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1.  Laminar Expression Of Ephrin-A2 In Primary Somatosensory Cortex Of Postnatal Rats 
Several Eph receptors, prominently EphA4 and EphA7, and their corresponding ligands are known to influence neocortical development, including topographic sorting of thalamocortical axons within primary somatosensory cortex (SI). The present study investigated postnatal expression of a ligand that can bind to these receptors, ephrin-A2. Quantitative methods revealed that expression of ephrin-A2 mRNA in SI reached maximum levels on postnatal day (P) 4 and dropped thereafter to background by P18. Ephrin-A2 mRNA expression assessed by in situ hybridization qualitatively revealed a similar time course and localized the expression pattern primarily in two broad laminae in SI, comprising the supragranular and infragranular layers, and with additional expression in the subplate. This expression pattern was investigated in greater detail using immunohistochemistry for ephrin-A2 protein. Immunoreactivity generally showed the same laminar distribution as seen with in situ hybridization, except that it persisted longer, lasting to approximately P14. Expression in the cortical plate was low or absent within presumptive layer IV, and it remained so as cortical lamination progressed. Double-labeling immunohistochemistry with confocal microscopy revealed that cortical neurons were the principal elements expressing ephrin-A2 protein. These findings are consistent with possible involvement of ephrin-A2, in concert with one or more Eph receptors, in influencing arbor development of thalamocortical axons at cortical layer IV boundaries.
PMCID: PMC3240726  PMID: 22147308
Eph receptors; cortical lamination; thalamocortical axons; axon guidance molecules; barrel cortex
2.  Happiness and Stress Alter Susceptibility to Cardiac Events in Long QT Syndrome 
We sought to determine whether the circumstances preceding an arrhythmic event differed from those preceding a prior control occasion in patients with Long QT Syndrome (LQTS), a well-characterized genetically-based disorder that puts affected individuals at risk for sudden cardiac death.
38 patients (89% female) with LQTS completed a “case-crossover interview” in which each patient served as his/her own control by reporting on circumstances preceding an arrhythmic event (syncope, aborted cardiac arrest or defibrillator discharge) and preceding a control occasion (the next-to-last birthday). On average the interview was conducted 17 months after the cardiac event and control occasion.
During the 24-hour period preceding the cardiac event compared to the day before the control occasion, psychological stress was elevated, peak happiness was reduced, and peak exertion was not significantly different. Rated for the 6-month intervals preceding the event and control occasions, none of these three variables was significantly associated with events.
Happiness is associated with a reduction in the 24-hour risk of cardiac events in patients with LQTS, with stress having an opposite effect. To our knowledge this is the first report indicating that positive emotion may have a protective effect on life-threatening ventricular arrhythmias. This study lends further support to the role of emotions in influencing cardiac events in arrhythmia-prone patients.
PMCID: PMC4029944  PMID: 19419405
Happiness; Long QT Syndrome; Resilience; Stress; Sudden Cardiac Death
3.  Functional, structural, and emotional correlates of impaired insight in cocaine addiction 
JAMA psychiatry  2014;71(1):61-70.
Individuals with cocaine use disorder (CUD) have difficulty monitoring ongoing behavior, possibly stemming from dysfunction of brain regions subserving insight and self-awareness [e.g., anterior cingulate cortex (ACC)].
To test the hypothesis that CUD with impaired insight (iCUD) would show abnormal (A) ACC activity during error processing, assessed with functional magnetic resonance imaging during a classic inhibitory control task; (B) ACC gray matter integrity assessed with voxel-based morphometry; and (C) awareness of one’s own emotional experiences, assessed with the Levels of Emotional Awareness Scale (LEAS). Using a previously validated probabilistic choice task, we grouped 33 CUD according to insight [iCUD: N=15; unimpaired insight CUD: N=18]; we also studied 20 healthy controls, all with unimpaired insight.
Multimodal imaging design.
Clinical Research Center at Brookhaven National Laboratory.
Thirty-three CUD and 20 healthy controls.
Main Outcome Measure
Functional magnetic resonance imaging, voxel-based morphometry, LEAS, and drug use variables.
Compared with the other two study groups, iCUD showed lower (A) error-induced rostral ACC (rACC) activity as associated with more frequent cocaine use; (B) gray matter within the rACC; and (C) LEAS scores.
These results point to rACC functional and structural abnormalities, and diminished emotional awareness, in a subpopulation of CUD characterized by impaired insight. Because the rACC has been implicated in appraising the affective/motivational significance of errors and other types of self-referential processing, functional and structural abnormalities in this region could result in lessened concern (frequently ascribed to minimization and denial) about behavioral outcomes that could potentially culminate in increased drug use. Treatments targeting this CUD subgroup could focus on enhancing the salience of errors (e.g., lapses).
PMCID: PMC4193926  PMID: 24258223
cocaine addiction; insight; fMRI; VBM; emotional awareness; anterior cingulate cortex; color-word Stroop
4.  How Is Emotional Awareness Related to Emotion Regulation Strategies and Self-Reported Negative Affect in the General Population? 
PLoS ONE  2014;9(3):e91846.
The Levels of Emotional Awareness Scale (LEAS) as a performance task discriminates between implicit or subconscious and explicit or conscious levels of emotional awareness. An impaired awareness of one's feeling states may influence emotion regulation strategies and self-reports of negative emotions. To determine this influence, we applied the LEAS and self-report measures for emotion regulation strategies and negative affect in a representative sample of the German general population.
Sample and Methods
A short version of the LEAS, the Hospital Anxiety and Depression Scale (HADS) and the Emotion Regulation Questionnaire (ERQ), assessing reappraisal and suppression as emotion regulation strategies, were presented to N = 2524 participants of a representative German community study. The questionnaire data were analyzed with regard to the level of emotional awareness.
