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Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 1 Nature of emotion - Part 1 of 3 Dr Tom Barry Department of Psychology, King’s College London Dr Jennifer Lau Department of Psychology,...

Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 1 Nature of emotion - Part 1 of 3 Dr Tom Barry Department of Psychology, King’s College London Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 4 I would like you to complete an introductory assignment before the lecture. I would like you to spend five to 10 minutes answering the questions on the screen. We are going to practice using introspective techniques. These are techniques used historically by philosophers of mind and psychologists to learn from their own experiences by turning their thinking inward to their own mind and behaviour. Slide 5 For what seem to be very simple questions about phenomena that we experience often, it is difficult to get to the bottom of what emotions are and what their defining characteristics are. Researchers and academics from different disciplines agree that there are various components and features of emotions. But they disagree in what the defining central characteristics of these emotions are. Having said that, most perspectives would agree that there needs to be a stimulus or eliciting event, something that provokes a change in equilibrium of experience. This can be an external stimulus, seeing a car speeding towards you, or an internal stimulus, the memory of your partner cheating on you with someone else. The stimulus could signal something real and objective, such as the car speeding towards you. Or it could be a subjective evaluation of the potential consequences of a situation, such as anticipating winning the lottery. However, what then defines the emotion? Are they a conserved set of expressive behaviours that serve an adaptive function? Or do they represent a set of sociocultural rules and responses that have been internalised? And should they be defined by a subjective feeling state, a change in the state of consciousness, or by physiological body responses? Finally, what drives the feelings of emotions? Changes in brain processing that are automatically activated in response to an emotion eliciting stimulus? Or a more conscious reappraisal of a situation? We can see that there are, indeed, different perspectives on what the defining characteristics of emotions are. Transcripts by 3Playmedia Week © King’s College London 2018 1.  Slide 6 A neuroscience perspective would consider that the set of behaviours, physiological responses, and subjective states result from a cascade of events coordinated by the nervous system that have evolved to ensure survival. Slide 7 Neuroscientists would specify that these neural events emerge in response to various events involving punishments and rewards. Slide 8 Edmund Rolls provided a working definition of what a punishment and reward is in his book The Brain and Emotion. “A reward is anything for which an animal will work, while a punishment is anything an animal will work to avoid and escape.” Slide 9 He further goes on to argue that specific emotions can be defined on the basis of whether they involve the presence of reward and punishments. Thus, happiness is a set of behavioural, bodily, neural, and cognitive responses to the presence of a reward, for example, winning money or being praised. And its role is to facilitate an approach to such rewards, because they are beneficial. In contrast, fear is an emotion state elicited by the presence of a punishment. Its role is to facilitate escape or avoidance. Rolls also suggests that emotions result from the termination and reduction in the likelihood of rewards or punishments. Thus, anger is felt when there is a termination of a reward, whereas relief is felt when a punishment is no longer present. Can all emotions conform in this way to the mere presence or absence of a reward or punishment? Rolls would say yes, but that different emotions could reflect differences between individuals in their habitual responses. So while some may feel anger towards termination of a reward, others may feel sad. But nonetheless, both occur in response to the same trigger. Rolls also would argue that what we call different emotions are actually the same in nature, but that they differ in intensity. So fear, apprehension, and terror all emerge in the presence of a punishment, but vary in their intensity. Finally, Rolls also makes some interesting points about whether hunger and pain conform to these definitions, and you will read more about those and discuss them in the discussion forum. Slide 10 In contrast to the neuroscientific perspective, a social constructivist perspective would suggest that emotions are learned rules in response to sociocultural norms. However, as behaviours associated with many basic emotions are shown by other species, and there is a conserved brain circuitry for expression of basic emotions, such as fear and pleasure, suggests that emotions have evolved to facilitate survival. Another piece of data that would argue against the social constructivist approach is that the way in which basic emotions are expressed is universal. Paul Ekman did a lot of work on this, showing that people from different cultural backgrounds, even preliterate cultures in New Guinea, who had not been exposed to mass media presentations of facial expression, where still able to link faces displaying particular emotions appropriately with what was happening in a story that they were being told. These data, together with many other studies, strongly suggest something that is biologically inherent about emotions. Yet it also cannot be denied that there are some cultural differences in the extent to which some emotions are expressed and managed, supporting the social constructivist approach. For example, some of this work compared the facial expressions of Japanese and American Transcripts by 3Playmedia Week © King’s College London 2018 2.  participants when viewing stressful films. It was found that Japanese participants displayed less intense emotions, particularly in the presence of a high status scientist from their own culture. Also, there have been differences between Japanese and American participants in how intensely they rate emotional facial expressions. The American participants had higher mean intensity ratings than the Japanese for all emotions except disgust. Thus, it appears that there are some cultural effects on display rules, the way that emotions are managed and controlled in particular social settings. Slide 11 There is also disagreement over whether emotions are the consequences of physiological bodily responses or whether physiological bodily responses are the consequences of emotions. Slide 12 William James posed these alternatives through an interesting question. Do we run from a bear because we are afraid, i.e. the physiological bodily responses occur in response to an emotion? Or are we afraid because we run, i.e. do we only feel the emotion because of the physiological bodily responses? Slide 13 He himself then went on to argue the latter. “Our natural way of thinking about emotions is that the mental perception of some fact excites the mental affection called emotion and that this latter state of mind gives rise to the bodily expression. My thesis, on the contrary, is that the bodily changes follow directly the perception of the exciting fact and that our feeling of the same changes as they occur is the emotion.” Slide 14 Finally, cognitive scientists would suggest that emotions occur in response to subjective appraisals of particular situations. So an ambiguous situation that resembles a threatening situation could be initially interpreted negatively and so instigate a cascade of subjective feeling, neural responses, bodily changes, and behaviours that are consistent with fear, but then, upon re-appraisal that the ambiguous situation is not actually dangerous, could then reduce the set of fear responses. Transcripts by 3Playmedia Week © King’s College London 2018 3.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 1 Nature of emotion - Part 2 of 3 Dr Tom Barry Department of Psychology, King’s College London Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 3 Now that we have some idea of what emotions are, we might ask what function, if any, do emotions serve? Can they be helpful, or are they merely a hindrance in our lives? Not everyone thinks that emotions can serve any beneficial function. These researchers, such as B.F Skinner, think that emotions are useless and bad for our peace of mind and blood pressure. I’m sure we’ve each experienced times where we feel that emotions might not be very functional or good for us, particularly when thinking about negative emotions like sadness. However, most scientists agree emotions have beneficial consequences. In particular, we can view emotions, both positive and negative, as solutions to physical or social problems or opportunities that we encounter in our lives that can benefit our survival. Slide 4 There are several functions that emotions have been hypothesised to serve, as this diagram illustrates. For example, they can help our bodies to prepare for action by generating autonomic and endocrine responses. The feeling of relief, for example, is associated with a decrease in heart rate, and the feeling of apprehension is associated with secretion of the stress hormone cortisol. Emotions can serve various other functions, too. In the following slides, we will focus on some of these functions. Slide 5 As you saw in the diagram, emotions can aid in motivating us to approach or avoid things in our environment. Whether or not the behaviour of approach or avoidance is selected depends on the type of emotion that a stimulus elicits. We can test this experimentally with Pavlovian conditioning. For example, we might pair one stimulus, a right triangle, with an electric shock. And another stimulus, a green square, may be paired with an increase in a financial reward given to participants. We then give participants a joystick which controls a small mannequin on the computer screen and ask participants to approach the stimuli by pushing the joystick. In studies which use this kind of paradigm, the degree of fear that a participant shows in the presence of the red triangle is likely to correlate with the extent to which participants push the mannequin Transcripts by 3Playmedia Week 3 © King’s College London 2017 1.  