Abstract
Background
Given findings showing that emotion regulation may be enhanced through prefrontal neurostimulation, the present study examined whether the effect of transcranial direct current stimulation on emotional reactivity is mediated via biased interpretation, and whether emotion regulation goals further moderate this relationship.
Methods
Healthy participants (n = 79) were allocated to one of four conditions to receive either active or sham tDCS concurrently with an emotion regulation task during which they were instructed to maintain or down-regulate their emotional reactions (between groups). A homograph priming task assessed biased interpretation, and emotional reactivity was assessed in response to a negative video viewing task.
Results
Those receiving active tDCS showed smaller elevations in negative mood in response to viewing negative videos compared to sham stimulation. Neither tDCS condition nor emotion regulation condition had an impact on interpretive bias, and there was no evidence for tDCS-enhancement of emotion regulation. As such, interpretive bias did not significantly mediate the relationship between tDCS and emotional reactivity, and no moderating role of emotion regulation was observed.
Conclusions
The present results are consistent with neural models implicating increased frontal activity with reduction in emotional reactivity, but provides no support for the role of interpretive bias in this relationship, and no evidence that tDCS enhanced the effects of emotion regulation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
High arousal image numbers: 1304; 2703; 3103; 3120; 3350; 6230; 6312; 6520; 6560; 8485; 9050; 9163; 9250; 9254; 9410; 9412; 9413; 9414; 9423; 9429; 9424; 9600; 9911; 9921.
Low arousal image numbers: 2141; 2276; 2301; 2456; 2692; 2718; 2799; 3181; 3300; 4621; 7520; 9000; 9010; 9186; 9295; 9331; 9419; 9426; 9430; 9584; 9435; 9610; 9922; 9927.
References
Allaert, J., De Raedt, R., Sanchez-Lopez, A., Baeken, C., & Vanderhasselt, M.-A. (2020). Mind the social feedback: effects of tDCS applied to the left DLPFC on psychophysiological responses during the anticipation and reception of social evaluations. Social Cognitive and Affective Neuroscience. https://doi.org/10.1093/scan/nsaa066.
Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & van Ijzendoorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study. Psychological Bulletin, 133(1), 1–24. https://doi.org/10.1037/0033-2909.133.1.1.
Baumert, A., Buchholz, N., Zinkernagel, A., Clarke, P., MacLeod, C., Osinsky, R., et al. (2019). Causal underpinnings of working memory and Stroop interference control: Testing the effects of anodal and cathodal tDCS over the left DLPFC. Cognitive, Affective, & Behavioral Neuroscience.. https://doi.org/10.3758/s13415-019-00726-y.
Berking, M., Wirtz, C. M., Svaldi, J., & Hofmann, S. G. (2014). Emotion regulation predicts symptoms of depression over five years. Behaviour Research and Therapy, 57, 13–20. https://doi.org/10.1016/j.brat.2014.03.003.
Bindman, L. J., Lippold, O. C. J., & Redfearn, J. W. T. (1964). The action of brief polarizing currents on the cerebral cortex of the rat (1) during current flow and (2) in the production of long-lasting after-effects. The Journal of Physiology, 172(3), 369–382. https://doi.org/10.1113/jphysiol.1964.sp007425.
Bishop, S. J. (2007). Neurocognitive mechanisms of anxiety: an integrative account. Trends in Cognitive Sciences, 11(7), 307–316. https://doi.org/10.1016/j.tics.2007.05.008.
Brunoni, A. R., Moffa, A. H., Fregni, F., Palm, U., Padberg, F., Blumberger, D. M., et al. (2016). Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data. The British Journal of Psychiatry, 208(6), 522–531.
Brunoni, A. R., Zanao, T. A., Vanderhasselt, M. A., Valiengo, L., Oliveira, J. F., Boggio, P. S., et al. (2014). Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression. Neuromodulation Technology at the Neural Interface, 17(2), 138–142. https://doi.org/10.1111/ner.12080.
Chattanooga Group, H. (United States). Chattanooga Dual Channel Iontophoresis System. Hixon, TN, USA: Encore Medical.
Chen, N. T. M., Basanovic, J., Notebaert, L., MacLeod, C., & Clarke, P. J. F. (2017). Attentional bias mediates the effect of neurostimulation on emotional vulnerability. Journal of Psychiatric Research, 93, 12–19. https://doi.org/10.1016/j.jpsychires.2017.05.008.
Cisler, J. M., & Olatunji, B. O. (2012). Emotion Regulation and Anxiety Disorders. Current Psychiatry Reports, 14(3), 182–187. https://doi.org/10.1007/s11920-012-0262-2.
