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Neuropsychopharmacology : Official... Jan 2022Neuroimaging has revealed robust interactions between the prefrontal cortex and the hippocampus when people stop memory retrieval. Efforts to stop retrieval can arise... (Review)
Review
Neuroimaging has revealed robust interactions between the prefrontal cortex and the hippocampus when people stop memory retrieval. Efforts to stop retrieval can arise when people encounter reminders to unpleasant thoughts they prefer not to think about. Retrieval stopping suppresses hippocampal and amygdala activity, especially when cues elicit aversive memory intrusions, via a broad inhibitory control capacity enabling prepotent response suppression. Repeated retrieval stopping reduces intrusions of unpleasant memories and diminishes their affective tone, outcomes resembling those achieved by the extinction of conditioned emotional responses. Despite this resemblance, the role of inhibitory fronto-hippocampal interactions and retrieval stopping broadly in extinction has received little attention. Here we integrate human and animal research on extinction and retrieval stopping. We argue that reconceptualising extinction to integrate mnemonic inhibitory control with learning would yield a greater understanding of extinction's relevance to mental health. We hypothesize that fear extinction spontaneously engages retrieval stopping across species, and that controlled suppression of hippocampal and amygdala activity by the prefrontal cortex reduces fearful thoughts. Moreover, we argue that retrieval stopping recruits extinction circuitry to achieve affect regulation, linking extinction to how humans cope with intrusive thoughts. We discuss novel hypotheses derived from this theoretical synthesis.
Topics: Amygdala; Animals; Extinction, Psychological; Fear; Hippocampus; Humans; Memory; Prefrontal Cortex
PubMed: 34446831
DOI: 10.1038/s41386-021-01131-1 -
American Family Physician Dec 2013Posttraumatic stress disorder (PTSD) occurs in an estimated 8% of men and 20% of women who are exposed to traumatic events. PTSD is a trauma- and stress-related disorder... (Review)
Review
Posttraumatic stress disorder (PTSD) occurs in an estimated 8% of men and 20% of women who are exposed to traumatic events. PTSD is a trauma- and stress-related disorder associated with significant psychosocial morbidity, substance abuse, and other negative physical health outcomes. The hallmarks of PTSD include exposure to a traumatic event; reexperiencing the event or intrusion symptoms; avoidance of people, places, or things that serve as a reminder of the trauma; negative mood and thoughts associated with the trauma; and chronic hyperarousal symptoms. Self-report questionnaires can assist clinicians in identifying anxiety problems associated with traumatic events. For patients who meet criteria for PTSD, trauma-focused psychotherapy and pharmacotherapy improve symptoms. Benzodiazepines and atypical antipsychotics are not recommended because studies have shown that adverse effects outweigh potential health benefits. Primary care physicians should monitor patients with PTSD for comorbid conditions such as substance abuse, mood disorders, and suicidality, and should refer patients to behavioral health specialists and support groups when appropriate.
Topics: Algorithms; Combined Modality Therapy; Decision Support Techniques; Humans; Psychotherapy; Psychotropic Drugs; Risk Factors; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; United States
PubMed: 24364547
DOI: No ID Found -
Journal of Reproductive and Infant... Jul 2020The postpartum period is a vulnerable time for the development of depression. While perinatal depression has been well studied, intrusive thoughts related to the infant...
BACKGROUND
The postpartum period is a vulnerable time for the development of depression. While perinatal depression has been well studied, intrusive thoughts related to the infant and classic obsessive-compulsive (OC) symptoms (e.g. chequering, ordering and cleaning) are also common in the postpartum and less well understood.
OBJECTIVE
The present study investigated the associations among depressive symptoms, intrusive thoughts, and OC symptoms and their relation to the quality of the mother-infant relationship, particularly in the realm of maternal responsiveness.
METHODS
Participants ( = 228) were recruited after delivery from a large Midwestern academic medical centre. At 2 and 12-week postpartum, participants completed self-report questionnaires that assessed demographics, depressive and OC symptoms, postpartum-specific intrusive thoughts and accompanying neutralising strategies, and maternal responsiveness.
RESULTS
At 12-week postpartum, maternal responsiveness was significantly lower for participants that endorsed intrusive thoughts, neutralising strategies or OC symptoms of clinical significance. More severe intrusive thoughts and neutralising strategies were associated with maternal responsiveness but not predictive after accounting for depressive symptoms; depressive symptoms were associated with lower levels of maternal responsiveness across the postpartum.
CONCLUSIONS
A sizable number of postpartum women experience clinically significant postpartum-specific intrusive thoughts and utilise neutralising strategies, especially in the context of postpartum depressive symptoms. Depressive symptoms have the most influence on maternal responsiveness but it is also important to target intrusive thoughts and OC symptoms in the context of postpartum depression to promote the welfare of new mothers and their offspring.
