Vol.:(0123456789) 1 3 Experimental Brain Research (2019) 237:211–222 https://doi.org/10.1007/s00221-018-5416-y RESEARCH ARTICLE Cognitive load and emotional processing in psoriasis: a thermal imaging study Maria Serena Panasiti 1,2  · Giorgia Ponsi 1,2  · Bianca Monachesi 1,2  · Luigi Lorenzini 1,2  · Vincenzo Panasiti 3  · Salvatore Maria Aglioti 1,2 Received: 12 June 2018 / Accepted: 24 October 2018 / Published online: 29 October 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Psoriasis is a chronic dermatologic disease which is frequently associated with psychological distress. Although studies sug- gest a relationship between this condition and difculties in emotion regulation, behavioral and physiological evidence about this link is scarce. We measured implicit emotion regulation abilities of psoriasis patients and a healthy control group by examining the impact of distracting emotional (positive, negative or neutral) images on a working memory task (“Emotional N-Back”) which could present high (2-back) or low (1-back) cognitive workload. Moreover, we used Functional Infrared Thermal Imaging to record participants’ facial temperature and obtain a measure of the activation of the autonomic system. Rising of temperature over the peri-orbital areas and the nose tip are believed to refect the activation and the de-activation of the sympathetic system, respectively. Patients scored higher than controls on the “Lack of emotional clarity” sub-scale of the Difculties in Emotion Regulation Scale. Compared to controls, who performed much better in the low vs. high cogni- tive load condition, patients showed a smaller accuracy diference between the two conditions. Moreover, patients showed less sympathetic (lower peri-orbital and higher nasal tip temperature) activity (especially in the negative and neutral blocks) during the high vs. low cognitive load condition, suggesting that the former condition might be less emotionally demand- ing for them. Patients beneft more than controls from the load-dependent interference efect when dealing with emotional information; thus, therapeutic techniques aiming at teaching how to use cognitive strategies to downregulate emotions might be particularly appropriated for them. Keywords Psoriasis · Emotion regulation · Thermal imaging · Working memory · Cognitive load Introduction Psoriasis is a chronic infammatory skin disease afecting approximately 2% of the population (Icen et al. 2009) and characterized by cutaneous infammation that causes signif- cant psychological distress (Picardi et al. 2000), and impair- ment of patient’s quality of life (De Arruda and De Moraes 2001). Stress, in turn, has a negative infuence on psoriasis symptoms leading to a self-perpetuating mechanism (Basa- varaj et al. 2011). Given its impact on patients’ physical appearance, psoriasis is frequently associated to experiences of social pain such as stigmatization and social exclusion (Richards et al. 2001; Hrehorów et al. 2012). Experiencing social pain is particularly critical in medical conditions as it can not only interfere with social behaviors by making people more unethical (Kouchaki and Wareham 2015) and egoistic (Twenge et al. 2007), but also can afect the experi- ence of physical pain (Mancini et al. 2011, 2014). Maria Serena Panasiti, Giorgia Ponsi contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00221-018-5416-y) contains supplementary material, which is available to authorized users. * Maria Serena Panasiti mariaserena.panasiti@uniroma1.it 1 Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185 Rome, Italy 2 IRCCS Santa Lucia Foundation, Rome, Italy 3 Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy