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Papers by Jonathan Remue

Cognitive Therapy and Research

Repetitive negative thinking (RNT) is considered to be an important transdiagnostic factor in the... more Repetitive negative thinking (RNT) is considered to be an important transdiagnostic factor in the onset, course and recurrence of both depressive and anxiety disorders. This study aimed to investigate whether an add-on group intervention ‘Drop it’, compared to treatment as usual, would improve RNT, anxiety and depressive symptoms, as well as quality of life and self-esteem of patients with Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD). Eighty patients were randomly allocated to 8 sessions of group intervention (n = 45) or a delayed treatment control group (n = 35). Both conditions continued their ongoing mental health care. Assessments took place before randomization, 12 weeks later (after group intervention) and at 3- and 9- months follow-up. Although all outcomes improved after the intervention, only the uncontrollability of rumination, worrying, distancing oneself from one’s thoughts, and quality of life remained statistically significant after Bonferroni correction compared to the delayed treatment control group. Group intervention improves RNT and quality of life of patients treated for MDD and/or GAD. Improvements remain stable until 9 months after treatment. Limitations of the study included the small sample size, the lack of a long-term follow-up in the delayed treatment control group and the inclusion of highly educated patients with mainly high comorbid generalized anxiety disorder and depression.

doi: 10.3389/fpsyg.2014.00207 The interplay between the anticipation and subsequent online proces... more doi: 10.3389/fpsyg.2014.00207 The interplay between the anticipation and subsequent online processing of emotional stimuli as measured by pupillary dilatation: the role of cognitive reappraisal

Transcranial Direct Current Stimulation (tDCS) is a neuromodulation technique with promising resu... more Transcranial Direct Current Stimulation (tDCS) is a neuromodulation technique with promising results for enhancing cognitive information processes. So far, however, research has mainly focused on the effects of tDCS on cognitive control operations for non-emotional material. Therefore, our aim was to investigate the effects on cognitive control considering negative versus positive material. For this sham-controlled, withinsubjects study, we selected a homogeneous sample of twenty-five healthy participants. By using behavioral measures and event related potentials (ERP) as indexes, we aimed to investigate whether a single session of anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) would have specific effects in enhancing cognitive control for positive and negative valenced stimuli. After tDCS over the left DLPFC (and not sham control stimulation), we observed more negative N450 amplitudes along with faster reaction times when inhibiting a habitual response to happy compared to sad facial expressions. Gender did not influence the effects of tDCS on cognitive control for emotional information. In line with the Valence Theory of side-lateralized activity, this stimulation protocol might have led to a left dominant (relative to right) prefrontal cortical activity, resulting in augmented cognitive control specifically for positive relative to negative stimuli. To verify that tDCS induces effects that are in line with all aspects of the well known Valence Theory, future research should investigate the effects of tDCS over the left vs. right DLPFC on cognitive control for emotional information.

Psychology and Psychotherapy: Theory, Research and Practice

Although depression is characterized by low self-esteem as measured by questionnaires, research u... more Although depression is characterized by low self-esteem as measured by questionnaires, research using implicit measures of self-esteem has failed to reveal the expected differences between depressed and non-depressed individuals. In this study, we used an implicit measure which enables the differentiation of ideal Self and actual Self-esteem, through the introduction of propositions: “I am” versus “I want to be”. We measured implicit relational associations about actual and ideal self in low (N=27) versus high dysphoric (N=29) undergraduates. Our data revealed that dysphoric individuals have a higher ideal-self-esteem, and lower actual selfesteem in comparison to healthy participants. The results underscore the need to go beyond simple associations and suggest that the use of individual–specific propositions could enhance our understanding of the implicit measurement of self-esteem. Furthermore, these results underscore the importance of actual versus ideal self-discrepancy theories...

Cognitive Therapy and Research, 2021

Journal of Psychiatric Research

Repetitive negative thinking (RNT) is a core process underlying various psychiatric disorders. &#... more Repetitive negative thinking (RNT) is a core process underlying various psychiatric disorders. 'Uncontrollability of rumination (UOR)' is one the most maladaptive factors of rumination, but little is known on how cognitive behavioral focused RNT psychotherapy may alter brain activity. In a subsample of 47 patients suffering from RNT who also underwent brain imaging (registered RCT trial NCT01983033), we evaluated the effect of cognitive behavioral based group psychotherapy (CBGP) (n = 25) as compared to a delayed treatment control group (DTCG) (n = 22) on frontolimbic brain perfusion with a focus on UOR. This RNT construct was measured using the subscale 'uncontrollability' of the Dutch version of the Rumination on Sadness Scale (LARSS-U). Brain perfusion was assessed with arterial spin labeling (ASL)-fMRI. LARSS-U scale scores significantly decreased in the CBGP cohort whereas no significant changes emerged in the DTCG group. Compared to the DTCG, this decrease on UOR in the CBGP group was related to significant perfusion increases in the left (dorsolateral) prefrontal cortex, part of the executive network. Besides the fact that CBGP significantly reduced RNT, this attenuation of uncontrollable ruminative thoughts was related to brain perfusion increases areas documented to be involved in the top down control of adaptive emotion regulation and the inhibition of ruminative processes.

