Atypical prefrontal neural activity during an emotional interference control task in adolescents with autism spectrum disorder: A functional near-infrared spectroscopy study.

Autism spectrum disorder (ASD) is typically characterized by impairments in social interaction and communication, which may be associated with a failure to naturally orient to social stimuli, particularly in recognizing and responding to facial emotions. As most previous studies have used nonsocial stimuli to investigate inhibitory control in children and adults with ASD, little is known about the behavioral and neural activation patterns of emotional inhibitory control in adolescent with ASD. Functional neuroimaging studies have underscored the key role of the prefrontal cortex (PFC) in inhibitory control and emotional face processing. Thus, this study aimed to examine whether adolescent with ASD exhibited altered PFC processing during an emotional Flanker task by using non-invasive functional near-infrared spectroscopy (fNIRS). Twenty-one adolescents with high-functioning ASD and 26 typically developing (TD) adolescents aged 13-16 years were recruited. All participants underwent an emotional Flanker task, which required to decide whether the centrally positioned facial emotion is consistent with the laterally positioned facial emotion. TD adolescents exhibited larger RT and mean O2Hb level in the incongruent condition than the congruent condition, evoking cortical activations primarily in right PFC regions in response to the emotional Flanker effect. In contrast, ASD adolescents failed to exhibit the processing advantage for congruent versus incongruent emotional face in terms of RT, but showed cortical activations primarily in left PFC regions in response to the emotional Flanker effect. These findings suggest that adolescents with ASD rely on different neural strategies to mobilize PFC neural resources to address the difficulties they experience when inhibiting the emotional face.

Estradiol effects on an emotional interference task in adolescents with current and remitted depression.

Attentional biases to emotional stimuli are thought to reflect vulnerability for mood disorder onset and maintenance. This study examined the association between the endogenous sex hormone estradiol and emotional attentional biases in adolescent females with either current or remitted depression. Three groups of participants (mean age ± SD) completed the Emotional Interrupt Task: 1) 20 adolescent females (15.1 ± 1.83 years) currently diagnosed with Major Depressive Disorder (MDD), 2) 16 adolescent females (16.4 ± 1.31 years) who had experienced at least one episode of MDD in their lifetime but currently met criteria for MDD in remission, and 3) 30 adolescent female (15.4 ± 1.83 years) healthy controls. Attentional interference (AI) scores were calculated as differences in target response reaction time between trials with emotional facial expressions versus neutral facial expressions. Estradiol levels were assayed by Salimetrics LLC using saliva samples collected within 30 min of waking on assessment days. Robust multiple regression with product terms evaluated estradiol's main effect on AI scores, as well as hypothesized estradiol × diagnostic group interactions. Although neither mean estradiol levels nor mean AI scores in the current-MDD and remitted-MDD groups differed from controls, the relationship between estradiol and overall AI score differed between control adolescents and the remitted-MDD group. Specifically, the remitted-MDD adolescents performed worse (i.e., showed greater attentional interference) when they had higher estradiol; no significant relationship existed in the current-MDD group. Because this finding was driven by angry and not happy stimuli, it appears higher estradiol levels were associated with greater susceptibility to the attention-capturing effects of negatively-valenced emotional content in girls at risk for MDD from prior history.

Emotional scene processing in children and adolescents with attention deficit/hyperactivity disorder: a systematic review.

"Impairments in emotional information processing are frequently reported in attention deficit hyperactivity disorder (ADHD) at a voluntary, explicit level (e.g., emotion recognition) and at an involuntary, implicit level (e.g., emotional interference). Most of previous studies have used faces with emotional expressions, rarely examining other important sources of information usually co-occurring with faces in our every day experience. Here, we examined how the emotional content of an entire visual scene depicting real-world environments and situations is processed in ADHD. We systematically reviewed in PubMed, SCOPUS and ScienceDirect, using the PRISMA guidelines, empirical studies published in English until March 2019, about processing of visual scenes, with or without emotional content, in children and adolescents with ADHD. We included 17 studies among the 154 initially identified. Fifteen used scenes with emotional content (which was task-relevant in seven and irrelevant in eight studies) and two used scenes without emotional content. Even though the interpretation of the results differed according to the theoretical model of emotions of the study and the presence of comorbidity, differences in scene information processing between ADHD and typically developing children and adolescents were reported in all but one study. ADHD children and adolescents show difficulties in the processing of emotional information conveyed by visual scenes, which may stem from a stronger bottom-up impact of emotional stimuli in ADHD, increasing the emotional experience, and from core deficits of the disorder, decreasing the overall processing of the scene".

