Available online at www.sciencedirect.com
ScienceDirect
The The subj subjec ecti tive ve expe experi rien ence ce of emotion: a fearful view Joseph E LeDoux1 and Stefan G Hofmann2 We argue that subjective emotional experience, the feeling, is the essence of an of an emotion, and that objective manifestations in behavior and in body or brain physiology are, at best, indirect indicators of these inner experiences. As a result, the most direct way to assess conscious emotional feelings is through verbal self-report. This creates a methodological barrier to studies of conscious feelings in animals. While the behavioral and physiologi physiological cal responses are not ‘emotions,’ they contribute to emotions indirectly, and sometimes profoundly. Whether non-verbal animals have emotional experiences is a difficult, maybe impossible, question to answer in the positive or negati negative. ve. But because behavioral and physiological responses are important contributors to emotions, and the circuits underlying these are highly conserved, studies of animals have an important role in understanding how emotions are expressed and regulated in the brain. Conflation of circuits of circuits that directly give rise to conscious emotional feelings with circuits that indirectly influences these conscious feelings has hampered progress in efforts to understand emotions, and also to understand and to develop treatments for emotional disorders. Recognition of differences of differences in these circuits will allow research in animals to have a lasting impact on understanding of huma human n emotions as research goes forward.
Addresses 1 4 Wash Washin ingt gton on Plac Place, e, Cent Center er for for Neur Neural al Scie Scienc nce, e, New New York York Univ Univer ersi sity ty,, United United States States 2 Depart Departmen mentt of Psycho Psycholog logica icall and Brain Brain Scienc Sciences, es, Boston Boston Unive Universi rsity, ty, United United States States
Corres Correspon pondin ding g author author:: LeDoux LeDoux,, Joseph Joseph E (
[email protected] (
[email protected] )
Curren Currentt Opinio Opinion n in Behavi Behavioral oral Science Sciences s 2018, 19:67–72
This This revi review ew come comes s from from a them themed ed issu issue e on Emotion-cognition interactions Mather and Michael Michael Fanselo Fanselow w Edit Edited ed by Mara Mather
http://dx.doi.org/10.1016/j.cobeha.2017.09.011
2352-1546/ ã 2017 2017 Else Elsevi vier er Ltd. Ltd. All All righ rights ts rese reserv rved ed..
The English word ‘emotion’ is based on the Latin emovere , whic which h means “to move away from.” When first appl applie ied d to psychological events in the 17th century, it pointe pointed d to an excited state of mind of mind that causes movement (behav (behavior ior). ). This This is still the most common meaning of emot em otio ion n in everyday vernacular speech. But in scientific www.sciencedirect.com
discussions, the noun ‘emotion,’ or its adjectival form ‘emotional,’ are variably used to refer to subjective experiences, behavioral movements, physiological responses, and/or cognitions that contribute to any of the abov above. e. Give Given n this multiplicity of referents, it is not surprising that there is debate and confusion about the natu nature re of emotions of emotions [1–11 1–11]. ]. In this this article, we argue that restriction of the use of the term ‘emotion’ ‘emotion’ to subjective experiences, and use of other of other terminology to describe objective responses that are often correlated with emotional experiences would eliminate much much of the of the conceptual confusion. In making this case, we discu iscuss ss several different conceptual approaches to subjective emotional experiences and the brain circuits proposed to underlie such experiences in these approaches approaches.. Because Because the emotion fear has been studied more mo re than than other emotions, especially in relation to brain circuits, and has been the center of much of the controversy ver sy about about the nature of subjectively experienced emotion tion,, we focus on it in our discussion. Because the argument ment made made in this article applies to both fear and anxiety, we will will not distinguish these two terms (for a discussion of the differ differenc ence e see [6]).
Measuri Measuring ng subjec subjectiv tive e experi experienc ences es Before consideri considering ng differen differentt appr approa oach ches es to subjective experiences, it is impo mportant tant to discuss how these unobservable priv privat ate e ev even ents ts are studied. Scientific assessments of inner experiences require some some form of self-reporting self-reporting [12,13 12,13]. ]. Peo People ple can typically give either either a verbal or a nonverba l report of inform informati ation on to which they they have ave introspective acce access ss,, but but cann cannot ot provide a verbal verbal report report of information that that is only processed processed nonconsci conscious ously ly [ 6,14,15 6,14,15]. ]. Fractures Fractures between between conscious conscious and noncon nonconsci scious ous proces processes ses by differ differenc ences es between verbal and non-verb non-verbal al resp respon onse sess have have thus thus play played ed a key key role role in studies of intr intros ospe pect ctiv ive e awar awaren enes esss in huma humans ns.. Whil While e other me meth thod odss of repo report rtin ing g that hat do not not requ equire ire verbal report report have have been been propo proposed sed [ 16–18 16–18], ], these also also depend depend on introspection [15 15]. ]. Verbal self-repor self-reportt remains the the go gold ld standard in studies of cons consci ciou ousn sness ess.. It is most suitable for for asse assess ssiing the content of immediate ex expe perrienc iences es rath rather er than han remembered experiences [14,19 14,19]] and is less useful for assessing the motivation motivationss underlying underlying actions actions since these are often not not cons consci ciou ousl sly y avai availa labl ble e and and ve verb rbal aliz izab able le [20,21 20,21]. ]. Sinc Since e nonnon-ve verb rbal al repo report rtin ing g is the the only only option in non non-ver -verb bal (nonnon-hu huma man) n) orga organi nism sms, s, determining whether other animals have cons consci ciou ous, s, subj subjec ecti tive ve experiences is difficult [6]. Current Current Opinio Opinion n in Behavio Behavioral ral Science Sciences s 2018, 19:1–6
2
Emotion-cognition interactions
Cont Contem empo porar rary y view views s of subjective subjective emotional emotional expe experi rien ence ces s in rela relati tion on to brai brain n circ circui uits ts Four contemporary approaches to subjective emotional experiences in the brain, and the historical roots of each, of each, are are desc descri ribe bed d below. Included are approaches in the traditions of Charles Darwin, William James, behaviorism, ism, and and cognitive psychology.
1. The Neuro-Darwinian The Neuro-Darwinian Approach: Subjective Fear Subjective Fear is an Innate State of State of Mind Inherited Inherited from Animal from Animal Ancestors. Ancestors. In his trea treati tise se on huma human n and and animal emotion, Darwin defined emotions as innate “states of mind” that humans have inherited inherited from animal animal ancestors, ancestors, and that, when aroused, cau cause the expression of so-called emotional behaviors [22 22]. ]. This is consistent with the original 17th century use of the f the term emotion mentioned above. It is still the common commonsen sense se view view of emotion that most people have, and and also also underlie Ekman’s widely cited basic emotions theo theory ry [23 23]. ]. A contemporary neuroscience proponent of the tradit tradition ional al Darwinian view is Jaak Panksepp, who views emotions emotions as subjective feelings that emerge from a subcortica subcorticall neural neural circuit that is highly conserved across mammals, mammals, including including humans [24,25 24,25]. ]. The circuit is centere tered d on the amygdala and related subcortical areas [24 24]. ]. In Pank Pankse sepp pp’s ’s formulation, the amygdala circuit, when acti activa vate ted d by a threat to well being, both gives rise to fearful fearful feelings feelings (subjective feelings of fear) and controls innate innate behaviors behaviors and supporting physiological responses that that help help the organism defend against harm. Cognitive elabor elaborati ation on of subcortical of subcortical fear by higher-cortical prefrontal tal circ circui uits ts makes possible introspection and verbal repo report rtss of fear in humans. But the core of fear is the inherited inherited mental mental state arising from the subcortical circuit. Problemati Problematicc for this view is evidence suggesting that the experience of fear is not embodied in the amygdala. Specificall Specifically, y, studies studies in humans show that the amygdala can can resp respon ond d to threats without the person knowing the threat is present and without feeling fear, and other stud studie iess show show that fear can be experienced when the amyg amygda dala la is damaged [26,27 26,27]; ]; for review see [6,7 6,7]. ]. Also Also,, medica medicatio tions ns can change behavioral responses to threats without changing subjective feelings of fear [28,29 28,29]. ]. Thus Thus,, whil while e the amygdala controls behavioral responses to thre threat atss it does not seem to be directly responsible for the subjec subjectiv tive e experience of fear. One could argue that perhap perhapss other other subcortical areas are responsible. But the emphasis in the literature has been on the amygdala. More Mo reov over er,, the the other hypothetical subcortical circuits wou would nee eed d to be identified before the role can be evaluated.
2. The Neuro-Jamesian Approach: Subjective Fear is a Consequence of Feedback of Feedback from Body Responses. William James famously argued that fear and other emotional experiences result by way of feedback from the act of resp respon ondi ding ng [ 30 30]]. Thus, contrary to the commonsense Curren Currentt Opinio Opinion n in Behavi Behavioral oral Science Sciences s 2018, 19:1–6
view, fear does not cause the responses but instead results as a consequence of the responses. Modern versions of this this theo theory ry by Antonio Damasio [31,32 31,32]] and A.D. Craig [33,34 33,34]] have proposed that fearful and other emotional feelin fee lings gs are the result of activity in body sensing circuits in the the neocortex (somato-sensory and/or insula areas) that repr repres esen entt body body states, such as those triggered when thre threat atss acti activa vate te amygdala circuits. Initially, Damasio emphasized cortical body sensing circuits but more recently has emphasized brainstem circuits [32 32]. ]. As in Panksepp’s theory, cognitive elaboration by highercortic cortical al circui circuits ts allows introspection and self-reporting about these states in Damasio’s theory. While these circ circui uits ts clear clearly ly represent body states, convincing evidenc dence e that that these representations are the main causes of emotional experiences is lacking [6]. We propose below that that body ody feedback makes important contributions to emotional experiences, but as modulators rather than as dire direct ct causes.
3. The Neuro-Behaviorist Neuro-Behaviorist Approach: Approach: Subjective Fear is Fear is a Folk Psychological Construct that Should be Replaced be Replaced by a Scie Scienntific Explana Explanatio tion. n. In the early 20th century, behaviorists eliminated mental states from the causal chain between external external stimuli stimuli and behavioral responses. However, they retained retained mental mental state terms when describing the empirical relati relation on between stimuli and responses. For example, ‘fea ‘fearr’ was was used to characterize the relation between thre threat atss and and defensive behaviors [35 35]. ]. With the rise of physiological approaches to behavior in the middle of the of the 20th 20th cent centur ury, y, fear became a hypothetical physiological state (central (central state), that connects threats with defensive behaviors [36 36]. ]. The intended purpose of this approach was to satisfy the behaviorist constraint against using subjec subjectiv tive e explan explanati ations ons of behavior. Ultimately, the amygdala emerged as the locus of the central fear state [37,38 37,38]]. The central state model has been popular in behavioral neuroscience [39–42 39–42]. ]. Many who call upon the the cent centra rall state view today are ambivalent abo about the ext extent ent to which fear means subjective fear or a nonsubjective state. But adherents of a strong version of the the posi positi tion on argue that subjective, conscious fear is an inaccurate inaccurate scientific scientific construct that can be replaced with a more rigorous rigorous scientific notion of fear of fear as a non-subjective stat state e of the amygdala-centered circuits [42 42]. ]. The wellknow known n lack lack of correlation between verbal reports and amygdala amygdala activity activity in humans [43–45 43–45]] is, in this view view,, due due to the lack of acce access ss to amygdala activity by cognitivebased based intros introspec pectio tion, n, and hence verbal report. In short, verbal ver bal report report of subjective experience is viewed as a less desi desira rabl ble e way way of asse assessi ssing ng fear than simply measuring amygdala-controlled responses. The mechanisti mechanisticc reason a threat elicits defense responses is beca becaus use e it activates cells and synapses in circuits that control control those responses. The fear construct is superfluous in this context [6,7,28,46 6,7,28,46]. ]. It adds conceptual baggage www.sciencedirect.com
Conscious emotion LeDoux and Hofmann
that reifies fear and imbues the circuit with the exact phenomenological properties that are trying to be avoided [47 47]. ]. The way to avoid these problems is by using nonsubjective terminology to name the non-subjective central tral stat states es.. Such states, for example, can be referred in terms of neural activity in a defe defens nsiv ive e survival circuit (rathe (ratherr than than in a fear circuit) [4]. This solves part of the problem but leaves open the question of how conscious fear comes about. The neuro-cognitive approach addres addresses ses this this issue.
