This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lane, R. D. Search for Related Content PubMed PubMed Citation Articles by Lane, R. D. Related Collections Psychophysiology Radiology and Brain Imaging Cognitive Functioning

Neural Substrates of Implicit and Explicit Emotional Processes: A Unifying Framework for Psychosomatic Medicine

From the Department of Psychiatry, University of Arizona, Tucson, Arizona.

Address correspondence and reprint requests to Richard D. Lane, Department of Psychiatry, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724-5002. E-mail: lane{at}email.arizona.edu

There are two broad themes in psychosomatic medicine research that relate emotions to physical disease outcomes. Theme 1 holds that self-reported negative affect has deleterious effects and self-reported positive affect has salubrious effects on health. Theme 2 holds that interference with the experience or expression of negative affect has adverse health consequences. From the perspective of self-report these two traditions appear contradictory. A key thesis of this paper is that the foundational distinction in cognitive neuroscience between explicit (conscious) and implicit (unconscious) processes, corresponding to Themes 1 and 2, respectively, provides a unifying framework that makes empirical research on unconscious emotional processes more tractable.

A psychological model called "levels of emotional awareness" is presented first that places implicit and explicit emotional processes on a cognitive-developmental continuum. This model holds that the ability to become consciously aware of one’s own feelings is a cognitive skill that goes through a developmental process similar to that which Piaget described for other cognitive functions. Empirical findings using the Levels of Emotional Awareness Scale are presented. A parallel hierarchical model of the neural substrates of emotional awareness is presented next supported by recent neuroimaging and lesion work. The evidence presented in this review suggests that the neural substrates of implicit and explicit emotional processes are distinct, that the latter have a modulatory effect on the former, and that at the neural level Theme 1 and Theme 2 phenomena share critical similarities. The implications of this psychobiological model for research in psychosomatic medicine are discussed.

Key Words: neuroscience • health • implicit processes • emotional awareness • emotion regulation

Abbreviations: ACC = anterior cingulate cortex; BA = Brodmann Area; dACC = dorsal anterior cingulate cortex; HF = high frequency; HRV = heart rate variability; IAPS = International Affective Picture System; IBS = irritable bowel syndrome; LEAS = Levels of Emotional Awareness Scale; PET = positron emission tomography; rCBF = regional cerebral blood flow.

This article has been cited by other articles:

				K. E. Freedland, E. J.C. de Geus, R. N. Golden, W. J. Kop, G. E. Miller, V. Vaccarino, B. Brumback, M. M. Llabre, V. J. White, and D. S. Sheps What's in a Name? Psychosomatic Medicine and Biobehavioral Medicine Psychosom Med, January 1, 2009; 71(1): 1 - 4. [Full Text] [PDF]