1. A Social Cognitive Neuroscience Approach to Emotion Regulation: Implications for Substance Abuse Kevin Ochsner OLUMBIA NIVERSITY OLUMBIA NIVERSITY CU Social/Cognitive/Affective/Neuroscience Unit Research supported by NIDA,NIH, NSF Research supported by NIDA, NIH, NSF

2. Our Research Village Stanford (past) James Gross Becky Ray Elaine Robertson John Gabrieli Jeff Cooper Columbia (present) Tor Wager Ethan Kross Brent Hughes Matthew Davidson Hedy Kober Walter Mischel Carl Hart

3. How could he have controlled his substance-abusing impulses?

4. 1.Describe research that builds a model of the brain bases of effective emotion regulation 2.Consider how this model might be translated to help understand mechanisms of substance abuse & its treatment Affect Regulation & Substance Abuse

5. If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment. -Marcus Aurelius -Marcus Aurelius 1. Mechanisms of Emotion Regulation

6. If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment. -Marcus Aurelius -Marcus Aurelius Aversive Stimulus/ Event Significance Appraise Significance Emotional Response 1. Mechanisms of Emotion Regulation

7. If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment. -Marcus Aurelius -Marcus Aurelius Aversive Stimulus/ Event Re- Significance Re-appraise Significance Altered Response 1. Mechanisms of Emotion Regulation

8. Instructional cue 2 secs 10 secs Photoperiod Affect rating Intertrial interval ~4 secs ~4-5 secs Typical Design for Studying Re-appraisal RELAX Strength of Affect REAPPRAISE or LOOK weak strong 1 2 3 4 5

9. Think about image in way that makes you feel less negative…. Increase Negative Affect Decrease Negative Affect “ ….” “He’s in pain, is weak of heart, may die soon….” Think about image in a way that makes you feel more neg.... “ ….” “He’s just tired/annoyed, is hearty, will be right as rain….”

10. CommonCore Goal- Specific Strategy- Specific 1. Why you reappraise 2. How you reappraise Stimulus or Emotion- Specific 4. When you reappraise Time Specific 3. What you reappraise Building the Model

11. CommonCore Two goals: Strategy- Specific 1. Why you reappraise 2. How you reappraise Stimulus or Emotion- Specific 4. When you reappraise Time Specific 3. What you reappraise Building the Model NegativeAffect

12. Increasing Neg Affect (Increase > Look) Lateral PFC Decreasing Neg Affect (Decrease > Look) Common PFC regions for each reappraisal Goal N = 23 Ochsner, Ray, Robertson, Cooper, Gabrieli & Gross (2004)

13. Amygdala modulated up or down in accord with reappraisal goal Look > Look > Decrease Decrease Look-neg Look-neu Photo 10 secs Cue2sec % signal change Lag Photo 10 secs Cue2sec % signal change > Look Increase > Look Lag Increase Look-neu Look-neg

14. Bilateral Activation for Decreasing Neg Affect Wager, Ochsner, Hughes & Davidson (in prep) Decrease > Look WM / Language / Response Selection regions RightLeft N = 34, optimized

15. LeftRight Decrease > Look Bilateral Activation for Decreasing Neg Affect Wager, Ochsner, Hughes & Davidson (in prep) Activity in many regions correlates with Reappraisal Success N = 34, optimized

16. LeftRight Decrease > Look Bilateral Activation for Decreasing Neg Affect Wager, Ochsner, Hughes & Davidson (in prep) N = 34, optimized Activity in many regions correlates with Reappraisal Success Drop in Neg Affect r =.63 Drop in Neg Affect r =.49

17. Core Prefrontal-Amygdala interactions Underlying the Cognitive Control of Emotion (Ochsner, in press; Ochsner & Gross, 2004, 2005, in press; cf. Beer et al, 2004; Lieberman et al, 2005) Medial Lateral Lateral PFC Top-down implementation of cognitive reappraisals Monitor reappraisal success Anterior Cingulate Cortex Amygdala Generate initial response

18. PFC/ACC - Amyg 1. Why you reappraise 2. How you reappraise 4. When you reappraise Goal- Specific Strategy- Specific Stimulus or Emotion- Specific Time Specific 3. What you reappraise Building the Model

19. PFC/ACC - Amyg DMPFC Right LPFC 1. Why you reappraise 2. How you reappraise 4. When you reappraise Stimulus or Emotion- Specific Time Specific Strategy- Specific 3. What you reappraise Ochsner et al, 2002, 2004; Wager, Ochsner et al, in prep Building the Model

