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Zhang C, Lu J, Gao G, Cui J, Li M, Zang Y, Yang J, Wang L. Anxiety is related to slower RSA oscillation during stress response and regulation. Psychophysiology 2024:e14654. [PMID: 39075646 DOI: 10.1111/psyp.14654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/05/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
Respiratory sinus arrhythmia (RSA), an index of the parasympathetic nervous system activity, has been considered indicative of stress response and emotion regulation. However, the relationship between RSA and anxiety remains inconclusive, partly because previous research has primarily focused on static RSA levels. In this nonclinical sample (N = 75, Mage = 20.89 ± 1.72 SD, 48 males), we used a damped oscillator model to characterize RSA dynamics across 30-s epochs while participants completed the Trier social stress test. Results showed that RSA constantly oscillated during the three periods of TSST (namely Rest, Stress, and Recovery). Importantly, slower RSA oscillation in the Stress period was related to elevated state anxiety, whereas in the Recovery period, it was related to higher trait anxiety. These findings demonstrated the dynamic nature of RSA during the whole course of stress response. Slower RSA oscillation may indicate inflexible and tardy physiological regulation which may give rise to anxiety issues.
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Affiliation(s)
- Chen Zhang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Junshi Lu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Guosong Gao
- Beijing Xiaomi Technology Co., Ltd, Beijing, China
| | - Jinshi Cui
- School of Intelligence Science and Technology and State Key Laboratory of General Artificial Intelligence, Peking University, Beijing, China
| | - Man Li
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Yinyin Zang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Jiongjiong Yang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Li Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 PMCID: PMC11381009 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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3
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Carpenter JK. Normalizing Uncertain Threat: What Change in Anxiety-Potentiated Startle Can Tell Us About Anxiety Treatment. Biol Psychiatry 2024; 95:e1-e3. [PMID: 38030310 DOI: 10.1016/j.biopsych.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Joseph K Carpenter
- National Center for PTSD, Women's Health Sciences Division, Boston, Massachusetts; Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
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4
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Correa KA, Delfel EL, Wallace AL, III WEP, Jacobus J. Hispanic/Latinx ethnic differences in the relationships between behavioral inhibition, anxiety, and substance use in youth from the ABCD cohort. Front Psychiatry 2023; 14:1251032. [PMID: 37867762 PMCID: PMC10587569 DOI: 10.3389/fpsyt.2023.1251032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Elevated levels of behavioral inhibition (BI) may connote risk for both anxiety and substance use disorders. BI has consistently been shown to be associated with increased levels of anxiety, while the association between BI and substance use has been mixed. It is possible that the relationship between BI and substance use varies by individual difference factors. Hispanic/Latinx (H/L) youth in particular may have stronger relationships between BI, anxiety, and substance use. Methods The present study therefore evaluated (1) the prospective relationships between BI [assessed via self-reported behavioral inhibition system (BIS) scale scores], anxiety, and substance use in youth (n = 11,876) across baseline, 1-, and 2-year follow-ups of the Adolescent Brain Cognitive Development (ABCD) Study (ages 9-12) and (2) whether these relationships differed by H/L ethnicity while covarying for average behavioral approach system scores, race, sex, age, highest parental income, highest parental education, and past-year substance use (for analyses involving substance use outcomes). Results Baseline levels of BIS scores predicted increased anxiety symptoms at both 1- and 2-year follow-ups and did not differ by H/L ethnicity. Baseline levels of BIS scores also prospectively predicted increased likelihood of substance use at 2-year follow-up, but only for H/L youth and not at 1-year follow-up. Discussion High scores on the BIS scale contribute risk to anxiety across ethnicities and may uniquely contribute to risk for substance use in H/L youth.
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Affiliation(s)
- Kelly A. Correa
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Everett L. Delfel
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- San Diego State University/University of California (SDSU/UC) San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Alexander L. Wallace
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - William E. Pelham III
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
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Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
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Modecki KL, Ryan KM, Waters AM. Fear learning and extinction predicts anxiety in daily life: a study of Pavlovian conditioning and ecological momentary assessment. Psychol Med 2023; 53:5301-5311. [PMID: 36093766 PMCID: PMC10476067 DOI: 10.1017/s0033291722002379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 06/07/2022] [Accepted: 07/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The association between anxious mood and aberrant fear learning mechanisms has not been fully elucidated. Studying how fear conditioning and extinction constructs relate to anxiety symptoms and reactivity to stressful and benign moments in everyday life provides a powerful addition to experimental paradigms. METHOD Fifty-one young adults completed laboratory-based differential conditioning and extinction tasks with (CS + ) and without (CS-) an aversive unconditional stimulus (US). Electrodermal skin conductance responses were measured during each phase, followed by ecological momentary assessment (EMA) tapping anxiety and stressors six times daily for seven days (2, 142 moments). RESULTS Conditioned electrodermal reactivity to the CS + and overgeneralisation to the CS- were associated with greater change in anxiety (measured via EMA), across non-stressful situations, remaining the same across stressful situations. Likewise, during extinction when the CS + is now safe, more electrodermal reactivity to the CS + was associated with more anxiety change across non-stressful situations and remained the same across stressful situations. Also, during extinction when threat is absent, more electrodermal reactivity at the late stage of the CS- was associated with less momentary anxiety change in response to stressful situations; more electrodermal activity at the late stage of the CS + was associated with more anxiety change across non-stressful situations and remained the same across stressful situations. CONCLUSIONS Sampling 'in vivo' emotion and stress experiences, study findings revealed links between conditioned electrodermal reactivity and overgeneralisation to safe stimuli and heightened anxious reactivity during non-stressful (i.e. safe) moments in daily life, coupled with less change in response to actual stressors.
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Affiliation(s)
- Kathryn L. Modecki
- Menzies Health Institute Queensland; Centre for Mental Health, School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| | - Katherine M. Ryan
- School of Applied Psychology Griffith University Mt Gravatt, Queensland, Australia
| | - Allison M. Waters
- Centre for Mental Health; School of Applied Psychology Griffith University Mt Gravatt, Queensland, Australia
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Wise T, Zbozinek TD, Charpentier CJ, Michelini G, Hagan CC, Mobbs D. Computationally-defined markers of uncertainty aversion predict emotional responses during a global pandemic. Emotion 2023; 23:722-736. [PMID: 35666908 PMCID: PMC9942526 DOI: 10.1037/emo0001088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Exposure to stressful life events involving threat and uncertainty often results in the development of anxiety. However, the factors that confer risk and resilience for anxiety following real world stress at a computational level remain unclear. We identified core components of uncertainty aversion moderating response to stress posed by the COVID-19 pandemic derived from computational modeling of decision making. Using both cross-sectional and longitudinal analyses, we investigated both immediate effects at the onset of the stressor, as well as medium-term changes in response to persistent stress. 479 subjects based in the United States completed a decision-making task measuring risk aversion, loss aversion, and ambiguity aversion in the early stages of the pandemic (March 2020). Self-report measures targeting threat perception, anxiety, and avoidant behavior in response to the pandemic were collected at the same time point and 8 weeks later (May 2020). Cross-sectional analyses indicated that higher risk aversion predicted higher perceived threat from the pandemic, and ambiguity aversion for guaranteed gains predicted perceived threat and pandemic-related anxiety. In longitudinal analyses, ambiguity aversion for guaranteed gains predicted greater increases in perceived infection likelihood. Together, these results suggest that individuals who have a low-level aversion toward uncertainty show stronger negative emotional reactions to both the onset and persistence of real-life stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Toby Wise
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Tomislav D Zbozinek
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA
| | - Caroline J. Charpentier
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Giorgia Michelini
- Department of Psychology, Queen Mary University of London, London UK
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA
| | - Cindy C Hagan
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA
| | - Dean Mobbs
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA
- Computational Neural Systems Program, California Institute of Technology, Pasadena, CA
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Mumper EE, Ferry RA, Klein DN, Nelson BD. Effects of early childhood behavioral inhibition and parental anxiety disorder on adolescents' startle response to predictable and unpredictable threat. Res Child Adolesc Psychopathol 2022; 50:1327-1338. [PMID: 35689731 PMCID: PMC9613508 DOI: 10.1007/s10802-022-00942-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
Numerous studies in children, adolescents and adults have reported that anxiety disorders and symptoms are associated with greater threat-potentiated startle responses. This suggests that it may also be related to risk factors that have been implicated in the genesis of anxiety disorders. Therefore, we examined the roles of early childhood temperamental behavioral inhibition (BI) and parental history of anxiety disorders in predicting threat-potentiated startle response in a community sample of 346 adolescents. Parental history of anxiety disorders moderated the effects of BI on subsequent startle responses. For both total startle response and unpredictable threat startle potentiation, higher levels of BI at age 3 predicted larger startle responses at age 15, but only among offspring of parents with a history of anxiety disorders. Among offspring of parents with no lifetime history of anxiety disorder, BI was unrelated to startle magnitude. These findings were evident even after adjusting for youth's biological sex, concurrent anxiety symptoms, and lifetime history of anxiety disorders. In contrast, neither BI nor parental anxiety significantly predicted startle potentiation to predictable threat. These findings have implications for tracing pathways to the development of anxiety disorders.
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Affiliation(s)
- Emma E Mumper
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, NY, USA
| | - Rachel A Ferry
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, NY, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, NY, USA.
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, NY, USA
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Hunt C, Webler R, Emich A, Fhong K, Hiljus J, Lissek S. Pre-COVID-19 fear conditioning responses predict COVID-19-related anxiety: evidence from an exploratory study. ANXIETY, STRESS, AND COPING 2022; 35:547-556. [PMID: 35114878 DOI: 10.1080/10615806.2022.2033735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/23/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Fear conditioning represents the prevailing model by which organisms acquire novel threat contingencies. However, little work has been devoted to linking laboratory measures of fear conditioning to the development of real-world threat responses. To fill this gap, the present study explored whether individual differences in a laboratory-based fear conditioning measure could predict levels of COVID-19-related anxiety and avoidance assessed during the first month of the pandemic. DESIGN AND METHOD Forty-eight undergraduate students who had previously participated in two fear conditioning experiments prior to COVID-19 completed a survey assessing COVID-19 anxiety and avoidance. The fear conditioning experiment involved learning to discriminate between a shape contingently associated with mild electric shock (CS+) and two other shapes that were not (CS-). RESULTS Increased subjective anxiety to our laboratory CS+ prior to the pandemic predicted heightened COVID-19 anxiety. Follow-up analyses revealed that participants with high COVID-19 anxiety exhibited increased anxiety to CS+ during the final experimental block relative to participants with low COVID-19 anxiety. CONCLUSIONS Findings from this exploratory study tentatively implicate fear conditioning in the development of real-world fear responses and underscore the importance of investigating laboratory fear conditioning as a predictor of anxiety responses to real-world threats.
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Affiliation(s)
- Christopher Hunt
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
| | - Ryan Webler
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
| | - Abigail Emich
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
| | - Kimberly Fhong
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
| | - Jenna Hiljus
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
| | - Shmuel Lissek
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, USA
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Zbozinek TD, Perez OD, Wise T, Fanselow M, Mobbs D. Ambiguity drives higher-order Pavlovian learning. PLoS Comput Biol 2022; 18:e1010410. [PMID: 36084131 PMCID: PMC9491594 DOI: 10.1371/journal.pcbi.1010410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/21/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
In the natural world, stimulus-outcome associations are often ambiguous, and most associations are highly complex and situation-dependent. Learning to disambiguate these complex associations to identify which specific outcomes will occur in which situations is critical for survival. Pavlovian occasion setters are stimuli that determine whether other stimuli will result in a specific outcome. Occasion setting is a well-established phenomenon, but very little investigation has been conducted on how occasion setters are disambiguated when they themselves are ambiguous (i.e., when they do not consistently signal whether another stimulus will be reinforced). In two preregistered studies, we investigated the role of higher-order Pavlovian occasion setting in humans. We developed and tested the first computational model predicting direct associative learning, traditional occasion setting (i.e., 1st-order occasion setting), and 2nd-order occasion setting. This model operationalizes stimulus ambiguity as a mechanism to engage in higher-order Pavlovian learning. Both behavioral and computational modeling results suggest that 2nd-order occasion setting was learned, as evidenced by lack and presence of transfer of occasion setting properties when expected and the superior fit of our 2nd-order occasion setting model compared to the 1st-order occasion setting or direct associations models. These results provide a controlled investigation into highly complex associative learning and may ultimately lead to improvements in the treatment of Pavlovian-based mental health disorders (e.g., anxiety disorders, substance use).
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Affiliation(s)
- Tomislav D. Zbozinek
- California Institute of Technology, Humanities and Social Sciences, Pasadena, California, United States of America
| | - Omar D. Perez
- California Institute of Technology, Humanities and Social Sciences, Pasadena, California, United States of America
- University of Santiago, CESS-Santiago, Faculty of Business and Economics, Santiago, Chile
- University of Chile, Department of Industrial Engineering, Santiago, Chile
| | - Toby Wise
- California Institute of Technology, Humanities and Social Sciences, Pasadena, California, United States of America
| | - Michael Fanselow
- University of California, Los Angeles, Department of Psychology, Los Angeles, California, United States of America
- University of California, Los Angeles, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, California, United States of America
- University of California, Los Angeles, Staglin Center for Brain and Behavioral Health, Los Angeles, California, United States of America
- University of California, Los Angeles, Brain Research Institute, Los Angeles, California, United States of America
| | - Dean Mobbs
- California Institute of Technology, Humanities and Social Sciences, Pasadena, California, United States of America
- California Institute of Technology, Computation and Neural Systems Program, Pasadena, California, United States of America
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Yarrington JS, Vinograd M, Williams AL, Wolitzky-Taylor KB, Zinbarg RE, Mineka S, Waters AM, Craske MG. Fear-potentiated startle predicts longitudinal change in transdiagnostic symptom dimensions of anxiety and depression. J Affect Disord 2022; 311:399-406. [PMID: 35597470 DOI: 10.1016/j.jad.2022.05.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Elevated defensive responding, through startle reflex (SR) and skin conductance response (SCR), may contribute to onset and maintenance of depression and anxiety. Most work examining SR and SCR has predicted psychiatric diagnoses. There is a paucity of research examining links between SR or SCR and dimensional measures of psychopathology. METHODS We used latent growth curve modeling to predict longitudinal change in three symptom factors (i.e., General Distress, Fears, Anhedonia-Apprehension) from SR and SCR measured during a fear-potentiated startle paradigm among adolescents oversampled for neuroticism (N = 129). RESULTS Elevated SCR in danger phases before and after an unpleasant muscle contraction predicted increasing Fears over time. Elevated SR in safe phases post-contraction also predicted increasing Fears over time. Attenuated SR in safe phases post-contraction predicted elevated General Distress longitudinally. Attenuated SCR pre-contraction in danger phases predicted elevated Anhedonia-Apprehension over time. LIMITATIONS Our non-clinical sample may limit generalizability of results. Additionally, we did not assess change in SR and SCR over time. CONCLUSIONS The present study demonstrates that SR and SCR during a fear-potentiated startle paradigm predict longitudinal change in dimensional anxiety and depression symptom factors and relatedly, that SR and SCR may represent risk factors for the exacerbation of symptomatology.
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Affiliation(s)
- Julia S Yarrington
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Meghan Vinograd
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | | - Kate B Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Mineka
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Queensland, Australia
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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12
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The relationship between borderline personality features and affective responses to altering emotional context. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Espinosa L, Bonsall MB, Becker N, Holmes EA, Olsson A. Pavlovian threat conditioning can generate intrusive memories that persist over time. Behav Res Ther 2022; 157:104161. [DOI: 10.1016/j.brat.2022.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
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14
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Abend R, Burk D, Ruiz SG, Gold AL, Napoli JL, Britton JC, Michalska KJ, Shechner T, Winkler AM, Leibenluft E, Pine DS, Averbeck BB. Computational modeling of threat learning reveals links with anxiety and neuroanatomy in humans. eLife 2022; 11:66169. [PMID: 35473766 PMCID: PMC9197395 DOI: 10.7554/elife.66169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Influential theories implicate variations in the mechanisms supporting threat learning in the severity of anxiety symptoms. We use computational models of associative learning in conjunction with structural imaging to explicate links among the mechanisms underlying threat learning, their neuroanatomical substrates, and anxiety severity in humans. We recorded skin-conductance data during a threat-learning task from individuals with and without anxiety disorders (N=251; 8-50 years; 116 females). Reinforcement-learning model variants quantified processes hypothesized to relate to anxiety: threat conditioning, threat generalization, safety learning, and threat extinction. We identified the best-fitting models for these processes and tested associations among latent learning parameters, whole-brain anatomy, and anxiety severity. Results indicate that greater anxiety severity related specifically to slower safety learning and slower extinction of response to safe stimuli. Nucleus accumbens gray-matter volume moderated learning-anxiety associations. Using a modeling approach, we identify computational mechanisms linking threat learning and anxiety severity and their neuroanatomical substrates.
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Affiliation(s)
- Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Diana Burk
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
| | - Sonia G Ruiz
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University, Providence, United States
| | - Julia L Napoli
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
| | - Jennifer C Britton
- Department of Psychology, University of Miami, Coral Gables, United States
| | - Kalina J Michalska
- Department of Psychology, University of California, Riverside, Riverside, United States
| | - Tomer Shechner
- Psychology Department, University of Haifa, Haifa, Israel
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Besthesda, United States
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
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15
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Hunt C, Fleig R, Almy B, Lissek S. Heightened false alarms of conditioned threat predict longitudinal increases in GAD and SAD symptoms over the first year of college. J Anxiety Disord 2022; 87:102539. [PMID: 35134626 DOI: 10.1016/j.janxdis.2022.102539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 11/19/2022]
Abstract
Lab-based fear-conditioning studies have repeatedly implicated exaggerated threat reactivity to benign (unreinforced) stimuli as concurrent markers of clinical anxiety, but little work has examined the strength of false alarms as a longitudinal predictor of anxiety problems. As such, we tested whether heightened false alarms of conditioned threat assessed in participants' first semester of college predicted second-semester symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) - two anxiety conditions that are common in college students, have been associated with excessive false alarms, and have yet to be assessed with longitudinal conditioning designs. Here, we focused on the predictive effects of behavioral threat responses (threat expectancy, subjective anxiety, avoidance) given their greater potential for translation to the clinic. Results implicate conditioning-related increases in anxiety to safe stimuli resembling the danger-cue as prospective predictors of GAD. In contrast, SAD was predicted by non-specific elevations in anxiety to a broad set of safe stimuli, as well as by increased threat expectancy toward cues least resembling the conditioned danger cue. These findings suggest that risk for GAD and SAD are captured by distinct, behavioral indicators of false-alarms that may be more feasibly collected in clinical settings compared to alternative experimental anxiety measures like psychophysiological responses.
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Affiliation(s)
- Christopher Hunt
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA.
| | - Ryan Fleig
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
| | - Brandon Almy
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
| | - Shmuel Lissek
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
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16
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Zinbarg RE, Williams AL, Mineka S. A Current Learning Theory Approach to the Etiology and Course of Anxiety and Related Disorders. Annu Rev Clin Psychol 2022; 18:233-258. [PMID: 35134320 DOI: 10.1146/annurev-clinpsy-072220-021010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The authors describe how contemporary learning theory and research provide the basis for models of the etiology and maintenance of anxiety and related disorders. They argue that contemporary learning theory accounts for much of the complexity associated with individual differences in the development and course of these disorders. These insights from modern research on learning overcome the limitations of earlier behavioral approaches, which were overly simplistic and have been justifiably criticized. The authors show how considerations of early learning histories and temperamental vulnerabilities affect the short- and long-term likelihood that experiences with stressful events will lead to the development of anxiety disorders. They also discuss how contextual variables during and after stressful learning experiences influence the maintenance of anxiety disorder symptoms. Thus, contemporary learning models provide a rich and nuanced understanding of the etiology and course of anxiety and related disorders. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, Illinois, USA; .,The Family Institute at Northwestern University, Evanston, Illinois, USA
| | | | - Susan Mineka
- Department of Psychology, Northwestern University, Evanston, Illinois, USA;
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17
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Zbozinek TD, Charpentier CJ, Qi S, Mobbs D. Economic Decisions with Ambiguous Outcome Magnitudes Vary with Low and High Stakes but Not Trait Anxiety or Depression. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2021; 5:119-139. [PMID: 38773996 PMCID: PMC11104296 DOI: 10.5334/cpsy.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 11/20/2022]
Abstract
Most of life's decisions involve risk and uncertainty regarding whether reward or loss will follow. Decision makers often face uncertainty not only about the likelihood of outcomes (what are the chances that I will get a raise if I ask my supervisor? What are the chances that my supervisor will be upset with me for asking?) but also the magnitude of outcomes (if I do get a raise, how large will it be? If my supervisor gets upset, how bad will the consequences be for me?). Only a few studies have investigated economic decision making with ambiguous likelihoods, and even fewer have investigated ambiguous outcome magnitudes. In the present report, we investigated the effects of ambiguous outcome magnitude, risk, and gains/losses in an economic decision-making task with low stakes (Study 1; $3.60-$5.70; N = 367) and high stakes (Study 2; $6-$48; N = 210) using a within-subjects design. We conducted computational modeling to determine individuals' preferences/aversions for ambiguous outcome magnitudes, risk, and gains/losses. We additionally investigated the association between trait anxiety and trait depression and decision-making parameters. Our results show that increasing stakes increased ambiguous gain aversion and unambiguous risk aversion but increased ambiguous sure loss preference; participants also became more averse to ambiguous sure gains relative to unambiguous risky gains. There were no significant effects of trait anxiety or trait depression on economic decision making. Our results suggest that as stakes increase, people tend to avoid uncertainty in the gain domain (especially ambiguous gains) but prefer ambiguous vs unambiguous sure losses.
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Affiliation(s)
- Tomislav D. Zbozinek
- Division of Humanities and Social Sciences, California Institute of Technology, 1200 E. California Blvd., MC 228-77, Pasadena, CA 91125, US
| | - Caroline J. Charpentier
- Division of Humanities and Social Sciences, California Institute of Technology, 1200 E. California Blvd., MC 228-77, Pasadena, CA 91125, US
| | - Song Qi
- National Institute of Mental Health, 6001 Executive Boulevard, Room 6200, MSC 9663, Bethesda, MD 20892, US
| | - Dean Mobbs
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA 91125, US
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18
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Zbozinek TD, Wise T, Perez OD, Qi S, Fanselow MS, Mobbs D. Pavlovian occasion setting in human fear and appetitive conditioning: Effects of trait anxiety and trait depression. Behav Res Ther 2021; 147:103986. [PMID: 34740100 DOI: 10.1016/j.brat.2021.103986] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/19/2021] [Accepted: 10/05/2021] [Indexed: 02/08/2023]
Abstract
Contexts and discrete stimuli often hierarchically influence the association between a stimulus and outcome. This phenomenon, called occasion setting, is central to modulation-based Pavlovian learning. We conducted two experiments with humans in fear and appetitive conditioning paradigms, training stimuli in differential conditioning, feature-positive discriminations, and feature-negative discriminations. We also investigated the effects of trait anxiety and trait depression on these forms of learning. Results from both experiments showed that participants were able to successfully learn which stimuli predicted the electric shock and monetary reward outcomes. Additionally, as hypothesized, the stimuli trained as occasion setters had little-to-no effect on simple reinforced or non-reinforced stimuli, suggesting the former were indeed occasion setters. Lastly, in fear conditioning, trait anxiety was associated with increases in fear of occasion setter/conditional stimulus compounds; in appetitive conditioning, trait depression was associated with lower expectations of monetary reward for the trained negative occasion setting compound and transfer of the negative occasion setter to the simple reinforced stimulus. These results suggest that clinically anxious individuals may have enhanced fear of occasion setting compounds, and clinically depressed individuals may expect less reward with compounds involving the negative occasion setter.
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Affiliation(s)
- Tomislav D Zbozinek
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA, 91125, USA.
| | - Toby Wise
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA, 91125, USA
| | - Omar D Perez
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA, 91125, USA; University of Santiago of Chile (USACH), Faculty of Business and Economics, Santiago, Chile
| | - Song Qi
- National Institute of Mental Health, 6001 Executive Boulevard, Room 6200, MSC 9663, Bethesda, MD, 20892, USA
| | - Michael S Fanselow
- University of California, Department of Psychology, 502 Portola Plaza, Los Angeles, CA, 90025, USA
| | - Dean Mobbs
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA, 91125, USA
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19
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Leen NA, Duits P, Baas JMP. Trajectories of fear learning in healthy participants are able to distinguish groups that differ in individual characteristics, chronicity of fear and intrusions. J Behav Ther Exp Psychiatry 2021; 72:101653. [PMID: 33743324 DOI: 10.1016/j.jbtep.2021.101653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 01/08/2021] [Accepted: 03/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Studies on the development and treatment of anxiety disorders mostly focus on the comparison of predefined groups. An alternative approach is to use data-driven latent class growth analyses (LCGA) to determine differentiation between groups based on particular mechanistic factors. This study validated the use of LCGA on responses in a compact fear conditioning task and whether specific characteristics are associated with maladaptive fear learning trajectories. METHODS Healthy subjects (N = 300) completed a fear conditioning task that included uninstructed and instructed acquisition and extinction phases. Subjective fearfulness and US expectancy were used as outcome measures. Latent classes in the responses to the CS+ (coupled with a scream) and the CS- (control stimulus) were determined based on trajectories across the experimental phases. State and trait anxiety were measured during testing, and return of fear and intrusions were measured one and six weeks later. RESULTS Fear learning trajectories of poor extinction in responding to the CS+ and generalization of fear to the CS- were associated with higher state and trait anxiety. Individuals belonging to these trajectories reported more intrusions, fear and had higher US expectancy ratings after 1 week. LIMITATIONS Only 56% of participants completed the six weeks follow-up measures. CONCLUSION Fear learning trajectories are associated with individual characteristics, return of fear and intrusions. Next, this task will be implemented in clinical practice to assess its predictive power for the extent to which patients benefit from exposure treatments.
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Affiliation(s)
- N A Leen
- Department of Experimental Psychology and Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands; Brain Research & Innovation Centre, Ministry of Defence, Lundlaan 1, 3584 EZ, Utrecht, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - P Duits
- Altrecht Academic Anxiety Center, Nieuwe Houtenseweg 12, 3524 SH Utrecht, The Netherlands
| | - J M P Baas
- Department of Experimental Psychology and Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands.
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20
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Grasser LR, Jovanovic T. Safety learning during development: Implications for development of psychopathology. Behav Brain Res 2021; 408:113297. [PMID: 33862062 PMCID: PMC8102395 DOI: 10.1016/j.bbr.2021.113297] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/23/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
Fear and safety learning are necessary adaptive behaviors that develop over the course of maturation. While there is a large body of literature regarding the neurobiology of fear and safety learning in adults, less is known regarding safety learning during development. Given developmental changes in the brain, there are corresponding changes in safety learning that are quantifiable; these may serve to predict risk and point to treatment targets for fear and anxiety-related disorders in children and adolescents. For healthy, typically developing youth, the main developmental variation observed is reduced discrimination between threat and safety cues in children compared to adolescents and adults, while lower expression of extinction learning is exhibited in adolescents compared to adults. Such distinctions may be related to faster maturation of the amygdala relative to the prefrontal cortex, as well as incompletely developed functional circuits between the two. Fear and anxiety-related disorders, childhood maltreatment, and behavioral problems are all associated with alterations in safety learning for youth, and this dysfunction may proceed into adulthood with corresponding abnormalities in brain structure and function-including amygdala hypertrophy and hyperreactivity. As impaired inhibition of fear to safety may reflect abnormalities in the developing brain and subsequent psychopathology, impaired safety learning may be considered as both a predictor of risk and a treatment target. Longitudinal neuroimaging studies over the course of development, and studies that query change with interventions are needed in order to improve outcomes for individuals and reduce long-term impact of developmental psychopathology.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C Room 273, Detroit, MI 48201 United States.