towards the triangle with more fear corresponding with greater distance between the triangle and the mannequin. Fearful participants might also move towards the stimulus more slowly. Similarly, the degree of pleasure that a person feels from being rewarded more money is likely to correlate with their approach of the green square and the speed with which they approach it. Interestingly, Carver and Harmon-Jones suggested, in their 2009 paper, that, if participants in such an experiment are forced to approach a stimulus that they have been conditioned to fear-- such as our triangle-- this may elicit anger. Slide 6 Emotions don’t just motivate and influence our own behaviour but also that of others. For example, by producing facial expressions, we can help others in two ways. Emotional expressions communicate to others the reinforcing value of stimuli they haven’t experienced themselves yet. For example, I might express disgust after eating a food that you may never have tasted before-- signalling to you that you should perhaps avoid it. These expressions can also help others prepare for approaching stimuli that they may not yet be aware of. For example, I might enter a room before you and express terror. How can you prepare your body? By activating the autonomic and endocrine response systems to be able to act quickly and respond to whatever is in the room. They can also help us form social bonds with others. For example, the infants of parents who express more positive emotions are more likely to be securely attached. In turn, these securely-attached infants are more likely to be comforted by contact with their parents, such as in the strange situation procedure. The emotional expressions of infants also help parents consolidate their bonds with their infant, too. Slide 7 As you’ll see in future topics, emotions can also influence the utilisation and efficiency of cognitive processes. For example, emotions can influence the way that things are stored in memory. More specifically, they can help us select the most relevant pieces of information from an event for further storage so that we only have to remember the bits of information from an event that are most important. The emotions that we feel during an event can also be stored alongside our memory for the details of an event. This means that, when we are in a particular mood or we experience an emotion at a later date, this can improve the ease with which information related to this current mood-- perhaps from previous related experiences-- can be retrieved from our memories. By improving access to certain memories, we are better able to select appropriate behavioural responses to current events on the basis of how we responded the last time we felt this emotion and what the effects of that response were. Slide 8 Another important consideration that we will come back to is-- although our emotions can serve some vital functions in helping us survive physically and socially-- for some people, there are situations in which the intensity with which they feel particular emotions may not be beneficial for survival and may even be detrimental. Also, if we are exposed to inappropriate emotions expressed by others, this might also be detrimental. For example, Radke-Yarrow and colleagues showed, in 1985, that exposure to inappropriate-- and in particular, excessively negative emotions-- when we’re young can also have detrimental effects on how we form social bonds with those. Transcripts by 3Playmedia Week 3 © King’s College London 2017 2.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 1 Nature of emotion - Part 3 of 3 Dr Tom Barry Department of Psychology, King’s College London Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 3 Now that we have discussed what emotions are, or rather, what components of emotions there are and why they are needed, we will discuss how we study the emotional experience in the lab. This is important, because in the next topic, we will consider how emotional stimuli or events or feeling emotional can affect cognitive processing. So how can we provoke, generate emotions in the lab? Perhaps the simplest way is to provide people with stimuli that might provoke an emotional response. Basic stimuli, such as faces wearing different negative emotions, for example, fear or anger, have been used in many studies and are known to activate responses in brain regions involved in the detection of emotions and the sympathetic nervous system. Presenting these can therefore be used to measure neural and physiological aspects of emotion. These stimuli have the advantage in that facial expressions are universally recognised, as we discussed earlier, and so can be applicable across individuals. Interestingly, these facial expressions carry such emotional significance that even when presented briefly and masked by a neutral face, they are capable of activating relevant emotional brain circuits. Yet, there are also criticisms of these stimuli. Some have argued that they are too mild to elicit a subjective response that is commensurate with most emotional responses that we feel. One improvement is to present a pair of eyes conveying the emotion. And a standardised set of eyes showing different emotions do exist for research purposes. This is called the eyes test, a test of emotion recognition. Arguably, such expressions are thought to generate stronger emotional expressions. And in fact, one famous study found that a picture of a pair of eyes in the corner of an office kitchen led more people to put money into the kitty for buying coffee and tea. But nonetheless, even a pair of eyes is not that realistic. How often are we confronted with just a pair of eyes? Moreover, they do not elicit strong emotions. A pair of eyes suggestive of happiness might generate a feeling of mild pleasantness in some people, but would not be expected to generate actual contentment, elation, or excitement, such as those experienced in everyday life. It is because Transcripts by 3Playmedia Week 3 © King’s College London 2017 1.  the emotion presented either on the face or a pair of eyes is removed from a wider sociocultural context, in which many of our richest emotional experiences occur. Slide 4 How can we generate emotional responses that are more realistic? One method is to embed the negative or positive stimulus in everyday contexts that we know generally generate emotional responses. So studies focusing on positive emotional responses have used monetary reward tasks, where participants win money based on their performance on a task. A well-known reward task is called the monetary incentive delay task, where on particular reward trials, cued by a particular geometric shape, if individuals respond quick enough after a variable interval, they win a specified amount of money. Such simple tasks can also activate brain regions that appear to be conserved for responding and anticipating rewards. While winning money is one way of generating positive emotions, there are other creative methods, for example, giving people chocolate while presenting pictures of chocolate. Again, these simulations of more real life positive emotions can activate the brain’s reward systems and enable us to study positive emotions in a more realistic way. Slide 5 What about negative emotions? How can we embed these in common, everyday events? A bit more care needs to be given to designing such studies for ethical reasons. We do not want to provoke any negative emotions that are likely to be long lasting after the end of the experiment. My group has been interested in studying teenagers’ emotional responses. And we all knew that teenagers could be cynical participants, so we needed something very salient than just faces to activate their emotions. Now, we also knew that peer feedback is very important for many teenagers. So together with collaborators in the US, we developed a paradigm called the chat room task, where teenagers were told that they would be chatting to other young people over the internet. They were then shown a series of pictures of these supposed other young people and were asked to rate how much they wanted to talk to each person. They were told that their photo was also being rated by other young people. Then, while they were lying in the MRI scanner, they received either rejecting or accepting feedback from each person in the photos they had seen. Using this method, we were able to measure both subjective responses towards peer rejection and peer acceptance, so the negative and positive emotions of teenagers, respectively, but also the correlated brain responses too. Unlike simple face emotions, these more complex social stimuli were far more emotionally provocative, particularly at the subjective rating level. Of course, such experiments need to be conducted only after a very in-depth consideration of ethical issues and approval by an ethics committee. In this case, all the photos and the feedback that the participants received were not real. The photos were of child actors and the feedback computer generated. All young people were, of course, fully debriefed. And we did not invite participants we knew to be particularly vulnerable, such as those who were suicidal, to this kind of study. We also had a clinician check that the young person was feeling OK before leaving the lab. Slide 6 While the chat room task is more realistic to everyday life than presenting faces and eyes, it has still been criticised for not being very believable and, again, somewhat more removed from everyday situations. Another method that addresses this is to get participants to keep real life diaries of events that they experience and then to rate their emotional response to it. Transcripts by 3Playmedia Week 3 © King’s College London 2017 2.  