# Motivation and emotion/Book/2016/False physiological feedback and emotional appraisal

* Multimedia presentation (3 min)

## Overview

The topic of this chapter is “false physiological feedback and emotional appraisal”. Appraisal theory encompasses a wide range of situations; therefore a definition of both “physiological feedback” and “emotional appraisal” is in order. This chapter focuses on false[explain?] physiological feedback and emotional appraisal.

## Physiological feedback

Physiological feedback (or 'biofeedback') is bodily information provided to the brain for interpretation. This interpretation is sometimes called 'interoception'. Physiological feedback that we commonly interpret includes pain (interpreted as injury), nausea (interpreted as disgust or illness), and increased heart rate (interpreted as exertion or fear). Individuals who have heightened interoceptive sensitivity emphasise feelings of activation and deactivation over their less sensitive counterparts [explain?] (Barrett, Quigley, Bliss-Mareau, & Aronson, 2004).
When attempting to determine the role of physiological feedback in emotion, it can be useful to disrupt the cognitive appraisal of bodily changes. By providing false feedback, for example, by displaying a falsely low heart rate readout when a person is monitored in a state of fear - we can determine how the cognitive appraisal of perceived bodily changes elicits emotional responses.
If the interpretation of physiological information can affect our emotions and emotions can generate physiological changes in the body, it is difficult to determine which comes first. In an attempt to answer this ‘chicken-and-egg’ question, some researchers have designed experiments where physiological feedback is falsified. This allows us to interrupt the stimulus-appraisal-physiological response- re-appraisal- response loop, and to monitor how a person's understanding of their physiological changes affects their emotions.

### Threat appraisal and the physiological response

To fully understand false physiological feedback and how it affects emotional appraisal, it is necessary to have a grasp of the physiological response to various stimuli. One of the more universal mammalian responses is the response to perceived threat. In humans, the adaptive “fight or flight” response causes an individual to mobilise the physiological resources required to take that action.
Each individual’s nervous system is made up of several divisions. The central nervous system (CNS), which includes the brain and spinal cord, and the peripheral nervous system (PNS). The PNS contains the autonomic nervous system (ANS), which itself contains the sympathetic and parasympathetic nervous systems. The parasympathetic nervous system works while muscles are relaxed ('rest and digest') while the sympathetic nervous system is responsible for emergency situations ('fight or flight'). During this response, which is very short-lived, heart rate, blood pressure, and blood flow to muscles all increase. Blood clotting functions increase (to help in case of injury) and muscle tension increases in order to give the individual more speed and strength.
It is easy to see how physiological feedback - and subsequent appraisal - has been beneficial throughout the evolution of the human species. An example: two ancestors of humans hear a noise in the grass. The first person assumes it is the wind (i.e., appraises it as a 'non-threat'), is untroubled and therefore does not change his behaviour; the second person appraises the sound (stimulus) as a potential threat, feels fear and runs to somewhere safe. If the noise really is just the wind, both individuals survive; if it is a predator, the first individual is eaten while the second individual survives and reproduces. Therefore, there is evolutionary advantage in generating a physiological response to a stimulus which has been appraised as a potential threat. How this physiological response is mediated - ie where it acts on the stimulus (noise) -> appraisal (threat/non-threat) -> emotion (fear/ambivalence) pathway - is the subject of this chapter.
Without the fight or flight response, it is unlikely that humans would have continued to survive in a world that was governed by “survival of the most adaptable” (Darwin, 1872). While the 'fight or flight' response has been (and in many cases still can be) beneficial, in this day and age where we live in relative safety and comfort this response can have a negative effect. Autonomic arousal can manifest as anger, aggression, or anxiety when not directed in a more literal 'fight or flight' situation, and all of these can have social ramifications.

## Appraisal theory

Appraisal theory is the notion that emotions come about from an individual’s evaluation of a particular incident or situation (Roseman, Smith, Scherer, Schorr, & Johnstone, 2001).
Two key questions help summarise appraisal theory: 1) Will this affect my life?
2) How will this affect my life?
Lazarus (Reeve, 2015) argued that situations which have no impact on an individual are essentially ignored, rather than appraised. Therefore, the answer to question one is dichotomous and determines whether the situation is further appraised.
The question of how a situation or event will affect an individual is more complex. Appraisal theory attempts to explain how the same or very similar events and situations can cause such a wide array of emotions at different times and in different individuals. Possible explanations include physiological differences, cultural differences, and many others (Roseman et al., 2001). These are explained in more detail below.
There are also a variety of theories within the broader field of appraisal theory, with some suggesting that appraisal is almost solely responsible for emotional response, while others incorporate other factors that may contribute to eliciting emotion. However, Fridja et al (Fridja, Zeelenberg, Scherer, Schorr, & Johnstone, 2001) argue that the causal link between appraisal and the subsequent emotion has not been clearly established. Another difficulty with this theory is the differences in how individuals assess risk – is it automatic and unconscious? Or is it a conscious process? Are both conscious and unconscious processes involved? Appraisal theory gives us some insight into the effect that physiological feedback has on emotion.
All appraisal theories share four central beliefs (Reeve, 2015):
* Without an antecedent cognitive appraisal of the event, emotions do not occur.
* The appraisal, not the event itself, causes the emotion.
* Emotion is a process.
* If the appraisal changes, even if the situation does not, then the emotion will change

### The early days of appraisal theory - Magda Arnold

Appraisal theory began in the 1940s, with Magda Arnold. Arnold began researching the appraisal of emotions in relation to general arousal. It was she who suggested that the first step of an emotion is an “appraisal” of the situation (Arnold, 1960). Her theory suggested appraisal was binary (good/bad) and occurred in the subcortical brain, which led to a conscious, cortical, binary response (like/dislike). From there "like" would lead to approach behaviour and "dislike" to avoidance behaviour. This binary system, however, lacks sufficient complexity to account for the large range of potential emotional responses to a stimulus, and was subsequently expanded upon by Lazarus, among others. Magda Arnold is, however, the theorist who "set the ball rolling" with regard to appraisal theory, and the core principles have endured.

### Biopsychology of arousal - Richard Lazarus

Following on from Magda Arnold’s seminal work, Richard Lazarus began in the 1950s to research this as well, focussing on the biopsychological components of the theory and expanding on the binary definitions. He made two distinctions within the appraisal theory: first, the nature of the appraisals themselves, and second, the antecedent conditions of the appraisal. Known as the Complex Appraisals Theory (or cognitive-motivational-relational theory) , Lazarus (1991) described what he called the primary and secondary aspects of appraisal: primary - is it relevant to me? and secondary - will I cope with the possible outcome? He regarded emotion as 'a result of an anticipated, experienced, or imagined outcome of an adaptationally relevant transaction between organism and environment' (p1023-1024), and regarded cognition (and therefore appraisal) as 'crucial' (p1024) in eliciting emotion.

### Appraisal and reappraisal - The process model

From here Lazarus and colleagues (Smith, Lazarus, & Pervin, 1990) tried to include the dynamic nature of emotion into their structural model of appraisal, leading to the process model of appraisal. They suggested that emotional responses may be cyclical in nature, with appraisal leading to coping and then back to appraisal (or reappraisal). Marsella and Gratch (2009) critiqued this aspect of Lazarus’s and Smith’s model, and found that it did not hold up scientifically. They pointed out that this model failed to account for the automatic and often very rapid nature of emotional responses.
Smith and Kirby followed on from this model, and developed their own “two process model of appraisal” (Forgas, 2001). This model contains three core elements: perceptual stimuli, associative processing and reasoning. Perceptual stimuli are what the individual picks up from the world around them (sensations such as pain or pleasure, as well as their perception of other individuals’ facial expressions). Associative processing is where the individual uses a memory-based process to enable them to associate the stimulus with other similar events/situations. The final component, reasoning, is the slowest of the three components. It uses logical, critical thinking combined with the associations provided from the associative processing to evoke a more reasoned emotional response.