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C, Detroit, MI 48201 United States.
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21
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Felmingham KL, Caruana JM, Miller LN, Ney LJ, Zuj DV, Hsu CMK, Nicholson E, To A, Bryant RA. Lower estradiol predicts increased reinstatement of fear in women. Behav Res Ther 2021; 142:103875. [PMID: 34052606 DOI: 10.1016/j.brat.2021.103875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 10/07/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Low levels of estradiol in women have been associated with impaired fear extinction recall, with suggestions this may promote the return of fear and heighten the female vulnerability for anxiety disorders. A particularly important measure for the return of fear is reinstatement, but no human studies to date have examined the impact of estradiol on fear reinstatement. Forty-two healthy females completed a differential fear conditioning, extinction and reinstatement task with skin conductance response (SCR) amplitude indexing level of conditioned fear. Saliva samples were taken to measure estradiol and progesterone. To examine fear reinstatement, SCR amplitude was compared between the last trial of the late extinction phase to the first re-extinction trial following the unsignaled presentation of two aversive electric shocks. No significant effects of estradiol were found for acquisition of fear conditioning or fear extinction learning. Lower estradiol predicted a significantly larger generalized SCR amplitude at re-extinction (post-reinstatement) in women. This provides novel evidence suggesting a protective role of estradiol in potentially reducing the relapse of fear following re-exposure to aversive stimuli, although further research is necessary in clinical populations to clarify this effect.
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Affiliation(s)
- Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia.
| | - Julia M Caruana
- School of Psychological Sciences, University of Melbourne, Australia
| | - Lisa N Miller
- School of Psychological Sciences, University of Melbourne, Australia
| | - Luke J Ney
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, Australia; Department of Psychology, Swansea University, UK
| | - Chia Ming K Hsu
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Emma Nicholson
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Annie To
- Division of Psychology, School of Medicine, University of Tasmania, Australia
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22
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Intrusive memories as conditioned responses to trauma cues: An empirically supported concept? Behav Res Ther 2021; 143:103848. [PMID: 34091275 DOI: 10.1016/j.brat.2021.103848] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/11/2021] [Accepted: 03/15/2021] [Indexed: 01/19/2023]
Abstract
Intrusions in posttraumatic stress disorder (PTSD) are clinically understood as conditioned responses (CRs) to trauma-cues; however, experimental evidence for this is limited. We subjected 84 healthy participants to a differential conditioned-intrusion paradigm, where neutral faces served as conditioned stimuli (CSs) and aversive film clips as unconditioned stimuli (USs). While one group only completed acquisition, another group additionally received extinction. Subsequently, participants provided detailed e-diary intrusion reports. Several key findings emerged: First, participants in both groups re-experienced not only USs but also CSs as content of their intrusions. Second, intrusions were elicited by cues resembling CSs, USs, and experimental context. Third, extinction reduced probability and severity of US intrusions, and accelerated their decay, and this was particularly the case in participants showing greater cognitive (US-expectancy) and physiological (SCR) differential responding to CS+ vs. CS- at end of acquisition (i.e., conditionability). Similarly, extinction reduced CS-intrusion probability and severity, but only in participants with greater cognitive conditionability. These results support conditioning's role in re-experiencing in two critical ways: (1) Conditioning during trauma provides cues that not only function as reminder cues, but also as content of intrusions; (2) After strong conditioning, weakening the original CS-US relationship via extinction reduces intrusion formation after analogue-trauma.
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23
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Premo JE, Mannella KA, Duval ER, Liu Y, Morrison CL, Moser JS, Muzik M, Rosenblum KL, Fitzgerald KD. Startle to neutral, not negative stimuli: A neurophysiological correlate of behavioral inhibition in young children. Dev Psychobiol 2021; 63:1322-1329. [PMID: 33782955 DOI: 10.1002/dev.22120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/27/2021] [Accepted: 03/06/2021] [Indexed: 11/06/2022]
Abstract
A putative biomarker of anxiety risk, the startle response is typically enhanced by negative compared to neutral emotion modulation in adults, but remains understudied in children. To determine the extent to which neutral, negative, and positively valenced emotional conditions modulate startle response in early life, a child-friendly film paradigm was used to vary emotion across these conditions during startle induction in sixty-four 4- to 7-year-old children. Association of emotion-modulated startle with parent-reported anxiety symptom severity and child behavioral inhibition, a risk factor for anxiety problems, were assessed. Analyses revealed no difference in startle magnitude during negative compared to neutral film clips. By contrast, startle during both negative and neutral conditions was greater than startle during the positive condition. Larger startle magnitude during the neutral condition associated with higher levels of child behavioral inhibition (BI). These results are consistent with possible immaturity of startle response in young children, and suggest that startle amplitude in more emotionally ambiguous, neutral conditions could serve as an early biomarker for anxiety risk.
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Affiliation(s)
- Julie E Premo
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Claire L Morrison
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Jason S Moser
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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24
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Odriozola P, Gee DG. Learning About Safety: Conditioned Inhibition as a Novel Approach to Fear Reduction Targeting the Developing Brain. Am J Psychiatry 2021; 178:136-155. [PMID: 33167673 PMCID: PMC7951569 DOI: 10.1176/appi.ajp.2020.20020232] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Adolescence is a peak time for the onset of psychiatric disorders, with anxiety disorders being the most common and affecting as many as 30% of youths. A core feature of anxiety disorders is difficulty regulating fear, with evidence suggesting deficits in extinction learning and corresponding alterations in frontolimbic circuitry. Despite marked changes in this neural circuitry and extinction learning throughout development, interventions for anxious youths are largely based on principles of extinction learning studied in adulthood. Safety signal learning, based on conditioned inhibition of fear in the presence of a cue that indicates safety, has been shown to effectively reduce anxiety-like behavior in animal models and attenuate fear responses in healthy adults. Cross-species evidence suggests that safety signal learning involves connections between the ventral hippocampus and the prelimbic cortex in rodents or the dorsal anterior cingulate cortex in humans. Particularly because this pathway follows a different developmental trajectory than fronto-amygdala circuitry involved in traditional extinction learning, safety cues may provide a novel approach to reducing fear in youths. In this review, the authors leverage a translational framework to bring together findings from studies in animal models and humans and to bridge the gap between research on basic neuroscience and clinical treatment. The authors consider the potential application of safety signal learning for optimizing interventions for anxious youths by targeting the biological state of the developing brain. Based on the existing cross-species literature on safety signal learning, they propose that the judicious use of safety cues may be an effective and neurodevelopmentally optimized approach to enhancing treatment outcomes for youths with anxiety disorders.
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Affiliation(s)
| | - Dylan G. Gee
- Department of Psychology, Yale University, New Haven, Conn
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25
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Contextual source information modulates neural face processing in the absence of conscious recognition: A threat-of-shock study. Neurobiol Learn Mem 2020; 174:107280. [DOI: 10.1016/j.nlm.2020.107280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/15/2020] [Accepted: 07/17/2020] [Indexed: 11/21/2022]
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26
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Abstract
The cumulative science linking stress to negative health outcomes is vast. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in health behaviors. In this review, we present a brief overview of (a) why we should be interested in stress in the context of health; (b) the stress response and allostatic load; (c) some of the key biological mechanisms through which stress impacts health, such as by influencing hypothalamic-pituitary-adrenal axis regulation and cortisol dynamics, the autonomic nervous system, and gene expression; and (d) evidence of the clinical relevance of stress, exemplified through the risk of infectious diseases. The studies reviewed in this article confirm that stress has an impact on multiple biological systems. Future work ought to consider further the importance of early-life adversity and continue to explore how different biological systems interact in the context of stress and health processes.
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Affiliation(s)
- Daryl B O'Connor
- School of Psychology, University of Leeds, Leeds LS2 9JT, United Kingdom;
| | - Julian F Thayer
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, California 92697, USA;
| | - Kavita Vedhara
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom;
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27
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Jovanovic T, Stenson AF, Thompson N, Clifford A, Compton A, Minton S, van Rooij SJF, Stevens JS, Lori A, Nugent N, Gillespie CF, Bradley B, Ressler KJ. Impact of ADCYAP1R1 genotype on longitudinal fear conditioning in children: interaction with trauma and sex. Neuropsychopharmacology 2020; 45:1603-1608. [PMID: 32590837 PMCID: PMC7421882 DOI: 10.1038/s41386-020-0748-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
Dysregulated fear conditioned responses have been associated with PTSD in adults, with increased fear-potentiated startle (FPS) serving as a potential intermediate phenotype for PTSD risk. This phenotype has also been associated with stress-related ADCYAP1R1 gene variants in adult women. However, FPS and genotype have not yet been examined during development. The aim of this study was to examine developmental changes in fear conditioning, and to see whether these changes were impacted by genotype and trauma. Differential fear conditioning using FPS was tested in n = 63 children ages 8-13 at two visits (V1, V2) 1 year apart. Startle response was measured using electromyograph recordings of the eyeblink muscle. The rs2267735 SNP of the ADCYAP1R1 gene was extracted from genome-wide (GWAS) analyses. Trauma exposure was assessed using the Violence Exposure Scale-Revised (VEX-R). We found significant Visit by Genotype interactions, with CC genotype increasing FPS from V1 to V2. At V2 there was a Genotype by Violence interaction, with higher FPS in the CC vs G allele groups among those with higher violence exposure (F = 17.46, p = 0.0002). Females with the CC genotype had higher FPS compared to G allele females (F = 12.09, p = 0.002); there were no effects of genotype in males. This study showed Gene × Environment × Development and Gene × Sex effects of ADCYAP1R1 in a high-risk pediatric population. Those with the CC genotype and high levels of violence exposure, as well as females with the CC genotype, showed the greatest conditioned fear responses in adolescence.
