Emotion in Clinical Psychology Chapter 15

Outline Taxonomy of Emotional Disorders MDD and 3 Theories Bipolar Disorder and PEP PTSD and Anxiety Disorders

Emotional Valence Disturbances Emotion Disturbances Emotional Valence Disturbances Emotional Intensity / Regulation Disturbances Disconnections (Berenbaum et al., 2003)

Emotional Valence Disturbances Predominantly Unpleasant U P U P U P Normal Level

Emotional Valence Disturbances Predominantly Unpleasant Deficits in Pleasant Emotions Joy, Tranquility, Contentment Pride Love Excesses in Unpleasant Emotions Distress Emotions Self-conscious Emotions

Emotional Valence Disturbances Predominantly Pleasant P U P U P U Normal Level

Emotional Valence Disturbances Predominantly Pleasant Deficits in Unpleasant Emotions Fear Guilt Shame Excesses in Pleasant Emotions Joy Pride Love Interest/Curiosity

Emotional Valence Disturbances Predominantly Pleasant Deficits in Pleasant Emotions Joy, Tranquility, Contentment Pride Love Excesses in Unpleasant Emotions Distress Emotions Self-conscious Emotions Predominantly Unpleasant Deficits in Unpleasant Emotions Fear Guilt Shame Excesses in Pleasant Emotions Joy Pride Love Interest/Curiosity

Emotional Intensity / Regulation Disturbances Hyperreactivity Hyporeactivity U P U P

Emotion Disconnections Affect Awareness

Major Depressive Disorder Positive Attenuation Hypothesis Negative Potentiation Hypothesis (Aaron Beck) Emotion-Context Insensitivity (ECI) Hypothesis (Rottenberg)

Positive Attenuation Hypothesis (PAH) Begins with low levels of positive mood Weakened responses to positive stimuli Anhedonia, apathy, fatigue Less likely to seek out or consume rewards

Negative Potentiation Hypothesis (NPH) Begins with high levels of negative mood Greater reactivity to negative emotional stimuli Negative worldview leads people to experience more negative emotions in response to unpleasant stimuli

Emotion Context Insensitivity (ECI) Restricted range of positive and negative emotions Weakened responses to both positive and negative stimuli Emotions not appropriate for context Partially supports PAH

Research Says! PAH: Depressed v. Control NPH: Depressed v. Control Less positive responses to rewarding stimuli Deficits in activation of left frontal lobe NPH: Depressed v. Control Greater SCR to negative social scenarios More negative attributions BUT, show weakened amygdala responses to fearful faces BUT, weakened SCR and startle to unexpected noise

For ECI, Research Says! Across sad, amusing and neutral contexts, people with most similar facial expressions and physiological reactions: Highest depression severity Depressed for longest period of time Least likely to recover 6 months later (Rottenberg, Kasch, et al., 2002)

Evidence for ECI Hypothesis Currently depressed, formerly depressed, healthy controls Film Clips: Happy, Sad DV: Subjective feelings

Evidence for ECI Hypothesis

Evidence for ECI Hypothesis

Evidence for ECI Hypothesis Supports ECI and Positive Attenuation: Across all clips, lower positive emotions than recovered and controls Similar sadness across 3 film clips Against ECI More negative emotions than recovered and controls No differences for facial expressions or physiology

Positive Emotion Persistence (PEP) Greater degree of positive emotions Increases in reward and achievement-oriented emotions Increased positive emotions across all contexts Deficiencies in Emotion Regulation Up-regulate positive emotions Difficulty down-regulating positive emotions (Gruber and colleagues)

Bipolar Risk Control (Gruber, 2011)