Nothing to fear? Neural systems supporting avoidance behavior in healthy youths

Intersect between brain mechanisms of conditioned threat, active avoidance, and reward

Active avoidance is a core behavior for human coping, and its excess is common across psychiatric diseases. The decision to actively avoid a threat is influenced by cost and reward. Yet, threat, avoidance, and reward have been studied in silos. We discuss behavioral and brain circuits of active avoidance and the interactions with fear and threat. In addition, we present a neural toggle switch model enabling fear-to-anxiety transition and approaching reward vs. avoiding harm decision. To fully comprehend how threat, active avoidance, and reward intersect, it is paramount to develop one shared experimental approach across phenomena and behaviors, which will ultimately allow us to better understand human behavior and pathology.

Diminished reward circuit response underlies pain avoidance learning deficits in problem drinkers

Individuals engaging in problem drinking show impaired proactive pain avoidance. As successful pain avoidance is intrinsically rewarding, this impairment suggests reward deficiency, as hypothesized for those with alcohol and substance misuse. Nevertheless, how reward circuit dysfunctions impact avoidance learning and contribute to drinking behavior remains poorly understood. Here, we combined functional imaging and a probabilistic learning go/nogo task to examine the neural processes underlying proactive pain avoidance learning in 103 adult drinkers. We hypothesized that greater drinking severity would be associated with poorer avoidance learning and that the deficits would be accompanied by weakened activity and connectivity of the reward circuit. Our behavioral findings indeed showed a negative relationship between drinking severity and learning from successful pain avoidance. We identified hypoactivation of the posterior cingulate cortex (PCC), a brain region important in avoidance, as the neural correlate of lower learning rate in association with problem drinking. The reward circuit, including the medial orbitofrontal cortex, ventral tegmental area, and substantia nigra, also exhibited diminished activation and connectivity with the PCC with greater drinking severity and learning deficits. Finally, path modeling suggested a pathway in which problem drinking disengaged the reward circuit. The weakened circuit subsequently induced PCC hypoactivation, resulting in poorer pain avoidance learning. As the learning dysfunction worsened alcohol use, the pathway represents a self-perpetuating cycle of drinking and distress. Together, these findings substantiate a role of reward deficiency in problem drinkers' compromised proactive avoidance, thus identifying a potential target for intervention aimed at mitigating harmful alcohol use.

Neural correlates of proactive avoidance deficits and alcohol use motives in problem drinking

Physical pain and negative emotions represent two distinct drinking motives that contribute to harmful alcohol use. Proactive avoidance, in contrast, can reduce consumption in response to these motives but appears to be impaired in those with problem drinking. Despite such evidence, proactive avoidance and its underlying neural deficits have not been assessed experimentally. How these deficits inter-relate with drinking motives to influence alcohol use also remains unclear. The current study leveraged neuroimaging data in forty-one problem and forty-one social drinkers who performed a probabilistic learning go/nogo task featuring proactive avoidance of painful outcomes. We identified the brain responses to proactive avoidance and contrasted the neural correlates of drinking to avoid negative emotions vs. physical pain. Behavioral results confirmed proactive avoidance deficits in problem drinking individuals' learning rate and performance accuracy, both which were associated with greater alcohol use. Imaging findings in the problem drinking group showed that negative emotions as a drinking motive predicted attenuated right anterior insula activation during proactive avoidance. In contrast, physical pain motive predicted reduced right putamen response. These regions' activations as well as functional connectivity with the somatomotor cortex also demonstrated a negative relationship with drinking severity and positive relationship with proactive avoidance performance. Path modeling further delineated the pathways through which physical pain and negative emotions influenced the neural and behavioral measures of proactive avoidance. Taken together, the current findings provide experimental evidence for proactive avoidance deficits in alcohol misuse and establish the link between their neural underpinnings and drinking behavior.

Responding to threat: Associations between neural reactivity to and behavioral avoidance of threat in pediatric anxiety

BACKGROUND

Despite broad recognition of the central role of avoidance in anxiety, a lack of specificity in its operationalization has hindered progress in understanding this clinically significant construct. The current study uses a multimodal approach to investigate how specific measures of avoidance relate to neural reactivity to threat in youth with anxiety disorders.

METHODS

Children with anxiety disorders (ages 6-12 years; n = 65 for primary analyses) completed laboratory task- and clinician-based measures of avoidance, as well as a functional magnetic resonance imaging task probing neural reactivity to threat. Primary analyses examined the ventral anterior insula (vAI), amygdala, and ventromedial prefrontal cortex (vmPFC).

RESULTS

Significant but distinct patterns of association with task- versus clinician-based measures of avoidance emerged. Clinician-rated avoidance was negatively associated with right and left vAI reactivity to threat, whereas laboratory-based avoidance was positively associated with right vAI reactivity to threat. Moreover, left vAI-right amygdala and bilateral vmPFC-right amygdala functional connectivity were negatively associated with clinician-rated avoidance but not laboratory-based avoidance.

LIMITATIONS

These results should be considered in the context of the restricted range of our treatment-seeking sample, which limits the ability to draw conclusions about these associations across children with a broader range of symptomatology. In addition, the limited racial and ethnic diversity of our sample may limit the generalizability of findings.

CONCLUSION

These findings mark an important step towards bridging neural findings and behavioral patterns using a multimodal approach. Advancing understanding of behavioral avoidance in pediatric anxiety may guide future treatment optimization by identifying individual-specific targets for treatment.

