attention, emotion & memory in depression & anxiety
Post on 23-Feb-2016
99 Views
Preview:
DESCRIPTION
TRANSCRIPT
Konstantinos G. Zeimpekis, MSc, DIC 22 November 2013
Attention, Emotion
& Memory in Depression
& AnxietyBasics and Definitions
Preview
Cognitive Functions
Anxiety and Depression
Attention
Emotion
Memory
Konstantinos Zeimpekis
Brain Imaging
MR Diffusion Tensor ImagingTractography
PET scan
Konstantinos Zeimpekis
Attention
Frontal Lobe & Thalamus, Hypothalamus
Konstantinos Zeimpekis
Memory
Temporal lobe, Hippocampus, Amygdala, Basal Ganglia
Konstantinos Zeimpekis
Emotion
Amygdala
Konstantinos Zeimpekis
Brain in Depression
- limbic system anterior cingulate cortex + dorsolateral prefrontal cortex
difficulty recruiting brain regions for cognitive control
Konstantinos Zeimpekis
Brain in Depression
Konstantinos Zeimpekis
Theories
o Self - World - Future
o Stimuli is congruent with certain schemas (loss, separation, failure etc)(Beck 1976)
o Congruent life events negative automatic thoughtsprocessing biases depressed mood
Konstantinos Zeimpekis
Depression
Increased elaboration of negative information
Difficulty in disengaging from negative material
Deficits in cognitive control when negative information is processed.
Konstantinos Zeimpekis
DepressionConcentration & memory deficit (Burt 1995)
Easily concentrate on negative self-focused thoughts
Enhanced recall of mood congruent material
Memory impairments not specific to depression but in general psychopathology (Burt 1995)
Not in all memory components but in free recall tasks (Hertel 1998)
Konstantinos Zeimpekis
Depression
MDD is characterized by negative automatic thoughts and biases in attention, interpretation and memory
Vulnerability stressor
Konstantinos Zeimpekis
Depression
Deficits in executive control and attentional deficits characterize depressed people whereas evidence for learning and memory deficits is more mixed (Castaneda et. al. 2008)
Difficult to differentiate between cognitive deficits and a lack of motivation that characterizes depressed patients (Scheurich et al. 2008)
Konstantinos Zeimpekis
Anxiety models
• panic disorder catastrophic interpretative bias
• social phobia focused attentional bias
• clinical depression negative attributional style and rumination
• GAD “worry about worry”
Konstantinos Zeimpekis
Cognitive Bias and Emotion Dysregulation
I. Inhibitory processes and deficits in working memory (Joormann 2005)
II. Ruminative responses to negative mood states and negative life events (Nolen-Hoeksema 2000)
III.Inability to use positive and rewarding stimuli to regulate negative mood (Joormann & Siemer 2004)
Konstantinos Zeimpekis
Emotion Dysregulation
o difficulties disengaging from negative material
o impaired emotion regulation
Konstantinos Zeimpekis
Cognition and Emotion Dysregulation
Anxietyquick detection of and fast orienting toward
threat-related stimuli
Depressiononce negative material has become the focus of attention
elaboration occursinability to disengage and recovery
Konstantinos Zeimpekis
Vulnerability to Emotional Disorders
1. early occurrence in the info-processing sequence (selective attention and
memory)
2. later reportable cognitive products (intrusive thoughts, worry or rumination)
Konstantinos Zeimpekis
Emotion
Bias not prerogative for disorder
Anxiety Disorders selective attention favoring threatening
information (Mathews & MacLeod 1994)
Depression biases in explicit memory favoring negative
self-related information
Konstantinos Zeimpekis
EmotionBiases and deficits in cognitive functioning,
affect people’s ability
to regulate emotion and mood states,
increasing their vulnerability to develop
emotional disorders (Joormann et al. 2009d).