Emotional distraction in working memory: Bayesian-based evidence of the equivalent effect of positive and neutral interference.

Evidence has shown that negative distracting stimuli are most difficult to control when we are focused in a relevant task, while positive and neutral distractors might be equally overcome. Still, recent meta-analytic evidence has pointed out that differences in the ability to cope with positive or neutral distractors may be difficult to detect in healthy people and in laboratory sets. Here we re-analyse memory performance in four already published working memory experiments in which affective and non-affective distractors were used. We focused on the positive versus neutral contrast, which did not reveal differences in the original analysis, with the aim of quantifying evidence for the null hypothesis using a Bayesian approach. Bayes factor (BF) estimates show substantial evidence in favour to the absence of differences in three out of four datasets. Further, BF aggregated from the four studies shows stronger evidence for the null hypothesis. Results from this analysis show that WM performance after positive and neutral interference can be considered equivalent, suggesting that positive distractors can be overcome to the same extent as neutral ones.

Updating Emotional Stimuli in Heroin Abstainers' Working Memory: An Event-Related Potential Investigation.

BACKGROUND: It is well-documented that heroin users demonstrate aberrant emotion-processing abilities. However, the mechanism by which heroin users process emotional information after it has captured their attention and entered their working memory is unclear. OBJECTIVES: A modified emotional 2-back task was used to examine whether heroin abstainers demonstrate specific bias patterns in updating emotional stimuli in their working memory. METHODS: In total, 26 male heroin abstainers and 29 healthy controls were asked to identify whether the current picture was the same as a picture that had appeared two trials earlier, while behavioral data and electroencephalogram data were collected. RESULTS: Contrary to predictions, the heroin abstainers and healthy controls demonstrated a similar pattern of P300 activity in response to emotional stimuli with no between-group differences in accuracy or reaction time. More specifically, the P300 amplitudes were larger for negative pictures than for positive and neutral pictures. Surprisingly, we found larger P300 amplitudes at Fz electrodes than at Cz and Pz electrodes in the control group, whereas there was no significant difference at midline electrodes in the heroin abstainers. CONCLUSIONS/IMPORTANCE: Although subtle differences may exist in attentional engagement toward incoming emotional stimulus between two groups, the similar P300 pattern may indicate partial preservation of emotional working memory capacity associated with adaptive emotion regulation in heroin abstainers. These results deepen our understanding of the emotion regulation impairments associated with chronic drug use.

Brain Activity and Network Interactions in the Impact of Internal Emotional Distraction.

Emotional distraction may come from the external world and from our mind, as internal distraction. Although external emotional distraction has been extensively investigated, less is known about the mechanisms associated with the impact of internal emotional distraction on cognitive performance, and those involved in coping with such distraction. These issues were investigated using a working memory task with emotional distraction, where recollected unpleasant autobiographical memories served as internal emotional distraction. Emotion regulation was manipulated by instructing participants to focus their attention either on or away from the emotional aspects of their memories. Behaviorally, focusing away from emotion was associated with better working memory performance than focusing on the recollected emotions. Functional MRI data showed reduced response in brain regions associated with the salience network, coupled with greater recruitment of executive prefrontal and memory-related temporoparietal regions, and with increased frontoparietal connectivity, when subjects focused on nonemotional contextual details of their memories. Finally, temporal dissociations were also identified between regions involved in self-referential (showing faster responses) versus context-related processing (showing delayed responses). These findings demonstrate that focused attention is an effective regulation strategy in coping with internal distraction, and are relevant for understanding clinical conditions where coping with distressing memories is dysfunctional.

Emotional interference during conflict resolution depends on task context.