### Motive consistency and emotional appraisal - Roseman

In another theory only a few years prior to Smith and Kirby’s, Roseman takes a slightly different approach. Roseman’s Theory of Appraisal, which was recently revised (Roseman, 1996), focusses more on the interaction of certain appraisal components, one of which is “motive consistency”. Here the premise is that if an individual evaluates an event/situation and finds it to be inconsistent with their goals, this elicits a negative emotion such as regret or anger. If it is found to be consistent, it elicits a positive emotion such as joy or contentment. Another component that can affect which emotion is produced or experienced is the “evaluation of responsibility or accountability”. If an individual feels the responsibility is solely or primarily on them, a desirable situation may elicit pride, while an undesirable situation may elicit guilt or anxiety. These components affect appraisal and their subsequent emotions; however, the intensity of each component can also have an effect. If the individual’s appraisal, specifically the strength and/or the certainty of the evaluation of responsibility.
Most current models of Appraisal Theory tend to be structural, which tend to have issues with the subject of repression. Repression is the mental process by which distressing thoughts, memories or impulses are relegated to the unconscious mind, to prevent them from subsisting in the conscious mind which could lead to high levels of anxiety. The second main type of Appraisal Theory model is called “process-oriented”, which asserts that it is highly important to specify the cognitive principles and operations underlying the appraisals. This model of the theory seems to have far fewer issues with the idea of repression than do the structural models.
Another significant distinction within Appraisal Theory is between the continuous versus the categorical nature of appraisal and emotion. It is generally accepted that appraisal and emotion are continuous in nature, however many of the structures and models within Appraisal Theory set “boundaries” for the continuum, which helps to determine which emotion will occur.

## How do conscious thoughts alter physiological response?

Most of us have heard a similar script for a guided relaxation exercise. But how do conscious thoughts and emotions translate to physiological changes? Critchley, Melmed, Featherstone, Mathias, and Dolan (2002) examined which areas of the brain are responsible for this mind-body interaction. They trained participants in relaxation techniques, then measured their autonomic arousal using skin sensors. The participants were then shown a graphic of a thermometer, representing their stress levels. Each participant was given two minutes to get their 'thermometer' levels to fall, using relaxation techniques. All of this was recorded on a functional MRI machine, allowing the researchers to pinpoint which areas of the brain have the capacity to 'down-regulate' the autonomic response (the hypothalamic and pontine responses) to stress. Most notable were the anterior cingulate, the globus pallidus and the insula.

## False physiological feedback and emotional appraisal

Now that we have a much keener grasp of physiological feedback and Appraisal Theory, it is time to focus on FALSE physiological feedback and emotional appraisal. There is a clear example that describes physiological feedback and emotional appraisal. The example is as follows: Imagine you are about to give a speech and you approach the podium and look out at the audience. Your mouth goes dry, your heart rate increases, your legs start shaking and your palms sweat. The physiological change is in response to the perceived threat (an audience of people); awareness of the dry mouth and shaky legs may then reinforce the anxiety relating to the threat. In this example, the appraisal - physiological response - reappraisal is clearly delineated.
But what if this physiological feedback is manipulated? What if you can be made to believe that your mouth isn't dry, your legs not shaky, your heart rate not increased? Will your reappraisal be that of reduced threat and therefore decreased fear?

### Example 1

Now let’s take another example. Imagine you have taken up jogging in order to increase your fitness, and decide to use a "fitbit" to monitor your heart rate. You put on your brand new running shoes, psych yourself up and begin, noting that your heart rate before starting is 100bpm, which is unusual as your resting heart rate is usually between 65 and 70bpm. You chalk it up to nerves/excitement because this is your first run. After 3 minutes your heart rate is 130, after 5 minutes it is 160. If this happened to a highly strung individual who was concerned about their health, what do you think would happen? It would be easy for this situation to lead the person involved to hyperventilating, which could then very easily induce a panic attack. As it turns out, after the person has passed out and had an ambulance called for them by a concerned passer-by, their heart rate monitor had malfunctioned and their actual heart rate never got above 120bpm. This is an (hypothetical) example of where false physiological feedback has elicited quite severe emotions, leading to an anxiety-induced panic attack.

### Example 2

The previous hypothetical situation elicits a negative emotion through its appraisal, however it can - at least in theory - work the other way. Imagine you are (like above) a highly strung individual who experiences panic attacks. Every time you get out of breath, or you cough, or sneeze, your mind automatically starts to worry about another panic attack. The panic attacks started from genuinely distressing events, but after a few of these events occurred in quick succession you’ve been more worried about them. You decide, as in the previous example, to increase your cardiovascular fitness through jogging. You have your fitbit, and begin running. Your chest is heaving, your lungs and legs are burning, and you start to feel the same feeling you always do just before you experience a panic attack. You look down at your fitbit (which also – for convenience in this example – measures blood pressure) and see that your heart rate is only 110bpm and your blood pressure is normal. Now suppose that a friend of yours had modified the fitbit (unbeknownst to you) to report a 20% lower heart rate and blood pressure than it is actually recording. This would have the desired effect using false physiological feedback.

### Manipulating feedback

Critchlet et al. (2002) examined which areas of the brain are involved in modulating autonomic responses. The authors extended this experiment by manipulating the 'thermometer' stress readings to which participants were exposed, adding apparent fluctuations in stress levels where really there were none. They observed that in the presence of this 'noise', participants found relaxation more difficult. The authors postulate that this is due to a dissonance between the experienced level of arousal and that represented to the subjects in the form of a thermometer.
Imagine if you were being asked to relax, and a monitor told you that your stress levels were rising, despite you feeling calmer. Would you be more, or less relaxed? If your initial appraisal is that you feel happy and calm, but you receive feedback that you remain stressed, your reappraisal is likely to be influenced by this and your mood will change. This demonstrates that emotional appraisal is context-dependent and fluctuates depending on external cues.

### Story & Craske - False physiological feedback and anxiety sensitivity

Hypothetical examples are useful tools in explaining concepts and theories; however they do require evidence in order to have any impact in the real world. A way of testing the role of physiological changes in generating versus reinforcing emotional states is to falsify physiological feedback – ie to change subjects’ perception of their level of autonomic arousal. A study conducted by Story and Craske (2008) did just that. It involved participants that were separated into two groups: the first being individuals with a history of panic attacks and elevated anxiety sensitivity, the second were a low anxiety group of individuals. The study used a between-subjects design, with the goal to determine the effect of false feedback (using falsely elevated heart rates) on anxiety. The study also involved “primers” in order to see if priming the participants who had elevated anxiety would increase the results measured. During the experiment, neither group’s heart rates responded to the false physiological feedback, however high risk participants did report more panic-specific symptoms than the low risk group. What this shows is that individuals in the high risk group were affected by the false feedback, although the false heart rate measurement did not increase their actual heart rate. Self-reported non-specific anxiety was also increased in the high risk group, however that mostly affected women; men in the high risk group did not differ greatly from the men in the low risk group, despite the panic-specific symptoms being reported amongst both men and women in the high risk group. The primers involved in the experiment (neutral priming and negative priming) did not influence either physiological or subjective responses to the false feedback. It has been suggested that this result indicates that false perception of genuine internal changes may increase the risk of panic disorders when exposed to believable situations (Story & Craske, 2008).

## Improving our motivational and emotional lives

Examining the concept of emotional appraisal requires interrupting the appraisal-reappraisal feedback loop. Falsifying physiological feedback allows us to do just that, isolating the cognitive response to altered physiology from the altered physiology itself. In so doing, it provides targets for manipulating the appraisal-reappraisal pathway - with potential clinical utility for managing panic and anxiety disorders.
As demonstrated in the studies described above, manipulating perception of physiological response to stressors - without even changing the underlying physiology - changes emotional appraisal of threatening stimuli. Although artificially altering biofeedback is neither practical nor desirable in a clinical setting, it does suggest that manipulating physiology could be used to improve emotional outcomes.
Biofeedback does not always involve electronic monitoring of heart rate. Subjects would be expected to have some awareness of their heart rate from sensations such as shortness of breath, palpitations, or even audible throbbing in the head. Changing this feedback would require changing actual physiology - either by mindfulness (deep breathing etc., engaging thoracic baroreceptors to lower heart rate) or pharmacological (eg beta blockade or benzodiazepines) means.
Again, hypothetical situations can only take us so far, but they can give us a glimpse of what is possible. What if an individual prone to panic attacks who was hyperventilating could press a button on their smart watch, which then measured their carbon dioxide levels and gave them some feedback? This feedback could be a genuine reading or a lie, but would it in theory help them with their appraisal of the situation and reduce their risk of an anxiety-induced panic attack? As with all hypothetical ideas, there are problems – is it technically possible? Who would pay for it? Once bought, would it fail to work because the individual was aware of how they work, and would always assume the positive carbon dioxide reading was a lie and therefore would not help them to relax?

## Conclusion

The interaction between physiological feedback and emotion is important in further articulating appraisal theory. It helps to untangle the relationship between evolutionary responses and cognitive responses to situations, particularly threatening situations. Increased understanding of the roles of subcortical and cortical brain activity in appraising situations may eventually improve management of psychological conditions including anxiety.