (i.e., personality functioning and traits) has the potential to contribute to a better understanding of their complex relationship. However, high intercorrelations among different types of childhood trauma, areas of personality functioning, and trait domains increase the difficulty of disentangling single effects. More research is needed including clinical and non-Western samples, especially considering the upcoming ICD-11 classification.

Investigating overt and covert shifts of attention within social naturalistic scenes.

Eye-tracking studies on social attention have consistently shown that humans prefer to attend to other human beings. Much less is known about whether a similar preference is also evident in covert attentional processes. To enable a direct comparison, this study examined covert and overt attentional guidance within two different experimental setups using complex naturalistic scenes instead of isolated single features. In the first experiment, a modified version of the dot-probe paradigm served as a measure of covert reflexive attention toward briefly presented scenes containing a social feature in one half of the visual field compared to nonsocial elements in the other while controlling for low-level visual saliency. Participants showed a stable congruency effect with faster reaction times and fewer errors for probes presented on the social side of the scene. In a second experiment, we tracked eye movements for the same set of stimuli while manipulating the presentation time to allow for differentiating reflexive and more sustained aspects of overt attention. Supportive of the first results, analyses revealed a robust preference for social features concerning initial saccade direction as well as fixation allocation. Collectively, these experiments imply preferential processing of social features over visually salient aspects for automatic allocation of covert as well as overt attention.

Oxytocin and social learning in socially anxious men and women.

OBJECTIVE: This study extended a classic self-referential learning paradigm by investigating the effects of intranasally-administered oxytocin in high and low socially anxious participants during social learning, as a function of social anxiety levels and sex. METHODS: In a randomized double-blinded design, 160 participants were either given intranasal oxytocin (24 I.U.) or placebo. Subsequently, while lying in an MR scanner, participants were shown neutral faces that were paired with positively, neutrally, or negatively valenced self-referential sentences, during which we measured self-reported arousal and sympathy of the facial stimuli, pupil dilation, and changes in the brain-oxygen-level dependent signal. Four-factor mixed analyses of variance with the between-subjects factors group (high socially anxious vs. low socially anxious), substance (oxytocin vs. placebo), and sex (male vs. female) and the within-subjects factor sentence valence (positive vs. neutral vs. negative) were conducted for each measure, respectively. RESULTS: Administration of intranasal oxytocin yielded an increase in sympathy ratings in high socially anxious compared to low socially anxious individuals and decreased arousal ratings for positively-conditioned faces in low socially anxious participants. As an objective physiological measure of arousal, pupil dilation mirrored the behavioral results. Oxytocin effects on neural activation in the insula interacted with anxiety levels and sex: low socially anxious individuals yielded lower activation under oxytocin than placebo; the converse was observed in high socially anxious individuals. This interaction also differed between sexes, as men yielded higher activation levels than women. These findings were more prominent for positively- and negatively-conditioned faces. Within the amygdala, high socially anxious men yielded higher activation than high socially anxious women in the left hemisphere, and low socially anxious men yielded higher activation than low socially anxious women from positively- and negatively-conditioned faces, though no influence of oxytocin was detected. CONCLUSION: These results suggest oxytocin-induced behavioral, physiological, and neural changes as a function of social learning in socially low and high anxious individuals. These findings challenge the amygdalocentric view of the role of emotions in social learning, instead contributing to the growing body of findings implicating the insula therein, revealing an interaction between oxytocin, sex, and emotional valence. Such discoveries raise an interesting set of questions regarding the computational goals of regions such as the insula in emotional learning and how neural activity can play a diagnostic or prognostic role in social anxiety, potentially leading to new treatment opportunities that may combine oxytocin and neurofeedback differentially for men and women.

Threat induction biases processing of emotional expressions.

Threats can derive from our physical or social surroundings and bias the way we perceive and interpret a given situation. They can be signaled by peers through facial expressions, as expressed anger or fear can represent the source of perceived threat. The current study seeks to investigate enhanced attentional state and defensive reflexes associated with contextual threat induced through aversive sounds presented in an emotion recognition paradigm. In a sample of 120 healthy participants, response and gaze behavior revealed differences in perceiving emotional facial expressions between threat and safety conditions: Responses were slower under threat and less accurate. Happy and neutral facial expressions were classified correctly more often in a safety context and misclassified more often as fearful under threat. This unidirectional misclassification suggests that threat applies a negative filter to the perception of neutral and positive information. Eye movements were initiated later under threat, but fixation changes were more frequent and dwell times shorter compared to a safety context. These findings demonstrate that such experimental paradigms are capable of providing insight into how context alters emotion processing at cognitive, physiological, and behavioral levels. Such alterations may derive from evolutionary adaptations necessary for biasing cognitive processing to survive disadvantageous situations. This perspective sets up new testable hypotheses regarding how such levels of explanation may be dysfunctional in patient populations.

The association between psychopathology, childhood trauma, and emotion processing.

