Emotion regulation via visual avoidance: Insights from neurological patients

Visual avoidance of unpleasant stimuli (i.e., strategic positioning of eyes, head and torso away from an environmental stimulus) is a common attentional control behavior that may down-regulate emotion by reducing visual input. Despite its ubiquity, relatively little is known about how visual avoidance is affected by neurological diseases that impact neural circuits involved in emotional functioning. We examined visual avoidance in 56 behavioral variant frontotemporal dementia (bvFTD) patients, 43 Alzheimer's disease (AD) patients, and 34 healthy controls. Participants came to our laboratory and viewed an extremely disgusting film clip while visual avoidance was measured using behavioral coding of head, body, and eye position. Controlling for differences in cognitive functioning, bvFTD patients were less likely to engage in visual avoidance behaviors than both AD patients and healthy controls. Additional analyses revealed that diminished visual avoidance in this task was associated with lower levels of real-world emotion regulation but not with emotion reactivity as reported by the primary caregiver.