Konstantinos Zeimpekis
Emotion
Disengagement difficulties predominate when
threats are encountered incidentally, but
anxious individuals also actively search for and
engage locations associated with potential
threat and possible escape routes (Thorpe & Salkovskis 1998)
Konstantinos Zeimpekis
Emotion
o recall more unpleasant memorieso interpret ambiguous events in a more negative
manner Emotional processing bias
Frequent comorbidityAnxiety : threat cues at early stagesDepression : selective attention to mood-congruent stimuli
Konstantinos Zeimpekis
Attentionattentional bias
operates rapidly in anxietylonger time needed for stimulus processing in depression
• Depressed attend selectively to sad faces (Eizenman 2003)
• Bias with relatively long exposure conditions is characteristic of depression, but not of anxiety disorders, may be due to early attention to threat in the anxious group being superceded by later avoidance (Gotlib 2004)
Konstantinos Zeimpekis
Attention
Attention biases of depressed individuals are
expected to endure beyond the depressive
episode (Bower 1981)
Konstantinos Zeimpekis
Attention
o Biased processing of subliminally presented anxiety-provoking stimuli (Bradley et al 1995)
o Only GAD patients exhibited that (not comorbid with depression) but GAD patients with depression did not differ from controls
o Increased attention to negative words for long time (Donaldson 2007)
Konstantinos Zeimpekis
Attention Depressed individuals do not direct their attention to
negative info more frequently than control do, BUT once it captures their attention they exhibit difficulties disengaging from it (Joormann & Gotlib 2007)
Selective bias for negative info different between depression and anxiety (Caseras 2007)
Depression disengagement difficultyAnxiety bias once they feel the stimulus in early
stagesKonstantinos Zeimpekis
Depression
These findings suggest that deficits in executive control and inhibition are related to sustained processing of negative material and rumination, which in turn maintains the negative mood state and hinders recovery from negative affect (Joormann & Gotlib 2008)
Konstantinos Zeimpekis
Memory
Autobiographical memory refers to the recall of specific incidents from one’s past, typically sampled by asking someone to produce a personal memory related to a cue word or phrase
That is, despite instructions to recall a specific event, depression-prone individuals frequently provide a general class of events
Konstantinos Zeimpekis
Memory
In contrast to the strong evidence of memory bias in depression, in anxiety disorders such an effect remains elusive and unconvincing, except in the case of panic disorder (Coles & Heimberg 2002, MacLeod & Mathews 2004)
Konstantinos Zeimpekis
Memory
It has been suggested that anxiety motivates avoidance of semantic elaboration, or promotes perceptual encoding of threat information, so it is stored in nonverbally accessible form (Brewin 2001)
Konstantinos Zeimpekis
Auto biographical Memory
• Negative biases in memory, interpretation and attention (Mathews & MacLeod 2005)
• Preferential recall of negative compared to positive material : most robust finding
Nondepressed / bias for positive info
• Not only memory of negative events but generic memories despite instructions to recall specific events (Williams et al 2007)
Konstantinos Zeimpekis
Auto biographical Memory
o Summarize categories of events rather than retrieving a single episode
capture and rumination processes
functional avoidance
impairment in executive capacity and control
Konstantinos Zeimpekis
Memory
Greater memory impairment when :
• Attention not constrained by task (Hertel 1991)
• Increased cognitive effort is required (Hartlage 1993)
• Attention is easily allocated to personal concerns (Ellis & Ashbrook 1988)
Konstantinos Zeimpekis
Overgeneral Memory
Overgenerality general memory deficitsrecalling contextual detail
Overgeneral memory is a consistent characteristic of patients with a diagnosis of
MDD
Konstantinos Zeimpekis
Overgeneral Memory
• Overgenerality does not occur in GAD, social phobia or blood and spider fearful individuals and it was not found in a mixed group of anxiety disorder patients (Wessel et al 2001)
• Unlike dysphoria, in which overgenerality is found, it is not found in individuals with high trait anxiety (Richards & Whittaker, 1990)
• Overgenerality– Depression– PTSD
Konstantinos Zeimpekis
Overgeneral MemoryDepression / Post Traumatic Stress Disorder
Overgeneral Memories
Negative experiences / trauma
events retrieval
Executive control Impairment
Failure to inhibit competing information
Konstantinos Zeimpekis
Journal Club
Konstantinos Zeimpekis
Journal Club
Emotion
Konstantinos Zeimpekis
Higher-order cognitive functions
Inhibitory Control
Journal Club
Konstantinos Zeimpekis
Journal Club
Konstantinos Zeimpekis
Journal Club
Konstantinos Zeimpekis
Journal Club
Konstantinos Zeimpekis
Thank you !
top related