OBJECTIVE: Childhood trauma is highly prevalent and can have a negative impact on the development of socioemotional processes resulting in a higher vulnerability for mental disorders in adulthood. Previous studies have associated the severity of childhood trauma with deficits in social functioning, such as a negative attention bias, suggesting altered social information processing as a mechanism underlying the association between childhood trauma and transdiagnostic psychopathologies. METHOD: In a cross-sectional setup with a total of 103 participants (26 with major depressive disorder, MDD; 24 with posttraumatic stress disorder, PTSD; 22 with somatic symptom disorder, SDD; and 31 healthy volunteers, HV), this study applied eye tracking in an emotion recognition paradigm. Reaction times, accuracy, and gaze behavior were analyzed for 4 different facial expressions as a function of self-reported childhood trauma and diagnosis. The aim was to investigate to what extent emotion processing is associated with (a) childhood trauma, (b) psychopathology, and (c) respective interacting effects. RESULTS: Patients showed higher reaction times and error rates overall in classifying emotions than HVs, especially for the recognition of anger and fear. Individuals with a diagnosis of PTSD and MDD were particularly slow in their response to these emotions. Higher scores of reported childhood trauma were associated with faster responses for classifying anger and fear and slower initiation of eye movements for SSD, MDD, and HVs for anger. CONCLUSION: These findings indicate that childhood trauma may contribute to attentional and information-processing biases relevant for social interaction. Identifying individual social deficits offers implications for tailored therapeutic interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The (un)learning of social functions and its significance for mental health.

Social interactions are dynamic, context-dependent, and reciprocal events that influence prospective strategies and require constant practice and adaptation. This complexity of social interactions creates several research challenges. We propose a new framework encouraging future research to investigate not only individual differences in capacities relevant for social functioning and their underlying mechanisms, but also the flexibility to adapt or update one's social abilities. We suggest three key capacities relevant for social functioning: (1) social perception, (2) sharing emotions or empathizing, and (3) mentalizing. We elaborate on how adaptations in these capacities may be investigated on behavioral and neural levels. Research on these flexible adaptations of one's social behavior is needed to specify how humans actually "learn to be social". Learning to adapt implies plasticity of the relevant brain networks involved in the underlying social processes, indicating that social abilities are malleable for different contexts. To quantify such measures, researchers need to find ways to investigate learning through dynamic changes in adaptable social paradigms and examine several factors influencing social functioning within the three aformentioned social key capacities. This framework furthers insight concerning individual differences, provides a holistic approach to social functioning, and may improve interventions for ameliorating social abilities in patients.

Don't Make Me Angry: Frustration-Induced Anger and Its Link to Aggression in Women With Borderline Personality Disorder.

Aggression is a prominent interpersonal dysfunction of individuals with borderline personality disorder (BPD). In BPD aggression is predominantly reactive in nature, often triggered by frustration, provocation, or social threat and is associated with intense anger and an inability to regulate this strong, negative emotion. Building on previous research, we were interested in investigating negative emotionality in general and anger in particular in women with BPD before and after frustration induction. To achieve this, 60 medication-free women with BPD and 32 healthy women rated the intensity of negative emotions (angry, frustrated, upset, embarrassed, nervous) before and after performing a Titrated Mirror Tracing Task, which reliably induces frustration and distress. As expected, women with BPD reported significantly greater intensity of negative emotions before and after frustration than healthy women. Specifically, they showed a significantly stronger frustration-induced increase in anger, while other negative emotions remained unaffected by frustration induction. This anger increase was significantly related to aggressive behavior reported in the 2 weeks prior to the experiment, as well as to the level of frustration experienced in the experiment itself, but not with emotion dysregulation. The current data confirm the important role of frustration-induced anger independent of emotion dysregulation in BPD, in particular with regard to aggression, a prominent interpersonal dysfunction of this disorder. These findings underline the importance of interventions with particular focus on anger.

Attentional Selection of Social Features Persists Despite Restricted Bottom-Up Information and Affects Temporal Viewing Dynamics.

Previous studies have shown an attentional bias towards social features during free-viewing of naturalistic scenes. This social attention seems to be reflexive and able to defy top-down demands in form of explicit search tasks. However, the question remains whether social features continue to be prioritized when peripheral information is limited, thereby reducing the influence of bottom-up image information on gaze orienting. Therefore, we established a gaze-contingent viewing paradigm, in which the visual field was constrained and updated in response to the viewer's eye movements. Participants viewed social and non-social images that were randomly allocated to a free and a gaze-contingent viewing condition while their eye movements were tracked. Our results revealed a strong attentional bias towards social features in both conditions. However, gaze-contingent viewing altered temporal and spatial dynamics of viewing behavior. Additionally, recurrent fixations were more frequent and closer together in time for social compared to non-social stimuli in both viewing conditions. Taken together, this study implies a predominant selection of social features when bottom-up influences are diminished and a general influence of social content on visual exploratory behavior, thus highlighting mechanisms of social attention.

Top-down influence on gaze patterns in the presence of social features.

Visual saliency maps reflecting locations that stand out from the background in terms of their low-level physical features have proven to be very useful for empirical research on attentional exploration and reliably predict gaze behavior. In the present study we tested these predictions for socially relevant stimuli occurring in naturalistic scenes using eye tracking. We hypothesized that social features (i.e. human faces or bodies) would be processed preferentially over non-social features (i.e. objects, animals) regardless of their low-level saliency. To challenge this notion, we included three tasks that deliberately addressed non-social attributes. In agreement with our hypothesis, social information, especially heads, was preferentially attended compared to highly salient image regions across all tasks. Social information was never required to solve a task but was regarded nevertheless. More so, after completing the task requirements, viewing behavior reverted back to that of free-viewing with heavy prioritization of social features. Additionally, initial eye movements reflecting potentially automatic shifts of attention, were predominantly directed towards heads irrespective of top-down task demands. On these grounds, we suggest that social stimuli may provide exclusive access to the priority map, enabling social attention to override reflexive and controlled attentional processes. Furthermore, our results challenge the generalizability of saliency-based attention models.