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    • Behaviorally self reports of negative affect following View

    2018-10-29

    Behaviorally, self-reports of negative affect following View-Sad and Reappraise trials did not show significant kinesin spindle protein in negative affect by reappraisal. However, a trend level effect was seen in control children, similar to that seen in a smaller and younger sample of healthy children in a previous study (Belden et al., 2014), There was no such trend in MDD-ever children, but the differences between the groups in the level of negative affect change was not significant. Thus, this pattern hints at the MDD children showing less reappraisal, but is not sufficient to make any strong conclusions. Given that the self-reports in reappraisal tasks are likely strongly influenced by demand characteristics (i.e., children know you want them to reduce their negative affect), self-reports may not be a particularly sensitive indicator of reappraisal efficacy. A large constellation of regions showed group by rumination interactions in FC related to viewing and reappraising sad images. For both left and right amygdala seeds, regions showing a group by rumination interaction had positive correlations between rumination and PPI values for reappraisal in children with a history of MDD and negative correlations between rumination and PPI values for reappraisal in control children. Regions showing this pattern included prefrontal, temporal, parietal and occipital cortical areas, as well as bilateral thalamus (Table 3). A number of these regions, particularly frontal and lateral temporal regions, have been associated with emotion regulation (Buhle et al., 2013; Wager et al., 2008; Kohn et al., 2014). As the typical influence of these control regions is to modulate amygdala activity during reappraisal (Belden et al., 2014), increased FC between these regions and amygdala in MDD-ever children may indicate that rumination is associated with inefficiency in the abilities to modulate affect-processing regions. Increased amygdala connectivity with areas associated with emotion and affect processing, including thalamus, insula, and right middle and superior temporal gyri, further suggests that rumination may be associated with less modulation of these regions during emotional reappraisal in MDD-ever children. Increased connectivity was also seen with bilateral cuneus, a region that has been associated with selective attention to stimulus attributes, including emotional content (Sander et al., 2005), as well as emotional reappraisal (Goldin et al., 2008). This suggests that MDD-ever ruminators exert increased effort with less effect in regulating their attention to the negative emotional aspects of the stimuli that they are attempting to reappraise. These findings are in line with findings in adult MDD, in which rumination is associated with patterns of neural activity suggesting inefficient regulation (Vanderhasselt et al., 2011; Cooney et al., 2010). In addition, many of these regions showed a negative correlation between rumination and PPI values for the View Sad condition in MDD-ever children, but none showed a significant correlation in controls. These findings are consistent with previous work examining the influence of worry during the processing of negative emotional stimuli. Worry is strongly associated with rumination in MDD (McEvoy et al., 2013), and acts as a cognitive avoidance technique that has been shown to reduce autonomic arousal to negative images (Borkovec et al., 2004) and both inhibits amygdala activity and increases negative connectivity between amygdala and prefrontal regions (Hoehn-Saric et al., 2005). While worry was not measured in the current sample, a speculative interpretation of these results may be that either rumination itself or a closely related manifestation of repetitive negative thinking, such as worry, may influence amygdala connectivity during passive viewing of negative images in the absence of explicit reappraisal effort in children with a history of MDD. Overall, these findings suggest that in children with a history of MDD, rumination is associated with increased connectivity between affect and emotion processing regions during attempts to reappraise emotional content, suggesting inefficient modulation of affect and emotion processing in regions associated with cognitive reappraisal, as well as decreased connectivity in these regions in the absence of conscious effort to reappraise.