LEAS scores were independent from depression, but related to self-reported anxiety. Although of small or medium effect size, different correlational patters between emotion regulation strategies and negative affectivity were related to implict and explict levels of emotional awareness. In participants with implicit emotional awareness, suppression was related to higher anxiety and depression, whereas in participants with explicit emotional awareness, in addition to a positive relationship of suppression and depression, we found a negative relationship of reappraisal to depression. These findings were independent of age. In women high use of suppression and little use of reappraisal were more strongly related to negative affect than in men.
Our first findings suggest that conscious awareness of emotions may be a precondition for the use of reappraisal as an adaptive emotion regulation strategy. They encourage further research in the relation between subconsious and conscious emotional awareness and the prefarance of adaptive or maladaptive emotion regulation strategies The correlational trends found in a representative sample of the general population may become more pronounced in clinical samples.
PMCID: PMC3956759  PMID: 24637792
5.  Is it possible to bridge the Biopsychosocial and Biomedical models? 
PMCID: PMC3898026  PMID: 24422973
6.  Cardiovascular Emotional Dampening: The Relationship between Blood Pressure and Recognition of Emotion 
Psychosomatic medicine  2011;73(9):743-750.
Persons with elevated blood pressure show dampened emotional responses to affect-laden stimuli. We sought to further examine cardiovascular emotional dampening by examination of the relationship between resting hemodynamic measures and recognition of emotion in an African-American community-based sample.
Participants were 106 African American men and women (55 female; mean age 52.8 years), mainly low in socioeconomic status and part of the Healthy Aging in Nationally Diverse Longitudinal Samples (HANDLS-Pilot) Pilot Study. Participants evaluated emotional expressions in faces and in sentences using the Perception of Affect Test (PAT). Resting blood pressure, total peripheral resistance (TPR), cardiac output and heart rate were obtained continuously using a Portapres blood pressure monitor.
Total PAT scores were inversely related to systolic (r = −.30) and diastolic (r = −.24) blood pressure, TPR (r = −.36) and age (r = − .31; p values < .01), and positively related to cardiac output (r = .27) and education (r = .38; p values <.01), and with mental state (r = .25) and body mass index (r = −.20; p values < .05). Accuracy of emotion recognition on the PAT tasks remained inversely related to TPR and blood pressure after adjustment for demographic variables, medication, mental state and body mass index.
Elevated blood pressure and TPR were associated with reduced perception of affect. TPR was the most consistent independent hemodynamic correlate of emotional dampening for the PAT scores. These results suggest potentially important links among CNS regulation of emotions, hemodynamic processes and hypertension development.
PMCID: PMC3210914  PMID: 22042880
Emotion regulation; blood pressure; hemodynamics; hypertension development; central nervous system; stress
7.  The reliability and validity of the Japanese version of the Levels of Emotional Awareness Scale (LEAS-J) 
The Levels of Emotional Awareness Scale (LEAS) was developed to assess five levels of emotional awareness: bodily sensations, action tendencies, single emotions, blends of emotion, and combinations of blends. It is a paper and pencil performance questionnaire that presents 20 emotion-evoking scenes. We developed a Japanese version of the LEAS (LEAS-J), and its reliability and validity were examined.
The LEAS-J level was independently assessed by two researchers who scored each response according to the LEAS scoring manual. High inter-rater reliability and internal consistency were obtained for the LEAS-J. Measures were socioeconomic status, LEAS-J, Toronto Alexithymia Scale-20 (TAS-20), Interpersonal Reactivity Index (IRI), and NEO Five-Factor Inventory (NEO-FFI). TAS-20, IRI and NEO-FFI were the measures used to explore the construct validity of LEAS-J, as it was predicted that higher scores on the LEAS-J would be related to fewer alexithymic features, greater empathetic ability, and a greater sense of cooperation with others. Questionnaires were completed by 344 university students.
The criterion-referenced validity was determined: a significant negative relationship was found with the externally-oriented thinking scores of TAS-20, and positive relationships were found with fantasy, perspective taking, and empathic concern on IRI and with extraversion, openness to experience, and agreeableness on NEO-FFI.
Consistent with our expectations, the findings provide evidence that the LEAS-J has good reliability and validity. In addition, women had significantly higher scores than men on LEAS-J, showing that the gender difference identified in the original LEAS was cross-culturally consistent.
PMCID: PMC3042374  PMID: 21281491
8.  Association between trait emotional awareness and dorsal anterior cingulate activity during emotion is arousal-dependent 
NeuroImage  2008;41(2):648.
The dorsal anterior cingulate cortex (dACC) is commonly thought to subserve primarily cognitive functions, but has been strongly implicated in the allocation of attention to emotional information. In a previous positron emission tomography (PET) study, we observed that women with higher emotional awareness as measured by the Levels of Emotional Awareness Scale (LEAS) showed greater changes in regional cerebral blood flow (rCBF) in dACC induced by emotional films and recall. In the current study, we tested whether these effects were due to the processing of any non-neutral stimulus, or were specific to conditions of high emotional arousal. Our results extend the previous finding by demonstrating a positive correlation between emotional awareness and dACC activity only in the context of viewing highly arousing pictures. No such relationship was observed when comparing pleasant or unpleasant pictures to neutral or to each other. We also observed that the relationship between LEAS and dACC activity was present in both sexes but stronger in women than men. These results reinforce the concept that greater trait awareness of one's own emotional experiences is associated with greater engagement of the dACC during emotional arousal, which we suggest may reflect greater attentional processing of emotional information.
PMCID: PMC2821667  PMID: 18406175

Results 1-8 (8)