Robert W. Levenson - US grants

This proposal requests support for a program of research concerning individual differences in psychological and physiological effects of alcohol consumption in stressful situations and the importance of these effects for understanding the process of development of alcoholism. The research uses nonalcoholic subjects who can be considered to be at varying risk for alcoholism by virtue of their sex, personality, and family history of alcoholism. The research program includes studies in which subjects are exposed to stress under varying conditions of alcohol consumption and alcohol expectation to determine the effects of alcohol on their psychophysiological and behavioral responses to stress. In another kind of study, subjects are exposed to stress to determine effects of stress on their consumption of alcohol. The overarching hypothesis of this program is that nonalcoholic subjects who are at high risk for alcoholism will derive a maximal reduction in the magnitude of their psychophysiological responses to stress when they consume alcohol, and further that these subjects will tend to consume greater amounts of alcohol when exposed to stress. The proposed research is divided into six experiments which will systematically explore the effects of dosage, type of stress, sex differences, and risk factors as they relate to the alcohol-stress relationship.

culture; emotions; face expression; paralinguistic behavior; gender difference; fear; angers; questionnaires;

This proposal describes a five year longitudinal study of the nature and quality of effective marital functioning in old and middle-aged couples. The focus of the research is on normal aging and on long-term first marriages. Marriage is viewed as a singularly important interpersonal relationship that plays an increasingly important role in the maintenance of well-being in old age. Our previous work with young married couples has shown that current and future levels of marital satisfaction can be best understood by directly observing the couple as they interact, especially when they are attempting to resolve problem areas in their marriage. We propose to study 140 married couples who differ as to age (old versus middle-age) and marital satisfaction (satisfied versus dissatisfied) and to observe three different kinds of marital interactions in the laboratory on two different occasions two years apart. During each interaction a multi- method data collection will be carried out that includes fine- grained measurement from a number of different domains. Longitudinal change in marital satisfaction and health will be assessed as well. The research addressed five specific aims: (a) to study the nature of marital interaction in old age; (b) to determine how happy and unhappy marriages differ in old-age and in middle age; (c) to find predictors of change in relationship satisfaction over a two year period in old-age and in middle age; (d) to determine the stability of marital interaction over a two year period in old-age and in middle age; and (e) to study the relations among marital satisfaction, marital interaction, and health in old-age and in middle age.

A series of experiments is proposed that systematically explores ethnic differences in the processes of emotional reactivity, emotional control, and emotional perception. Subjects will be young male and female African Americans, Chinese Americans, European Americans and Mexican Americans. Chinese Americans and Mexican Americans will be the first generation of their families born in the United States. Experiments will be conducted in a laboratory setting using a multi-method approach in which subjective experience (self-report of emotional state), expressive behavior (microanalytic and microanalytic observational coding) and autonomic and somatic nervous system physiology (monitoring of cardiovascular, electrodermal, somatic and respiratory activity) will be measured. The effects of socioeconomic status and acculturation will be determined in all experiments. To study emotional reactivity, a number of different stimuli will be used,some of which are more voluntary and internal to the subject (e.g., emotional memories and directed facial actions) and others that are more involuntary and external to the subject (acoustic startle and emotion- eliciting films). Several less emotional tasks (e.g., physical exercise) will be included to help isolate ethnic differences in emotional reactivity from possible ethnic differences in nonemotional reactivity. Whenever possible, multiple emotions will be sampled including anger, disgust, fear, happiness, sadness and surprise. To study emotional control, subjects will attempt to inhibit their emotional responses to an acoustic startle stimulus and to emotion-eliciting films. To study emotional perception, subjects will attempt to rate the feelings of another person who is engaged in a dyadic interactions. This research is motivated by suggestive empirical findings of ethnic differences in the realms of basic emotional processes and in vulnerability to emotion-related psychopathologies.