An Intensive time series investigation of the relationships across eating disorder-specific fear responses and behavior urges in partially remitted anorexia nervosa

Anorexia nervosa (AN) is a serious and persistent psychiatric illness. Many individuals with AN cycle between stages of remission (i.e., relapse), with research documenting that cognitive remission generally lags behind nutritional/weight restoration. Yet, little is known about which mechanisms promote movement from partial remission in AN (defined as nutritional, but not cognitive, recovery) to full remission. Fear-based processes, including avoidance and approach behaviors, likely contribute to the persistence of cognitive-behavioral AN symptoms after nutritional restoration. The current study used intensive longitudinal data to characterize these processes during partial remission (N = 41 participants with partially remitted AN; 4306 total observations). We aimed to a) characterize frequency of fear-based processes in real-time, b) investigate associations across fear-based processes and behavioral urges, and c) test if real-time associations among symptoms differed across commonly feared stimuli (e.g., food, social situations). On average, participants endorsed moderate fear and avoidance, with weight-gain fears rated higher than other feared stimuli. Momentary fear, avoidance, approach, and distress were all positively associated with AN behavior urges at one time-point and prospectively. Central symptoms and symptom connections differed across models with different feared stimuli. These findings provide empirical support for the theorized fear-avoidance-urge cycle in AN, which may contribute to the persistence of eating pathology during partial remission. Fear approach may be associated with temporary increases in urges, which should be considered during treatment. Future research should explore these associations in large, heterogeneous samples, and test the effectiveness of exposure-based interventions during partial remission.

Deficits in proactive avoidance and neural responses to drinking motives in problem drinkers

Physical pain and negative emotions represent two distinct drinking motives that contribute to harmful alcohol use. Proactive avoidance which can reduce problem drinking in response to these motives appears to be impaired in problem drinkers. However, proactive avoidance and its underlying neural deficits have not been assessed experimentally. How these deficits inter-relate with drinking motives to influence alcohol use also remains unclear. The current study leveraged neuroimaging data collected in forty-one problem and forty-one social drinkers who performed a probabilistic learning go/nogo task that involved proactive avoidance of painful outcomes. We characterized the regional brain responses to proactive avoidance and identified the neural correlates of drinking to avoid physical pain and negative emotions. Behavioral results confirmed problem drinkers' proactive avoidance deficits in learning rate and performance accuracy, both which were associated with greater alcohol use. Imaging findings in problem drinkers showed that negative emotions as a drinking motive predicted attenuated right insula activation during proactive avoidance. In contrast, physical pain motive predicted reduced right putamen response. These regions' activations as well as functional connectivity with the somatomotor cortex also demonstrated a negative relationship with drinking severity and positive relationship with proactive avoidance performance. Path modeling further delineated the pathways through which physical pain and negative emotions, along with alcohol use severity, influenced the neural and behavioral measures of proactive avoidance. Taken together, the current findings provide experimental evidence for proactive avoidance deficits in problem drinkers and establish the link between their neural underpinnings and alcohol misuse.

The Neural Correlates of Individual Differences in Reinforcement Learning during Pain Avoidance and Reward Seeking

Organisms learn to gain reward and avoid punishment through action-outcome associations. Reinforcement learning (RL) offers a critical framework to understand individual differences in this associative learning by assessing learning rate, action bias, pavlovian factor (i.e., the extent to which action values are influenced by stimulus values), and subjective impact of outcomes (i.e., motivation to seek reward and avoid punishment). Nevertheless, how these individual-level metrics are represented in the brain remains unclear. The current study leveraged fMRI in healthy humans and a probabilistic learning go/no-go task to characterize the neural correlates involved in learning to seek reward and avoid pain. Behaviorally, participants showed a higher learning rate during pain avoidance relative to reward seeking. Additionally, the subjective impact of outcomes was greater for reward trials and associated with lower response randomness. Our imaging findings showed that individual differences in learning rate and performance accuracy during avoidance learning were positively associated with activities of the dorsal anterior cingulate cortex, midcingulate cortex, and postcentral gyrus. In contrast, the pavlovian factor was represented in the precentral gyrus and superior frontal gyrus (SFG) during pain avoidance and reward seeking, respectively. Individual variation of the subjective impact of outcomes was positively predicted by activation of the left posterior cingulate cortex. Finally, action bias was represented by the supplementary motor area (SMA) and pre-SMA whereas the SFG played a role in restraining this action tendency. Together, these findings highlight for the first time the neural substrates of individual differences in the computational processes during RL.

Translating Developmental Neuroscience to Understand Risk for Psychiatric Disorders

The transition from childhood to adulthood represents the developmental time frame in which the majority of psychiatric disorders emerge. Recent efforts to identify risk factors mediating the susceptibility to psychopathology have led to a heightened focus on both typical and atypical trajectories of neural circuit maturation. Mounting evidence has highlighted the immense neural plasticity apparent in the developing brain. Although in many cases adaptive, the capacity for neural circuit alteration also induces a state of vulnerability to environmental perturbations, such that early-life experiences have long-lasting implications for cognitive and emotional functioning in adulthood. The authors outline preclinical and neuroimaging studies of normative human brain circuit development, as well as parallel efforts covered in this issue of the Journal, to identify brain circuit alterations in psychiatric disorders that frequently emerge in developing populations. Continued translational research into the interactive effects of neurobiological development and external factors will be crucial for identifying early-life risk factors that may contribute to the emergence of psychiatric illness and provide the key to optimizing treatments.

Altered striatal-opercular intrinsic connectivity reflects decreased aversion to losses in alcohol use disorder

The persistence of addictive behaviours despite their adverse consequences highlights decreased punishment sensitivity as a facet of decision-making impairments in Alcohol Use Disorder (AUD). This attitude departs from the typical loss aversion (LA) pattern, i.e. the stronger sensitivity to negative than positive outcomes, previously associated with striatal and limbic-somatosensory responsiveness in healthy individuals. Consistent evidence highlights decreased LA as a marker of disease severity in AUD, but its neural bases remain largely unexplored. AUD-specific modulations of frontolateral activity by LA were previously related to the higher executive demands of anticipating losses than gains, but the relationship between LA and executive/working-memory performance in AUD is debated. Building on previous evidence of overlapping neural bases of LA during decision-making and at rest, we investigated a possible neural signature of altered LA in AUDs, and its connections with executive skills, in terms of complementary facets of resting-state functioning. In patients, smaller LA than controls, unrelated to executive performance, reflected reduced connectivity within striatal and medial temporal networks, and altered connectivity from these regions to the insular-opercular cortex. AUD-specific loss-related modulations of intrinsic connectivity thus involved structures previously associated both with drug-seeking and with coding the trade-off between appetitive and aversive motivational drives. These findings fit the hypothesis that altered striatal coding of choice-related incentive value, and interoceptive responsiveness to prospective outcomes, enhance neural sensitivity to drug-related stimuli in addictions. LA and its neural bases might prove useful markers of AUD severity and effectiveness of rehabilitation strategies targeting the salience of negative choice outcomes.

Threat of shock promotes passive avoidance, but not active avoidance

Anxiety and stress are adaptive responses to threat that promote harm avoidance. In particular, prior work has shown that anxiety induced in humans using threat of unpredictable shock promotes behavioral inhibition in the face of harm. This is consistent with the idea that anxiety promotes passive avoidance-that is, withholding approach actions that could lead to harm. However, harm can also be avoided through active avoidance, where a (withdrawal) action is taken to avoid harm. Here, we provide the first direct within-study comparison of the effects of threat of shock on active and passive avoidance. We operationalize passive avoidance as withholding a button press response in the face of negative outcomes, and active avoidance as lifting/releasing a button press in the face of negative outcomes. We explore the impact of threat of unpredictable shock on the learning of these behavioral responses (alongside matched responses to rewards) within a single cognitive task. We predicted that threat of shock would promote both active and passive avoidance, and that this would be driven by increased reliance on Pavlovian bias, as parameterized within reinforcement-learning models. Consistent with our predictions, we provide evidence that threat of shock promotes passive avoidance as conceptualized by our task. However, inconsistent with predictions, we found no evidence that threat of shock promoted active avoidance, nor evidence of elevated Pavlovian bias in any condition. One hypothetical framework with which to understand these findings is that anxiety promotes passive over active harm avoidance strategies in order to conserve energy while avoiding harm.

Molecular and neurocircuitry mechanisms of social avoidance

Humans and animals live in social relationships shaped by actions of approach and avoidance. Both are crucial for normal physical and mental development, survival, and well-being. Active withdrawal from social interaction is often induced by the perception of threat or unpleasant social experience and relies on adaptive mechanisms within neuronal networks associated with social behavior. In case of confrontation with overly strong or persistent stressors and/or dispositions of the affected individual, maladaptive processes in the neuronal circuitries and its associated transmitters and modulators lead to pathological social avoidance. This review focuses on active, fear-driven social avoidance, affected circuits within the mesocorticolimbic system and associated regions and a selection of molecular modulators that promise translational potential. A comprehensive review of human research in this field is followed by a reflection on animal studies that offer a broader and often more detailed range of analytical methodologies. Finally, we take a critical look at challenges that could be addressed in future translational research on fear-driven social avoidance.

Dysregulation of behavioral and autonomic responses to emotional and social stimuli following bidirectional pharmacological manipulation of the basolateral amygdala in macaques

The amygdala is a key component of the neural circuits mediating the processing and response to emotionally salient stimuli. Amygdala lesions dysregulate social interactions, responses to fearful stimuli, and autonomic functions. In rodents, the basolateral and central nuclei of the amygdala have divergent roles in behavioral control. However, few studies have selectively examined these nuclei in the primate brain. Moreover, the majority of non-human primate studies have employed lesions, which only allow for unidirectional manipulation of amygdala activity. Thus, the effects of amygdala disinhibition on behavior in the primate are unknown. To address this gap, we pharmacologically inhibited by muscimol or disinhibited by bicuculline methiodide the basolateral complex of the amygdala (BLA; lateral, basal, and accessory basal) in nine awake, behaving male rhesus macaques (Macaca mulatta). We examined the effects of amygdala manipulation on: (1) behavioral responses to taxidermy snakes and social stimuli, (2) food competition and social interaction in dyads, (3) autonomic arousal as measured by cardiovascular response, and (4) prepulse inhibition of the acoustic startle (PPI) response. All modalities were impacted by pharmacological inhibition and/or disinhibition. Amygdala inhibition decreased fear responses to snake stimuli, increased examination of social stimuli, reduced competitive reward-seeking in dominant animals, decreased heart rate, and increased PPI response. Amygdala disinhibition restored fearful response after habituation to snakes, reduced competitive reward-seeking behavior in dominant animals, and lowered heart rate. Thus, both hypoactivity and hyperactivity of the basolateral amygdala can lead to dysregulated behavior, suggesting that a narrow range of activity is necessary for normal functions.

Spatial migration of human reward processing with functional development: Evidence from quantitative meta-analyses

Functional magnetic resonance imaging (fMRI) studies have shown notable age‐dependent differences in reward processing. We analyzed data from a total of 554 children, 1,059 adolescents, and 1,831 adults from 70 articles. Quantitative meta‐analyses results show that adults engage an extended set of regions that include anterior and posterior cingulate gyri, insula, basal ganglia, and thalamus. Adolescents engage the posterior cingulate and middle frontal gyri as well as the insula and amygdala, whereas children show concordance in right insula and striatal regions almost exclusively. Our data support the notion of reorganization of function over childhood and adolescence and may inform current hypotheses relating to decision‐making across age.

Neural correlates of reward-directed action and inhibition of action

Human and non-human primate studies have examined neural responses to action and inhibition of action. However, it remains unclear whether the cerebral processes supporting these two distinct responses are differentially modulated by reward. In a sample of 35 healthy human adults, we examined brain activations to action and inhibition of action in a reward go/no-go task, with approximately ⅔ go and ⅓ no-go trials. Correct go and no-go trials were rewarded with $1 or ¢5 in reward sessions. Behaviorally, reward facilitated go and impeded no-go. A conjunction analysis showed shared activation to rewarded go and no-go responses in the rostral anterior cingulate cortex (rACC) and inferior parietal cortex. A whole-brain two-way ANOVA of response (go vs no-go) and reward (dollar vs nickel) revealed a significant main effect of response, with greater activity for no-go vs go success in the middle frontal cortex and the reversed pattern in the dorsal ACC, insula, thalamus, and caudate. The thalamus and caudate also responded preferentially to dollar relative to nickel reward during go trials. The main effect of reward (dollar > nickel) involved not only regions associated with reward valuation (e.g., medial orbitofrontal cortex - mOFC) but also those implicated in motor control, saliency, and visual attention including the rACC, ventral striatum, insula, and occipital cortex. Finally, the mOFC distinguished go and no-go responses in the dollar but not nickel trials, suggesting a functional bias toward response execution that leads to larger rewards. Together, these findings identified both shared and non-overlapping neural processes underlying goal-directed action and inhibition of action as well as delineated the effects of reward magnitude on such processes.