Topics: Academic Medical Centers; Adult; Depression; Female; Humans; Longitudinal Studies; Midwestern United States; Mother-Child Relations; Obsessive-Compulsive Disorder; Postpartum Period; Pregnancy; Self Report; Surveys and Questionnaires; Thinking
PubMed: 31431052
DOI: 10.1080/02646838.2019.1652255 -
BMC Psychiatry Mar 2019Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive...
BACKGROUND
Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period.
METHODS
Participant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse.
DISCUSSION
There is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.
Topics: Adult; British Columbia; Child Abuse; Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Infant; Longitudinal Studies; Male; Mothers; Obsessive-Compulsive Disorder; Postpartum Period; Pregnancy; Puerperal Disorders; Risk Factors; Surveys and Questionnaires; Thinking; Young Adult
PubMed: 30898103
DOI: 10.1186/s12888-019-2067-x -
Brain Sciences Oct 2020Obsessive-compulsive disorder (OCD) is characterized by cognitive regulation deficits. However, the current literature has focused on executive functioning and emotional... (Review)
Review
Obsessive-compulsive disorder (OCD) is characterized by cognitive regulation deficits. However, the current literature has focused on executive functioning and emotional response impairments in this disorder. Herein, we conducted a systematic review of studies assessing the behavioral, physiological, and neurobiological alterations in cognitive regulation in obsessive-compulsive patients using the PubMed database. Most of the studies included explored behavioral (distress, arousal, and frequency of intrusive thoughts) and neurobiological measures (brain activity and functional connectivity) using affective cognitive regulation paradigms. Our results pointed to the advantageous use of reappraisal and acceptance strategies in contrast to suppression to reduce distress and frequency of intrusive thoughts. Moreover, we observed alterations in frontoparietal network activity during cognitive regulation. Our conclusions are limited by the inclusion of underpowered studies with treated patients. Nonetheless, our findings support the OCD impairments in cognitive regulation of emotion and might help to improve current guidelines for cognitive therapy.
PubMed: 33138023
DOI: 10.3390/brainsci10110797 -
Journal of Rational-emotive and... 2022Individuals suffer from insomnia through the presence of extraneous thoughts. Furthermore, there are cognitive and behavioral aspects, which afflict a person when they...
Individuals suffer from insomnia through the presence of extraneous thoughts. Furthermore, there are cognitive and behavioral aspects, which afflict a person when they have insomnia. In this context, there are strategies to address these thoughts. The Thought Control Questionnaire: Insomnia-Revised (TCQI-R) is a self-reporting instrument that aims to evaluate the strategies used by individuals to control their thoughts when suffering from insomnia. This study aimed to translate and adapt the TCQI-R to the Jordanian society. In this study, the questionnaire was applied to a sample of 361 participants aged between 19 and 61 years, of which 210 were women (58%). The principal component analysis determined five components: reappraisal, cognitive distraction, aggressive suppression, worry, and behavioral distraction. Each of the total scores of the questionnaire (α = 0.90) and its five components (Cronbach's α between 0.75 and 0.83) demonstrated high internal consistency. The results of the triple analysis of variance established that the instrument can distinguish between depressed and non-depressed people, anxious and non-anxious people, and people who suffer from insomnia and those who do not. Additionally, the results revealed significant statistical correlations between each of the total scores of the questionnaire and its five components as well as with the related scales. Finally, multiple regression analysis demonstrated the ability of the TCQI-R to predict depression, anxiety, and insomnia, and the prediction ratio for the overall score were 32.4%, 36.6%, and 42.6%, respectively. This indicates that worry and cognitive distraction were the most powerful strategies in dealing with insomnia. This instrument has the ability to assess and diagnose intrusive thoughts and adjust the strategies used to overcome insomnia.
PubMed: 34007101
DOI: 10.1007/s10942-021-00398-z -
Behavioral Sleep Medicine 2023Poor sleep is common in our society, particularly for African Americans, and is associated with adverse mental and physical health outcomes. Unwanted, intrusive thoughts...
INTRODUCTION
Poor sleep is common in our society, particularly for African Americans, and is associated with adverse mental and physical health outcomes. Unwanted, intrusive thoughts contribute to sleep disturbances and can be engendered by living in stressful urban environments, which are disproportionately inhabited by African Americans. Studies of other populations have shown that cognitive coping strategies to manage intrusive thoughts vary in their adaptiveness.
OBJECTIVE
To examine the relationship between thought control strategies and insomnia severity in urban residing young-adult African Americans.
METHOD
Sixty-four young adult African Americans completed a demographic questionnaire, the Thought Control Questionnaire for Insomnia-revised, and the Insomnia Severity Index.
RESULTS
There were moderate to strong positive correlations of aggressive suppression, worry, behavioral distraction, and social avoidance with ISI scores. Poor sleepers endorsed greater use of worry and aggressive suppression than good sleepers. Results from a multiple linear regression analysis revealed that aggressive suppression, social avoidance, and behavioral distraction significantly predicted insomnia severity, and aggressive suppression was the strongest predictor in the model.