DESCRIPTION (provided by applicant): Affective science (the study of emotions, moods, affect-based pathology and other emotion-related phenomena) has expanded dramatically in recent years. Its impact has been felt throughout psychology, biology, neurology, neuroscience, and psychiatry. This growth has been accompanied by scientific specialization that has had both benefits and costs. Among the benefits are increasingly mature theories and a veritable explosion of methodological advances and empirically-derived knowledge concerning aspects of affect ranging from molecular to molar levels. Among the costs are more narrow training and increasing isolation among areas of specialization, resulting in affective scientists who may not have familiarity and facility with traditions other than their own. Our training program augments the specialized training predoctoral students receive in their chosen fields with substantive exposure to other traditions and methods within affective science. Moreover, by sharing didactic, workshop, and other experiences over a three-year period, predoctoral trainees form a cohort group at an early stage of their career that fosters much stronger professional ties to those from other approaches and disciplines than would occur in traditional training. The multi-university nature of the training program also serves these goals, greatly expanding the community of affective scientists that trainees meet, learn from, and work with. The training program is built on the view that fostering an appreciation and understanding of the theories, methods, and data of areas of affective science beyond one's own area of specialization lays the groundwork for better communication among subspecialties, more interdisciplinary collaborations, and a stronger and more integrative affective science. In this application for a second five years of support, we propose to continue selecting four new predoctoral trainees per year from psychology, neuroscience, and health sciences programs at four Bay Area universities (the Berkeley, Davis, and San Francisco campuses of the University of California and Stanford University). Trainees participate in a three-year training sequence leading up to their dissertation research. Training takes place in a yearlong seminar at Berkeley, visits to training faculty laboratories at the four campuses, specialized methods workshops, and an annual conference/workshop where trainees' research findings are shared and discussed. Close mentoring and monitoring of trainee progress is maintained throughout. We believe that this method of training students has significant social benefits, which derive in part from the considerable potential for applying knowledge derived from basic affective science to a range of public health issues. Research on emotion and other affective phenomena has numerous important applications including: (a) mental health and illness; (b) physical health and disease; (c) attachment, loyalty, and relationship quality; (d) well-being; (e) societal problems such as addiction and violence; (f) treatment design and evaluation; and (g) inter-group conflict and communication.

Emotion is a prominent feature of life, increasingly thought to play a central role throughout the life-span in a wide range of human processes. Whereas losses are seen in many psychological and physical domains in old age, emotion may be an area of functioning that is relatively spared. Learning and experience play a critical role in many aspects of emotion, thus it is conceivable that actual gains may be seen in old age. This proposal requests support for a series of studies in which three of the most fundamental aspects of emotion--emotional reaction, emotional regulation, and emotional understanding--are studied cross-sectionally in samples of young, middle-age, and elderly individuals and longitudinally in samples of middle-aged and older individuals who will have been studied three times over a ten-year period. The proposed studies are characterized by a multi-method approach in which subjective, expressive, and physiological aspects of both positive and negative emotions are considered. Although all studies are conducted in a laboratory setting, both naturalistic and experimentally manipulated behaviors are studied. The work attempts to disambiguate several issues in the literature on emotion and age. By studying relatively non-emotional tasks (e.g., isometric exercise) and highly emotional tasks, it should be possible to separate age differences in emotional reactivity from possible age differences in non-emotional reactivity. By instructing subjects to regulate their emotions in different ways (suppress and amplify using antecedent focused, response-focused, and non-directed strategies), we will be able to determine if the capacity to control emotion increases in late life. By using an empathic accuracy task with high ecological validity and objective accuracy criteria, it should be possible to determine whether there are actual changes in one important aspect of emotional understanding--the ability to know what others are feeling--with age. By studying emotion in vivo in a longitudinal sample, we should learn whether age differences in emotional reaction and regulation previously observed in cross-sectional comparisons are also reflected within individuals over time. Finally, using the longitudinal data it should be possible to test the notion that gender differences, which are quite large in the realm of emotion early in life, diminish with age.