Parental coping socialization is associated with healthy and anxious early-adolescents' neural and real-world response to threat

The ways parents socialize their adolescents to cope with anxiety (i.e., coping socialization) may be instrumental in the development of threat processing and coping responses. Coping socialization may be important for anxious adolescents, as they show altered neural threat processing and over reliance on disengaged coping (e.g., avoidance and distraction), which can maintain anxiety. We investigated whether coping socialization was associated with anxious and healthy adolescents' neural response to threat, and whether neural activation was associated with disengaged coping. Healthy and clinically anxious early adolescents (N = 120; M = 11.46 years; 71 girls) and a parent engaged in interactions designed to elicit adolescents' anxiety and parents' response to adolescents' anxiety. Parents' use of reframing and problem solving statements was coded to measure coping socialization. In a subsequent visit, we assessed adolescents' neural response to threat words during a neuroimaging task. Adolescents' disengaged coping was measured using ecological momentary assessment. Greater coping socialization was associated with lower anterior insula and perigenual cingulate activation in healthy adolescents and higher activation in anxious adolescents. Coping socialization was indirectly associated with less disengaged coping for anxious adolescents through neural activation. Findings suggest that associations between coping socialization and early adolescents' neural response to threat differ depending on clinical status and have implications for anxious adolescents' coping.

Translating Developmental Neuroscience to Understand Risk for Psychiatric Disorders

The transition from childhood to adulthood represents the developmental time frame in which the majority of psychiatric disorders emerge. Recent efforts to identify risk factors mediating the susceptibility to psychopathology have led to a heightened focus on both typical and atypical trajectories of neural circuit maturation. Mounting evidence has highlighted the immense neural plasticity apparent in the developing brain. Although in many cases adaptive, the capacity for neural circuit alteration also induces a state of vulnerability to environmental perturbations, such that early-life experiences have long-lasting implications for cognitive and emotional functioning in adulthood. The authors outline preclinical and neuroimaging studies of normative human brain circuit development, as well as parallel efforts covered in this issue of the Journal, to identify brain circuit alterations in psychiatric disorders that frequently emerge in developing populations. Continued translational research into the interactive effects of neurobiological development and external factors will be crucial for identifying early-life risk factors that may contribute to the emergence of psychiatric illness and provide the key to optimizing treatments.

Using a Developmental Ecology Framework to Align Fear Neurobiology Across Species

Children's development is largely dependent on caregiving; when caregiving is disrupted, children are at increased risk for numerous poor outcomes, in particular psychopathology. Therefore, determining how caregivers regulate children's affective neurobiology is essential for understanding psychopathology etiology and prevention. Much of the research on affective functioning uses fear learning to map maturation trajectories, with both rodent and human studies contributing knowledge. Nonetheless, as no standard framework exists through which to interpret developmental effects across species, research often remains siloed, thus contributing to the current therapeutic impasse. Here, we propose a developmental ecology framework that attempts to understand fear in the ecological context of the child: their relationship with their parent. By referring to developmental goals that are shared across species (to attach to, then, ultimately, separate from the parent), this framework provides a common grounding from which fear systems and their dysfunction can be understood, thus advancing research on psychopathologies and their treatment.

Gray Matter Structural Alterations in Social Anxiety Disorder: A Voxel-Based Meta-Analysis

The current insight into the neurobiological pathogenesis underlying social anxiety disorder (SAD) is still rather limited. We implemented a meta-analysis to explore the neuroanatomical basis of SAD. We undertook a systematic search of studies comparing gray matter volume (GMV) differences between SAD patients and healthy controls (HC) using a whole-brain voxel-based morphometry (VBM) approach. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of SAD patients compared with HC. We included eleven studies with 470 SAD patients and 522 HC in the current meta-analysis. In the main meta-analysis, relative to HC, SAD patients showed larger GMVs in the left precuneus, right middle occipital gyrus (MOG) and supplementary motor area (SMA), as well as smaller GMV in the left putamen. In the subgroup analyses, compared with controls, adult patients (age ≥ 18 years) with SAD exhibited larger GMVs in the left precuneus, right superior frontal gyrus (SFG), angular gyrus, middle temporal gyrus (MTG), MOG and SMA, as well as a smaller GMV in the left thalamus; SAD patients without comorbid depressive disorder exhibited larger GMVs in the left superior parietal gyrus and precuneus, right inferior temporal gyrus, fusiform gyrus, MTG and superior temporal gyrus (STG), as well as a smaller GMV in the bilateral thalami; and currently drug-free patients with SAD exhibited a smaller GMV in the left thalamus compared with HC while no larger GMVs were found. For SAD patients with different clinical features, our study revealed directionally consistent larger cortical GMVs and smaller subcortical GMVs, including locationally consistent larger precuneus and thalamic deficits in the left brain. Age, comorbid depressive disorder and concomitant medication use of the patients might be potential confounders of SAD at the neuroanatomical level.