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Affiliation(s)
- Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
| | - Anaïs F. Stenson
- grid.254444.70000 0001 1456 7807Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI USA
| | - Nadia Thompson
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Aimee Clifford
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Alisha Compton
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Sean Minton
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Sanne J. F. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Adriana Lori
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Nicole Nugent
- grid.40263.330000 0004 1936 9094Departments of Psychiatry and Pediatrics Brown Medical School, Providence, RI USA
| | - Charles F. Gillespie
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Bekh Bradley
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA ,grid.414026.50000 0004 0419 4084Atlanta VA Medical Center, Decatur, GA 30033 USA
| | - Kerry J. Ressler
- grid.38142.3c000000041936754XMcLean Hospital, Harvard Medical School, Belmont, MA 02478 USA
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28
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Roque A, Craske MG, Treanor M, Rosenfield D, Ritz T, Meuret AE. Stress-induced cortisol reactivity as a predictor of success in treatment for affective dimensions. Psychoneuroendocrinology 2020; 116:104646. [PMID: 32200225 PMCID: PMC8978549 DOI: 10.1016/j.psyneuen.2020.104646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/31/2020] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Response rates to first-line treatments for depression and anxiety remain unsatisfactory. Identification of predictors or moderators that can optimize treatment matching is of scientific and clinical interest. This study examined the role of prolonged laboratory-induced stress cortisol reactivity as a predictor of outcome for a treatment of affective dimensions (TAD). Patients received 15-sessions of a treatment targeting reductions in negative affect or increases in positive affect (Craske et al., 2019). A second aim was to examine whether treatment type would moderate the association between cortisol reactivity and treatment outcome. METHODS Thirty-five participants underwent a 36-minute intermittent stress induction task composed of a mental arithmetic task and a fear-potentiated startle task one week before treatment initiation. Cortisol was collected at five-time points with reactivity being quantified as peak during the task minus basal level of cortisol the evening before the assessment. Using multilevel modeling, we examined the associations between cortisol reactivity and slopes of symptom improvement. RESULTS Cortisol reactivity was related to treatment outcome, with average and higher levels of stress-induced cortisol response predicting greater decreases in symptoms throughout treatment and 6-month follow-up. Treatment condition differences (moderation) were not observed in the effect of cortisol reactivity on symptoms. CONCLUSION Our findings demonstrate the impact of greater cortisol stress reactivity on treatment outcome. Future studies should investigate how to enhance this therapeutic benefit through capitalizing on endogenous diurnal fluctuations or exogenous cortisol manipulation.
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Affiliation(s)
- Andres Roque
- Department of Psychology, Southern Methodist University
| | | | - Michael Treanor
- Department of Psychology, University of California Los Angeles
| | | | - Thomas Ritz
- Department of Psychology, Southern Methodist University
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Acute stress reduces out-group related safety signaling during fear reinstatement in women. Sci Rep 2020; 10:2092. [PMID: 32034214 PMCID: PMC7005737 DOI: 10.1038/s41598-020-58977-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/22/2020] [Indexed: 11/08/2022] Open
Abstract
When using in-group and out-group faces as conditional stimuli (CS) in fear conditioning designs, extinction learning is selectively impaired for out-group faces. Additionally, stress seems to inhibit extinction retrieval leading to a higher return of fear, which might be especially the case for out-group faces. To test this hypothesis, 51 healthy women underwent fear acquisition training, consisting of repeated presentations of two in-group and two out-group faces. One of each (CS+) was paired with an electrical stimulation (unconditional stimulus, UCS), whereas the other was not coupled with the UCS (CS-). During immediate extinction training, all CS were presented again. On the next day, a retrieval and reinstatement test took place after a stress or a control procedure. Confirming previous research, impaired extinction learning occurred for out-group relative to in-group faces. During the reinstatement test, stress specifically increased responding towards the out-group CS-, thus reducing its safety signaling properties. So, stress seems to reduce the ability to adequately distinguish threat and safety cues after aversive experiences mimicked by reinstatement shocks.
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Besharat MA, Khadem H, Zarei V, Momtaz A. Mediating Role of Perceived Stress in the Relationship between Facing Existential Issues and Symptoms of Depression and Anxiety. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:80-87. [PMID: 32377217 PMCID: PMC7193236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed at investigating the mediating role of perceived stress in anticipation of anxiety and depression on facing the ultimate concerns (death, loneliness, freedom, and meaningfulness). Method : A total of 389 students from Ferdowsi University of Mashhad participated in this study in 2017-18. The participants were selected using random sampling. The data were collected using the subscales of anxiety and depression in depression, anxiety, stress scale (DASS), Death Anxiety Scale (DAS), the third edition of Loneliness Scale UCLA (UCLA-LS), the subscale of meaning in life in Meaningfulness of Life Questionnaire (MLQ), responsibility scale of California Psychological Inventory (CPI), and the Perceived Stress Scale (PSS). Then, they were evaluated using Pearson correlation and path analysis. Results: The correlation between the symptoms of anxiety and depression, and death anxiety and loneliness was direct and significant with the perceived stress. The relationship between the perceived stress with meaningfulness of life and responsibility was significantly inverse. The analysis of the data path showed that the component dealing with existence (loneliness and death anxiety) predicted 20% of anxiety symptoms through perceived stress in the model that was fitted well with research data. Conclusion: According to the findings, it can be concluded that the relationship between dealing with ultimate concerns and anxiety symptoms was not linear. Dealing with ultimate concerns affects the anxiety symptoms through the perceived stress. Therefore, attention to the perceived stress management to promote health and prevent anxiety disorders is important.
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Affiliation(s)
- Mohammad-Ali Besharat
- Department of Psychology, School of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Hossein Khadem
- Department of Psychology, School of Psychology and Educational Sciences, Shahid Beheshti University, Tehran, Iran
| | - Vahid Zarei
- Department of Psychology, School of Psychology and Educational Sciences, Ferdowsi University, Mashhad, Iran
| | - Ali Momtaz
- Department of psychology, School of Psychology and Educational Sciences, Semnan University, Semnan, Iran
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Alarcón DE, Bonardi C. Under the influence of the environment: Children's responding invigorated and biased by predictive cues. J Exp Child Psychol 2019; 191:104741. [PMID: 31809989 DOI: 10.1016/j.jecp.2019.104741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 12/15/2022]
Abstract
Cues that signal motivationally significant consequences can elevate responding and bias choice. A task known as Pavlovian-to-instrumental transfer (PIT) has been used to assess the influence of these cues on independently trained responses and to study the effect of drug-related and food-related cues on behavior in adult populations, but it has not yet been employed in children. This study aimed to develop a simple computer task to study PIT in children. Participants, aged 7-11 years, observed a screen in which different pairings of distinct cartoon images and specific outcomes were presented (images of foods and drinks in Experiment 1 and images of pets in Experiment 2). After this, the participants pressed two keys, each consistently reinforced with one of the two outcomes. Finally, the children pressed both keys in the absence of any outcome, and each cartoon image was presented periodically so that the effect of these cues on behavior could be measured. Experiment 1 showed that the cartoons' presentations biased responding toward the key that was trained with the same outcome as the cartoon being presented, that is, outcome-specific PIT. Experiment 2 replicated this finding and also showed that a cartoon trained with an outcome different from that reinforcing the responses elevated performance of both responses relative to a cartoon that was not paired with any outcome in training, that is, general PIT. These findings are consistent with those reported in the adult population and might be a useful tool to study the early development of maladaptive behaviors.
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Affiliation(s)
- Daniel E Alarcón
- School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Charlotte Bonardi
- School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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Coifman KG, Summers CB. Understanding Emotion Inflexibility in Risk for Affective Disease: Integrating Current Research and Finding a Path Forward. Front Psychol 2019; 10:392. [PMID: 30873087 PMCID: PMC6402431 DOI: 10.3389/fpsyg.2019.00392] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/08/2019] [Indexed: 01/04/2023] Open
Abstract
Emotion-related disorders (e.g., depression, anxiety, stress, eating, substance and some personality disorders) include some of the most common, burdensome, and costly diseases worldwide. Central to many, if not all of these disorders, may be patterns of rigid or inflexible emotion responses. Indeed, theorists point to emotion in-flexibility as a potential cause or maintaining factor in emotion-related diseases. Despite the increasing prominence of emotion inflexibility in theories of affective disease, a comprehensive review of the developing empirical literature has not yet been conducted. Accordingly, this review will examine the three dominant lines of inquiry assessing emotion flexibility. These include: (1) the capacity to use and vary deliberate emotion regulation strategies, (2) the context sensitivity of spontaneous emotional responses, and (3) flexibility in the appraisal of emotional events and experiences. Moreover, current evidence suggests that each of these three lines of research may converge to suggest the interplay of two key biological dimensions in emotion inflexibility, threat sensitivity, and cognitive control, known to be impaired in patients with affective disorders. In short, this developing body of work suggests a path by which future research could explicate and even exploit the ties between emotion inflexibility and affective disease, contributing to the development of improved models of risk, assessment, and intervention, with broad implications for psychological health.