PROJECT SUMMARY (See instructions): We will study the effects of frontotemporal lobar degeneration (FTLD), Alzheimer's disease (AD), and mild cognitive impairment (MCI) on socioemotional functioning using laboratory procedures that allow for precise assessment of a number of aspects of actual emotional functioning including: (a) emotional reactivity (the type and magnitude of responses to salient challenges and opportunities), (b) emotion regulation (the ability to adjust emotional responses to situational demands) and (c) empathy and prosocial behavior (recognizing others' emotions and responding to their distress). These laboratory-based assessments measure the major aspects of emotional responding, including: (a) subjective emotional experience, (b) emotional expressive behavior, (c) emotional language, and (d) autonomic and somatic nervous system physiology. This approach allows us to identify specific areas of lost and preserved socioemotional functioning in FTLD and AD, compared to each other and to MCI and controls. A particular focus of the proposed work is on understanding the basis of symptoms of FTLD that are very troublesome for caregivers, including a progressive loss of warmth and an increase in socially inappropropriate behavior. We will use our detailed analyses of emotional functioning to explore the particular deficits that contribute to these real world symptoms. Delineating specific deficits will enable us to make strong links to damage in specific brain circuits (explored via structural imaging) and particular kinds of neuropathology (explored at autopsy). In addition, we will determine the extent to which changes in particular aspects of socioemotional functioning are related to genetic risk factors for FTLD by studying unaffected family members with and without suspected genetic markers in families with a high incidence of FTLD.

DESCRIPTION (provided by applicant): There is growing interest in utilizing an interdisciplinary perspective to identify key targets and transition points in the life span that create unique opportunities for behavior change to improve health and well-being. The aim of this application is to develop unique interdisciplinary research teams that would be able to leverage the basic and applied research strengths on the Berkeley campus to conduct innovative research on behavior change. In support of this aim, we propose two interdisciplinary conferences with leading scholars from economics, neuroscience, psychology, and public health that will focus on decision making and emotion regulation during two key life-span transitions (adolescence and late life). The first conference would be focused on basic research and the second conference would be focused on applied research. Bringing together leading scholars from outside Berkeley at the two conferences will enable us to benefit from their expertise and help us identify key questions for the study of behavior change that cut across disciplines. We focus on adolescence and late life because they are key inflection points in the life span where trajectories for future development are set. These two points in the life span share important similarities (e.g., times of significant biological and social change) but have rarely been looked at together. We focus on decision making and emotion regulation because they: (a) involve similar neural systems; (b) undergo major reorganization in adolescence and late life; (c) influence each other; (d) predict outcomes of behavior change; and (e) have emerged as important topics in economics, neuroscience, psychology, and public health. We draw on complex neurobiological, cognitive, emotional, social, and contextual processes that go beyond the purview of individual disciplines. This rare opportunity for interdisciplinary dialogue will led to the (a) identification of key conceptual questions that span different disciplines, (b) development of novel hypotheses, and (c) exchange of knowledge about promising scientific methodologies. The conference format we are proposing reflects our desire to promote interdisciplinary exchange, build research collaborations, and utilize conference synergies to support have embraced an interdisciplinary approach because these questions preparation of future grant applications. To increase the intellectual yield and training benefits from this effor, we will make a special effort to engage junior scholars from different disciplines in the proposed activities, affording them opportunities to engage in interdisciplinary networking and professional socialization at the two conferences. The long-term significance of this project is in its contribution to building interdisciplinary research teams that can advance the science of behavior change, especially as applied to critical developmental periods and critical processes that are vital for successful aging, health, and well-being.

DESCRIPTION (provided by applicant): Caring for a loved one with a neurodegenerative disease can be a meaningful part of family life. However, it can also be associated with negative outcomes for caregivers, including increased burden and reduced health and well-being. For the past 10 years, our multidisciplinary group (neurology, nursing, and psychology) has collaborated on a program project grant (AG19724) focusing on patients with frontotemporal dementia (FTD). FTD typically presents with impairments in emotional and social functioning, with many aspects of cognitive functioning initially spared. Although this constellation of symptoms can be extremely difficult for caregivers, there has been relatively little research focusing on FTD caregiving or comparing FTD caregivers with other kinds of caregiving. We propose to study the associations between patient and caregiver emotional functioning and negative caregiver outcomes (i.e., higher burden, lower health and well-being). We will recruit 200 patients with FTD, Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS) and their caregiver spouses plus 50 neurologically normal controls and their spouses (Total N = 500). Emotional functioning will be evaluated in all participants using an observational approach that assesses emotional functioning in three domains: (a) emotional reactivity (responding to emotional stimuli), (b) emotion regulation (adjusting emotional responses to situational demands), and (c) emotional empathy (recognizing others' emotions, responding emotionally to others' emotions, helping others in need). Caregiver outcomes will be assessed using well- established measures of caregiver burden, mental and physical health, and well-being. The research addresses four specific aims: Aim 1: To determine how specific emotional deficits in patients contribute to negative caregiver outcomes (i.e., higher caregiver burden, lower caregiver health and well-being). Aim 2: To understand how caregivers' emotional functioning and select genetic and personality characteristics predict vulnerability to the negative effects of caregiving. Aim 3: To characterize the emotional qualities of caregiver- patient interactions in FTD, AD, and ALS. Aim 4: To test the efficacy of a caregiver training intervention designed to improve ability to recognize emotion in reducing negative caregiver outcomes. The proposed research is innovative in its multidisciplinary approach, translational application of basic affective science methodology to the study of dementia caregiving, focus on FTD caregiving, emphasis on emotional functioning in both patients and caregivers, and testing of an intervention for caregivers that might reduce negative caregiver outcomes and improve the caregiver-patient relationship.

? DESCRIPTION (provided by applicant): Corrosive couple conflict (CCC) and coercive parent-child conflict constitute a ubiquitous, potent, and destructive (but modifiable) interpersonal poison to a wide range of adult and children's health outcomes. Such patterns are also linked with poor parent-child relationships and with more harsh punishment, which is associated with disturbed responses to environmental stresses (e.g., disruption in sympathetic nervous system and hypothalamic-pituitary-adrenocortical responses), a wide variety of adverse health outcomes in childhood, including dental caries, obesity, and diabetes related metabolic markers. This phase of NIH's Science of Behavior Change program emphasizes an experimental medicine approach to behavior change necessitating identification of central interpersonal/social targets for maximal impact on far-reaching panoply of health outcomes. This project will focus on factors associated diabetes and oral health (though the processes affect many other disease outcomes). Both are associated with pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. As requested by the RFA, we will isolate three proximal health behaviors: (a) medical regimen adherence; (b) eating and drinking high sugar/calorie items; and (c) self-care behaviors. CCC/coercive parent-child conflicts are marked by an interrelated set of affective, behavioral, and physiological signatures. In the UH2 phase, we will identify/develop/validate assays. We will also identify/develop, and test interventions to reduce CCC/coercion targets. In the UH3 phase, we expect to conduct at least 2 studies to test whether reduction in targets results in improvement in adherence and other health behaviors of interest. One study will focus on parents and children, the other on adults in intimate relationships. Health behaviors related to diabetes and oral health problems will serve as dependent variables as will self-care behaviors in both diabetes and oral health. To place these health behaviors in the context of disease conditions and medical regimen adherence, we expect to focus one study on a sample of children with early childhood caries and the other study on an adult sample with diabetes.