Presumably, such a method is more realistic, because the participants themselves have selected emotionally salient events. However, there are still problems with these methods. Because the events that the participants choose are not the same, some may actually experience objectively more serious events than others, and so a higher rating could be reflective of the objective characteristics of the event, rather than the emotional response of the participants. Slide 7 So far, we have talked about methods that involve presenting emotionally provocative stimuli to try and capture emotional responses. Another method that is very different is to try and change people’s mood state. This is called mood induction and can be done in a variety of ways experimentally, but also pharmacologically. But we will only cover the first of these in this section. In fact, we are now going to get you to try this yourselves. [MUSIC PLAYING] Slide 8 We hope that you are now in a pretty good mood and that this was reflected in your ratings before and after the induction. But if we did this in the lab and found this pattern of results across participants, we can never be sure that any change in positive mood is not a demand effect. That is, participants may only be responding in such a way as they think the experimenter wants them to. So it would be useful to demonstrate that there is a transfer of the positive mood effects to other measures. Wright and Bower found evidence that after positive mood induction, participants report higher probabilities for positive events and lower probabilities for negative events, while those who received negative mood induction showed the opposite pattern. Then, finally, those who had neutral mood inductions showed no difference between positive and negative events. Slide 9 In summary, we have covered what emotions are, why they are needed, and how we can study emotional responses in the lab. In the next topic, we will be discussing how emotions can impact our cognitive processing, the processing of events in the environment. Transcripts by 3Playmedia Week 3 © King’s College London 2017 3.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 2 Emotion processing: bottom-up effects of emotions on cognitive processes - Part 1 of 3 Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 3 In this section, we will consider the effects of emotions on attention processing, the degree to which individuals differ on how much emotions enhance or interfere with attention. And finally, how these individual differences can be considered factors in the maintenance or even onset of certain mental health conditions. Attention is a set of cognitive functions that select and prioritise some information for further processing. This selection occurs due to limits in our cognitive capacities to process all information. Within this selective process, emotional stimuli, that is objects, events, or situations that signal potential danger or reward, can grab attention. From an adaptive evolutionary perspective, this makes a lot of sense because emotional stimuli signal events or situations that can effect our survival. They are therefore likely to filter through the selection process to be processed further, both physiologically, for example, through autonomic arousal. And cognitively, for example, to be learned, consolidated, and remembered. All of the consequences of the further processing of emotional stimuli is to enable us to act accordingly. To fight or flight in the present situation, but also on future occasions. Slide 4 Even artificial threats stimuli as presented in laboratory tests can pop out and capture our attention. In one study by Ohman and colleagues in 2001, participants were presented in one condition with a discrepant fear relevant stimulus, a snake or a spider, embedded in a grid like array of fear irrelevant stimuli, such as flowers or mushrooms. In another condition, a discrepant fear irrelevant stimulus, such as the flower or mushroom, appeared within a grid array of either fear relevant stimuli so, for example, snakes and spiders. Participants on each trial had to locate the discrepant stimulus. Participants were found to be far quicker at detecting discrepant fear relevant stimuli from fear irrelevant distractors than they were at identifying the discrepant fear irrelevant stimuli from fear relevant distractors. In other words, they were quicker on trials in the first condition than in the second condition. Transcripts by 3Playmedia Week 3 © King’s College London 2017 1.  What was also interesting was that the speeded reaction times of the participants for detecting these fear relevant stimuli was unaffected by other task factors, such as the number of distractors or the actual location of the target stimulus, suggesting a robust pop out effect. Slide 5 A variation of this task is the faces in the crowd study where similar findings were also reported for identifying a discrepant angry face from a crowd of happy faces. The finding that even mildly threatening stimuli as presented in a laboratory can grab our attention shows how strong and natural the tendency to detect and respond to actually dangerous situations is. Slide 6 But individuals can vary from one another in this selective attention bias to threat. They can differ in the degree to which their attention is automatically captured by mild threats, even if briefly presented. They can also differ in the extent to which they can disengage or unlock their attention from that threat allowing it to disrupt other ongoing cognitive processes. And they can also differ in the type of threat stimulus that captures their attention. People with mental health problems have been found to show heightened attention for threatening stimuli. Particularly ones that are congruent with their concerns. Experimentally, this has been studied using a task known as the visual probe task. In this task, participants are presented with a fixation cross first to orient their attention to the middle of the computer screen. Next, two stimuli, and these can be words or pictures as long as one is always emotional and the other neutral, are flashed up side by side for a certain time duration. After the stimuli have disappeared, a probe appears to which the participants have to respond. This probe can be an arrow either pointing to the left or right. And participants have to press one button if it is on the left, and one button if it is on the right. Their accuracy and reaction times in responding to this probe are recorded. So the response to the probe is a measure of where your attention focus is at that particular time. The crucial experimental manipulation is whether the probe, in this case, the arrow, appears in the place of the threatening stimulus or the neutral stimulus. If it appears in the place of the threatening stimulus, we call this a congruent trial. And if it appears in the place of the neutral stimulus, we call it an incongruent trial. An attention bias for threat index can be derived by taking the difference between reaction times to the probe on congruent versus incongruent trials. What researchers have found fairly consistently is that amongst people with some mental health problems, if the threat stimulus matches their concerns, they are quicker at responding on congruent trials, and slower to respond on incongruent trials. What this pattern of responding suggests is that their attention had been very quickly captured, and possibly locked in by the presence of the threatening stimulus. Slide 7 Illustrating this bias is the study using the visual dot probe task to investigate the attention processing of stimuli relating to eating, body shape, and body weight in women with and without eating disorders and an anxious control group. Trials present a control stimulus with an emotional stimulus for about one second followed by a probe. In this case, the emotional stimuli could be a picture of a positive eating scenario, such as eating something healthy. A negative eating scenario such as eating junk food. A neutral eating scenario such as a picture of a restaurant. A positive body shape stimulus so someone looking of normal weight about to go for a swim. A negative body shape stimulus, someone’s figure. A neutral body shape stimulus such as the body part. Or a neutral weight stimulus such as scales. Results from their first experiment suggested that women with an eating disorder were quicker at responding if the probe appeared behind the negative eating stimulus than the control stimulus. Transcripts by 3Playmedia Week 3 © King’s College London 2017 2.  