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Kunas SL, Yang Y, Straube B, Kircher T, Gerlach AL, Pfleiderer B, Arolt V, Wittmann A, Stroehle A, Wittchen HU, Lueken U. The impact of depressive comorbidity on neural plasticity following cognitive-behavioral therapy in panic disorder with agoraphobia. J Affect Disord 2019; 245:451-460. [PMID: 30428445 DOI: 10.1016/j.jad.2018.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/09/2018] [Accepted: 11/03/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Depressive disorders are a frequent comorbidity of panic disorder with agoraphobia (PD/AG). Cognitive-behavioral therapy (CBT) for PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbidities. However, as depressive comorbidities can confound fear circuitry activation (i.e. amygdalae, insulae, anterior cingulate cortex) in PD/AG, we investigated whether comorbid depressive disorders alter neural plasticity following CBT. METHODS Within a randomized, controlled clinical trial on exposure-based CBT, forty-two PD/AG patients including fifteen (35.7%) with a comorbid depressive disorder (PD/AG + DEP) participated in a longitudinal functional magnetic resonance imaging (fMRI) study. A differential fear conditioning task was used as probe of interest. A generalized psycho-physiological interaction analysis (gPPI) served to study functional connectivity patterns. RESULTS After CBT, only PD/AG patients without comorbid depressive disorders (PD/AG-DEP) showed reduced activation in the left inferior frontal gyrus (IFG) extending to the insula. While PD/AG-DEP patients showed enhanced functional connectivity (FC) between the left IFG and subcortical structures (anterior cingulate cortex, thalamus and midbrain), PD/AG + DEP patients exhibited increased FC between the left IFG and cortical structures (prefrontal, parietal regions). In both groups, FC decreased following CBT. LIMITATIONS Primary depressed and medicated patients were excluded. Major depression and dysthymia were collapsed. CONCLUSIONS Reduced activation in the left IFG, as previously shown in PD/AG, appears to be a specific substrate of CBT effects in PD/AG-DEP patients only. Differential patterns of FC pertaining to fear circuitry networks in patients without depression vs. cognitive networks in patients with comorbid depression may point towards different pathways recruited by CBT as a function of comorbidity.
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Affiliation(s)
- Stefanie L Kunas
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy, Phillipps-University Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Phillipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Phillipps-University Marburg, Marburg, Germany
| | | | - Bettina Pfleiderer
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Münster, Germany
| | - André Wittmann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Stroehle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Lueken
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Pittig A, Treanor M, LeBeau RT, Craske MG. The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neurosci Biobehav Rev 2018; 88:117-140. [DOI: 10.1016/j.neubiorev.2018.03.015] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 12/25/2022]
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Craske MG, Hermans D, Vervliet B. State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170025. [PMID: 29352025 PMCID: PMC5790824 DOI: 10.1098/rstb.2017.0025] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 01/10/2023] Open
Abstract
Through advances in both basic and clinical scientific research, Pavlovian fear conditioning and extinction have become an exemplary translational model for understanding and treating anxiety disorders. Discoveries in associative and neurobiological mechanisms underlying extinction have informed techniques for optimizing exposure therapy that enhance the formation of inhibitory associations and their consolidation and retrieval over time and context. Strategies that enhance formation include maximizing prediction-error correction by violating expectancies, deepened extinction, occasional reinforced extinction, attentional control and removal of safety signals/behaviours. Strategies that enhance consolidation include pharmacological agonists of NMDA (i.e. d-cycloserine) and mental rehearsal. Strategies that enhance retrieval include multiple contexts, retrieval cues, and pharmacological blockade of contextual encoding. Stimulus variability and positive affect are posited to influence the formation and the retrieval of inhibitory associations. Inhibitory regulation through affect labelling is considered a complement to extinction. The translational value of extinction will be increased by more investigation of elements central to extinction itself, such as extinction generalization, and interactions with other learning processes, such as instrumental avoidance reward learning, and with other clinically relevant cognitive-emotional processes, such as self-efficacy, threat appraisal and emotion regulation, will add translational value. Moreover, framing fear extinction and related processes within a developmental context will increase their clinical relevance.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California, 405 Hilgard Avenue, Los Angeles, CA, USA
| | - Dirk Hermans
- Center for Excellence on Generalization, University of Leuven, Leuven, Belgium
| | - Bram Vervliet
- Center for Excellence on Generalization, University of Leuven, Leuven, Belgium
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Craske MG. Honoring the Past, Envisioning the Future: ABCT's 50th Anniversary Presidential Address. Behav Ther 2018; 49:151-164. [PMID: 29530256 DOI: 10.1016/j.beth.2017.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 12/17/2022]
Abstract
The theme of the Association for Behavioral and Cognitive Therapies (ABCT) 50th Anniversary was to honor the past and envision the future. From the wisdom, foresight, and determination of the pioneers of our organization, and the continuous upholding of the scientific method over the last 50 years, cognitive behavioral therapy (CBT) has become the most empirically supported psychological treatment for a wide array of mental health problems. Yet, we still have a long way to go. This address outlines a vision for the future of CBT, which involves greater collaborative science, with all minds working together on the same problem, and greater attention to the risk factors and critical processes that underlie psychopathology and explain treatment change. Such knowledge generation can inform the development of new, more efficient and more effective therapies that are tailored with more precision to the needs of each person. Latest technologies provide tools for a precision focus while at the same time increasing the reach of our treatments to the many for whom traditional therapies are unavailable. Our impact will be greatly enhanced by large samples with common methods and measures that inform a precision approach. We have come a long way since ABCT was founded in 1966, and we are poised to make even larger strides in our mission to enhance health and well-being by harnessing science, our major guiding principle.
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Asselmann E, Stender J, Grabe HJ, König J, Schmidt CO, Hamm AO, Pané-Farré CA. Assessing the interplay of childhood adversities with more recent stressful life events and conditions in predicting panic pathology among adults from the general population. J Affect Disord 2018; 225:715-722. [PMID: 28922735 DOI: 10.1016/j.jad.2017.08.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/06/2017] [Accepted: 08/15/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Although research suggests that (a) childhood adversities and more recent stressful life events/conditions are risk factors for panic pathology and that (b) early life stress increases vulnerability to later psychopathology, it remains unclear whether childhood adversities amplify the association between more recent stressful life events/conditions and panic pathology. METHODS Data were derived from a general population sample (Study of Health in Pomerania, SHIP). Lifetime panic pathology was assessed with the Munich Composite International Diagnostic Interview (M-CIDI). Childhood adversities (emotional, physical and sexual abuse; emotional and physical neglect) were assessed with the Childhood Trauma Questionnaire (CTQ). More recent separation/loss events and long-lasting stressful conditions were assessed with the Stralsund Life Event List (SEL). Individuals with lifetime panic pathology (fearful spell, panic attack or panic disorder, N = 286) were compared to controls without any psychopathology (N = 286, matched for sex and age). RESULTS Conditional logistic regressions revealed that childhood adversities as well as more recent separation/loss events and long-lasting stressful conditions were associated with panic pathology (OR 1.1-2.5). Moreover, more recent separation/loss events - but not long-lasting stressful conditions - interacted statistically with each of the examined childhood adversities except for sexual abuse in predicting panic pathology (OR 1.1-1.3). That is, separation/loss events were associated more strongly with panic pathology among individuals with higher childhood adversities. LIMITATIONS Data were assessed retrospectively and might be subject to recall biases. CONCLUSIONS Findings suggest that early childhood adversities amplify the risk of developing panic pathology after experiencing separation or loss events.
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Affiliation(s)
- E Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany.
| | - J Stender
- Department of Physiological and Clinical Psychology, University of Greifswald, Germany
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - J König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - C O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - A O Hamm
- Department of Physiological and Clinical Psychology, University of Greifswald, Germany
| | - C A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Germany
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Low Endogenous Fibroblast Growth Factor 2 Levels Are Associated With Heightened Conditioned Fear Expression in Rats and Humans. Biol Psychiatry 2017; 82:601-607. [PMID: 28460841 DOI: 10.1016/j.biopsych.2017.03.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Hippocampal concentrations of the neurotrophic factor fibroblast growth factor 2 (FGF2) are negatively associated with the expression of fear following conditioning in rats. Heightened conditioned fear expression may be a prospective risk factor for the development of human anxiety and trauma disorders. However, the relationship between conditioned fear expression and FGF2 is yet to be established in humans. METHODS Using a cross-species approach, we first investigated the relationship between serum concentrations of FGF2 and individual differences in conditioned fear expression in rats (n = 19). We then subjected 88 human participants, who were recruited from university and community advertisements, to a differential fear conditioning procedure and assessed the relationship between salivary concentrations of FGF2 and fear expression to a conditioned stimulus (CS) (a stimulus paired with a shock) and a CS that was never paired with shock. RESULTS Rats with low serum levels of FGF2 exhibited significantly more freezing than rats with high serum levels of FGF2. Similarly, relative to those with high salivary FGF2, human participants with low salivary FGF2 exhibited significantly heightened skin conductance responses to the CS without shock during fear conditioning and to both the CS with shock and CS without shock during fear recall. CONCLUSIONS These studies establish that peripheral markers of FGF2 concentrations are negatively associated with fear expression in both rats and humans. To the extent that conditioned fear expression predicts anxiety and trauma disorder vulnerability, FGF2 may be a clinically useful biomarker in the prediction and eventual prevention of these disorders.