ABSTRACT This project applies basic affective science methodology to assess socioemotional functioning in patients with frontotemporal dementia (FTD) and Alzheimer's disease (AD). By measuring multiple emotion processes (reactivity, regulation, and recognition), types (positive, negative, self-conscious emotions), and response systems (subjective experience, expressive behavior, peripheral physiology, emotional language), we obtain an unusually comprehensive and fine-grained assessment of socioemotional functioning. Using this approach, we have identified particular aspects of socioemotional functioning that distinguish among FTD-spectrum disorders, AD, and normal aging. This assessment has also been well-suited for establishing links with anatomical data derived from structural neuroimaging and post-mortem neuropathology. In the next project period, we will expand this research to include: (a) psychiatric patients with major depressive disorder (MDD) and bipolar affective disorder (BD), which also produce changes in socioemotional functioning and can be difficult to distinguish from dementia in late life; (b) additional measures of social/interpersonal functioning in the realms of emotional reactivity (pride, an emotion that arises from complex social comparisons), regulation (social down-regulation of response to stress associated with presence of caregiver), and recognition (continuous ratings of one's own emotions, recognizing comfortable interpersonal distance); (c) new measures of autonomic nervous system functioning (stomach activity) and visceral awareness (gastric filling); (d) longitudinal assessments of patients' real-world socioemotional functioning; and (e) additional imaging measures (PET assays of tau and amyloid accumulation and circuit-focused assessment of functional connectivity. We will pursue three specific aims: Aim 1. Social/Interpersonal functioning. We will utilize our expanded assessment of social/interpersonal functioning to characterize social/interpersonal functioning in FTD-spectrum disorders, AD, MDD, and BD; Aim 2. Difficult diagnoses. We will identify optimal groups of predictors from our laboratory-assessment of socioemotional functioning for distinguishing among patients with FTD, AD, MDD, and BD. Aim 3. Brain-behavior relationships. We will delineate brain circuitry associated with deficits in specific aspects of emotional reactivity, regulation, and recognition. Innovations of this project include: (a) applying basic affective science methodology to characterize social and emotional functioning in patients with dementia and mood disorders; (b) using classification analysis techniques with strong criterion measures (state-of-the-art clinical diagnoses, and, when possible, autopsy-confirmed diagnoses) to identify optimal groups of predictors for increasing diagnostic accuracy; and (c) studying brain-behavior relationships using fine-grained measures of emotional reactivity, regulation, and recognition linked with anatomical data derived from MRI and PET imaging, functional connectivity analyses, and autopsy-based neuropathology focused on selectively vulnerable brain regions.

Alzheimer?s disease (AD) and frontotemporal dementia (FTD) lead to profound cognitive, emotional, and functional deficits. As the disease progresses, the person with dementia (PWD) becomes increasingly dependent on a caregiver (CG) for functional, psychological, and economic assistance. Caring for a PWD is a highly meaningful part of family life but can have adverse consequences for CGs including increased economic hardships, reduced health and well-being, and greater mortality. When CGs suffer these effects, their ability to provide high quality care for PWDs can become comprised, leading to an accelerating cycle of decline. Importantly, beneath these sobering group-level data are striking differences among individual caregivers in how profoundly they experience adverse effects, which raises the possibility that adverse effects of caregiving could be predicted, modified, or even prevented. The proposed research focuses on CG risk associated with emotional functioning in PWDs, CGs, and PWD-CG relationships. This focus reflects the profound impact that problematic emotional behaviors and psychological symptoms in PWDs have on CGs, the strong links between emotions and health, and our previous research linking emotional factors with adverse CG outcomes. CGs and PWDs will undergo a comprehensive, laboratory-based assessment of: (a) emotional reactivity?ability to generate emotional responses to significant challenges and opportunities; (b) emotion regulation?ability to adjust emotional responses to meet situational demands; and (c) emotion recognition?ability to detect emotions accurately in others and respond appropriately. Five studies are proposed to address four specific aims: Aim 1: To determine how emotional functioning in PWDs, CGs, and PWD-CG relationships is associated with individual differences in adverse CG outcomes (i.e., lower CG mental health, physical health, and well- being) during active caregiving (Study 1, N=180) and after caregiving has ended (Study 2, N=200). Aim 2: To use longitudinal assessments to evaluate hypothesized biological and behavioral pathways connecting risk factors with adverse CG outcomes during active caregiving (Study 3, N=84 studied for 3 years). Aim 3: To examine relationships between changes in CG health and PWD mortality (Study 4, N=400). Aim 4: To identify an optimal set of laboratory-based measures of emotional functioning for predicting adverse CG outcomes both during and after active caregiving and to determine their incremental validity compared to other established risk factors and traditional survey measures of emotional functioning (Study 5, N=350). Innovations include: (a) multidisciplinary approach (psychology, neurology, and nursing); (b) translational application of laboratory-based methods used in basic affective science methodology to CG research; (c) including CGs of individuals with both AD and FTD; (d) focusing on interpersonal functioning; (e) examining individual differences in adverse CG outcomes both during and after active caregiving; (f) examining adverse outcomes for both CGs and PWDs; and (g) longitudinal behavioral and biological assessments of CG functioning.