They were also slow to respond to the probe if it followed the positive eating stimulus than if it replaced the control stimulus. Finally, they were also quicker to respond to the probe if it appeared behind the neutral weight stimulus. Together, these data suggested that women with an eating disorder had an attention orienting bias towards negative eating stimuli and the neutral weight stimuli. But that they tended to turn their attention away from positive eating stimuli. That is, they showed an attention avoidance. These biases were greater than in the anxious control group and in the healthy women, even amongst those who reported having high shape concern. These findings were then replicated in a second experiment, but where they also found an attention orienting bias for negative and neutral shape stimuli, which was not found in the first study. Slide 8 While the visual probe task has been used a lot in its simple form, there are some limitations. One criticism is that it is not easily able to differentiate between whether it’s a hypervigilance towards the emotional stimulus, what has been called an attention orienting response. Or if it is the inability to unlock your attention or has been called disengaging your attention away from the stimulus. Another criticism is that it is difficult to trace the time course of attention vices. That is, at what point do people revert attention away from the stimulus because it is too distressing? One way of differentiating between these explanations is to use eye tracking methodology. Eye tracking methods enable a more continuous measure of attention because they can measure initial fixations to particular stimuli as they appear on a screen. As well as the length of time spent gazing at a particular stimulus before a fixation away from the stimulus occurs. Thus, one can obtain more precise information about the time course of attention vices from early to late. And map out the direction of the bias when it changes from vigilance to avoidance. A number of studies have used eye tracking to measure attention biases for threats or negative stimuli in relation to anxiety and depression. And these studies are summarised in a review paper that appears on your reading list. Slide 9 Another way that individuals can differ is the extent to which attention to an emotional stimulus can disrupt and interfere with the ability to complete an ongoing task. The effects of emotional stimuli, such as threats on simple cognitive tasks such as labelling the colour of a word, have been shown to differentiate people with certain mental health problems and healthy controls. This has been shown through the administration of a task known as the emotional Stroop task. I’m going to show this to you now. In this task, you will see some words. I want you to label the colour of each word. You can do this out loud. I want you to repeat the task again, but this time, thinking whether you noticed anything special about the content of the words. Did you notice how the content of the words effected your ability to name the colour in a timely fashion? This task has been used to show differences between anxious and non-anxious people. Namely that anxious people are much more affected by the threatening content of the word than are non- anxious people. In a classic study, Matthews and MacLeod in 1985 asked group of anxious patients to complete the same task. Amongst their patients, there were people with social concerns. For example, they would find it embarrassing to talk to new people. While others had physical concerns. For example, they thought it was likely that they would have a heart attack. What the authors found was that while non-anxious control participants showed no difference in Transcripts by 3Playmedia Week 3 © King’s College London 2017 3.  colour naming reaction times between the threat and non-threat words, patients with anxiety were much slower at this task for threats words than for the non-threat words. What the study also showed was that which words affected attention, very much depended on the content of the word, and the concerns of the patient. So whereas all anxious patients were disrupted on social threat cues, only physical worriers were disrupted on the physical threat words. Indeed for people with other psychiatric conditions, there was a similar disruption of their performance on colour naming when the word is close to their concern. So for example, people with depression can be more affected by words that trigger inadequacy to reflect their low self- esteem. For example, loser. People with eating disorders are disrupted by words around body weight and shape. Slide 10 In summary, threat stimuli and negative stimuli can quickly capture attention and take up cognitive resources so that it disrupts ongoing cognitive processing. We have discussed how this may be an adaptive process because it facilitates our detection of danger and allows us to act. However, not all threatening and negative stimuli may actually be dangerous. And in those situations, having our attention captured by the stimuli that don’t have an impact on our survival, can be a drain on our resources. In these circumstances, being hypervigilant to a mild threat or negative cue is maladaptive. Something which we think may characterise individuals with mental health conditions, such as anxiety disorders, eating disorders, and depression. Research suggests that such biases in attention could contribute to the maintenance or onset of psychopathology. On the other side of the coin, it is important to note that positive and rewarding stimuli also capture attention. And that individuals can also vary in this tendency. With those who are depressed, showing an absence of this tendency, and those with more optimistic and resilient traits, showing greater vigilance for positive stimuli. Transcripts by 3Playmedia Week 3 © King’s College London 2017 4.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 2 Emotion processing: bottom-up effects of emotions on cognitive processes - Part 2 of 3 Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 2 We have already talked about how the presence of emotional, particularly threatening stimuli can disrupt our attention processing resources, so that we do worse at a concurrent task. But the presence of emotional stimuli can help in some circumstances to enhance learning too. Parents often use rewards to motivate their children to learn. And at work, people are motivated to perform well by promotions and salary increases. Clearly, the use of rewards, an example of a positive motivational stimulus, can be effective, although note that this can be controversial too, given that there are suggestions that external rewards can dampen intrinsic motivation. Slide 3 Experimentally, we can also see these effects of emotion on learning by using very simple associative learning tasks, where one cue is paired with another consistently across trials, so that the two become associated through the contingency. Sui He and Humphreys developed an experiment where participants learned during the training phase to associate three types of shape, a triangle, square, and a circle, with a high, medium, or low monetary reward, respectively. Then, in a test phase, they completed a matching task, in which they were presented with shapes paired with either the same or different reward values that they had seen during the training phase. In this test phase, they had to judge whether the shape value pairs matched what they had learned earlier. For correct match and non-matching judgements, participants gained extra rewards according to the value initially assigned to the shape. What they found was that there was a beneficial learning effect for the high reward pairing compared to the medium reward and compared to the low reward. This suggests that by including a reward, learning was enhanced on the simple shape matching task. Slide 4 What was really interesting about the set of experiments which this study was a part of was that in a variant of the task, where participants had to learn to associate the geometric shapes with the self, a friend, and a stranger, there was also a clear bias for the self-shape associations. That is, shapes that were paired with the self were much better learned than those for a friend and Transcripts by 3Playmedia Week 3 © King’s College London 2017 1.  stranger, suggesting that self-associations can be as rewarding or at least salient than monetary rewards. Slide 5 Another example by which the presence of emotional stimuli can affect learning is through the phenomenon called fear conditioning. During fear conditioning, the occurrence of an aversive or unpleasant stimulus can transfer some of the fear provoking effects to other neutral stimuli that are in the environment through association. We came across fear conditioning earlier on in this module by the case of Little Albert. If you remember, Little Albert was recruited to a study conducted by John Watson, in which a loud noise was presented every time Little Albert encountered a small, furry creature, a mouse. Prior to the experiment, the investigators established that while the loud noise provoked crying in Little Albert, the mouse initially did not. However, after being paired together, the mouse suddenly provoked crying and distress in Little Albert too. What had happened was that the mouse had become a conditioned threat stimulus, in the language of fear conditioning, having acquired the ability to provoke an unconditioned fear response similar to that of the loud noise, called an unconditioned stimulus. Thus, this little case study illustrates well how people can learn to fear particular objects by being paired with an emotional stimulus. Slide 6 Fear conditioning has been demonstrated experimentally in the lab in many, many studies. Typically, these studies may pair a geometric shape, such as a small circle, with an electric shock, while a second geometric shape, such as a big circle, is never paired with a shock. As you can imagine, after the conditioning phase, during the test phase, even though the