4. The Neuro-Cognitive Approach: Neuro-Cognitive Approach: Subjective Fear Fear Emerges Emerges from Higher-Order Processing. Cognitive approaches to emotio emo tion n arose arose in the 1960s in an effort to address certain critic criticisms isms of the of the Jamesian Jamesian approach, and to overcome the behavioris behaviorist’s t’s restricti restrictions ons on inner explanations. Stanley Schach Schachter ter propos proposed ed that emotional experiences result when we interpret physiological arousal in the brain and/or body in light of cognitive assessments of social situations situations,, allowing allowing the categorization and labeling of the of the experience [48,49 48,49]. ]. While there have been a number of cognitive cognitive approaches approaches to emotion [50–53 50–53], ], recent theorizing ing has has emphasized that emotional experiences are cognitive nitive construct constructions ions based on conceptualizations of situasituation tionss [11,54–56 11,54–56]] or higher-order states that emerge as a resu result lt of the of the cognitive integration in working memory of diverse diverse sources sources of inform informati ation on from within the brain and body body [6,7,37,57,58 6,7,37,57,58]. ]. Both Both of these of these positions reject the idea that emotional emotional experiences arise from subcortical circuits (views of the Neuro-Darwinian and Neuro-Jamesian approa approache ches) s) and also reject the idea that the subjective experience is a non-scientific construct (Neuro-Behaviorist approa approach) ch).. The higher-order approach builds on recent developmen me nts in the science and philosophy of consciousness (e.g (e.g.. [7,59–61 7,59–61]), ]), arguin arguing g that a general general network network of cognitions tions underl underlies ies both cognitive and emotional states of consciousne consciousness. ss. In higher-order emotion theory, what distinguishes tinguishes cognitive cognitive and emotional states of consciousness, ness, and different kinds of emotional of emotional states, is the kind of inputs inputs processed. processed. The subcortical fear circuit of the the other models models become becomess a defens defensive ive survival circuit that detects and respon responds ds to threats. The consequences of defensive surviv survival al circui circuitt activation (brain arousal, body feedback, etc.) contribut contribute e indirectly to the experience of fear of fear but do not determ determine ine it. Fear is the cognitive assessment that yo you u are are in harms way, a view that allows fear to arise from activi activity ty in any survival circuits (fear of being harmed by starvation, dehydration, hypothermia, reproductive isolation, tion, and so forth) forth),, or by existential concerns (such as fear of the the eventuality of death of death or the meaninglessness of your of your life life), ), in addition to predatory-related dangers that trigger the defens defensive ive survival circuit.
5: Summar Summaryy of the the Four Four Approaches. Approaches. The neuro-Darwinian, neur neuroo-Ja Jame mesia sian, n, and and neuro-behaviorist approaches all www.sciencedirect.com
3
imply that if through psychotherapy or pharmaceutical treatm treatment ent you successfully reduce amygdala activity, as measured by amygdala-mediated behavioral and/or physiological iological responses, responses, pathological fear should be ameliorate rated. d. But But different reasons underlie this conclusion in each each approa approach. ch. In the neuro-Darwinian approach, treatments that weaken defensive behavior should treat fear prob proble lems ms by altering amygdala activity underlying both beha behavi vior or and and feelings. In the neuro-Jamesian approach, treatments that weaken defensive behavior by altering amygdala amygdala activity activity should treat fear problems because the behaviors, being weaker, shou should ld give give rise to less body feedback and thus weaker subjective feelings. In the neuro-behaviorist approach, altering amygdala activity through behavioral (CBT) or pharmaceutical treatments should should treat treat pathological fear because the problems are due to the non-subjective amygdala state. Once this changes, changes, subjective subjective fear might also change because it is an indire indirect ct cognitive readout of amygdala activity. However, whether whether self-reported feelings change is less important tant than than whether defensive behavior changes since the latt latter er is a direc irectt readout of amygdala activity. A major chal challe leng nge e for for these approaches is accounting for the fail failur ure e of studies using defensive behaviors in animals as me mean anss of drug-discovery of drug-discovery to generate novel agents with clinic clinical al efficac efficacy y in treating fear and anxiety [6,28,29,62 6,28,29,62]. ].
Cons Consci ciou ous s feel feelin ings gs in clin clinic ical al asse assess ssmen mentt A major reason why people seek the help of mental of mental health spec specia iali list stss is because they feel bad and want to feel better. A treatment that reduces behavior (freezing, behavioral timidity, avoidance) and physiology (hyperarou arousa sal) l) but but does not diminish subjectively reported fearful feelings is not likely likely to be viewed as a satisfactory outc outcom ome e by the afflict afflicted ed person person.. In the contemporary cognitive therapy literature, selfreport reports, s, and the subjective experiences that these reports reflect, reflect, have not been given much credence. This reflects the influen influence ce of behaviorism of behaviorism in the development of both of both traditiona traditionall behavioral behavioral therapy [63 63]] and cognitive behavioral ioral therap therapy y (CBT) [64 64], ], as well as findings suggesting that behaviora behaviorall physiological responses related to fear or anxiety in humans are poorly correlated [43–45 43–45]. ]. A recent argu argume ment nt has has been made for more attention to verbal repo report rtss of subjective of subjective experiences, but mainly to validate non-subjective measures [65 65]. ]. This reflects the dominanc nance e of the of the amygdala fear center view described above in clinic clinical al concep concepts. ts. If behavioral, physiological and sub jective responses are all products of the of the same circuit, one resp respon onse se is as good as another as a way to judge clinical outcome. outcome. This logi logicc is also apparent in the NIHM RDoC initiative, which treats subjective reports as just another meas me asur ure e of fear. Kozak and Cuthbert [66 66], ], for example, note note that that “ . . . the RDoC approach accords self-report data data no special precedence among different measurement Current Current Opinio Opinion n in Behavio Behavioral ral Science Sciences s 2018, 19:1–6
4
Emotion-cognition interactions
classes, any of which might contribute to a nomolo nomologic gical al net net (p. 292).” An important important advantag advantage e of the of the neuro-cognitive neuro-cognitive approach to fear fear is that it accoun accounts ts for the two troubling observation tionss me ment ntio ione ned d abov above e that are not not easi easily ly hand andled led by fearfear-cen cente terr views: views: subjec subjectiv tive e fear fear does not not requ requir ire e the the amygda amygdala, la, and medica medicati tions ons that that target the amygd amygdala ala do not neces necessar sarily ily reliev relieve e subjec subjecti tive ve fear. fear. It would seem that that the neuro-cognitive approach should mesh mesh well well with with modern CBT. CBT. Howeve However, r, despi despite te the centra centrali lity ty of introspection and and cogn cognit itiv ive e proc proces esse sess in human human mental mental life, as noted above, above, subjecti subjective ve report report never reached a central stat status us in CBT. Self-repo Self-report rt has always been seen as an easy but unreliable way to measure anxiety and fear. For example, Zoellner and Foa [67 67]] agree with Kozak and Cuthbert that self-r self-repo eports rts do not have any special status, noting that “self-report is one piece of the of the net in terms of studying of studying a phenomenon.” But they nevertheless go on to say that self-repor self-reports ts “should “should be considered potential valid measur sures of key of key constructs, some of which cannot be measure sured d in any other way, and sometimes the best measure of the construct of intere interest st (p. 334).” Toda Today, y, CBT CBT therapists routinely use subjective patient repo report rt as part of treatment. However, its value continues to be debated. Some argue that self-reported fear is an inad inadeq equa uate te me meas asur ure e of the patient’s emotional state because because reduction reduction in reported fear during exposure sessions sions does does not predict long-term treatment effects [68,69 68,69]. ]. While While this finding is consistent with the neuro-behaviorist (non-subjective) amygdala fear state model described abov above, e, the the evidence presented is not especially strong, and and othe otherr findings directly contradict the conclusion. Specifically, more recent clinical trials examining the augmen augmentat tation ion effect effect of D-cycloserine (DCS), a partial ago agonist nist at the glycine recognition site of the NMDA recept receptor or comple complex, x, show the DCS enhances exposure therap therapy y primar primarily ily in those people who report a clear reduction of reported fear during the exposures [70,71 70,71]. ]. This This sugges suggests ts that the reduction in reported fear ratings during during an exposure session is, in fact, a cruc crucia iall factor that determines determines the success of treatment of treatment [72 72]. ]. Also intriguing is the recent finding that Pavlovian conditioned threat resp respon onses ses can can be extinguished without the arousal of consci conscious ous fear fear [73 73]. ]. We argue that subjective reports of fear and anxiety are not not unre unreli liab able le proxy measures of fear and anxiety, as sugges suggested ted by the neuro-behaviorist model. Rather, they are are the the best direct, and, at least so far, the only measures easily easily accessi accessible ble for clinicians to assess the efficacy of treatm treatment ent.. If this is correct, therapists need to carefully list listen en to the clients’ report about their emotional states, furt furthe herr deve develo lop p reliable assessment instruments of Curren Currentt Opinio Opinion n in Behavi Behavioral oral Science Sciences s 2018, 19:1–6
subjective reports, and utilize verbal strategies to elicit and modify modify them. However, we suggest that this be done afte afterr othe otherr approaches, such as CBT or pharamceutical treatm treatment ents, s, to first dampen the amygdala central state, which which indire indirectl ctly y affects subjective experience. We also recommend recommend that future research re-examine the relationship ship betw betwee een n subjective report, behaviors, and physiologica logicall respon responses ses of fear and anxiety in order to explain the reason reasonss for the dissociation between these measures.
Confl Conflic ictt of inte intere rest st stat statem emen entt Nothing declared.
Funding Funded in part by the James S. McDonnell Foundation 21 Century Science Initiative in Understanding Human Cogn Cognit itio ion n – Spec Specia iall Initiative. st
References 1.
Candla Cand land nd DK DK,, Fe Fell ll JP JP,, Ke Keen en E, Le Lesh shne nerr AI AI,, Ta Tarp rpy y RM RM:: Emotion Emotion.. Belmon Bel mont, t, CA: Wad Wadswo sworth rth Pub Publis lishin hing g Com Compan pany, y, Inc Inc.; .; 197 1977. 7.
2.