Evidence is currently mixed regarding the way in which cognitive conflict modulates the effect of emotion on task performance. The present study aimed to address methodological differences across previous studies and investigate the conditions under which interference from emotional stimuli can either be elicited or eliminated under high cognitive conflict. Four behavioural experiments were conducted with a university sample using a gender-discrimination stimulus-response compatibility task. In line with our previous findings, Experiment 1 found that when emotion and cognitive conflict conditions were blocked, emotional faces increased reaction time interference during response compatible trials (low conflict) but not response incompatible trials (high conflict). However, when conflict and emotion conditions were randomised in different configurations across Experiments 2 (all trials randomised), 3 (emotion blocked, compatibility randomised) and 4 (compatibility blocked, emotion randomised), emotion interfered with task performance across both high and low conflict trials. These results suggest that predictability of both compatibility and emotion is required in order to obtain reduced emotional interference under high cognitive conflict. Consistent with prior reports, a top-down anticipatory control mechanism seems to be engaged in the presence of negative emotion when there are incompatible stimulus-response mappings.

Dissociations of cognitive inhibition, response inhibition, and emotional interference: Voxelwise ALE meta-analyses of fMRI studies.

Inhibitory control is the stopping of a mental process with or without intention, conceptualized as mental suppression of competing information because of limited cognitive capacity. Inhibitory control dysfunction is a core characteristic of many major psychiatric disorders. Inhibition is generally thought to involve the prefrontal cortex; however, a single inhibitory mechanism is insufficient for interpreting the heterogeneous nature of human cognition. It remains unclear whether different dimensions of inhibitory processes-specifically cognitive inhibition, response inhibition, and emotional interference-rely on dissociated neural systems. We conducted systematic meta-analyses of fMRI studies in the BrainMap database supplemented by PubMed using whole-brain activation likelihood estimation. A total of 66 study experiments including 1,447 participants and 987 foci revealed that while the left anterior insula was concordant in all inhibitory dimensions, cognitive inhibition reliably activated specific dorsal frontal inhibitory system, engaging dorsal anterior cingulate, dorsolateral prefrontal cortex, and parietal areas, whereas emotional interference reliably implicated a ventral inhibitory system, involving the ventral surface of the inferior frontal gyrus and the amygdala. Response inhibition showed concordant clusters in the fronto-striatal system, including the dorsal anterior cingulate region and extended supplementary motor areas, the dorsal and ventral lateral prefrontal cortex, basal ganglia, midbrain regions, and parietal regions. We provide an empirically derived dimensional model of inhibition characterizing neural systems underlying different aspects of inhibitory mechanisms. This study offers a fundamental framework to advance current understanding of inhibition and provides new insights for future clinical research into disorders with different types of inhibition-related dysfunctions.

Brain Activity and Network Interactions Linked to Valence-Related Differences in the Impact of Emotional Distraction.

Previous investigations showed that the impact of negative distraction on cognitive processing is linked to increased activation in a ventral affective system (VAS) and simultaneous deactivation in a dorsal executive system (DES). However, less is known about the influences of positive valence and different arousal levels on these effects. FMRI data were recorded while participants performed a working memory (WM) task, with positive and negative pictures presented as distracters during the delay between the memoranda and probes. First, positive distraction had reduced impact on WM performance, compared with negative distraction. Second, fMRI results identified valence-specific effects in DES regions and overlapping arousal and valence effects in VAS regions, suggesting increased impact of negative distraction and enhanced engagement of coping mechanisms for positive distraction. Third, a valence-related rostro-caudal dissociation was identified in medial frontal regions associated with the default-mode network (DMN). Finally, these DMN regions showed increased functional connectivity with DES regions for negative compared with positive distraction. Overall, these findings suggest that, while both positive and negative distraction engage partly similar arousal-dependent mechanisms, their differential impact on WM performance is linked to dissociations in the engagement of, and coupling between, regions associated with emotion processing and higher lever cognitive control.

Using executive control training to suppress amygdala reactivity to aversive information.

The ability to regulate emotions is essential for adaptive behavior. This ability is suggested to be mediated by the connectivity between prefrontal brain regions and the amygdala. Yet, it is still unknown whether the ability to regulate emotions can be trained by using a non-emotional procedure, such as the recruitment of executive control (EC). Participants who were trained using a high-frequent executive control (EC) task (80% incongruent trials) showed reduced amygdala reactivity and behavioral interference of aversive pictures. These effects were observed only following multiple-session training and not following one training session. In addition, they were not observed for participants exposed to low-frequent EC training (20% incongruent trials). Resting-state functional connectivity analysis revealed a marginally significant interaction between training group and change in the connectivity between the amygdala and the right inferior frontal gyrus (IFG). Amygdala-IFG connectivity was significantly increased following the training only in the high-frequent EC training group. These findings are the first to show that non-emotional training can induce changes in amygdala reactivity to aversive information and alter amygdala-prefrontal connectivity.

Unwanted reminders: The effects of emotional memory suppression on subsequent neuro-cognitive processing.

The neural basis of voluntarily suppressing conscious access to one's own memories (retrieval suppression [RS]) has recently received considerable attention. However, to date there has been limited research examining the effects of RS on subsequent processing of associated retrieval cues. In this study 47 healthy participants completed a Think/No Think task for memories of emotionally unpleasant visual scenes. While undergoing functional magnetic resonance imaging (fMRI), participants were then presented with cues associated with both suppressed ("no-think-cues") and non-suppressed ("think-cues") memories, and then asked to perform simple arithmetic problems. We observed that, compared to think-cues, no-think-cues were associated with greater left mid/anterior insula activation and with greater insula-anterior cingulate functional connectivity; left insula activation also predicted worse arithmetic performance. These results suggest that cues associated with suppressed negative memories may lead to greater activation of the brain's "salience" network, and reduced available cognitive resources for completion of an ongoing goal-directed task.

Self-control problems in Intermittent Explosive Disorder: Presentation of an explanatory approach.

BACKGROUND AND OBJECTIVES: Intermittent Explosive Disorder (IED) is an impulsive aggression disorder with self-control problems. However, the mechanisms underpinning the self-control problems in IED have not been clearly investigated. Therefore, this study examined the nature of self-control problems and their types, including cognitive inhibition, behavioral inhibition, and emotional interference in IED. METHODS: Participants included three groups: IED (n = 54), psychiatric control (n = 59), and healthy control (n = 62). They were first screened with SCL-90-R, and then they were clinically interviewed. They all did computerized neurocognitive tasks, including Color-Word Stroop Task, Emotional Stroop Task, Go-NoGo Task, and Stop-Signal Task. RESULTS: MANOVA analyses showed that the IED group had poorer performance in cognitive inhibition, response inhibition, and increased emotional interference than the two psychiatric and healthy control groups. They performed much worse than the other two groups, particularly in action cancellation (Stop-Signal Task), and showed increasingly emotional interference. LIMITATIONS: The brain reaction of individuals while doing the tasks was not examined, and some variables were not measured. Also, it is unclear how the emotional eruption interferes with cognitive content and behavioral inhibition. CONCLUSIONS: These findings indicate that self-control problems in IED can be due to deficient cognitive, emotional, and behavioral inhibitions, each appearing sequentially during a step-by-step process and facilitating the onset of IED signs and symptoms. Such a distinguished understanding of the role of neurocognitive mechanisms can lead to the development of accurate explanatory approaches and increase the effectiveness of treatment.

Emotional interference and attentional bias in compulsive sexual behaviors disorder - An fMRI study on heterosexual males.

Background and aims: Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the 11th edition of the International Classification of Diseases, emotional and cognitive impairments related to CSBD remains unclear. This study aimed to investigate the behavioral and neuronal effects of emotional interference on cognition among CSBD patients. Methods: Thirty heterosexual males with CSBD and matched healthy controls (HC) were studied with the Emotional Stroop Task using 5 categories of emotionally arousing words (sex-related, positive, fear-related, negative, neutral) during functional magnetic imaging. Results: At the behavioral level, we found the main effect of the condition: sex-related words evoked a stronger Stroop effect than other conditions. At the neural level, we found a significant group effect. Among CSBD patients processing of sex-related words was related to increased activity in the right putamen, right thalamus, hippocampi, and left pulvinar, when compared to HC. We also found a negative correlation between neuronal activation and time spent on sexual activity during the week preceding study and numerous group differences in brain regions connected to the emotional and motivational processing of sexually explicit material, correlating with CSBD symptoms. Conclusions: Behavioral results indicate a specific attentional bias toward sex-related stimuli in both groups, while neural data uncovered stronger reactivity to sex-related words in CSBD compared to HC. This reactivity is related to CSBD symptoms and provides evidence for the interference of sex-related stimuli with cognition. Such results are firmly in line with the Incentive Salience Theory and conceptualizing CSBD as a behavioral addiction.