Decision-making impairments following insular and medial temporal lobe resection for drug-resistant epilepsy

Besides the prefrontal cortex, the insula and medial structures of the temporal lobe are thought to be involved in risky decision-making. However, their respective contributions to decision processes remain unclear due to the lack of studies involving patients with isolated insular damage. We assessed adult patients who underwent resection of the insula (n = 13) or of the anterior temporal lobe (including medial structures) (n = 13) as part of their epilepsy surgery, and a group of healthy volunteers (n = 20), on the Iowa Gambling Task (IGT) and on the Cups Task. Groups were matched on sociodemographic, estimated-IQ and surgery-related factors. On the IGT, patients with temporal lobe resection performed significantly worse than both the insular and healthy control groups, as they failed to learn which decks were advantageous on the long-term. On the Cups Task, the insular and temporal groups both showed impaired sensitivity to expected value in the loss domain, when compared with healthy controls. These findings provide clinical evidence that the insula and mesiotemporal structures are specifically involved in risky decision-making when facing a potential loss, and that temporal structures are also involved in learning the association between behavior and consequences in the long-term.

Infant avoidance training alters cellular activation patterns in prefronto-limbic circuits during adult avoidance learning: II. Cellular imaging of neurons expressing the activity-regulated cytoskeleton-associated protein (Arc/Arg3.1)

Positive and negative feedback learning is essential to optimize behavioral performance. We used the two-way active avoidance (TWA) task as an experimental paradigm for negative feedback learning with the aim to test the hypothesis that neuronal ensembles activate the activity-regulated cytoskeletal (Arc/Arg3.1) protein during different phases of avoidance learning and during retrieval. A variety of studies in humans and other animals revealed that the ability of aversive feedback learning emerges postnatally. Our previous findings demonstrated that rats, which as infants are not capable to learn an active avoidance strategy, show improved avoidance learning as adults. Based on these findings, we further tested the hypothesis that specific neuronal ensembles are "tagged" during infant TWA training and then reactivated during adult re-exposure to the same learning task. Using cellular imaging by immunocytochemical detection of Arc/Arg3.1, we observed that, compared to the untrained control group, (1) only in the dentate gyrus the density of Arc/Arg3.1-expressing neurons was elevated during the acquisition phase of TWA learning, and (2) this increase in Arc/Arg3.1-expressing neurons was not specific for the TWA learning task. With respect to the effects of infant TWA training we found that compared to the naïve non-pretrained group (a) the infant pretraining group displayed a higher density of Arc/Arg3.1-expressing neurons in the anterior cingulate cortex during acquisition on training day 1, and (b) the infant pretraining group displayed elevated density of Arc/Arg3.1-expressing neurons in the dentate gyrus during retrieval on test day 5. Correlation analysis for the acquisition phase revealed for the ACd that the animals which showed the highest number of avoidances and the fastest escape latencies displayed the highest density of Arc/Arg3.1-expressing neurons. Taken together, we are the first to use the synaptic plasticity protein Arc/Arg3.1 to label neuronal ensembles which are involved in different phases of active avoidance learning and whose activity patterns are changing in response to previous learning experience during infancy. Our results indicate (1) that, despite the inability to learn an active avoidance response in infancy, lasting memory traces are formed encoding the subtasks that are learned in infancy (e.g., the association of the CS and UCS, escape strategy), which are encoded in the infant brain by neuronal ensembles, which alter their synaptic connectivity via activation of specific synaptic plasticity proteins such as Arc/Arg3.1 and Egr1, and (2) that during adult training these memories can be retrieved by reactivating these neuronal ensembles and their synaptic circuits and thereby accelerate learning.

Anatomical brain difference of subthreshold depression in young and middle-aged individuals

BACKGROUND

Subthreshold depression (StD) is associated with substantial functional impairments due to depressive symptoms that do not fully meet the diagnosis of major depressive disorder (MDD). Its high incidence in the general population and debilitating symptoms has recently put it at the forefront of mood disorder research.

AIM

In this study we investigated common volumetric brain changes in both young and middle-aged StD patients.

METHODS

Two cohorts of StD patients, young and middle-aged, (n = 57) and matched controls (n = 76) underwent voxel-based morphometry (VBM).

RESULTS

VBM analysis found that: 1) compared with healthy controls, StD patients showed decreased gray matter volume (GMV) in the bilateral globus pallidus and precentral gyrus, as well as increased GMV in the left thalamus and right rostral anterior cingulate cortex/medial prefrontal cortex; 2) there is a significant association between Center for Epidemiological Studies Depression Scale scores and the bilateral globus pallidus (negative) and left thalamus (positive); 3) there is no interaction between age (young vs. middle-age) and group (StD vs. controls).

CONCLUSIONS

Our findings indicate significant VBM brain changes in both young and middle-aged individuals with StD. Individuals with StD, regardless of age, may share common neural characteristics.

Mapping Depression in Schizophrenia: A Functional Magnetic Resonance Imaging Study

Depressive symptoms are common in schizophrenia, often left untreated, and associated with a high relapse rate, suicidal ideation, increased mortality, reduced social adjustment and poor quality of life. The neural mechanisms underlying depression in psychosis are poorly understood. Given reports of altered brain response to negative facial affect in depressive disorders, we examined brain response to emotive facial expressions in relation to levels of depression in people with psychosis. Seventy outpatients (final N= 63) and 20 healthy participants underwent functional magnetic resonance imaging during an implicit affect processing task involving presentation of facial expressions of fear, anger, happiness as well as neutral expressions and a (no face) control condition. All patients completed Beck Depression Inventory (BDI-II) and had their symptoms assessed on the Positive and Negative Syndrome Scale (PANSS). In patients, depression (BDI-II) scores associated positively with activation of the left thalamus, extending to the putamen-globus pallidus, insula, inferior-middle frontal and para-post-pre-central gyri during fearful expressions. Furthermore, patients with moderate-to-severe depression had significantly higher activity in these brain regions during fearful expressions relative to patients with no, minimal, or mild depression and healthy participants. The study provides first evidence of enhanced brain response to fearful facial expressions, which signal an uncertain source of threat in the environment, in patients with psychosis and a high level of self-reported depression.