shapes appear without electric shock, people still show greater fear responses to the conditioned threat stimulus, in this example, the smaller of the two circles. So through association, individuals can learn to fear a previously neutral stimulus. What is more is that individuals can generalise their fear. So sometimes, individuals show slightly elevated fear to the conditioned safe stimulus as well, in this example, the larger of the two circles. What happens if they are presented with intermediate sized circles such as these? Slide 7 Lissac and colleagues investigated this and found a gradient of fear responses that could be related to the perceptual similarity of the shape to the original conditioned threat stimulus. In other words, there were continuous decreases in generalisation as the presented stimulus became less similar to the conditioned threat stimulus. Coming back to the example of Little Albert, his fear to the mouse that was paired with the loud noise apparently generalised to all white, furry objects. Depending on many factors, including what the unconditioned stimulus was that generated the fear in the first place, the fear to the conditioned threat stimulus can be pretty resistant to change. Normally, to reduce the fear in a process, called fear extinction, the individual has to experience the conditioned threat stimulus without the aversive unconditioned stimulus across many trials. And even then, there is a suggestion that the memory for the conditioned fear is not erased. It is simply inhibited. You will learn more about this process of fear extinction later on in the next topic. Slide 8 As you may probably have guessed, fear conditioning is a nice model for how people acquire phobias, namely, that they experience an aversive incident and go on to fear cues that happen to have been present at the time and seemed to also predict the outcome. You can imagine this for people with water phobia. An accident in the bath can lead to fears of drowning, the unconditioned Transcripts by 3Playmedia Week 3 © King’s College London 2017 2.  stimulus, and therefore water, the now conditioned stimulus. It is also plausible that this fear also generalises to other cues that were present, so for example, the bath tub and to other contexts involving water, so for example, swimming pools. This is an appealing account of many phobias. However, it is also quite a simplistic account. For one, not everyone who has a phobia can immediately recall a negative event that preceded it. Second, not everyone who has similar accidents in the bath subsequently develop phobias. Slide 9 Addressing the first of these problems, Stanley Rachman proposed an expansion of the initial fear conditioning account of phobias to include other pathways by which individuals could acquire fear of neutral objects, without directly experiencing the aversive unconditioned stimulus and the conditioned threat stimulus themselves. These pathways involve vicarious and informational transmission of fears, which can occur in the absence of direct contact with the fear stimuli. Slide 10 Vicarious learning, sometimes also referred to as observational learning or social referencing, is when people acquire fears by observing fearful responses to what was previously a neutral stimulus or situation in other people. One study illustrating this nicely showed that the offspring of rhesus monkeys were much more likely to acquire intense and persistent fear of snakes after watching their parents behave fearfully to a real model or even toy snake for a short period of time. In humans, there are also strong suggestions that children model their levels of fear to novel stimuli based on their parents’ responses. For example, in the famous visual cliff experiment, one-year- old infants only crawled across what looked like a drop in height, but was actually a piece of glass superimposed over patterns that resembled a change in depth cues, when the mother displayed facial expressions that were positive, such as joy, and much less likely to crawl across the piece of glass when the mother displayed fear or anger. These data together with other studies suggest that many fears can be acquired through modelling their parents’ responses. This can explain why many specific fears and phobias have an early age of onset. Slide 11 Similarly, fears can be acquired through transmission of verbal information. Again illustrating this, a study allocated children aged between seven and nine to receive either negative or positive information about an unknown monster doll. Results showed that fear related beliefs about the monster doll changed significantly as a function of the emotional valence of verbal information. Moreover, the authors demonstrated that fear beliefs only changed when the information was presented as a story, i.e. verbally, but not as a video. Also, fear beliefs only changed if information was presented by an adult, such as a teacher or an adult stranger, but not by a peer. This study has interesting implications for the transmission of fear from adults, such as parents, to children. Slide 12 Another problem that we mentioned about using fear conditioning to explain phobias is that not everyone who has a nasty encounter, who is provided with negative information, or whose parents model fearful behaviour develops phobias. So somehow, the model of fear conditioning needs to take into account individual differences in how fear is acquired. As mentioned earlier, fear conditioning, generalisation, and extinction, the capacity to reduce fear when the unconditioned stimulus no longer follows the conditioned stimulus, can be studied in the laboratory using simple experimental paradigms involving geometric shapes and electric shock. Using these paradigms and those with and without particular anxiety conditions shows that those with various anxiety conditions, including phobias, but also panic disorder, vary in the degree to Transcripts by 3Playmedia Week 3 © King’s College London 2017 3.  which they generalise fear to similar stimuli and contexts, and in how resistant they are to fear extinction. In fact, a recent meta-analysis, pooling across studies to include 963 anxiety disorder patients and 1,222 control participants, showed that anxiety based differences were not in the initial acquisition of fear following fear conditioning, but much more in those later processes of generalisation and extinction. The suggestion is that disturbances in these processes maintain a state of fear that then affects avoidance behaviours. This is a vicious cycle, because the more individuals avoid the fear stimuli, the less natural extinction can occur, and so fear is maintained. Slide 13 While associative learning mechanisms have been used to explain phobias, there are also convincing accounts of PTSD, Post-Traumatic Stress Disorder, where the cues present during a traumatic incident can provoke powerful sensory images through flashbacks that are like reliving the original trauma and instal extreme levels of fear and avoidance. In contrast, individual differences in the ability to acquire positive associations with rewarding outcomes and neutral stimuli have been used to explain addictions, specifically drug addiction. Here, a neutral stimulus, for example, a cigarette, has acquired certain effective ‘pleasant’ qualities associated with the effects of an unconditioned stimulus, tobacco. Transcripts by 3Playmedia Week 3 © King’s College London 2017 4.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 2 Emotion processing: bottom-up effects of emotions on cognitive processes - Part 3 of 3 Dr Jennifer Lau Department of Psychology, King’s College London Lecture transcript Slide 2 Memory is the process by which new information is encoded, consolidated, and subsequently retrieved. There is widespread belief that emotional events are better remembered than non- emotional events. Some really good examples of this comes from patients with profound amnesia. In one study, Johnson and colleagues presented patients with Korsakoff’s syndrome with photographs of male faces. Some faces were described as good guys, while others were described as bad guys. A week later, the same patients were shown these photographs again and asked to make judgments about the person in each photo, whether they seemed nice or not. As these patients have difficulties learning new information, have an inability to remember recent events, and long term memory gaps, they showed no overall recollection of the faces, but nonetheless, their judgments were consistent with the initial descriptions. It is clear that emotions can impact on the outputs of the system. Slide 3 Another clear illustration of this is through flashbulb memories, which refer to memories that are laid down in great detail to salient events. These don’t just have to be personally salient events. But in fact, many studies of flashbulb memories are conducted during big events in the news, for example the assassination of President Kennedy, the death of Princess Diana, the September 11th attacks. When asked about such stories, most people can usually describe exactly where they were, what they were doing, who they were with, et cetera, with great clarity and say that their memories are vivid. But how accurate are these memories? Are they a valid depiction of reality? The data would suggest that these memories are certainly confidently reported on, but that the memories are not always accurate. Such designs usually involve interviewing people immediately after an event and again three years later with some discrepancies in information between the two assessment points. Slide 4 It seems that in the case of big news stories, some of the memories are not as accurate as first thought. This may be because they are more subject to wider scale post-event analysis, for example, reading commentaries by other people, talking to others, et cetera. What about in the case of more controlled lab experiments? Transcripts by 3Playmedia Week 3 © King’s College London 2017 1.  