Clarke, P. J. F., Browning, M., Hammond, G., Notebaert, L., & MacLeod, C. (2014). The Causal Role of the Dorsolateral Prefrontal Cortex in the Modification of Attentional Bias: Evidence from Transcranial Direct Current Stimulation. Biological Psychiatry, 76(12), 946–952. https://doi.org/10.1016/j.biopsych.2014.03.003.
Clarke, P. J. F., Sprlyan, B. F., Hirsch, C. R., Meeten, F., & Notebaert, L. (2020). tDCS increases anxiety reactivity to intentional worry. Journal of Psychiatric Research, 120, 34–39. https://doi.org/10.1016/j.jpsychires.2019.10.013.
Clifton, J. L., Hedley, S., Mountier, E., Tiszai, B., & Grimshaw, G. M. (2016). Practice makes perfect: Training the interpretation of emotional ambiguity. Cognition & Emotion, 30(4), 654–668. https://doi.org/10.1080/02699931.2015.1020768.
Etkin, A., & Wager, T. D. (2007). Functional Neuroimaging of Anxiety: A Meta-Analysis of Emotional Processing in PTSD, Social Anxiety Disorder, and Specific Phobia. American Journal of Psychiatry, 164(10), 1476–1488. https://doi.org/10.1176/appi.ajp.2007.07030504.
Everaert, J., Grahek, I., Duyck, W., Buelens, J., Van den Bergh, N., & Koster, E. H. W. (2017). Mapping the interplay among cognitive biases, emotion regulation, and depressive symptoms. Cognition and Emotion, 31(4), 726–735. https://doi.org/10.1080/02699931.2016.1144561.
Feeser, M., Prehn, K., Kazzer, P., Mungee, A., & Bajbouj, M. (2014). Transcranial Direct Current Stimulation Enhances Cognitive Control During Emotion Regulation. Brain stimulation, 7(1), 105–112.
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271.
Hayes, A. F. (2017). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach (2nd ed.). New York, United States: Guilford Press.
Heeren, A., Baeken, C., Vanderhasselt, M.-A., Philippot, P., & de Raedt, R. (2015). Impact of anodal and cathodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex during attention bias modification: An eye-tracking study. PLoS ONE, 10(4), e0124182. https://doi.org/10.1371/journal.pone.0124182.
Heeren, A., Billieux, J., Philippot, P., De Raedt, R., Baeken, C., de Timary, P., et al. (2017). Impact of transcranial direct current stimulation on attentional bias for threat: a proof-of-concept study among individuals with social anxiety disorder. Social Cognitive and Affective Neuroscience, 12(2), 251–260. https://doi.org/10.1093/scan/nsw119.
Hill, A. T., Fitzgerald, P. B., & Hoy, K. E. (2016). Effects of Anodal Transcranial Direct Current Stimulation on Working Memory: A Systematic Review and Meta-Analysis of Findings From Healthy and Neuropsychiatric Populations. Brain stimulation, 9(2), 197–208. https://doi.org/10.1016/j.brs.2015.10.006.
Hirsch, C. R., Meeten, F., Krahé, C., & Reeder, C. (2016). Resolving Ambiguity in Emotional Disorders. The Nature and Role of Interpretation Biases, 12(1), 281–305. https://doi.org/10.1146/annurev-clinpsy-021815-093436.
Ironside, M., Browning, M., Ansari, T. L., Harvey, C. J., Sekyi-Djan, M. N., Bishop, S. J., et al. (2019). Effect of Prefrontal Cortex Stimulation on Regulation of Amygdala Response to Threat in Individuals With Trait Anxiety: A Randomized Clinical Trial. Jama Psychiatry, 76(1), 71–78. https://doi.org/10.1001/jamapsychiatry.2018.2172.
Ironside, M., O’Shea, J., Cowen, P. J., & Harmer, C. J. (2016). Frontal Cortex Stimulation Reduces Vigilance to Threat: Implications for the Treatment of Depression and Anxiety. Biological Psychiatry, 79(10), 823–830. https://doi.org/10.1016/j.biopsych.2015.06.012.
JASP Team. (2020). JASP (Version 0.13.1). Retrieved from https://jasp-stats.org/
Joormann, J., & D'Avanzato, C. (2010). Emotion regulation in depression: Examining the role of cognitive processes. Cognition and Emotion, 24(6), 913–939. https://doi.org/10.1080/02699931003784939.
Joormann, J., & Gotlib, I. H. (2010). Emotion regulation in depression: Relation to cognitive inhibition. Cognition and Emotion, 24(2), 281–298. https://doi.org/10.1080/02699930903407948.
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1997) International affective picture system (IAPS) Technical manual and affective ratings. NIMH Center for the Study of Emotion and Attention, 39–58.
Lovibond, P., & Lovibond, S. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.