Ekman Ekma n P, Da Davi vids dson on R: The Nat Nature ure of Emo Emotio tion: n: Fu Funda ndamen mental tal Questions.. Ne Questions New w Yo York rk:: Ox Oxfo ford rd Un Univ iver ersi sity ty Pr Pres ess; s; 19 1994 94..
3.
Functio ctional nal spe special cializat ization ion doe does s not req requir uire e a one one-Scarantino A: Fun Scarantino to-on toone e map mappi ping ng be betw tween een br brain ain re regio gions ns an and d emo emotio tions ns. Behav Brain Bra in Sci Sci 2012, 2012, 35:161-162.
4.
Rethink inking ing the emo emotion tional al bra brain in. Neuron 2012, 73: LeDoux J: Reth LeDoux 653-676.
5.
Comin ming g to ter terms ms wi with th fea fearr. Pr LeDoux JE: Co LeDoux ProcNat ocNatll Ac AcadSciU adSciU S A 2014, 111:2871-2878.
6.
LeDoux LeDou x JE: JE: Anxious: Anxious: Using the Brain to Understand and Treat Fear and Anxiety . Ne New w Yo York rk:: Vi Viki king ng;; 20 2015 15..
7.
LeDoux LeDo ux JE JE,, Br Brow own n R: A higher-order theory of emotional consciousness . Proc Natl Acad Sci U S A 2017, 114: E2016-E2025.
8.
Deco codi ding ng th the e na natu ture re of em emot otio ion n in th the e Kragel Krag el PA PA,, La LaBa Barr KS KS:: De brain. Tr Tren ends ds Co Cogn gn Sc Sci i 2016.
9.
Kuppen Kupp ens s P, Tu Tuerl erlin inck ckx x F, Yi Yik k M, Ko Kova vall P, Co Coos osem eman ans s J, Ze Zeng ng KJ KJ,, The e rel relati ation on be betw tween een va valen lence ce an and d aro arous usal al in Russel Rus selll JA: Th subject sub jective ive exp experie erience nce var varies ies with pers persona onality lity and cult culture ure. J Pers 2016.
10. Tourou Touroutog toglou lou A, Lin Lindqu dquist ist KA, Dic Dicker kerson son BC, Bar Barret rettt LF: Intrinsic conne con necti ctivi vity ty in th the e hu human man br brai ain n do does es no nott rev reveal eal net netwo works rks fo forr ‘basic’ emotion emotions s. SocCogn Aff Affect ect Neu Neuros rosci ci 2015, 2015, 10:1257-1265. 11. Barrett Barrett LF: Ho How w Em Emot otio ions ns ar are e Ma Made de.. New Yor York: k: Hou Hough ghton ton Mif Mifflin flin Harcourt; Harco urt; 2017 2017.. 12. Weiskr Weiskrant antz z L: Co Cons nsci ciou ousn snes ess s Lo Lost st an and d Fo Foun und: d: A Neuropsych Neuro psychologi ological cal Explo Exploratio ration n . New Yor York: k: Oxf Oxford ord Uni Univer versit sity y Press;; 1997 Press 1997.. Kinds s of acce access: ss: diff differen erentt meth methods ods 13. Overga Overgaard ard M, San Sandbe dberg rg K: Kind forr re fo repo port rt rev reveal eal di diffe fferen rentt ki kind nds s of me metac tacog ognit nitiv ive e acc acces ess s. In The Cog Cognit nitive ive Neu Neuros roscie cience nce of Met Metaco acogn gnitio ition. n. Edi Edited ted by Fle Flemin ming g SM, Fri Frith th CD. Spr Spring ingerer-Verl Verlag ag Ber Berlin lin Hei Heidel delber berg; g; 201 2014: 4:6767-86 86 .
14. Ericcs Ericcson on KA, Sim Simon on H: Pro Protoc tocol ol Ana Analysi lysis: s: Ver Verbal bal Rep Report orts s as Data Data.. Camb Ca mbrid ridge ge,, MA MA:: MIT Pr Pres ess; s; 19 1993 93.. Post-decision ecision wagerin wagering g measur measures es metacogn metacognitive itive 15. Seth Seth AK AK:: Post-d content con tent,, not sen sensor sory y con conscio sciousn usness ess. Consc Conscious ious Cogn 2008, 17:981-983.
www.sciencedirect.com
Conscious emotion LeDoux and Hofmann
Post-decision ecision wagerin wagering g 16. Pers Persau aud d N, Mc McLe Leod od P, Co Cowe wey y A: Post-d objecti obj ectively vely meas measure ures s awar awarene eness ss. Nat Neu Neuros rosci ci 2007, 10: 257-261. Relativ tive e bli blinds ndsigh ightt in nor normal mal 17. Lau Lau HC HC,, Pa Pass ssin ingh gham am RE RE:: Rela obse ob serv rvers ers an and d th the e ne neur ural al co corr rrela elate te of vi visu sual al co cons nsci ciou ousn snes ess s. Proc Natl Acad Sci U S A 2006, 103:18763-18768. signal nal pro process cessing ing arch architec itecture ture 18. Mani Manisc scal alco co B, La Lau u H: The sig underly und erlying ing sub subject jective ive rep reports orts of sen sensor sory y awa awarene reness ss. Neurosci Conscious 2016:2016. The e pr prop oper er pro protoc tocol ol:: va valid lidity ity an and d co comp mple leten tenes ess s of 19. Wilson Wilson TD: Th verbal ver bal repo reports rts. Psy Psycho choll Sci Sci 1994, 1994, 5:249-252. Tell llin ing g mo more re th than an we ca can n kn know ow:: ve verb rbal al 20. Nisb Nisbet ettt RE RE,, Wi Wils lson on TD TD:: Te repo re port rts s on me ment ntal al pr proc oces esses ses. Psy Psycho choll Rev Rev 1977, 1977, 84:231-259.