Scientists have examined this question by giving people emotional and non-emotional stimuli, either words or pictures, during an initial encoding phase. At a later retrieval phase, participants are asked whether the picture is old or new, and if it is an old picture, whether they know or remember it. ‘Know’ refers to whether the stimulus is familiar even though the specific contextual details are forgotten, while ‘remember’ refers to being able to bring to mind the event and the various contextual details. Using this paradigm, Kevin Ochsner in 2000 showed that negative pictures were remembered more accurately relative to positive or neutral pictures and that more arousing pictures, both positive and negative, were remembered more accurately. Moreover, of the correctly identified old negative pictures, participants were more likely to endorse ‘remember’ judgements and not so much ‘know’ judgments. Thus, negative pictures appeared to be remembered more accurately with rich detail. Slide 5 But what are the mechanisms by which emotions affect memories? Animal experiments show that stress hormones enhance post-learning consolidation of aversive memories but are also thought to have effects of the more immediate processes during memory formation. One hypothesis is that emotional arousal can narrow attention to hone in on particular aspects of the central event but not those that are peripheral. This is, in fact, consistent with what we studied in the section on attention when we discussed how emotional situations, those that involved danger and reward, grabbed attention and made it through the selective process for further processing, enabling us to respond appropriately. This effect can have consequences for eyewitness testimony in crime scenes, as one study showed not only that participants spent a greater period of time focusing in on a weapon in a crime scene, but also that the amount of time doing this was inversely correlated with their ability to identify a criminal. As such, it has been termed the weapon focus effect. Slide 6 While this narrowing of attention is clearly adaptive, under some forms of extreme stress some individuals respond by presenting with memories that are not specific and, in fact, overgeneral. These memories are termed overgeneral autobiographical memory and characterise individuals with a number of psychiatric conditions that mostly arise after a traumatic or negative life events, such as post traumatic stress disorder, bipolar, or major depression. In fact, differences between individuals with these conditions and healthy controls on overgeneral memory cannot easily be explained by other factors such as education, verbal intelligence, or general episodic memory differences. Overgeneral memories are those that are vaguely described when asked to think of the memory in response to cue word. So an example of cue word could be “garden,” where a specific memory might be, I spent last Friday drinking wine with some friends in the garden because it was a lovely evening, versus a general memory which could be, I have a nice garden. Producing these overgeneral memories could be a structural memory deficit or could reflect a somewhat adaptive strategy for managing extreme emotional distress following aversive events. Specifically, the individual truncates memory searches to avoid recalling unwanted memories. Indeed, some studies that have investigated overgeneral memory in children and young people who have experienced maltreatment in early life, finding that compared to non-abuse or non-neglected comparison participants, they are less specific in their description of autobiographical memories when responding to positive, negative, and neutral cue words. Slide 7 While overgeneral memory appears to relate to a deficit in the verbal retrieval of aversive memories, there is some suggestion that memories formed under stress can also present in the form of intrusive involuntary images. Unlike overgeneral memories that are vague, these intrusive Transcripts by 3Playmedia Week 3 © King’s College London 2017 2.  visual images are usually extremely vivid and detailed. Their presence following adversity or trauma can reflect functioning of a second memory system that processes lower level sensory information. Interestingly, these are prominent in a number of mental health conditions, including post traumatic stress disorder, other anxiety disorders, depression, eating disorders, and psychosis, where patients frequently report repeated visual intrusions corresponding to a small number of real or imaginary events. These can be highly distressing and again may be important in maintaining arousal, fears, and other psychopathological features. Slide 8 Clearly then, emotional events and stress may be encoded, consolidated, and possibly retrieved in different ways to non-emotional memories. This would also suggest that mood state has an effect on memory processes. In everyday life, this seems plausible. If we are in a bad mood, we are likely to remember more negative things, whereas if we are in a good mood, then happy memories seem easier to bring to mind. There are two phenomena that have been intensively studied, mood-congruent memory, which refers to our previous suggestion that we remember things that are similar to the mood that we are in, and mood-dependent memory, when the material is more likely to be recalled when in the same mood as when the material was learned. That is, there needs to be a congruence between mood at learning and at retrieval for that to be maximal effects on memory performance. This is an extension of a so-called context-dependent learning, when again material is thought to be recalled best when in the same environment as when it was learned. I want you to spend a little bit of time now thinking about how these phenomena, mood-congruent memory and mood-dependent memory, can be studied experimentally. To give you a clue, you may need to use some of the techniques learned in the earlier topic to manipulate mood. You can read more about experiments that have demonstrated mood-congruent memory and mood-dependent memory in the reading, but there is fairly robust evidence that mood can influence memory. Slide 10 If mood can affect memory, then it follows that individuals with mood disturbances can struggle with memories that are congruent with their mood state. Indeed, a fairly robust finding in major depression is that they show strong explicit recall and recognition of negative material at the expense of positive material. One criticism of this work, however, is that these memory biases could just reflect a response bias where, for example, depressed participants remember both positive and negative words equally well, but that they choose to select the negative word. To show that this is not the case, implicit memory tests have been used. That is, in these tasks, it is not obvious that the participants are being tested on memory. An example of an implicit memory task is a word completion task. Here, participants are presented with a list of positive, depressive relevant negative, and neutral words during encoding, which they have to rate for self relevance. Then at the memory test phase, they are given a word fragment to complete, where they have to complete these as quickly as possible. While some of these words are new words, some are from the list that was rated during encoding. Data from these tasks generally showed that depressed participants are quicker at completing the work fragments of negative words seen at encoding. This suggests that even when response biases are reduced, there still appears to be a memory bias. Again, memory biases may play a role in maintaining depression. Slide 11 In summary, we have considered how emotions affect attention, learning, and memory, and how some people might be particularly susceptible to these effects. In the next topic we will consider how cognitive processes can in turn affect the emotional experience. Transcripts by 3Playmedia Week 3 © King’s College London 2017 3.  Module: Psychological Foundations of Mental Health Week 3 Introduction to emotion and emotional processing Topic 3 Emotion regulation: top-down cognitive regulation on emotional responses Dr Tom Barry Department of Psychology, King’s College London Lecture transcript Slide 3 In the early 2000s, researchers called Derryberry and Reed recognised that, while some researchers had suggested that anxiety was associated with attention biases towards threat, and in particular, difficulty disengaging attention from threats, this wasn’t true for all people with high levels of anxiety. Some anxious people showed no such bias. They suggested that attention is not only bottom up or involuntary, but that there is also a voluntary attention system. That is, the general capacity to voluntarily control attention in relation to positive as well as negative reactions. They broke attention control down into two separate components. The ability to voluntarily maintain the focus of attention on the task that you’re performing and to ignore thoughts or things in your environment that might distract you. Also, the ability to intentionally shift attention from one thing to another, such as when we’re multitasking. Like when we’re making notes in a lecture, and we shift between listening and writing. Slide 4 They hypothesised that differences between individuals and their ability to control their attention, to focus and shift it at will, might explain why some people show an attention bias and others don’t. In their 2002 study, they found that individual differences in self-reported attention controllability, moderated the extent to which anxious people attended towards threat stimuli in a dot probe experiment. This finding has been replicated elsewhere, too. This means that for anxious people with high attention control, they were better able to shift their attention away from and disengage from threat stimuli and so show less or no bias. For people with low attention control, they had greater difficulty disengaging from the threat stimuli. They suggested that attention control and the ability to shift away from threatening thoughts or stimuli can help limit the emotional impact of threatening information. Consistent with this idea is evidence suggesting that people who are exposed to trauma but who have high attention control seem to develop less post-traumatic stress symptoms than people with low attention control. Slide 5 But it gets more complicated. The ability to control one’s attention voluntarily is not static. It might change depending on various factors. In other words, in some circumstances, one might show good attention control, whereas in other circumstances, the same person might show poor Transcripts by 3Playmedia Week © King’s College London 2018 1.  