Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2017 Memory, emotion and grief : investigating processes and a clinical application Xiu, Daiming Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-142627 Dissertation Published Version Originally published at: Xiu, Daiming. Memory, emotion and grief : investigating processes and a clinical application. 2017, University of Zurich, Faculty of Arts. MEMORY, EMOTION AND GRIEF: INVESTIGATING PROCESSES AND A CLINICAL APPLICATION Thesis (cumulative thesis) presented to the Faculty of Arts and Social Sciences of the University of Zurich for the degree of Doctor of Philosophy by Daiming Xiu Accepted in the spring semester 2017 on the recommendation of the doctoral committee: Prof. Dr. Dr. Andreas Maercker (main adviser) Prof. Dr. Markus Landolt PD Dr. Peter Klaver Zurich, 2017 “Let go the clinging, yearning and attaching, Take back home the nature of mind, May all beings being enlightened, May all beings purifying negative karma and suffering, May all beings being peaceful and joyful.” ----- Sogyal Rinpochel, “The Tibetan Book of Living and Dying” ABSTRACT Multiple disciplines in psychology endeavor to clarify the neural and psychological mechanisms regarding how emotion interacts with memory process, in an attempt to explain emotional influences on learning performance and clinical psychopathology. This thesis proposed a process-oriented perspective on emotion-memory interaction, in which the competitive processes between bottom-up saliency (i.e. extrinsic properties of the stimuli such as physical differences and emotional valence) and top-down modulation (i.e. extra-retinal effects from intrinsic expectations, knowledge and goals) drive psychophysiological arousal (e.g. the selectivity of attention and increased autonomic nervous system activities) to modulate memory processing. The cumulative PhD thesis applied this theoretical perspective to investigate neural process during memory formation and clinical manifestations during memory retrieval. The first study in neuroscience aimed identify the role of bottom-up and top-down neural mechanisms supporting memory formation of emotional faces. The bottom-up process assumes that emotion works simultaneously with the perception that further contributes to the memory formation. Top-down modulation emphasizes the primary role of prefrontal cortex on the emotional processing. The findings revealed that bottom-up neural mechanism was more dominated and operated through two pathways to the orbitofrontal cortex: the connection from the inferior occipital gyrus correlated with memory performance, independently of valence; whereas the connection from the superior parietal lobule was associated with response bias for negative valence. In a clinical application, the Study 2 and Study 3 adopted the process-oriented perspective to explore the disruptions in autobiographical remembering as a core psychopathological function of prolonged grief (i.e. a clinical emotional state following bereavement). The bottom- up saliency manifested in the pathologically cognitive process of “preoccupation of loss-related memories”: bereaved persons exhibited a preferential access to loss-related memories in response to negative emotion cues, and tended to use loss-related memories as a reference event for one’s self (i.e. self-defining memories). Meanwhile, as a competitive process, the top-down modulation was supported by the maladaptive mechanisms of “functional avoidance of negative affect” and “maladaptive cognitive appraisal”: results showed that prolonged grief severity was associated with a reduced specificity in narrating non-loss-related memories and an increased level of negative appraisals for self-defining memories. Furthermore, these manifestations were I observed in bereaved parents from different cultures, but were moderated by personal value orientations (e.g. traditional-vs.-modern values). The empirical findings from the three studies were integrated to draw general conclusions and to give theoretical implications in relation to the emotion-memory interaction: ventral and dorsal neutral pathways as the neural basis, negative bias as a behavioral feature, and grief- related memory disruptions as a psychopathological mechanism of prolonged grief. Particular focus is given to the discussion of the cultural effect in the emotion-memory interaction combining the cultural background and cultural components. These theoretical discussions provide suggestions for clinical practices in terms of clinical interventions for pathological emotional memory, and multiculturalism in psychotherapy. II ACKNOWLEGEMENT I would like to give my sincere thanks to all those people who have supported me during my PhD period. Thanks to the trust from my previous university, Beijing Normal University, and financial support from Chinese Scholarship Council, I can have an opportunity to develop my career in Switzerland. Primarily, I would like to express my deepest gratitude to my supervisor Prof. Andreas Maercker who gave me the opportunity to work in such an exciting and meaningful field of research. Prof. Andreas Maercker has created such a free and trustful atmosphere, in which my time at the University of Zurich becomes a most fruitful and instructive experience. I admire his work and lifestyle that presents me a model how to be a wise scientist with an artistic soul. I would further like to thank Dr. Peter Klaver who offered guidance in my fresh year in Zurich and keep supporting me professionally and emotionally. Many thanks to Prof. Markus Landolt for his supports in the research project and for participating as a member of my doctoral committee. A big thank you goes to my colleagues from the Division of psychopathology and clinical intervention for all their support in my work and life. I have developed a strong feeling of belonging to our big family. Many thanks to my two Master students, Stefanie Woynar and Bettina Geirhofer. Their amazing work and full-hearted participation made a great contribution to my research project. I am very grateful to the collaborators in China. Prof. Xiaoming Jia and her group provided me with a strong support in data collection and analysis. I thank my amazing team in Sichuan University. A group of young girls brought their full energy and creativity into our project. It is unforgettable to experience our growth together. Moreover, I would like to express my deep gratitude to the participating bereaved parents. I am thankful for the stories these parents shared, and I was touched by their feeling, pains and bravery. Their suffering and purification have given me a great lesson about the meaning of life, and nourished my aspirations. III FUNDING This dissertation was funded by the China Scholarship Council (CSS). IV TABLE OF CONTENTS 1. INTRODUCTION ...................................................................................................................... 1 2. THEORITICAL BACKGROUND ............................................................................................. 3 2.1 Bottom-up and Top-down Processes in Memory and Emotion studies ................................ 3 2.1.1 A constructivist perspective on memory formation and retrieval ................................ 3 2.1.2 Emotional influence on cognitive process .................................................................... 4 2.1.3 Emotion-memory interaction based on arousal-biased process ................................... 6 2.1.4 Process-oriented emotion-memory interaction............................................................. 8 2.2 Neuroscience Exploration on Bottom-up and Top-down Processes in Emotion-Memory Interaction ............................................................................................................................ 10 2.3 Grief and Autobiographical Memory: A Clinical Investigation on the Effect of Emotional State on Memory ................................................................................................................. 11 2.3.1 Grief and its manifestations ........................................................................................ 11 2.3.2 “Failure to integrate loss-related memories” hypothesis in prolonged grief .............. 12 2.3.3 Culture, autobiographical memory and grief.............................................................. 18 3. THE PRESENT THESIS .......................................................................................................... 22 3.1 Aim and Research Questions of the Thesis ......................................................................... 22 3.2 Summary of Study 1 ............................................................................................................ 23 3.3 Summary of Study 2 ............................................................................................................ 24 3.3 Summary of Study 3 ............................................................................................................ 25 4. GENERAL DISCUSSION ....................................................................................................... 27 4.1 Theoretical Implications on Emotion-Memory Interaction ................................................ 27 4.2 Cultural Considerations on Grief and Autobiographical Memory ...................................... 32 4.3 Practical Implications