Neural networks involved in adolescent reward processing: An activation likelihood estimation meta-analysis of functional neuroimaging studies

Behavioral responses to, and the neural processing of, rewards change dramatically during adolescence and may contribute to observed increases in risk-taking during this developmental period. Functional MRI (fMRI) studies suggest differences between adolescents and adults in neural activation during reward processing, but findings are contradictory, and effects have been found in non-predicted directions. The current study uses an activation likelihood estimation (ALE) approach for quantitative meta-analysis of functional neuroimaging studies to: (1) confirm the network of brain regions involved in adolescents' reward processing, (2) identify regions involved in specific stages (anticipation, outcome) and valence (positive, negative) of reward processing, and (3) identify differences in activation likelihood between adolescent and adult reward-related brain activation. Results reveal a subcortical network of brain regions involved in adolescent reward processing similar to that found in adults with major hubs including the ventral and dorsal striatum, insula, and posterior cingulate cortex (PCC). Contrast analyses find that adolescents exhibit greater likelihood of activation in the insula while processing anticipation relative to outcome and greater likelihood of activation in the putamen and amygdala during outcome relative to anticipation. While processing positive compared to negative valence, adolescents show increased likelihood for activation in the posterior cingulate cortex (PCC) and ventral striatum. Contrasting adolescent reward processing with the existing ALE of adult reward processing reveals increased likelihood for activation in limbic, frontolimbic, and striatal regions in adolescents compared with adults. Unlike adolescents, adults also activate executive control regions of the frontal and parietal lobes. These findings support hypothesized elevations in motivated activity during adolescence.

The manipulative skill: Cognitive devices and their neural correlates underlying Machiavellian's decision making

Until now, Machiavellianism has mainly been studied in personality and social psychological framework, and little attention has been paid to the underlying cognitive and neural equipment. In light of recent findings, Machiavellian social skills are not limited to emotion regulation and "cold-mindedness" as many authors have recently stated, but linked to specific cognitive abilities. Although Machiavellians appear to have a relatively poor mindreading ability and emotional intelligence, they can efficiently exploit others which is likely to come from their flexible problem solving processes in changing environmental circumstances. The author proposed that Machiavellians have specialized cognitive domains of decision making, such as monitoring others' behavior, task orientation, reward seeking, inhibition of cooperative feelings, and choosing victims. He related the relevant aspects of cognitive functions to their neurological substrates, and argued why they make Machiavellians so successful in interpersonal relationships.

Not so bad: avoidance and aversive discounting modulate threat appraisal in anterior cingulate and medial prefrontal cortex

The dorsal anterior cingulate (adACC) and dorsal medial prefrontal cortex (dmPFC) play a central role in the discrimination and appraisal of threatening stimuli. Yet, little is known about what specific features of threatening situations recruit these regions and how avoidance may modulate appraisal and activation through prevention of aversive events. In this investigation, 30 healthy adults underwent functional neuroimaging while completing an avoidance task in which responses to an Avoidable CS+ threat prevented delivery of an aversive stimulus, but not to an Unavoidable CS+ threat. Extinction testing was also completed where CSs were presented without aversive stimulus delivery and an opportunity to avoid. The Avoidable CS+ relative to the Unavoidable CS+ was associated with reductions in ratings of negative valence, fear, and US expectancy and activation. Greater regional activation was consistently observed to the Unavoidable CS+ during avoidance, which declined during extinction. Individuals exhibiting greater aversive discounting—that is, those more avoidant of immediate monetary loss compared to a larger delayed loss—also displayed greater activation to the Unavoidable CS+, highlighting aversive discounting as a significant individual difference variable. These are the first results linking adACC/dmPFC reactivity to avoidance-based reductions of aversive events and modulation of activation by individual differences in aversive discounting.

How absent negativity relates to affect and motivation: an integrative relief model

The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO.

Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety

BACKGROUND AND OBJECTIVES

Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders.

METHODS

Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline.

RESULTS

Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome.

LIMITATIONS

Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables.

CONCLUSIONS

Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts.

A Critical Review of Attentional Threat Bias and Its Role in the Treatment of Pediatric Anxiety Disorders

Threat bias, or exaggerated selective attention to threat, is considered a key neurocognitive factor in the etiology and maintenance of pediatric anxiety disorders. However, upon closer examination of the literature, there is greater heterogeneity in threat-related attentional biases than typically acknowledged. This is likely impacting progress that can be made in terms of interventions focused on modifying this bias and reducing anxiety, namely attention bias modification training. We suggest that the field may need to "take a step back" from developing interventions and focus research efforts on improving the methodology of studying attention bias itself, particularly in a developmental context. We summarize a neurocognitive model that addresses the issue of heterogeneity by broadly incorporating biases toward and away from threat, linking this variation to key neurodevelopmental factors, and providing a basis for future research aimed at improving the utility of threat bias measures and interventions in clinical practice.

Parietal abnormalities are related to avoidance in social anxiety disorder: a study using voxel-based morphometry and manual volumetry

Evidence is accumulating that various mental disorders are related to neural abnormalities in the parietal cortices that are associated with the default mode network (DMN). Participants comprised 67 persons with social anxiety disorder (SAD) and 64 matched healthy controls who underwent structural magnetic resonance imaging (MRI) and a comprehensive clinical assessment. Voxel-based morphometry (VBM) across the entire brain and manual volumetry of the parietal cortices were performed. The results indicate abnormal manually segmented volumes or gray matter (GM) volumes within the precuneus, postcentral gyrus and inferior parietal cortex, as well as in the premotor cortices including the supplementary motor cortex. Significant negative correlations were obtained between parietal, especially precuneus, abnormalities and social avoidance severity, indicating stronger avoidance in SAD participants with smaller volumes or less GM. We conclude that pathological avoidance behaviors in SAD are associated with structural deficits of parietal regions that are associated with the DMN, which has been shown to mediate introspection and reflection upon one's own mental state in healthy humans.