21. Hass Hassin in RR RR,, Ul Ulem eman an JS JS,, Ba Barg rgh h JA (E (Eds ds): ): The New Uncon Unconsci scious ous.. New York: York: Oxford Oxford Unive Universi rsity ty Press; Press; 2005. 2005. 22. Darwin Darwin C: Th The e Ex Expr pres essi sion on of th the e Em Emot otio ions ns in Ma Man n an and d An Anim imal als s. Londo Lo ndon: n: Fon Fontan tana a Pre Press; ss; 18 1872. 72.
41. Anderson DJ, Adolphs R: A framework for studying emotions across acro ss spec species ies. Cell 2014, 157:187-200. Neurobehavior ehavioral al perspec perspectives tives on 42. Perusi Perusini ni JN, Fan Fansel selow ow MS: Neurob the th e dis distin tincti ction on bet betwee ween n fea fearr an and d an anxi xiety ety . Lea Learn rn Mem 2015, 22:417-425. Fearreductionand tionand fearbehav fearbehavior ior:: pro proble blems ms intreatin intreating g 43. LangPJ: Fearreduc a constru construct ct. In Resea Researchin rchin Psycho Psychothera therapy py , vol3. Editedby Schl Schlien ien JM . American American Psycholog Psychological ical Associati Association; on; 1968:90-1 1968:90-103. 03. II.. Des Desyn ynch chro rony ny in me meas asur ures es of fe fear ar. 44. Hodg Hodgso son n R, Ra Rach chma man n S: II Beha Be hav v Re Res s Th Ther er 1974, 1974, 12:319-326. Sync nchr hron ony y an and d des desyn ynch chro rony ny in fea fearr 45. Rachma Rachman n S, Hod Hodgso gson n R: I. Sy and avo avoidan idance ce. Be Beha hav v Re Res s Th Ther er 1974, 1974, 12:311-318. Sema mant ntics ics,, su surp rplu lus s mea meani ning ng,, an and d th the e sc scien ience ce of 46. LeDoux LeDoux JE: Se fear. Tr Tren ends ds Co Cogn gn Sc Sci i 2017. Interve ervenin ning g var variabl iable e or hyp hypoth othetic etical al con constru struct? ct? 47. Marx Marx MH MH:: Int Psycho Psy choll Rev Rev 1951, 1951, 58:235-247.
23. Ekma Ekman n P: Are there basic emotions? Psyc Psychol hol Rev Rev 1992, 1992, 99: 550-553.
Cognition tion and centralis centralist-perip t-peripheralist heralist 48. Schach Schachter ter S: Cogni controv con trovers ersies ies in mot motivat ivation ion and emo emotion tion. In Han Handbo dbook ok of Psychobiology. Ed Edit ited ed by Ga Gazza zzani niga ga MS MS,, Bl Blak akem emor ore e CB CB.. Academic Press; 1975:529-564 1975:529-564..
24. Panksepp Panksepp J: J: Affective Affective Neuroscience Neuroscience.. New Yo York: rk: Oxf Oxford ord U. Pre Press; ss; 1998.
Cogniti nitive, ve, soc social, ial, and phy physio siolog logical ical 49. Scha Schach chte terr S, Si Sing nger er JE JE:: Cog determinants determi nants of emotion emotional al state. Psycho Psycholl Rev Rev 1962, 1962, 69:379-399.
cross-m s-mamma ammalian lian neu neurop rophen henome omenol nology ogy of 25. Pankse Panksepp pp J: The cros prim pr imal al emo emotio tiona nall aff affect ects: s: fr from om an anim imal al fee feelin lings gs to hu human man therapeutics. J Comp Neurol 2016, 524:1624-1635.
50. Mandle Mandlerr G: Mi Mind nd an and d Bo Body dy:: Th The e Ps Psyc ycho holo logy gy of Em Emot otio ion n an and d Stress.. Ne Stress New w Yo York rk:: No Nort rton on;; 19 1984 84..
26. Fein Feinst stei ein n JS JS,, Bu Buzza zza C, Hu Hurle rlema mann nn R, Fo Foll llme merr RL RL,, Da Dahd hdale aleh h NS NS,, Fear ar an and d pa pani nic c in Cory Co ryel elll WH WH,, We Wels lsh h MJ MJ,, Tr Tran anel el D, We Wemm mmie ie JA JA:: Fe humans hum ans wit with h bil bilater ateral al amyg amygdal dala a dama damage ge. Nat Neu Neuros rosci ci 2013, 16:270-272. the e hu huma man n am amyg ygda dala la cr criti itical cal fo forr the 27. Anderson AK, Phelps EA: Is th subj su bject ectiv ive e exp experi erienc ence e of em emoti otion on? ? Ev Evide idenc nce e of in intac tactt dispos dis positio itional nal affe affect ct in pati patients ents with amy amygdal gdala a lesi lesions ons. J Cogn Neurosci 2002, 14:709-720. Using ng neu neurosc roscienc ience e to help und unders erstand tand 28. LeDo LeDoux ux JE JE,, Pi Pine ne DS DS:: Usi fear fe ar an and d an anxi xiety ety:: a tw twoo-sy syst stem em fra framew mewor ork k . Am J Psychiatry 2016, 173:1083-1093. years ars of hu hurd rdles les an and d ho hope pe in an anxio xioly lytic tic 29. Griebe Griebell G, Hol Holmes mes A: 50 ye drug dru g dis discove covery ry . Na Natt Re Rev v Dr Drug ug Di Disc scov ov 2013, 2013, 12:667-687. What at is an em emot otio ion? n? Mind 1884, 9:188-205. 30. Ja Jame mes s W: Wh