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Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14 Year-Old Girls. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 45:397-410. [PMID: 27224989 DOI: 10.1007/s10802-016-0169-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
There is growing evidence that heightened sensitivity to unpredictability is a core mechanism of anxiety disorders. In adults, multiple anxiety disorders have been associated with a heightened startle reflex in anticipation of unpredictable threat. Child and adolescent anxiety has been linked to an increased startle reflex across baseline, safety, and threat conditions. However, it is unclear whether anxiety in youth is related to the startle reflex as a function of threat predictability. In a sample of 90 8 to 14 year-old girls, the present study examined the association between anxiety symptom dimensions and startle potentiation during a no, predictable, and unpredictable threat task. Depression symptom dimensions were also examined given their high comorbidity with anxiety and mixed relationship with the startle reflex and sensitivity to unpredictability. To assess current symptoms, participants completed the self-report Screen for Child Anxiety Related Emotional Disorders and Children's Depression Inventory. Results indicated that social phobia symptoms were associated with heightened startle potentiation in anticipation of unpredictable threat and attenuated startle potentiation in anticipation of predictable threat. Negative mood and negative self-esteem symptoms were associated with attenuated and heightened startle potentiation in anticipation of unpredictable threat, respectively. All results remained significant after controlling for the other symptom dimensions. The present study provides initial evidence that anxiety and depression symptom dimensions demonstrate unique associations with the startle reflex in anticipation of unpredictable threat in children and adolescents.
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Functional Heterogeneity in the Bed Nucleus of the Stria Terminalis. J Neurosci 2017; 36:8038-49. [PMID: 27488624 DOI: 10.1523/jneurosci.0856-16.2016] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/05/2016] [Indexed: 11/21/2022] Open
Abstract
Early work stressed the differing involvement of the central amygdala (CeA) and bed nucleus of the stria terminalis (BNST) in the genesis of fear versus anxiety, respectively. In 2009, Walker, Miles, and Davis proposed a model of amygdala-BNST interactions to explain these functional differences. This model became extremely influential and now guides a new wave of studies on the role of BNST in humans. Here, we consider evidence for and against this model, in the process highlighting central principles of BNST organization. This analysis leads us to conclude that BNST's influence is not limited to the generation of anxiety-like responses to diffuse threats, but that it also shapes the impact of discrete threatening stimuli. It is likely that BNST-CeA interactions are involved in modulating responses to such threats. In addition, whereas current views emphasize the contributions of the anterolateral BNST region in anxiety, accumulating data indicate that the anteromedial and anteroventral regions also play a critical role. The presence of multiple functional subregions within the small volume of BNST raises significant technical obstacles for functional imaging studies in humans.
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Kesby A, Maguire S, Brownlow R, Grisham JR. Intolerance of Uncertainty in eating disorders: An update on the field. Clin Psychol Rev 2017; 56:94-105. [PMID: 28710918 DOI: 10.1016/j.cpr.2017.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 01/12/2023]
Abstract
Pathological fear and anxiety regarding food, eating, weight and body shape are at the core of eating disorder (ED) psychopathology. To manage anxiety, patients develop complicated repertoires of ritualistic and repetitive behaviours, which can lead to total functional impairment. Yet the cognitive processes underlying anxiety, fear, and anxiety-driven behaviours in EDs remain poorly understood. Intolerance of Uncertainty (IU) is defined as a tendency to react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events. There is substantial evidence that IU is a transdiagnostic process that contributes to the maintenance of anxiety disorders; however, IU may also be relevant to the understanding and treatment of EDs. The current review summarises the growing literature examining IU in relation to ED symptoms, including restriction, bingeing, purging, ritualised behaviours, reassurance-seeking and body checking. Extending from the obsessive-compulsive disorder (OCD) and anxiety disorder literature, we propose that IU provides a novel theoretical and clinical framework from which to understand the anxiety, fixation with rules and rituals, and the cognitively rigid profile that is characteristic of ED presentations. We conclude with suggestions for future research, and discuss IU as a potential treatment target for core features of EDs and comorbid symptoms.
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Affiliation(s)
- Alice Kesby
- School of Psychology, UNSW Australia, Sydney, NSW, Australia.
| | - Sarah Maguire
- Boden Institute, University of Sydney, Sydney, NSW, Australia
| | - Rachel Brownlow
- Boden Institute, University of Sydney, Sydney, NSW, Australia
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Heightened extended amygdala metabolism following threat characterizes the early phenotypic risk to develop anxiety-related psychopathology. Mol Psychiatry 2017; 22:724-732. [PMID: 27573879 PMCID: PMC5332536 DOI: 10.1038/mp.2016.132] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 05/19/2016] [Accepted: 06/01/2016] [Indexed: 12/12/2022]
Abstract
Children with an anxious temperament are prone to heightened shyness and behavioral inhibition (BI). When chronic and extreme, this anxious, inhibited phenotype is an important early-life risk factor for the development of anxiety disorders, depression and co-morbid substance abuse. Individuals with extreme anxious temperament often show persistent distress in the absence of immediate threat and this contextually inappropriate anxiety predicts future symptom development. Despite its clear clinical relevance, the neural circuitry governing the maladaptive persistence of anxiety remains unclear. Here, we used a well-established nonhuman primate model of childhood temperament and high-resolution 18fluorodeoxyglucose positron emission tomography (FDG-PET) imaging to understand the neural systems governing persistent anxiety and to clarify their relevance to early-life phenotypic risk. We focused on BI, a core component of anxious temperament, because it affords the moment-by-moment temporal resolution needed to assess contextually appropriate and inappropriate anxiety. From a pool of 109 peri-adolescent rhesus monkeys, we formed groups characterized by high or low levels of BI, as indexed by freezing in response to an unfamiliar human intruder's profile. The high-BI group showed consistently elevated signs of anxiety and wariness across >2 years of assessments. At the time of brain imaging, 1.5 years after initial phenotyping, the high-BI group showed persistently elevated freezing during a 30-min 'recovery' period following an encounter with the intruder-more than an order of magnitude greater than the low-BI group-and this was associated with increased metabolism in the bed nucleus of the stria terminalis, a key component of the central extended amygdala. These observations provide a neurobiological framework for understanding the early phenotypic risk to develop anxiety-related psychopathology, for accelerating the development of improved interventions, and for understanding the origins of childhood temperament.
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Lau JYF, Waters AM. Annual Research Review: An expanded account of information-processing mechanisms in risk for child and adolescent anxiety and depression. J Child Psychol Psychiatry 2017; 58:387-407. [PMID: 27966780 DOI: 10.1111/jcpp.12653] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Anxiety and depression occurring during childhood and adolescence are common and costly. While early-emerging anxiety and depression can arise through a complex interplay of 'distal' factors such as genetic and environmental influences, temperamental characteristics and brain circuitry, the more proximal mechanisms that transfer risks on symptoms are poorly delineated. Information-processing biases, which differentiate youth with and without anxiety and/or depression, could act as proximal mechanisms that mediate more distal risks on symptoms. This article reviews the literature on information-processing biases, their associations with anxiety and depression symptoms in youth and with other distal risk factors, to provide direction for further research. METHODS Based on strategic searches of the literature, we consider how youth with and without anxiety and/or depression vary in how they deploy attention to social-affective stimuli, discriminate between threat and safety cues, retain memories of negative events and appraise ambiguous information. We discuss how these information-processing biases are similarly or differentially expressed on anxiety and depression and whether these biases are linked to genetic and environmental factors, temperamental characteristics and patterns of brain circuitry functioning implicated in anxiety and depression. FINDINGS Biases in attention and appraisal characterise both youth anxiety and depression but with some differences in how these are expressed for each symptom type. Difficulties in threat-safety cue discrimination characterise anxiety and are understudied in depression, while biases in the retrieval of negative and overgeneral memories have been observed in depression but are understudied in anxiety. Information-processing biases have been studied in relation to some distal factors but not systematically, so relationships remain inconclusive. CONCLUSIONS Biases in attention, threat-safety cue discrimination, memory and appraisal may characterise anxiety and/or depression risk. We discuss future research directions that can more systematically test whether these biases act as proximal mechanisms that mediate other distal risk factors.
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Affiliation(s)
- Jennifer Y F Lau
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Gold Coast, Qld, Australia
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Burklund LJ, Torre JB, Lieberman MD, Taylor SE, Craske MG. Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder. Psychiatry Res 2017; 261:52-64. [PMID: 28129556 PMCID: PMC5435374 DOI: 10.1016/j.pscychresns.2016.12.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/19/2016] [Accepted: 12/27/2016] [Indexed: 02/08/2023]
Abstract
Previous research has often highlighted hyperactivity in emotion regions to simple, static social threat cues in social anxiety disorder (SAD). Investigation of the neurobiology of SAD using more naturalistic paradigms can further reveal underlying mechanisms and how these relate to clinical outcomes. We used fMRI to investigate responses to novel dynamic rejection stimuli in individuals with SAD (N=70) and healthy controls (HC; N=17), and whether these responses predicted treatment outcomes following cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). Both HC and SAD groups reported greater distress to rejection compared to neutral social stimuli. At the neural level, HCs exhibited greater activations in social pain/rejection regions, including dorsal anterior cingulate cortex and anterior insula, to rejection stimuli. The SAD group evidenced a different pattern, with no differences in these rejection regions and relatively greater activations in the amygdala and other regions to neutral stimuli. Greater responses in anterior cingulate cortex and the amygdala to rejection vs. neutral stimuli predicted better CBT outcomes. In contrast, enhanced activity in sensory-focused posterior insula predicted ACT responses.