Marques, L. M., Morello, L. Y. N., & Boggio, P. S. (2018). Ventrolateral but not Dorsolateral Prefrontal Cortex tDCS effectively impact emotion reappraisal—effects on Emotional Experience and Interbeat Interval. Scientific Reports, 8(1), 15295. https://doi.org/10.1038/s41598-018-33711-5.
Martin, D. M., Liu, R., Alonzo, A., Green, M., Player, M. J., Sachdev, P., et al. (2013). Can transcranial direct current stimulation enhance outcomes from cognitive training? A randomized controlled trial in healthy participants. International Journal of Neuropsychopharmacology, 16(9), 1927–1936. https://doi.org/10.1017/s1461145713000539.
Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., et al. (2008). Transcranial direct current stimulation: State of the art 2008. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 1(3), 206–223. https://doi.org/10.1016/j.brs.2008.06.004.
Nitsche, M. A., & Paulus, W. (2001). Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology, 57(10), 1899–1901. https://doi.org/10.1212/wnl.57.10.1899.
Ochsner, K. N., Ray, R. D., Cooper, J. C., Robertson, E. R., Chopra, S., Gabrieli, J. D. E., et al. (2004). For better or for worse: neural systems supporting the cognitive down- and up-regulation of negative emotion. NeuroImage, 23(2), 483–499. https://doi.org/10.1016/j.neuroimage.2004.06.030.
Peña-Gómez, C., Vidal-Piñeiro, D., Clemente, I. C., Pascual-Leone, Á., & Bartrés-Faz, D. (2011). Down-regulation of negative emotional processing by transcranial direct current stimulation: effects of personality characteristics. PLoS ONE, 6(7), e22812.
Pergamin-Hight, L., Naim, R., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., & Bar-Haim, Y. (2015). Content specificity of attention bias to threat in anxiety disorders: A meta-analysis. Clinical Psychology Review, 35, 10–18. https://doi.org/10.1016/j.cpr.2014.10.005.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods Instruments & Computers, 36(4), 717–731. https://doi.org/10.3758/bf03206553.
Sanchez-Lopez, A., Vanderhasselt, M.-A., Allaert, J., Baeken, C., & De Raedt, R. (2018). Neurocognitive mechanisms behind emotional attention: Inverse effects of anodal tDCS over the left and right DLPFC on gaze disengagement from emotional faces. Cognitive, Affective, and Behavioral Neuroscience, 18(3), 485–494. https://doi.org/10.3758/s13415-018-0582-8.
Siegle, G. J., Thompson, W., Carter, C. S., Steinhauer, S. R., & Thase, M. E. (2007). Increased Amygdala and Decreased Dorsolateral Prefrontal BOLD Responses in Unipolar Depression: Related and Independent Features. Biological Psychiatry, 61(2), 198–209. https://doi.org/10.1016/j.biopsych.2006.05.048.
Smits, F. M., Schutter, D. J. L. G., van Honk, J., & Geuze, E. (2020). Does non-invasive brain stimulation modulate emotional stress reactivity? Social Cognitive and Affective Neuroscience, 15(1), 23–51. https://doi.org/10.1093/scan/nsaa011.
Van Bockstaele, B., Notebaert, L., Salemink, E., Clarke, P. J. F., MacLeod, C., Wiers, R. W., et al. (2019). Effects of interpretation bias modification on unregulated and regulated emotional reactivity. Journal of Behavior Therapy and Experimental Psychiatry, 64, 123–132. https://doi.org/10.1016/j.jbtep.2019.03.009.
Vicario, C. M., Salehinejad, M. A., Felmingham, K., Martino, G., & Nitsche, M. A. (2019). A systematic review on the therapeutic effectiveness of non-invasive brain stimulation for the treatment of anxiety disorders. Neuroscience & Biobehavioral Reviews, 96, 219–231. https://doi.org/10.1016/j.neubiorev.2018.12.012.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063.
Williams, J. M. G., Watts, F. N., MacLeod, C., & Mathews, A. (1997). Cognitive psychology and emotional disorders (2nd ed.). Oxford, England: John Wiley & Sons.
Wilson, E. J., MacLeod, C., Mathews, A., & Rutherford, E. M. (2006). The causal role of interpretive bias in anxiety reactivity. Journal of Abnormal Psychology, 115(1), 103–111. https://doi.org/10.1037/0021-843X.115.1.103.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interests
The authors report no financial interests or potential conflicts of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Clarke, P.J.F., Haridas, S.M.P., Van Bockstaele, B. et al. Frontal tDCS and Emotional Reactivity to Negative Content: Examining the Roles of Biased Interpretation and Emotion Regulation. Cogn Ther Res 45, 19–30 (2021). https://doi.org/10.1007/s10608-020-10162-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-020-10162-9