Individual differences in response to positive and negative stimuli: endocannabinoid-based insight on approach and avoidance behaviors

Approach and avoidance behaviors-the primary responses to the environmental stimuli of danger, novelty and reward-are associated with the brain structures that mediate cognitive functionality, reward sensitivity and emotional expression. Individual differences in approach and avoidance behaviors are modulated by the functioning of amygdaloid-hypothalamic-striatal and striatal-cerebellar networks implicated in action and reaction to salient stimuli. The nodes of these networks are strongly interconnected and by acting on them the endocannabinoid and dopaminergic systems increase the intensity of appetitive or defensive motivation. This review analyzes the approach and avoidance behaviors in humans and rodents, addresses neurobiological and neurochemical aspects of these behaviors, and proposes a possible synaptic plasticity mechanism, related to endocannabinoid-dependent long-term potentiation (LTP) and depression that allows responding to salient positive and negative stimuli.

Are you gonna leave me? Separation anxiety is associated with increased amygdala responsiveness and volume

The core feature of separation anxiety is excessive distress when faced with actual or perceived separation from people to whom the individual has a strong emotional attachment. So far little is known about the neurobiological underpinnings of separation anxiety. Therefore, we investigated functional (amygdala responsiveness and functional connectivity during threat-related emotion processing) and structural (grey matter volume) imaging markers associated with separation anxiety as measured with the Relationship Scale Questionnaire in a large sample of healthy adults from the Münster Neuroimaging Cohort (N = 320). We used a robust emotional face-matching task and acquired high-resolution structural images for morphometric analyses using voxel-based morphometry. The main results were positive associations of separation anxiety scores with amygdala reactivity to emotional faces as well as increased amygdala grey matter volumes. A functional connectivity analysis revealed positive associations between separation anxiety and functional coupling of the amygdala with areas involved in visual processes and attention, including several occipital and somatosensory areas. Taken together, the results suggest a higher emotional involvement in subjects with separation anxiety while watching negative facial expressions, and potentially secondary neuro-structural adaptive processes. These results could help to understand and treat (adult) separation anxiety.

Potentiation of the early visual response to learned danger signals in adults and adolescents

The reinforcing effects of aversive outcomes on avoidance behaviour are well established. However, their influence on perceptual processes is less well explored, especially during the transition from adolescence to adulthood. Using electroencephalography, we examined whether learning to actively or passively avoid harm can modulate early visual responses in adolescents and adults. The task included two avoidance conditions, active and passive, where two different warning stimuli predicted the imminent, but avoidable, presentation of an aversive tone. To avoid the aversive outcome, participants had to learn to emit an action (active avoidance) for one of the warning stimuli and omit an action for the other (passive avoidance). Both adults and adolescents performed the task with a high degree of accuracy. For both adolescents and adults, increased N170 event-related potential amplitudes were found for both the active and the passive warning stimuli compared with control conditions. Moreover, the potentiation of the N170 to the warning stimuli was stable and long lasting. Developmental differences were also observed; adolescents showed greater potentiation of the N170 component to danger signals. These findings demonstrate, for the first time, that learned danger signals in an instrumental avoidance task can influence early visual sensory processes in both adults and adolescents.

The neural correlates of the dominance dimension of emotion

Emotion has been conceptualized as a dimensional construct, while the number of dimensions - two or three - has been debated. Research has consistently identified two dimensions - valence and arousal - though ample evidence exists that three dimensions are necessary to describe emotion. One proposed third dimension, identified as dominance, is relevant in clinical syndromes, personality and consumer psychology. Dominance refers to an individual's sense of having an ability to affect the environment. Neuroimaging studies have generally focused on the two dimensions of valence and arousal, leaving the neural correlates of dominance unexplored. The current study used functional magnetic resonance imaging to explore the neural basis of dominance in 17 healthy male controls. Participants viewed images from the International Affective Picture System that were selected to represent high and low dominance conditions. Results indicated activation in paralimbic regions, including the bilateral anterior insula for high dominance and the right precuneus for low. The findings of this exploratory study support the consideration of dominance in dimensional models of emotion and suggest that further research is needed to understand the neural representation of dominance in emotional experience.

Escape from harm: linking affective vision and motor responses during active avoidance

When organisms confront unpleasant objects in their natural environments, they engage in behaviors that allow them to avoid aversive outcomes. Here, we linked visual processing of threat to its behavioral consequences by including a motor response that terminated exposure to an aversive event. Dense-array steady-state visual evoked potentials were recorded in response to conditioned threat and safety signals viewed in active or passive behavioral contexts. The amplitude of neuronal responses in visual cortex increased additively, as a function of emotional value and action relevance. The gain in local cortical population activity for threat relative to safety cues persisted when aversive reinforcement was behaviorally terminated, suggesting a lingering emotionally based response amplification within the visual system. Distinct patterns of long-range neural synchrony emerged between the visual cortex and extravisual regions. Increased coupling between visual and higher-order structures was observed specifically during active perception of threat, consistent with a reorganization of neuronal populations involved in linking sensory processing to action preparation.

The functional and structural neural basis of individual differences in loss aversion

Decision making under risk entails the anticipation of prospective outcomes, typically leading to the greater sensitivity to losses than gains known as loss aversion. Previous studies on the neural bases of choice-outcome anticipation and loss aversion provided inconsistent results, showing either bidirectional mesolimbic responses of activation for gains and deactivation for losses, or a specific amygdala involvement in processing losses. Here we focused on loss aversion with the aim to address interindividual differences in the neural bases of choice-outcome anticipation. Fifty-six healthy human participants accepted or rejected 104 mixed gambles offering equal (50%) chances of gaining or losing different amounts of money while their brain activity was measured with functional magnetic resonance imaging (fMRI). We report both bidirectional and gain/loss-specific responses while evaluating risky gambles, with amygdala and posterior insula specifically tracking the magnitude of potential losses. At the individual level, loss aversion was reflected both in limbic fMRI responses and in gray matter volume in a structural amygdala-thalamus-striatum network, in which the volume of the "output" centromedial amygdala nuclei mediating avoidance behavior was negatively correlated with monetary performance. We conclude that outcome anticipation and ensuing loss aversion involve multiple neural systems, showing functional and structural individual variability directly related to the actual financial outcomes of choices. By supporting the simultaneous involvement of both appetitive and aversive processing in economic decision making, these results contribute to the interpretation of existing inconsistencies on the neural bases of anticipating choice outcomes.