CONCLUSIONS
These results extend findings of aggressive suppression as a correlate of insomnia severity to an urban-residing young adult African American sample. Future research should identify adaptive approaches and the utility of modifying maladaptive strategies.
Topics: Humans; Young Adult; Sleep Initiation and Maintenance Disorders; Black or African American; Cognition; Anxiety; Sleep
PubMed: 35362345
DOI: 10.1080/15402002.2022.2057986 -
PloS One 2018A key mechanism thought to underlie Posttraumatic Stress Disorder (PTSD) is enhanced emotional memory consolidation. Recent evidence in healthy controls revealed that...
BACKGROUND
A key mechanism thought to underlie Posttraumatic Stress Disorder (PTSD) is enhanced emotional memory consolidation. Recent evidence in healthy controls revealed that women have greater negative memory consolidation following stress relative to men. This study examined emotional memory consolidation in women and men with PTSD, and in trauma-exposed and non-trauma controls to test the hypothesis that emotionally negative memory consolidation would be greater in women with PTSD.
METHOD
One hundred and forty-seven men and women (47 with PTSD, 49 trauma-exposed controls, and 51 non-trauma controls) completed an emotional memory task where they looked at negative, neutral and positive images from the International Affective Picture System (IAPS). Delayed recall and an intrusive memory diary were completed two days later.
RESULTS
Women displayed greater recall, and reported more negative intrusive memories than men. A gender x group interaction effect showed that both women with PTSD and trauma-exposed women reported more intrusive memories than women without trauma exposure or men.
CONCLUSION
This study provided preliminary evidence of sex differences in intrusive memories in those with PTSD as well as those with a history of trauma exposure. Future research should include measures of sex hormones to further examine sex differences on memory consolidation in the context of trauma exposure and PTSD.
Topics: Female; Humans; Male; Memory Consolidation; Sex Factors; Stress Disorders, Post-Traumatic; Stress, Psychological
PubMed: 30521618
DOI: 10.1371/journal.pone.0208575 -
ELife May 2018Generalization during aversive decision-making allows us to avoid a broad range of potential threats following experience with a limited set of exemplars. However,...
Generalization during aversive decision-making allows us to avoid a broad range of potential threats following experience with a limited set of exemplars. However, over-generalization, resulting in excessive and inappropriate avoidance, has been implicated in a variety of psychological disorders. Here, we use reinforcement learning modelling to dissect out different contributions to the generalization of instrumental avoidance in two groups of human volunteers ( = 26, = 482). We found that generalization of avoidance could be parsed into perceptual and value-based processes, and further, that value-based generalization could be subdivided into that relating to aversive and neutral feedback - with corresponding circuits including primary sensory cortex, anterior insula, amygdala and ventromedial prefrontal cortex. Further, generalization from aversive, but not neutral, feedback was associated with self-reported anxiety and intrusive thoughts. These results reveal a set of distinct mechanisms that mediate generalization in avoidance learning, and show how specific individual differences within them can yield anxiety.
Topics: Avoidance Learning; Brain; Decision Making; Generalization, Psychological; Humans; Magnetic Resonance Imaging
PubMed: 29735014
DOI: 10.7554/eLife.34779 -
Psychology and Aging Mar 2012The current study incorporated a life span perspective into existing theories of intrusive thoughts to examine age-related differences in the difficulty controlling...
The current study incorporated a life span perspective into existing theories of intrusive thoughts to examine age-related differences in the difficulty controlling intrusive thoughts, the distress following intrusive thought recurrences, and the meanings assigned to these recurrences. Younger (N = 51) and older (N = 49) community adults were randomly assigned to suppress (i.e., keep out of mind) or monitor an intrusive thought. Participants rated their positive and negative affect throughout engagement with the intrusive thought, and they also rated the meanings they gave to recurrences of their everyday intrusive thoughts. The results demonstrated that older adults tended to perceive greater difficulty with controlling the intrusive thought than younger adults despite the fact that they did not differ in the actual recurrence of the intrusive thought. With regard to distress, older adults experienced steadier levels of positive affect than younger adults throughout engagement with the intrusive thought. However, older adults also reported greater residual negative affect after engaging with the intrusive thought than younger adults. Finally, older and younger adults appeared to assign meanings to recurrences of intrusive thoughts in line with age-relevant concerns. Specifically, older adults were prone to interpret the recurrence of intrusive thoughts as a sign of cognitive decline, but they were less likely than younger adults to see intrusive thoughts as a sign of moral failure. Together, these results highlight a range of potential risk and protective factors in older adults for experiencing emotion dysregulation after intrusive thoughts.
Topics: Adolescent; Adult; Affect; Aged; Aging; Analysis of Variance; Emotional Intelligence; Female; Humans; Male; Psychiatric Status Rating Scales; Psychological Tests; Psychological Theory; Recurrence; Regression Analysis; Repression, Psychology; Self Concept; Stress, Psychological; Thinking; Young Adult
PubMed: 21707184
DOI: 10.1037/a0024249