The influence of bilingual experience on executive function under emotional interference: Evidence from the N1 component.

The influence of bilingual education and experience on an individual's information-processing ability has recently been a hot issue in international studies. Previous studies have found that bilingual experience affects executive function, but the results remain controversial. Executive function refers to the conscious control of purposeful behavior. It is responsible for processing high-level action controls, including such sub-functions as inhibitory control, cognitive switching, and working memory updating. Emotion, as an essential factor in daily life, also has a complex interaction with executive function. This paper explores whether the bilingual cognitive advantage effect can continue in the more complex conditions of emotional interference. To investigate the specific electrophysiological characteristics of the participants at different stages of cognitive processing, we used a combination of the behavioral and ERP experiments in which the positive, neutral, and negative emotional stimuli were selected as emotional interference conditions and the emotional Simon paradigm, the cognitive switching of emotion paradigm, and the emotional N-back paradigm was adopted. The results show that the main effect of the N1 component amplitude is significant. Specifically, the amplitude of the N1 component in the proficient bilinguals is significantly smaller than that of the non-proficient bilinguals, while the main effects of other component groups are not significant, indicating that under the condition of emotional interference, the influence of bilingual experience on executive function only exists in the early attention stage and that the bilingual experience can improve the individual's attentional control and speed up attention processing in the early attention stage.

The role of arousal and motivation in emotional conflict resolution: Implications for spinal cord injury.

Under many conditions, emotional information is processed with priority and it may lead to cognitive conflict when it competes with task-relevant information. Accordingly, being able to ignore emotional information relies on cognitive control. The present perspective offers an integrative account of the mechanism that may underlie emotional conflict resolution in tasks involving response activation. We point to the contribution of emotional arousal and primed approach or avoidance motivation in accounting for emotional conflict resolution. We discuss the role of arousal in individuals with impairments in visceral pathways to the brain due to spinal cord lesions, as it may offer important insights into the "typical" mechanisms of emotional conflict control. We argue that a better understanding of emotional conflict control could be critical for adaptive and flexible behavior and has potential implications for the selection of appropriate therapeutic interventions.

Abnormal behavioral and neural responses in the right dorsolateral prefrontal cortex during emotional interference for cognitive control in pedophilic sex offenders.

Studies within the last decade have reported neural and behavioral differences in cognitive control between men with the pedophilic disorder who commit (CSO+) and do not commit (CSO-) child sexual abuse. Prior studies reported a higher number of errors in Go/Nogo task and lower activity of the prefrontal cortex in NoGo trials, in CSO+ compared with CSO-. Moreover, negative mood was reported as a risk factor for child sexual abuse in pedophilic men. We aimed to examine differences in brain function and behavior between CSO+ and CSO- patients regarding emotional interference on cognitive processes and inhibition. We recruited CSO+ (n = 11) and CSO- (n = 14) patients as well as matched healthy controls (HC) (n = 17). Participants performed the affective Go/NoGo task in a block-design functional magnetic resonance imaging experiment. The task comprised the following four conditions: Negative Go, including only Go stimuli and negatively valenced pictures; Negative NoGo, including 50% of Go and 50% of NoGo trials as well as negatively valenced pictures; and two corresponding conditions with neutral pictures. Brain analysis was restricted to the dorsolateral prefrontal (DLPFC), orbitofrontal, and anterior cingulate cortices. The HC and CSO- groups, but not the CSO+ group, showed significantly slower reactions in negative blocks compared with neutral blocks. Brain analysis revealed increased activation in the right DLPFC during emotional interference contrast (Negative > Neutral) in the HC and CSO- groups; however, there was decreased activation in the CSO+ group. In the CSO+ group, negative distractors did not increase cognitive control processes, which was observed in the CSO- and HC groups at the behavioral and neural levels. These results support previous reports indicating offender status is associated with cognitive and emotional impairments.

Heart rate variability as a predictor of improvement in emotional interference in Generalized Anxiety Disorder.

