# Presentation: 125073

## Implications for Substance Abuse 

- to Emotion Regulation:
- Implications for Substance Abuse
- Kevin Ochsner
-   OLUMBIA      NIVERSITY

- Research supported by NIDA, NIH, NSF

## Our Research Village

- Columbia
- (present)

## How could he have controlled his substance-abusing impulses?

## Affect Regulation & Substance Abuse

- Describe research that builds a model of the brain bases of effective emotion regulation
- Consider how this model might be translated to help understand mechanisms of substance abuse & its treatment

## 1. Mechanisms of Emotion Regulation

## 1. Mechanisms of Emotion Regulation

- 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

- AversiveStimulus/Event

- Appraise Significance

- Emotional Response

## 1. Mechanisms of Emotion Regulation

- 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

- Aversive Stimulus/Event

*Re-**appraise* Significance

*Altered* Response

## Typical Design for Studying Re-appraisal

- 2 secs

- 10 secs

- Photo
- period

- 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

## 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....”

**Notes:**
Participants would view a stimulus like this and could be cued to attend to their feelings, or in this case, reappraise an initial negative reaction.

For this photo, reappraial might involve telling one’s self that the sick man is in the hospital to get well, and will be better soon.

## Building the Model

- Common
- Core

- 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

- Common
- Core

- 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

- Negative
- Affect

## Common PFC regions for each reappraisal Goal

- Increasing
- Neg Affect
- (Increase > Look)

- Lateral PFC

- Decreasing
- Neg Affect
- (Decrease > Look)

- N = 23

- Ochsner, Ray, Robertson, Cooper, Gabrieli & Gross (2004)

## Amygdala modulated up or down in accord with reappraisal goal

## Bilateral Activation for Decreasing Neg Affect

- Wager, Ochsner, Hughes & Davidson (*in prep)*

- Decrease > Look

- WM / Language / Response Selection regions

- Right

- Left

- N = 34, optimized

## Bilateral Activation for Decreasing Neg Affect

- Left

- Right

- Decrease > Look

- Wager, Ochsner, Hughes & Davidson (*in prep)*

- Activity in many regions correlates with Reappraisal Success

- N = 34, optimized

## Bilateral Activation for Decreasing Neg Affect

- Decrease > Look

- Wager, Ochsner, Hughes & Davidson (*in prep)*

- N = 34, optimized

- Activity in many regions correlates with Reappraisal Success

## 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

## Building the Model

- 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

- 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

- 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

- Medial PFC for self-focused strats

- Ochsner et al, 2002, 2004;
- Wager, Ochsner et al, *in prep*

## Building the Model

- 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*

- Left PFC for memories, like images

- Medial PFC for self-focused strats

- Ochsner et al, 2002, 2004;
- Wager, Ochsner et al, *in prep*

## Building the Model

- 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*

- Medial PFC for self-focused strats

- Ochsner et al, 2002, 2004;
- Wager, Ochsner et al, *in prep*

## Building the Model

- PFC/ACC - Amyg

- DMPFC
- Right LPFC

- 1. Why you reappraise

- 2. How you reappraise

- 4. When you reappraise

- 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

## 2. Translating the Model

- Aversive need states, drugs or related cues

- How does affect regulation play a role in substance abuse?

## 2. Translating the Model

- Aversive need states, drugs or related cues

- Craving, Drug Use

*Cooling Reappraisals*

- PFC/ACC

- How does affect regulation play a role in substance abuse?

## 2. Translating the Model

- Craving, Drug Use

- Aversive need states, drugs or related cues

- How does affect regulation play a role in substance abuse?

## 2. Translating the Model

- Craving, Drug Use

- Aversive need states, drugs or related cues

- How does affect regulation play a role in substance abuse?

## 2. Translating the Model

- How does affect regulation play a role in substance abuse?

*Cooling Reappraisals*

- PFC/ACC

- Drugs and drug cues “turn on” affective circuits (e.g. Breiter et al.; Grant et al.; Volkow et al.)
- Long term use may damage control circuits (e.g. London et al.; Nordahl et al.)
- Drug users have self-regulatory deficits
- Childhood deficits predispose towards drug use (e.g. Mischel et al.)
- Deficits in lab tasks following drug use (e.g. Garavan & Stout)

- Aversive need states, drugs or related cues

## 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.
- 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
- Can show how specific regulatory mechanisms are dysfunctional – or effective – which may be useful for designing treatments that target them
- 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

## 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

- 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