attention control. In some circumstances, people with poor attention control can compensate for this deficit by increasing their effort. This is most likely to happen when one is engaged in doing something that is particularly relevant to one’s goals. For example, a person might have poor attention control in many other areas of life. But they may want to get a degree so much that during their lectures, they’re able to put off distraction and focus very hard on their lectures. Michael Eysenck and his colleagues from various colleges in the University of London suggested in 2007 as part of their attention control theory that this ability to compensate for poor attention control has its limits. And this is particularly relevant for anxious people. When people are engaged in doing something that is exceptionally demanding, and their cognitive resources are heavily loaded or when they’re not very motivated to focus, then it will become increasingly more difficult to prevent themselves from being distracted by irrelevant thoughts and similarly in their environment. Berggren and colleagues examined this idea using a visual search task, where participants who had high and low anxiety had to locate certain target faces amongst distracted faces. They then manipulated cognitive load by presenting a number on the screen in between visual search trials and asking half of participants to count back in threes from that number. High and low anxious participants didn’t differ from one another in their performance in the visual search task when they were not cognitively loaded. However, when there was high cognitive load, highly anxious participants showed evidence of difficulty locating neutral faces amongst emotional distracted faces, whereas participants low in anxiety showed no such difficulty. Slide 6 We might ask whether, if attention control can limit the emotional impact of stressful events on people’s lives, can we train people so as to enhance their attention control, and in so doing, help them deal with stress and anxiety? Bernstein and Zvielli recently investigated this using their attention control training tool, the attention feedback awareness and control training, A-FACT. In A-FACT, participants are given a standard dot probe to measure their attention bias. After each block of trials, participants are shown a thermometer that reflects the extent of their bias. They’re told that this reflects the extent to which their attention is grabbed by the threatening pictures they’re shown. And when the thermometer is in the red, this means that their attention is being influenced a lot by these images. They’re told that to get their thermometer down to the green, they must balance their attention more evenly between the images and not let the content of the images influence their attention. After the training, participants were shown a number of fear-eliciting images and were told that they could press a button to stop the presentation of each image if they wished. This was used as a measure of avoidance. After this, they were shown anxiety-eliciting movie clips of a person being chased by an aggressor. They were asked to rate their anxiety immediately after the clip and then again 60 seconds later. They used this to index emotional recovery after a stressor. Participants who completed A-FACT showed improved ability to disengage with threatening images in a dot probe administered after the training was complete, suggesting that their attention control had improved. They also shared less avoidance of the threatening images and quicker recovery after the stressor than participants in the control condition. This suggests that attention control can influence the way people respond to emotional information they’re exposed to, and that training attention control might reduce the emotional impact of this information. Slide 7 Another way to control emotional experiences is through cognitive reappraisal or restructuring. Cognitive reappraisal involves transforming the meaning of a negative situation that one Transcripts by 3Playmedia Week © King’s College London 2018 2.  encounters, and in so doing, reducing its emotional impact. This approaches said to be antecedent focused, as it involves thinking about the causes or antecedents of a situation and trying to reinterpret them so as to reduce the emotional impact of that situation. This is in contrast to response-focused emotion regulation strategies, where one might try to directly manage the feelings that a situation evokes, such as with relaxation techniques. Reappraisal also runs counter to other cognitive strategies for regulating emotions, such as expressive suppression, which involves active attempts to hide the emotional impact of an event. As with attention biases and attention control, individuals differ from one another in terms of the extent to which they reappraisal or suppressive strategies in their management of the negative emotions evoked by certain situations that they encounter in their lives. Slide 8 It’s often possible to reappraise situations ourselves. Such as if we’re walking past some friends and we wave, but they don’t respond and our immediate thought is that they’re ignoring us. But we then reappraise the situation and conclude that they probably didn’t see us. However, sometimes we are only able to reappraise something because of information given to us that helps us transform the meaning of a situation. In 1997, Stemmler provided a novel example of this. In their experiments, participants completed a mock task. And then an angry experimenter tells them that they have performed poorly, and that this is because they must have intentionally not complied with the experimental instructions given to them before the task. Participants were either given no excuse for the behaviour of the experimenter, or they were given one of two different interpretations for why the angry experimenter made such accusations. They were either told that the experimenter was faking it or that the experimenter was new and that their accusations should be ignored. The actual researchers then measured differences in the effect of these instructions on participants’ ability to reappraise the behaviour of the experimenter. The participants who were given excuses for the experimenter’s behaviour showed less physiological reactivity to the experimenter’s provocation. And they also reported being less angry with the experimenter. Mauss and colleagues replicated this study, but found that individual differences in the ability to use reappraisal to regulate one’s emotions, as reported using a questionnaire, influenced the extent to which participants in Stemmler’s original experiment could use the excuses for the experimenter’s behaviour to down regulate their physiological response to provocation. Slide 9 There are a range of emotional disorders that have been associated with an inability to properly reappraise emotionally provocative situations. As with attention control, it might be possible to help people down regulate their emotional experiences by training them in being able to reappraise negative situations. In fact, this training is one of the core components of cognitive therapy for emotional disorders like major depressive disorder and anxiety disorders. During this therapy, people are first taught to identify negative thoughts. Then they are asked to consider the evidence in support of this conclusion or appraisal and evaluate the probability that this appraisal is true. After this they are asked to challenge their negative thoughts by considering evidence that this thought might not be true. They are then asked to reevaluate the probability that their appraisal is correct. For example, someone who is socially anxious might see someone laughing whilst they are giving a speech. Through this training in restructuring and reappraising negative thoughts, a person would be taught to evaluate what they think the person might be laughing at, how likely it is that the belief is true, and then to consider an alternative cause for the laughter. By practicing this reappraisal technique, it is hoped that a person who is less able to reappraise negative situations on their own would develop the tools to do it when they encounter negative situations in the future. And in so Transcripts by 3Playmedia Week © King’s College London 2018 3.  