31. Damasi Damasio o A: De Desc scar arte te’s ’s Er Erro ror: r: Em Emot otio ion, n, Re Reas ason on,, an and d th the e Hu Huma man n Brain.. Ne Brain New w Yo York rk:: Go Goss sset et/P /Put utna nam; m; 19 1994 94.. nature ure of feel feeling ings: s: evo evolut lution ionary ary 32. Dama Damasi sio o A, Ca Carv rval alho ho GB GB:: The nat and neurob neurobiologi iological cal origins. NatRev Neu Neuros rosci ci 2013, 2013, 14:143-152. How w do yo you u fe feel el — no now? w? Th The e an ante teri rior or in insu sula la an and d 33. Craig Craig AD: Ho human awarenes awareness s. Na Natt Re Rev v Ne Neur uros osci ci 2009, 2009, 10:59-70. Interoc erocepti eption, on, hom homeos eostati tatic c emo emotion tions s and 34. Strig Strigo o IA IA,, Cr Crai aig g AD AD:: Int sympathovaga sympa thovagall balance. Phi hilo los s Tr Tran ans s R So Soc c Lo Lond nd B Bi Biol ol Sc Sci i 2016:371. Emotion tions s con concept ceptuali ualized zed as int interve ervenin ning g 35. Brow Brown n JS JS,, Fa Farb rber er IE IE:: Emo vari va riab ables les — wi with th su sugg gges estio tions ns to towar ward d a th theor eory y of fr frus ustr trati ation on. Psycho Psy choll Bul Bull l 1951, 48:465-495. process cess lear learnin ning g theo theory: ry: 36. Resc Rescor orla la RA RA,, So Solo lomo mon n RL RL:: Two pro relatio rel ationsh nships ips betw between een Pav Pavlov lovian ian con conditi ditioni oning ng and instrumental instru mental learning. Psy Psycho choll Rev Rev 1967, 1967, 74:151-182.
37. LeDoux LeDoux JE: The Emoti Emotional onal Brain Brain.. Ne New w Yo York rk:: Si Simo mon n an and d Sc Schu hust ster er;; 1996. The e ro role le of th the e amy amygda gdala la in con condit dition ioned ed fear. In The 38. Davis Davis M: Th Amygdala: Neurobiological Aspects of Emotion, Memory, and Mentall Dysfun Menta Dysfunction ction.. Ed Edit ited ed by Ag Aggl glet eton on JP JP.. Wi Wile leyy-Li Liss ss,, In Inc; c; 1992:255-306 . From m nor normal mal fearto path patholo ologica gicall anx anxiety iety . 39. Rosen Rosen JB,Schul JB,SchulkinJ: kinJ: Fro Psycho Psy choll Rev Rev 1998, 1998, 105:325-350. The e bi biol olog ogy y of fe fear ar. Cur 40. Adolphs R: Th Currr Bio Biol l 2013, 23:R79-R93.
www.sciencedirect.com
5
Emotion n definitio definition n (psych (psychologica ologicall 51. Frij Frijda da NH NH,, Sc Sche here rerr KR KR:: Emotio perspectives). In OxfordCompanio OxfordCompanion n to Emotio Emotion n and the Affec Affective tive Sciences. Ed Edit ited ed by Sa Sand nder er D, Sc Sche here rerr KR KR.. Ox Oxfo ford rd Un Univ ivers ersit ity y Press;; 2009 Press 2009:142 :142-143 -143.. Emotion tions, s, moo moods, ds, and con conscio scious us 52. Orto Ortony ny A, Cl Clor ore e GL GL:: Emo awareness. Cog Cogn n Emo Emot t 1989, 3:125-137. Self-organisi rganising ng cogniti cognitive ve apprais appraisals als. Cog 53. Lewis Lewis MD: Self-o Cogn n Emo Emot t 1996, 10:1-26. Core re aff affect ect and th the e ps psyc ycho holo logi gical cal co cons nstr truc uctio tion n of 54. Russel Russelll JA: Co emotion. Psy Psycho choll Rev Rev 2003, 2003, 110:145-172. Solving ng the emotionparadox:categorizationand the 55. Barrett Barrett LF: Solvi experie exp erience nce of emot emotion ion. Pe Pers rs So Soc c Ps Psyc ycho holl Re Rev v 2006, 2006, 10:20-46.
56. Barre Barrett tt LF LF,, Ru Russ ssel elll JA (E (Eds ds): ): The Psycho Psycholog logica icall Constr Construct uction ion of Emotion. Emotion. New New York York:: Guil Guilfo ford rd Pres Press; s; 2015 2015.. 57. LeDoux LeDoux JE: Sy Syna napti ptic c Se Self lf:: Ho How w Ou Ourr Br Brai ains ns Be Beco come me Wh Who o We Ar Are e. New Ne w Yo York rk:: Vi Viki king ng;; 20 2002 02.. Emotion tional al colo colourat uration ion of con consci scious ousnes ness: s: how 58. LeDoux LeDoux JE: Emo feeling feel ings s com come e abo about ut. In Fro Fronti ntiers ers of Con Consci scious ousnes ness: s: Chi Chiche chele le Lectures. Ed Edit ited ed by We Weis iskr kran antz tz L, Da Davi vies es M. Ox Oxfo ford rd Un Univ iver ersi sity ty Press;; 2008 Press 2008:69:69-130 130..