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Affiliation(s)
- Lisa J Burklund
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States.
| | - Jared B Torre
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Matthew D Lieberman
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Shelley E Taylor
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
| | - Michelle G Craske
- University of California Los Angeles, Department of Psychology, Los Angeles, CA 90095-1563, United States
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Waters AM, Theresiana C, Neumann DL, Craske MG. Developmental differences in aversive conditioning, extinction, and reinstatement: A study with children, adolescents, and adults. J Exp Child Psychol 2017; 159:263-278. [PMID: 28347936 DOI: 10.1016/j.jecp.2017.02.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 01/21/2023]
Abstract
This study investigated developmental differences in aversive conditioning, extinction, and reinstatement (i.e., the recovery of conditioned aversive associations following reexposure to the unconditioned stimulus [US] post-extinction). This study examined these mechanisms in children (Mage=8.8years), adolescents (Mage=16.1years), and adults (Mage=32.3years) using differential aversive conditioning with a geometric shape conditional stimulus (CS+) paired with an aversive sound US and another shape (CS-) presented alone. Following an extinction phase in which both CSs were presented alone, half of the participants in each age group received three US exposures (reinstatement condition) and the other half did not (control condition), followed by all participants completing an extinction retest phase on the same day. Findings indicated (a) significant differences in generalizing aversive expectancies to safe stimuli during conditioning and extinction that persisted during retest in children relative to adults and adolescents, (b) significantly less positive CS reevaluations during extinction that persisted during retest in adolescents relative to adults and children, and (c) reinstatement of US expectancies to the CS+ relative to the CS- in all age groups. Results suggest important differences in stimulus safety learning in children and stimulus valence reevaluation in adolescents relative to adults.
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Affiliation(s)
- Allison M Waters
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia.
| | - Cindy Theresiana
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia
| | - David L Neumann
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, USA
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Shackman AJ, Tromp DPM, Stockbridge MD, Kaplan CM, Tillman RM, Fox AS. Dispositional negativity: An integrative psychological and neurobiological perspective. Psychol Bull 2016; 142:1275-1314. [PMID: 27732016 PMCID: PMC5118170 DOI: 10.1037/bul0000073] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dispositional negativity-the propensity to experience and express more frequent, intense, or enduring negative affect-is a fundamental dimension of childhood temperament and adult personality. Elevated levels of dispositional negativity can have profound consequences for health, wealth, and happiness, drawing the attention of clinicians, researchers, and policymakers. Here, we highlight recent advances in our understanding of the psychological and neurobiological processes linking stable individual differences in dispositional negativity to momentary emotional states. Self-report data suggest that 3 key pathways-increased stressor reactivity, tonic increases in negative affect, and increased stressor exposure-explain most of the heightened negative affect that characterizes individuals with a more negative disposition. Of these 3 pathways, tonically elevated, indiscriminate negative affect appears to be most central to daily life and most relevant to the development of psychopathology. New behavioral and biological data provide insights into the neural systems underlying these 3 pathways and motivate the hypothesis that seemingly "tonic" increases in negative affect may actually reflect increased reactivity to stressors that are remote, uncertain, or diffuse. Research focused on humans, monkeys, and rodents suggests that this indiscriminate negative affect reflects trait-like variation in the activity and connectivity of several key brain regions, including the central extended amygdala and parts of the prefrontal cortex. Collectively, these observations provide an integrative psychobiological framework for understanding the dynamic cascade of processes that bind emotional traits to emotional states and, ultimately, to emotional disorders and other kinds of adverse outcomes. (PsycINFO Database Record
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Affiliation(s)
- Alexander J. Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
- Department of Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742 USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742 USA
| | - Do P. M. Tromp
- Department of Psychology, University of California, Davis, CA 95616 USA
| | - Melissa D. Stockbridge
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742 USA
| | - Claire M. Kaplan
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Rachael M. Tillman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA 95616 USA
- California National Primate Research Center, University of California, Davis, CA 95616 USA
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Kuhn M, Mertens G, Lonsdorf TB. State anxiety modulates the return of fear. Int J Psychophysiol 2016; 110:194-199. [DOI: 10.1016/j.ijpsycho.2016.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/22/2016] [Accepted: 08/01/2016] [Indexed: 12/12/2022]
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Meyer A, Hajcak G, Glenn CR, Kujawa AJ, Klein DN. Error-related brain activity is related to aversive potentiation of the startle response in children, but only the ERN is associated with anxiety disorders. ACTA ACUST UNITED AC 2016; 17:487-496. [PMID: 27819443 DOI: 10.1037/emo0000243] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Identifying biomarkers that characterize developmental trajectories leading to anxiety disorders will likely improve early intervention strategies as well as increase our understanding of the etiopathogenesis of these disorders. The error-related negativity (ERN), an event-related potential that occurs during error commission, is increased in anxious adults and children-and has been shown to predict the onset of anxiety disorders across childhood. The ERN has therefore been suggested as a biomarker of anxiety. However, it remains unclear what specific processes a potentiated ERN may reflect. We have recently proposed that the ERN may reflect trait-like differences in threat sensitivity; however, very few studies have examined the ERN in relation to other indices of this construct. In the current study, the authors measured the ERN, as well as affective modulation of the startle reflex, in a large sample (N = 155) of children. Children characterized by a large ERN also exhibited greater potentiation of the startle response in the context of unpleasant images, but not in the context of neutral or pleasant images. In addition, the ERN, but not startle response, related to child anxiety disorder status. These results suggest a relationship between error-related brain activity and aversive potentiation of the startle reflex during picture viewing-consistent with the notion that both measures may reflect individual differences in threat sensitivity. However, results suggest the ERN may be a superior biomarker of anxiety in children. (PsycINFO Database Record
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Affiliation(s)
| | - Greg Hajcak
- Department of Psychology, Stony Brook University
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Shackman AJ, Fox AS. Contributions of the Central Extended Amygdala to Fear and Anxiety. J Neurosci 2016; 36:8050-63. [PMID: 27488625 PMCID: PMC4971357 DOI: 10.1523/jneurosci.0982-16.2016] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/30/2016] [Accepted: 06/03/2016] [Indexed: 01/01/2023] Open
Abstract
It is widely thought that phasic and sustained responses to threat reflect dissociable circuits centered on the central nucleus of the amygdala (Ce) and the bed nucleus of the stria terminalis (BST), the two major subdivisions of the central extended amygdala. Early versions of this hypothesis remain highly influential and have been incorporated into the National Institute of Mental Health Research Research Domain Criteria framework. However, new observations encourage a different perspective. Anatomical studies show that the Ce and BST form a tightly interconnected unit, where different kinds of threat-relevant information can be integrated and used to assemble states of fear and anxiety. Imaging studies in humans and monkeys show that the Ce and BST exhibit similar functional profiles. Both regions are sensitive to a range of aversive challenges, including uncertain or temporally remote threat; both covary with concurrent signs and symptoms of fear and anxiety; both show phasic responses to short-lived threat; and both show heightened activity during sustained exposure to diffusely threatening contexts. Mechanistic studies demonstrate that both regions can control the expression of fear and anxiety during sustained exposure to diffuse threat. These observations compel a reconsideration of the central extended amygdala's contributions to fear and anxiety and its role in neuropsychiatric disease.
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Affiliation(s)
- Alexander J Shackman
- Department of Psychology, Neuroscience and Cognitive Science Program, and Maryland Neuroimaging Center, University of Maryland, College Park, Maryland 20742, and
| | - Andrew S Fox
- Department of Psychology and California National Primate Research Center, University of California, Davis, California 95616
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Adversity-induced relapse of fear: neural mechanisms and implications for relapse prevention from a study on experimentally induced return-of-fear following fear conditioning and extinction. Transl Psychiatry 2016; 6:e858. [PMID: 27434492 PMCID: PMC5545712 DOI: 10.1038/tp.2016.126] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/22/2016] [Accepted: 05/05/2016] [Indexed: 12/18/2022] Open
Abstract
The efficacy of current treatments for anxiety disorders is limited by high relapse rates. Relapse of anxiety disorders and addiction can be triggered by exposure to life adversity, but the underlying mechanisms remain unexplored. Seventy-six healthy adults were a priori selected for the presence or absence of adverse experiences during childhood (CA) and recent past (RA; that is, past 12 months). Participants underwent fear conditioning (day 1) and fear extinction and experimental return-of-fear (ROF) induction through reinstatement (a model for adversity-induced relapse; day 2). Ratings, autonomic (skin conductance response) and neuronal activation measures (functional magnetic resonance imaging (fMRI)) were acquired. Individuals exposed to RA showed a generalized (that is, not CS- specific) fear recall and ROF, whereas unexposed individuals showed differential (that is, CS+ specific) fear recall and ROF on an autonomic level despite no group differences during fear acquisition and extinction learning. These group differences in ROF were accompanied by corresponding activation differences in brain areas known to be involved in fear processing and differentiability/generalization of ROF (that is, hippocampus). In addition, dimensional measures of RA, CA and lifetime adversity were negatively correlated with differential skin conductance responses (SCRs) during ROF and hippocampal activation. As discriminating signals of danger and safety, as well as a tendency for overgeneralization, are core features in clinically anxious populations, these deficits may specifically contribute to relapse risk following exposure to adversity, in particular to recent adversity. Hence, our results may provide first and novel insights into the possible mechanisms mediating enhanced relapse risk following exposure to (recent) adversity, which may guide the development of effective pre- and intervention programs.
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