doing, they should be better able to regulate the emotional response to those situations. Slide 10 So far we’ve talked about ways of down regulating emotional experiences through purely cognitive means. But emotions such as fear can be down regulated through direct experience also through a process called extinction. As you are no doubt aware, after somebody has acquired fear for a conditional stimulus, or CS, by its pairing with an aversive unconditional stimulus, or US, fear can then be reduced or extinguished by repeated presentation of the CS in the absence of the US. So if we pair a triangle with an electric shock four times, then we would expect that repeatedly presenting this triangle without the electric shock would reduce any fear that had been acquired. As with the other things we’ve discussed, it’s important to remember that there is variability between individuals in the extent and speed with which fear extinguishes. Slide 11 So how does extinction reduce fear? Previous researchers believed it involved unlearning of fear. So if conditioning involves the formation of a CS-US association, through extinction this association was gradually broken up or deleted. However, several researchers showed that fear can return after it has been extinguished, suggesting that the association between the CS and the US that evokes fear has not been deleted. This suggested that extinction may involve the development of an inhibitory association between the CS and the nonoccurrence of the US, a CS-no US association. So the excitatory, fear evoking CS-US association remains intact after extinction, but it becomes inhibited by the new CS-no US association that has developed through repeated presentation of the CS without the US. After extinction, these associations compete with one another. And if the CS-US association is insufficiently inhibited, then fear can return. There are several circumstances in which there might be insufficient inhibition after extinction. These are discussed in the references in your slides. But we’ll focus on one particular example of return of fear here. Slide 12 The example we’ll use is referred to as context renewal. This was exemplified in a study by Vansteenwegen and colleagues in 2007, some experts in this field from Belgium. They examined how extinction learning can be context dependent and how if extinction takes place in a context that is different from an original conditioning context, a return to this original context or some other context after extinction might evoke a return of fear. In their study, they recruited participants who had specific phobia for spiders and they presented them with videotapes of spiders in a real world context, such as walking along the kitchen counter. Over the course of this presentation, participants fear reduced. After this phase, participants were shown a spider in a different context, such as in a bedroom. This change in context evoked a return of fear, suggesting that the learning that had taken place during extinction was context dependent. In other words, rather than learning that spiders were not as dangerous or unpleasant as they previously believed, participants instead seemed to have learned that spiders in kitchens, for example, were not so bad. This meant that when a different context was presented after extinction, there was insufficient inhibition of the CS-US association, and fear was again evoked. Given that extinction learning underlies CBT for anxiety disorders, this might be an important mechanism that explains clinical relapse. Slide 13 But extinction is not only useful in treating pathological fear and anxiety. Extinction occurs in everyday life and can prevent fear from becoming pathological after we have aversive experiences. To this end, individual differences in extinction learning might influence the emergence of anxiety disorders. For example, Lohman and colleagues examined whether individual differences Transcripts by 3Playmedia Week © King’s College London 2018 4.  in performance in a fear conditioning and extinction procedure predicted the later emergence of PTSD. Participants in their study were soldiers who were to be deployed in Afghanistan. Four months prior to deployment, participants completed a fear conditioning and extinction procedure like the procedure we previously described with the triangles. When participants returned from deployment, the researchers completed structured clinical interviews with them to examine whether they had acquired post-traumatic stress symptoms. Soldiers who returned from deployment with PTSD showed difficulty learning to extinguish their fear prior to deployment, relative to participants who returned without PTSD. This relationship was independent of pre-deployment stress symptoms. It appears then that individual differences in the ability to extinguish one’s fear after an aversive experience can help regulate one’s emotional responses to these experiences, with potentially long term consequences on a person’s mental health. Slide 14 Finally, another way to regulate the emotions that are evoked by a situation is to alter the memory for that situation after it has occurred. As you’ve already learned, memories are not fixed representations of events as they actually happened. Instead they are flexible and can be subject to change. With memory rescripting, this change is intentional and top down, rather than some of the more bottom up ways in which memories can become altered, such as through biases and encoding and consolidation. This idea was first presented by Pierre Janet, who conducted imagery substitution with hysterical patients in 1919, and was then adopted by Aaron Beck, who was considered to be one of the fathers of cognitive therapy. Beck realised that it was possible to modify what he called visual cognitions or mental images of negative experiences and modify the emotions that they provoked. Slide 15 During memory rescripting, people first activate a memory of an emotional event. They must then identify and focus their attention on the feelings, emotions, and thoughts that this memory evokes. Then they must rescript this memory by framing it within a positive or neutral context, or even by altering the events in the memory so the consequence is less negative. For example, a person might recall a memory of them being assaulted. They might then think about the fear and helplessness they experienced during this event. Then they could rescript this memory by changing it, so that someone intervenes and stops the person committing the assault. Slide 16 Memory rescripting might also be used to enhance extinction learning. In extinction, besides the inhibitory learning that goes on, there is also some learning regarding how aversive the unconditional stimulus, or US, is. For example, when someone is socially anxious and they are afraid that talking in public will result in criticism or humiliation, extinction involves reevaluating how aversive it would be to be criticised or humiliated in public. In one study, Dibbets and colleagues adapted the context renewal paradigm that we described earlier by Vansteenwegen and colleagues, and they used this paradigm to examine the effect of rescripting on extinction learning. Participants were first conditioned to be afraid of a picture of a motor vehicle presented in a play area by presenting it with a US, images of a mutilated child. The motor vehicle therefore acted as the CS and the play area was the context. In the next phase, the vehicle was then presented repeatedly in a different context, a service station, and the images of mutilation were never shown. One group of participants was told that during extinction, they should devalue the US by thinking about how they were able to save the life of the child. Whereas another group were given no instructions. The participants who were given the rescripting instructions showed less return of fear after extinction when the CS was shown in the original context, the play area, than those Transcripts by 3Playmedia Week © King’s College London 2018 5.  participants who were given no instructions. So rescripting the original conditioning memory and devaluing the US seemed to prevent a return of fear. Slide 17 Rescripting has therefore been suggested to serve a number of different functions. It gives people the opportunity to update memories for negative or traumatic experiences and correct them if they’ve been poorly processed. It allows people to explore any emotional responses that may be inhibited and which may not have been fully acknowledged or experienced before or after a negative event. And it allows people to explore any trauma related beliefs that they might have, such as feelings of helplessness or powerlessness. It does this by encouraging mastery and control over the outcomes of a negative situation. This has been referred to as Type A imagery rescripting by Emily Holmes and colleagues, as it involves retrieving a memory for a negative experience and modifying that memory and its associated emotions and beliefs. Type B imagery rescripting, on the other hand, is said to involve regulating negative emotions about one’s self by constructing a new positive image about one’s self. Given its focus on revisiting traumatic memories and altering them, memory rescripting techniques are often taught to people with post-traumatic stress disorder to help them deal with the emotional response to a traumatic memory. But it can also be used in everyday life to deal with the negative experiences we encounter on a daily basis that evoke a significant emotional response, but which we cannot go back and change. Instead, we can try to modify and rescript our memory for these events and make them more positive or benign. Transcripts by 3Playmedia Week © King’s College London 2018 6.