Psychiatry research. Neuroimaging, Jan 30, 2018

Transcranial direct current stimulation (tDCS) involves positioning two electrodes at specificall... more Transcranial direct current stimulation (tDCS) involves positioning two electrodes at specifically targeted locations on the human scalp. In neuropsychiatric research, the anode is often placed over the left dorsolateral prefrontal cortex (DLPFC), while the cathode is positioned over a contralateral cephalic region above the eye, referred-to as the supraorbital region. Although the 10-20 EEG system is frequently used to locate the DLPFC, due to inter-subject brain variability, this method may lack accuracy. Therefore, we compared in forty participants left DLPFC-localization via the 10-20 EEG system to MRI-guided neuronavigation. In one participant, with individual electrode positions in close proximity to the mean electrode position across subjects, we also investigated whether distinct electrode localizations were associated with different tDCS-induced electrical field distributions. Furthermore, we aimed to examine which neural region is targeted when placing the reference-electr...

Human brain mapping, Jan 28, 2018

Transcranial direct current stimulation (tDCS) is a potential treatment strategy for mood and anx... more Transcranial direct current stimulation (tDCS) is a potential treatment strategy for mood and anxiety disorders, but how this application may influence emotional processes, and whether this is related to individual characteristics, is not well understood. It has been proposed that perceived criticism (PC) may represent a vulnerability factor for the development of such mental illnesses. To decipher whether neural mechanisms of action of tDCS potentially differ depending on PC status (low vs. high), we evaluated mood and brain perfusion before and after applying MRI-compatible tDCS, and after participants were exposed to verbal criticism in the scanner. Experimental design 30 healthy nondepressed females were included in a sham-controlled crossover MRI-compatible tDCS study. Brain perfusion was measured by means of arterial spin labeling (ASL) before and after tDCS applied to the left dorsolateral prefrontal cortex (DLPFC), and after hearing criticism. Before the experiment, all part...

Brain imaging and behavior, Jan 4, 2018

The mechanisms by which transcranial direct current stimulation (tDCS) influences emotional proce... more The mechanisms by which transcranial direct current stimulation (tDCS) influences emotional processing - and whether this is related to individual vulnerability for psychopathology - are still poorly understood. The present study aimed to investigate if one prefrontal tDCS session modulates mood and neural functional connectivity after being exposed to negative information differently in individuals low or high in perceived criticism (PC), which has been related to vulnerability for psychiatric illness. In a randomized cross-over design, one session of MRI-compatible prefrontal tDCS (neuronavigated placement of the anodal electrode at the left dorsolateral prefrontal cortex and the cathodal electrode at the right supraorbital region; vs. sham) was administered to healthy females, prior to listening to self-referential criticism. PC-dependent (low vs. high PC) changes in mood and resting-state functional connectivity patterns following tDCS and after hearing criticism were explored. ...

Behaviour research and therapy, 2017

It has been proposed that a crucial link between cognitive (i.e., self-schemas) and biological vu... more It has been proposed that a crucial link between cognitive (i.e., self-schemas) and biological vulnerability is prefrontal control. This is because decreased control leads to impaired ability to inhibit ruminative thinking after the activation of negative self-schemas. However, current evidence is mainly correlational. In the current experimental study we tested whether the effect of neurostimulation of the dorsolateral prefrontal cortex (DLPFC) on self-esteem is mediated by momentary ruminative self-referential thinking (MRST) after the induction of negative self-schemas by criticism. We used a single, sham-controlled crossover session of anodal transcranial Direct Current Stimulation (tDCS) applied to the left DLPFC (cathode over the right supraorbital region) in healthy female individuals. After receiving tDCS/sham stimulation, we measured MRST and exposed the participants to critical audio scripts, followed by another MRST measurement. Subsequently, all participants completed tw...

Brain Stimulation

Transcranial direct current stimulation (tDCS) is a non-invasive electrical stimulation technique... more Transcranial direct current stimulation (tDCS) is a non-invasive electrical stimulation technique, assumed to influence cognition and emotional processing. However, it is unclear how tDCS influences spontaneous cognitive processes such as momentary self-referential thoughts on the neuronal level. Forty healthy female volunteers participated in a single session sham-controlled crossover tDCS study while being in the MRI scanner. We measured brain perfusion (arterial spin labeling) just before and just after tDCS. Before and after the stimulation procedure, participants were scored on mood (visual analogue scales) and on the Momentary Ruminative Self-focus Inventory (MRSI). We performed a 1.5 mA, 20-min, anodal left dorsolateral prefrontal cortex, cathodal right supraorbital stimulation. One sham-controlled tDCS session did not result in subjective mood changes. However, as compared to before, MRSI scores significantly decreased only after active tDCS. Regression analysis revealed that this reduction in momentary ruminative self-referential thoughts was related to tDCS-related increases in left prefrontal cortical perfusion. tDCS decreased momentary self-referential thoughts, which was associated with increasing perfusion in the left prefrontal cortex. Our findings are in line with the hypothesis that tDCS of the DLPFC attenuates ruminative processes.

Neuropsychologia, 2016

Non-invasive neurostimulation or neuromodulation techniques such as repetitive transcranial magne... more Non-invasive neurostimulation or neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) were welcomed as promising tools for investigating cognitive and mood processes in healthy participants as well as in patients suffering from neuropsychiatric conditions. Due to their rather easy application, both modalities have been used to experimentally examine prefrontal cognitive and emotional control. However, it remains unclear whether a single session of such stimulation may affect the mood of participants in a healthy state. We provide a systematic review of studies reporting the effects of a single session of rTMS or tDCS (…-2014) on self-reported mood in healthy participants. Although early studies reported significant effects on self-reported mood in healthy participants, more recent work investigating mood effects after a single rTMS/tDCS session has failed to find any significant changes in self-reported mood. Therefore it appears that a single session of rTMS/tDCS has no impact on mood in the healthy state.