Neuroimaging the temporal dynamics of human avoidance to sustained threat

Many forms of human psychopathology are characterized by sustained negative emotional responses to threat and chronic behavioral avoidance, implicating avoidance as a potential transdiagnostic factor. Evidence from both nonhuman neurophysiological and human neuroimaging studies suggests a distributed frontal-limbic-striatal brain network supports avoidance. However, our understanding of the temporal dynamics of the network to sustained threat that prompts sustained avoidance is limited. To address this issue, 17 adults were given extensive training on a modified free-operant avoidance task in which button pressing avoided money loss during a sustained threat period. Subsequently, subjects underwent functional magnetic resonance imaging while completing the avoidance task. In our regions of interest, we observed phasic, rather than sustained, activation during sustained threat in dorsolateral and inferior frontal regions, anterior and dorsal cingulate, ventral striatum and regions associated with emotion, including the amygdala, insula, substantia nigra and bed nucleus of the stria terminalis complex. Moreover, trait levels of experiential avoidance were negatively correlated with insula, hippocampal and amygdala activation. These findings suggest knowledge that one can consistently avoid aversive outcomes is not associated with decreased threat-related responses and that individuals with greater experiential avoidance exhibit reduced reactivity to initial threat. Implications for understanding brain mechanisms supporting human avoidance and psychological theories of avoidance are discussed.

Pain, decisions, and actions: a motivational perspective

Because pain signals potential harm to the organism, it immediately attracts attention and motivates decisions and action. However, pain is also subject to motivations—an aspect that has led to considerable changes in our understanding of (chronic) pain over the recent years. The relationship between pain and motivational states is therefore clearly bidirectional. This review provides an overview on behavioral and neuroimaging studies investigating motivational aspects of pain. We highlight recent insights into the modulation of pain through fear and social factors, summarize findings on the role of pain in fear conditioning, avoidance learning and goal conflicts and discuss evidence on pain-related cognitive interference and motivational aspects of pain relief.

Neural correlates of Machiavellian strategies in a social dilemma task

In spite of having deficits in various areas of social cognition, especially in mindreading, Machiavellian individuals are typically very successful in different tasks, including solving social dilemmas. We assume that a profound examination of neural structures associated with decision-making processes is needed to learn more about Machiavellians' abilities in exploiting other people. More specifically, we predicted that high-Mach people would show elevated activity in the brain areas involved in reward-seeking, anticipation of risky situations, and inference making. To test this hypothesis, we used an fMRI technique to examine individuals as they played the Trust Game. In accordance with our predictions, we found consistent activation in high-Machs' thalamus and anterior cingulate cortex (player 1), and dorsal anterior insula/inferior frontal gyrus (player 2). We suggest that Machiavellians conduct specific neural operations in social dilemma situations that make them successful in exploiting others. Machiavellians may have cognitive heuristics that enable them to make predictions about the future reward in a basically risky and unpredictable situation.

Interaction between catechol-O-methyltransferase (COMT) Val158Met genotype and genetic vulnerability to schizophrenia during explicit processing of aversive facial stimuli

BACKGROUND

Emotion dysregulation is a key feature of schizophrenia, a brain disorder strongly associated with genetic risk and aberrant dopamine signalling. Dopamine is inactivated by catechol-O-methyltransferase (COMT), whose gene contains a functional polymorphism (COMT Val158Met) associated with differential activity of the enzyme and with brain physiology of emotion processing. The aim of the present study was to investigate whether genetic risk for schizophrenia and COMT Val158Met genotype interact on brain activity during implicit and explicit emotion processing.

METHOD

A total of 25 patients with schizophrenia, 23 healthy siblings of patients and 24 comparison subjects genotyped for COMT Val158Met underwent functional magnetic resonance imaging during implicit and explicit processing of facial stimuli with negative emotional valence.

RESULTS

We found a main effect of diagnosis in the right amygdala, with decreased activity in patients and siblings compared with control subjects. Furthermore, a genotype × diagnosis interaction was found in the left middle frontal gyrus, such that the effect of genetic risk for schizophrenia was evident in the context of the Val/Val genotype only, i.e. the phenotype of reduced activity was present especially in Val/Val patients and siblings. Finally, a complete inversion of the COMT effect between patients and healthy subjects was found in the left striatum during explicit processing.

CONCLUSIONS

Overall, these results suggest complex interactions between genetically determined dopamine signalling and risk for schizophrenia on brain activity in the prefrontal cortex during emotion processing. On the other hand, the effects in the striatum may represent state-related epiphenomena of the disorder itself.

Safe from harm: learned, instructed, and symbolic generalization pathways of human threat-avoidance

Avoidance of threatening or unpleasant events is usually an adaptive behavioural strategy. Sometimes, however, avoidance can become chronic and lead to impaired daily functioning. Excessive threat-avoidance is a central diagnostic feature of anxiety disorders, yet little is known about whether avoidance acquired in the absence of a direct history of conditioning with a fearful event differs from directly learned avoidance. In the present study, we tested whether avoidance acquired indirectly via verbal instructions and symbolic generalization result in similar levels of avoidance behaviour and threat-beliefs to avoidance acquired after direct learning. Following fear conditioning in which one conditioned stimulus was paired with shock (CS+) and another was not (CS-), participants either learned or were instructed to make a response that cancelled impending shock. Three groups were then tested with a learned CS+ and CS- (learned group), instructed CS+ (instructed group), and generalized CS+ (derived group) presentations. Results showed similar levels of avoidance behaviour and threat-belief ratings about the likelihood of shock across each of the three pathways despite the different mechanisms by which they were acquired. Findings have implications for understanding the aetiology of clinical avoidance in anxiety.