BACKGROUND: Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders but the least successfully treated. The search for accessible clinical, psychological and biological markers is crucial for developing more effective and personalized interventions. AIMS: To evaluate if changes in heart rate variability (HRV) between rest and stress conditions before interventions could predict improvement in emotional interference (EI) in a cognitive task after three different treatment modalities in patients with GAD. METHOD: This is a post-hoc analysis study reporting data from a larger randomized controlled trial (NCT03072264) assessing a mindfulness-based intervention (BMT), fluoxetine (FLX), and an active comparison group (QoL) in adult patients diagnosed with GAD. We assessed pulse plethysmography (PPG) data using a Shimmer3 GSR to measure HRV. Regression analyses were performed using the variation between baseline and endpoint EI scores as dependent variables and contrasts considering changing in HRV*group interaction in the baseline. RESULTS: 106 individuals were included. The correlations between HRV changing from rest to task predicted improvement in IE only in the FLX versus control group contrast (estimated = -80.24; SE = 27.31; p = 0.005) and not in the BMT and control group contrast. CONCLUSION: More flexible HRV at baseline predicted EI improvement only in the FLX group. This finding is clinically relevant since it may help us develop more personalized interventions for GAD.

Perceptual inhibition of emotional interference in children.

In daily life, when a bee approaches us while we are sitting in the garden, we must pay attention to that threatening stimulus and give an appropriate response. However, if this bee approaches us while riding a bike, we must inhibit that distractor to avoid an accident. In this case, avoiding the interference of an emotional stimuli and continuing with the task should be preferential. In general, perceptual inhibition is responsible for controlling and suppressing the environmental distractions that interrupt the course of the realization of a goal. In this study, 435 children performed a modified flanker task with entirely irrelevant emotional and neutral stimuli in order to assess perceptual inhibition in contexts with high and low emotional salience. The results showed that entirely irrelevant distractors affected performance, but that there were no significant differences according to whether these distractors were emotionally salient or neutral. These results constitute a first approach to the problem of emotional interference in children considering the multidimensional approach of inhibition.

Frontal brain activity in individuals at risk for schizophrenic psychosis and bipolar disorder during the emotional Stroop task - an fNIRS study.

OBJECTIVES: The emotional Stroop effect is defined as increased reaction times to emotional stimuli compared to neutral ones. It has been often reported in the literature, on both behavioral and neurophysiological level. The goal of this study was to investigate the frontal brain activation in individuals at risk for schizophrenic psychosis and bipolar disorder during an emotional Stroop task. We expected to observe decreased activation in the at-risk individuals compared to the healthy controls. METHODS: Individuals at high risk for psychosis (HR), at ultra-high risk for psychosis (UHR), at risk for bipolar disorder (BIP) and healthy controls (HC) performed an emotional Stroop task, which included positively, negatively and neutrally valenced words. Functional near-infrared spectroscopy (fNIRS) was used to measure levels of oxygenated hemoglobin (O2Hb) representing brain activity in the dorsolateral prefrontal and frontotemporal cortex. RESULTS: Results showed significantly decreased levels of O2Hb in the right dorsolateral prefrontal cortex (DLPFC) in the HR and UHR groups compared to the HC, indicating lower activity. Even though the decrease was independent from the valence of the words, it was the most visible for the negative ones. Moreover, significantly lower O2Hb levels in the frontotemporal cortex (FTC) were observed in all at risk groups compared to the HC. CONCLUSIONS: Lower activity in the FTC in groups at risk for psychosis and bipolar disorder reflects unspecific dysfunctions. Decreased activity in the DLPFC in the HR and UHR groups indicates that hypofrontality can be found already in individuals at risk for schizophrenic psychosis.

Cumulative cortisol exposure in the third trimester correlates with postpartum mothers' neural response to emotional interference.

Prolonged stress affects the central nervous system, rendering individuals vulnerable to a wide range of mental health disorders. 76 healthy postpartum mothers were studied by means of functional magnetic resonance imaging within 6 days of childbirth. The subjects were required to perform the emotional Stroop task involving happy and anxious word-face combinations. Hair samples were collected to determine cumulative hair cortisol concentration (HCC) in the third trimester. HCC was found to be negatively correlated with the recruitment of the dorsal anterior cingulate cortex (ACC) and the midcingulate cortex (MCC). In response to the emotional interference of only anxious target faces, a negative correlation was seen between HCC and the bilateral orbitofrontal cortex, extending to the rostral ACC and the MCC. Women with lower HCC recruited brain areas relevant to emotional cognitive control, indicating that lower HCC helps preserve conflict monitoring and resolution capacities and thus benefits mental health in pregnancy.