59. Dehaen Dehaene e S: Co Cons nsci ciou ousn snes ess s and and th the e Br Brai ain: n: De Deci ciph pher erin ing g ho how w th the e Brain Bra in Cod Codes es Our Th Thoug oughts hts.. Ne New w Yo York rk:: Pe Peng ngui uin n Bo Book oks; s; 20 2014 14.. 60. Rosenthal Rosenthal DM: Con Consci scious ousnes ness s and Min Mind d . Oxfor Oxford: d: Oxfor Oxford d Unive Un iversi rsity ty Pre Press; ss; 20 2005. 05. Empirical cal suppo support rt for higher higher-order -order theories 61. LauH, Ros Rosent enthalD: halD: Empiri of con conscio scious us awa awarene reness ss. Tr Tren ends ds Co Cogn gn Sc Sci i 2011, 15:365-373. pharm arma a ru runn nnin ing g ou outt of br brain ainy y id ideas eas? ? Science 2010, 62. Miller Miller G: Is ph 329:502-504. The e ne negat gativ ive e imp impact act of th the e co cogn gniti itive ve mo move veme ment nt on 63. Levis Levis DJ: Th the th e con contin tinue ued d gr growt owth h of th the e be beha havi vior or th thera erapy py mo move vemen ment: t: a historical histor ical perspe perspective ctive. Ge Gene nett So Soc c Ge Gen n Ps Psyc ycho holl Mo Mono nogr gr 1999, 1999, 125:157-171. science ence of cog cogniti nitive ve 64. Hofman Hofmann n SG,Asmun SG,Asmundso dson n GJ,Beck AT: The sci therapy . Beh Behav av The Ther r 2013, 44:199-212.
65. Hamm Hamm AO AO,, Ri Rich chte terr J, Pa Pane ne-F -Far arre re C, We West stph phal al D, Wi Witt ttch chen en HU HU,, Vossbe Vos sbeckck-Els Elsebu ebusch sch AN, Ger Gerlac lach h AL, Glo Gloste sterr AT, Str Strohl ohle e A, Pani nic c di diso sord rder er wi with th ag agor orap apho hobi bia a fr from om a Lang La ng T et al al..: Pa behavio beh avioral ral neu neuros roscien cience ce pers perspect pective ive:: app applyin lying g the res researc earch h princi pri nciplesformu plesformulate lated d by theResearchDomai theResearchDomain n Cri Criteri teria a (RD (RDoC) oC) initiative. Psychophysiology 2016, 53:312-322. Current Current Opinio Opinion n in Behavio Behavioral ral Science Sciences s 2018, 19:1–6
6
Emotion-cognition interactions
The e NI NIMH MH Res Resear earch ch Do Doma main in Cr Crit iteri eria a 66. Kozak Kozak MJ MJ,, Cu Cuth thbe bert rt BN BN:: Th Initiat Ini tiative ive:: bac backgro kground und,, iss issues ues,, and prag pragmati matics cs. Psychophysiology 2016, 53:286-297.
67. Zoelln Zoellner er LA,Foa EB: Applying Research Domain Criteria (RDoC) to th the e st stud udy y of fe fear ar an and d an anxi xiet ety: y: a cr crit itic ical al co comm mmen entt. Psychophysiology 2016, 53:332-335. 68. Cras Craske ke MG MG,, Ki Kirc rcan ansk skii K, Ze Zeli liko kows wsky ky M, My Myst stko kows wski ki J, Optimiz mizing ing inh inhibi ibitory tory lear learnin ning g dur during ing Chow Ch owdh dhur ury y N, Ba Bake kerr A: Opti exposu exp osure re ther therapy apy . Be Beha hav v Re Res s Th Ther er 2008, 2008, 46:5-27. 69. Cras Craske ke MG MG,, Tr Trea eano norr M, Co Conw nway ay CC CC,, Zb Zboz ozin inek ek T, Ve Verv rvli liet et B: Maximiz Max imizing ing exp exposu osure re ther therapy apy:: an inh inhibi ibitory tory lear learnin ning g approach. Be Beha hav v Re Res s Th Ther er 2014, 2014, 58:10-23. 70. Smit Smits s JA JA,, Ro Rose senfi nfiel eld d D, Ot Otto to MW MW,, Ma Marq rque ues s L, Da Davi vis s ML ML,, Meur Me uret et AE AE,, Si Simo mon n NM NM,, Po Poll llac ack k MH MH,, Ho Hofm fman ann n SG SG:: D-cycloserine enhance enh ancement ment of exp exposu osure re ther therapy apy for soc social ial anx anxiety iety dis disord order er
Curren Currentt Opinio Opinion n in Behavi Behavioral oral Science Sciences s 2018, 19:1–6
depends depend s on the suc success cess of exp exposu osure re ses session sions s. J Psychiatr Res 2013, 47:1455-1461.
71. Smit Smits s JA JA,, Ro Rose senfi nfiel eld d D, Ot Otto to MW MW,, Po Powe wers rs MB MB,, Ho Hofm fman ann n SG SG,, D-cycloserine oserine enhanc enhancement ement of Telch Tel ch MJ, Po Poll llac ack k MH MH,, Ta Tart rt CD CD:: D-cycl fearr ex fea extin tincti ction on is sp speci ecific fic to su succe ccess ssfu full exp expos osur ure e se sess ssion ions: s: evide ev idenc nce e fro from m th the e tre treatm atmen entt of he heigh ightt ph phob obia ia. Biol Psychi Psychiatry atry 2013, 73:1054-1058. D-cyclo ycloser serine ine for trea treatin ting g anx anxiety iety dis disord orders: ers: 72. Hofman Hofmann n SG: D-c makin mak ing g go good od ex expo posu sures res be bette tterr an and d ba bad d ex expo posu sure res s wo wors rse e. Depress Depres s Anxie Anxiety ty 2014, 31:175-177.
73. Koizumi A, Amano K, Cor Cortes tese e A, Sh Shiba ibata ta K, Yos Yoshid hida a W, reduction ion witho without ut Seym Se ymou ourr B, Ka Kawa wato to M, La Lau u H: Fear reduct fear throu through gh reinf reinforceme orcement nt of neu neural ral activity that bypasses consc conscious ious expos exposure ure. Nat Huma Human n Beha Behav v 2016, 1:0006.
www.sciencedirect.com