20. PFC/ACC - Amyg DMPFC Right LPFC 1. Why you reappraise 2. How you reappraise 4. When you reappraise Stimulus or Emotion- Specific Time Specific 3. What you reappraise Ochsner et al, 2004 Building the Model Medial PFC for self- focused strats Ochsner et al, 2002, 2004; Wager, Ochsner et al, in prep

21. PFC/ACC - Amyg DMPFC Right LPFC 1. Why you reappraise 2. How you reappraise 4. When you reappraise Time Specific 3. What you reappraise Ochsner et al, 2004 Kross & Ochsner in prep Building the Model Left PFC for memories, like images Medial PFC for self- focused strats Ochsner et al, 2002, 2004; Wager, Ochsner et al, in prep

22. PFC/ACC - Amyg DMPFC Right LPFC 1. Why you reappraise 2. How you reappraise 4. When you reappraise Pre-appraisal = LPFC, like Reapp Left PFC for memories, like images 3. What you reappraise Ochsner et al, 2004 Kross & Ochsner in prep Wager, Ochsner et al, in prep Building the Model Medial PFC for self- focused strats Ochsner et al, 2002, 2004; Wager, Ochsner et al, in prep

23. PFC/ACC - Amyg DMPFC Right LPFC 1. Why you reappraise 2. How you reappraise 4. When you reappraise Building the Model Pre-appraisal = LPFC, like Reapp 5. Who reappraises 3. What you reappraise Ochsner et al, 2004 Kross & Ochsner in prep Wager, Ochsner et al, in prep Ray, Ochsner et al, 2006 Left PFC for memories, like images Medial PFC for self- focused strats Ochsner et al, 2002, 2004; Wager, Ochsner et al, in prep

24. 2. Translating the Model Craving, Drug Use Cooling Reappraisals PFC/ACC Amyg/Striatum Arousing Appraisals Aversive need states, drugs or related cues How does affect regulation play a role in substance abuse?

25. 2. Translating the Model Aversive need states, drugs or related cues Craving, Drug Use Cooling Reappraisals PFC/ACC Amyg/Striatum Arousing Appraisals Craving, Drug Use Amyg/Striatum Non-arousing Appraisals How does affect regulation play a role in substance abuse?

26. 2. Translating the Model Cooling Reappraisals PFC/ACC Craving, Drug Use Amyg/Striatum Arousing Appraisals Aversive need states, drugs or related cues How does affect regulation play a role in substance abuse?

27. 2. Translating the Model Cooling Reappraisals PFC/ACC Craving, Drug Use Amyg/Striatum Arousing Appraisals Aversive need states, drugs or related cues How does affect regulation play a role in substance abuse?

28. 2. Translating the Model Craving, Drug Use Cooling Reappraisals PFC/ACC Amyg/Striatum Arousing Appraisals 1.Drugs and drug cues “turn on” affective circuits (e.g. Breiter et al.; Grant et al.;Volkow et al.) 1.Drugs and drug cues “turn on” affective circuits (e.g. Breiter et al.; Grant et al.; Volkow et al.) 2.Long term use may damage control circuits (e.g. London et al.; Nordahl et al.) 3.Drug users have self-regulatory deficits Childhood deficits predispose towards drug use (e.g. Mischel et al.)Childhood deficits predispose towards drug use (e.g. Mischel et al.) Deficits in lab tasks following drug use(e.g. Garavan & Stout)Deficits in lab tasks following drug use (e.g. Garavan & Stout) Aversive need states, drugs or related cues

29. The Translational Future A 2-step, translational social cognitive neuroscience approach to emotion regulation may be useful for understanding substance abuse…… Q:But will it be successful? A: Yes. 1.Extant work has characterized cognitive and structural neural deficits, but has not examined socioemotional functions and the ability to regulate per se, which is central to treatment 2.Can show how specific regulatory mechanisms are dysfunctional – or effective –which may be useful for designing treatments that target them 2.Can show how specific regulatory mechanisms are dysfunctional – or effective – which may be useful for designing treatments that target them 3.The same 2-step process already has been successful in applying Cog Neuro models of memory and attention to Mood Disorders, Schizophrenia, and substance abuse

30. If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment. - Marcus Aurelius - Marcus Aurelius If you desire anything external, the urge is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment. - Marcus Aurelius