Test-retest & familial concordance of MDD symptoms

Psychopathology research has increasingly sought to study the etiology and treatment of individual symptoms, rather than categorical diagnoses. However, it is unclear whether commonly used measures have adequate psychometric properties for assessing individual symptoms. This study examined the test-retest reliability and familial concordance (an indicator of validity) of the symptoms of Major Depressive Disorder (MDD), a disorder consisting of nine core symptoms, most of which are aggregated (e.g., symptom 7 of the DSM criteria for MDD is worthlessness or guilt). Lifetime MDD symptoms were measured in 504 young adults (237 sibling pairs) using the Structured Clinical Interview for DSM-5 (SCID). Fifty-one people completed a second SCID within three weeks of their first SCID. Results indicated that aggregated and unaggregated symptoms demonstrated moderate to substantial test-retest reliability and generally significant, but slight to fair familial concordance (with the highest familial concordance being for markedly diminished interest or pleasure and its unaggregated components - decreased interest and decreased pleasure). Given the increasing focus on the differential validity of individual MDD symptoms, the present study suggests that interview-based assessments of depression can assess most individual symptoms with adequate levels of reliability and validity.

Social Feedback Valence Differentially Modulates the Reward Positivity, P300, and Late Positive Potential

Abnormal social or reward processing is associated with several mental disorders. Although most studies examining reward processing have focused on monetary rewards, recent research also has tested neural reactivity to social rewards (e.g., positive social feedback). However, the majority of these studies only include two feedback valences (e.g., acceptance, rejection). Yet, social evaluation is rarely binary (positive vs. negative) and people often give 'on the fence' or neutral evaluations of others. Processing of this type of social feedback may be ambiguous and impacted by factors such as psychopathology, self-esteem, and prior experiences of rejection. Thus, the present study probed the reward positivity (RewP), P300, and late positive potential (LPP) following acceptance, rejection, and "one the fence" [between acceptance and rejection] feedback in undergraduate students (n = 45). Results indicated that the RewP showed more positive amplitudes following acceptance compared to both rejection and "on the fence" feedback, and the RewP was larger (i.e., more positive) following rejection relative to "on the fence" feedback. In contrast, the P300 did not differ between rejection and "on the fence" feedback, and both were reduced compared to acceptance. The LPP was blunted in response to rejection relative to acceptance and "on the fence" feedback (which did not differ from each other). Exploratory analyses demonstrated that greater self-reported rejection sensitivity was associated with a reduced LPP to acceptance. Taken together, these findings suggest that the neural systems underlying the RewP, P300, and LPP may evaluate "on the fence" social feedback differently, and that individuals high on rejection sensitivity may exhibit reduced attention toward and elaborative processing of social acceptance.

Psychomotor Slowing in Schizophrenia: Implications for Endophenotype and Biomarker Development

Motor abnormalities (e.g., dyskinesia, psychomotor slowing, neurological soft signs) are core features of schizophrenia that occur independent of drug treatment and are associated with the genetic vulnerability and pathophysiology for the illness. Among this list, psychomotor slowing in particular is one of the most consistently observed and robust findings in the field. Critically, psychomotor slowing may serve as a uniquely promising endophenotype and/or biomarker for schizophrenia considering it is frequently observed in those with genetic vulnerability for the illness, predicts transition in subjects at high-risk for the disorder, and is associated with symptoms and recovery in patients. The purpose of the present review is to provide an overview of the history of psychomotor slowing in psychosis, discuss its possible neural underpinnings, and review the current literature supporting slowing as a putative endophenotype and/or biomarker for the illness. This review summarizes substantial evidence from a diverse array of methodologies and research designs that supports the notion that psychomotor slowing not only reflects genetic vulnerability, but is also sensitive to disease processes and the pathophysiology of the illness. Furthermore, there are unique deficits across the cognitive (prefix "psycho") and motor execution (root word "motor") aspects of slowing, with cognitive processes such as planning and response selection being particularly affected. These findings suggest that psychomotor slowing may serve as a promising endophenotype and biomarker for schizophrenia that may prove useful for identifying individuals at greatest risk and tracking the course of the illness and recovery.

The Relation Between Posttraumatic Stress Symptom Severity and Startle Potentiation to Predictable and Unpredictable Threat

Aberrant threat reactivity has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD); however, the literature on this association is mixed. One factor that may contribute to this inconsistent association is differences in severity of posttraumatic stress symptoms (PTSSs) across studies, but no studies have tested this hypothesis. The relation between PTSD and threat reactivity may also differ between unpredictable threats (U-threats) and predictable threats (P-threats), given burgeoning evidence to support a particular role for aberrant responding to U-threat in PTSD. The present study examined how PTSS severity relates to startle potentiation to U-threat and P-threat in a trauma-exposed community sample (N = 258). There was a negative linear, but not quadratic, relation between PTSS severity and startle potentiation to U-threat, but not P-threat. Blunted defensive responding to U-threat may therefore contribute to higher levels of PTSSs and may represent a novel treatment target for higher levels of PTSSs.

The replicability and generalizability of internalizing symptom networks across five samples

The popularity of network analysis in psychopathology research has increased exponentially in recent years. Yet, little research has examined the replicability of cross-sectional psychopathology network models, and those that have used single items for symptoms rather than multiitem scales. The present study therefore examined the replicability and generalizability of regularized partial correlation networks of internalizing symptoms within and across 5 samples (total N = 2,573) using the Inventory for Depression and Anxiety Symptoms, a factor analytically derived measure of individual internalizing symptoms. As different metrics may yield different conclusions about the replicability of network parameters, we examined both global and specific metrics of similarity between networks. Correlations within and between nonclinical samples suggested considerable global similarities in network structure (rss = .53-.87) and centrality strength (rss = .37-.86), but weaker similarities in network structure (rss = .36-.66) and centrality (rss = .04-.54) between clinical and nonclinical samples. Global strength (i.e., connectivity) did not significantly differ across all 5 networks and few edges (0-5.5%) significantly differed between networks. Specific metrics of similarity indicated that, on average, approximately 80% of edges were consistently estimated within and between all 5 samples. The most central symptom (i.e., dysphoria) was consistent within and across samples, but there were few other matches in centrality rank-order. In sum, there were considerable similarities in network structure, the presence and sign of individual edges, and the most central symptom within and across internalizing symptom networks estimated from nonclinical samples, but global metrics suggested network structure and symptom centrality had weak to moderate generalizability from nonclinical to clinical samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Startle during threat longitudinally predicts functional impairment independent of DSM diagnoses

Heightened responsivity to unpredictable, and perhaps predictable, threat characterizes some internalizing disorders and may be vulnerability factors for psychopathology as well. However, few studies have directly tested whether individual differences in unpredictable and/or predictable threat responding longitudinally predict symptoms of psychopathology and functional outcomes. Examining functioning is particularly important given that functioning is separable from symptoms of psychopathology. The present study examined whether electromyography startle measures of predictable and/or unpredictable threat responding was associated with interviewer-assessed symptoms of internalizing psychopathology and functional impairment at baseline (n = 409) and one-year follow-up (n = 104). Elevated startle responding to unpredictable and predictable threat longitudinally predicted a worsening of functioning over time and this effect was independent of change of symptoms over time. Importantly, threat responding at baseline predicted functional impairment during the follow-up independent of the effects of DSM-defined fear-based (e.g., panic disorder) or distress-misery (e.g., major depressive disorder) internalizing disorders. These findings provide initial support for the incremental validity of neurobiological vulnerability markers of threat responding over and above DSM disorders and highlight the importance of distinguishing functional outcomes from symptom outcomes.

Emotion-based brain mechanisms and predictors for SSRI and CBT treatment of anxiety and depression: a randomized trial

Mechanisms and predictors for the successful treatment of anxiety and depression have been elusive, limiting the effectiveness of existing treatments and curtailing the development of new interventions. In this study, we evaluated the utility of three widely used neural probes of emotion (experience, regulation, and perception) in their ability to predict symptom improvement and correlate with symptom change following two first-line treatments-selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT). Fifty-five treatment-seeking adults with anxiety and/or depression were randomized to 12 weeks of SSRI or CBT treatment (ClinicalTrials.gov identifier: NCT01903447). Functional magnetic resonance imaging (fMRI) was used to examine frontolimbic brain function during emotion experience, regulation, and perception, as probed by the Emotion Regulation Task (ERT; emotion experience and regulation) and emotional face assessment task (EFAT; emotion perception). Brain function was then related to anxiety and depression symptom change. Results showed that both SSRI and CBT treatments similarly attenuated insula and amygdala activity during emotion perception, and greater treatment-related decrease in insula and amygdala activity was correlated with greater reduction in anxiety symptoms. Both treatments also reduced amygdala activity during emotion experience but brain change did not correlate with symptom change. Lastly, greater pre-treatment insula and amygdala activity during emotion perception predicted greater anxiety and depression symptom improvement. Thus, limbic activity during emotion perception is reduced by both SSRI and CBT treatments, and predicts anxiety and depression symptom improvement. Critically, neural reactivity during emotion perception may be a non-treatment-specific mechanism for symptom improvement.

The Titrated Monetary Incentive Delay Task: Sensitivity, convergent and divergent validity, and neural correlates in an RDoC sample

INTRODUCTION

Neuropsychological tests are designed to assay brain function via performance measurements. Many tests corresponding to visual and motor cortex function have been validated. Tests probing reward circuitry, including the ventral striatum (VS), could benefit assessment of numerous neurological and psychiatric disorders in which reward or VS function is disturbed. The present study sought to examine convergent and divergent validity of our modified, titrated version of the Monetary Incentive Delay Task, such that it may in the future stand as a validated neuropsychological test for reward function.

METHOD

Participants were 132 individuals with a history of mood disturbance (HMD) and 43 healthy comparisons, ages 18-30 years. In addition to a standard neuropsychological battery and symptom measures, participants completed a modified version of the Monetary Incentive Delay Task (T-MIDT) during functional magnetic resonance imaging (fMRI), which involved a multistage titration procedure to incrementally increase or decrease the response window time per each participant's psychomotor speed and optimize individual performance.

RESULTS

Across groups after titration, performance on the T-MIDT diverged from measures of processing speed, attention, and spatial working memory, but not inhibitory control. Performance in the HMD group was differentially correlated with executive function measures before and after titration. The reward circuit (e.g., subcortical, insular, medial prefrontal) was activated during reward anticipation.

CONCLUSION

The present findings provide preliminary evidence that the T-MIDT measures a construct distinct from many executive functions and that individualized titration of the task parameters is critical in parsing reward from executive function. The T-MIDT correlated with residual mood symptoms in individuals with remitted depression or bipolar disorder, implying that behavioral or brain activation group differences are only to be observed in the active state of illness.

Error-related neural activity and alcohol use disorder: Differences from risk to remission

Studies suggest that individuals with alcohol use disorder (AUD) display abnormal neural error-processing, measured via the error-related negativity (ERN). The nature of the error-related abnormalities in AUD is unclear, however, as prior research has yielded discrepant findings. In addition, no study to date has attempted to characterize the dispositional nature of the ERN in AUD and directly test to what extent ERN amplitude reflects a risk factor, disease marker, and/or scar of AUD psychopathology. The current study compared ERN amplitude across 244 adult volunteers in the following five groups: 1) current AUD (n = 39), 2) AUD in remission (n = 60), 3) at-risk for AUD (n = 43), 4) psychiatric controls with comparable rates of internalizing psychopathology as the AUD groups (n = 53), and 5) healthy controls with no lifetime history of psychopathology (n = 49). Risk for AUD was defined as a positive, first-degree family history. All participants completed a well-validated flanker task, designed to robustly elicit the ERN, during continuous electroencephalographic (EEG) data collection. Results indicated that individuals with current AUD displayed smaller ERNs compared with individuals at-risk for AUD, with AUD in remission, psychiatric controls, and healthy controls. There were no differences amongst any of the other groups. This suggests that a blunted ERN may be concomitant with current AUD psychopathology and relatedly, a novel neurobiological AUD treatment target and/or objective marker of AUD disease status.

The time course of responding to aversiveness in females with a history of non-suicidal self-injury

Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Two prominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may lead to increased risk for suicide. Several laboratory studies examining the relationship between physiological habituation and suicide attempt history have yielded mixed results, potentially due to their use of broad measures of physiological arousal and/or focus on specific psychopathologies. However, no studies have examined the association between the time course (e.g., habituation, initial reactivity) of responding to aversiveness and NSSI, which may help to elucidate psychophysiological mechanisms of NSSI. Therefore, we examined habituation and initial reactivity to aversiveness (indexed by the time course of acoustic startle reflex, a well-validated measure of defensive responding) in three groups of young adult females - those with a history of NSSI, psychiatric controls matched on potential confounds (e.g., psychopathology, trauma history, demographics), and healthy controls. Results indicated that individuals with a history of NSSI exhibited blunted initial reactivity and marginally slower habituation to aversiveness relative to the two control groups. The NSSI group's insensitivity to aversiveness may reflect prior psychophysiological habituation, and may be a mechanism through which prior NSSI exposure leads to increased risk for suicidal behavior.

Multidimensional imaging techniques for prediction of treatment response in major depressive disorder

A large number of studies have attempted to use neuroimaging tools to aid in treatment prediction models for major depressive disorder (MDD). Most such studies have reported on only one dimension of function and prediction at a time. In this study, we used three different tasks across domains of function (emotion processing, reward anticipation, and cognitive control, plus resting state connectivity completed prior to start of medication to predict treatment response in 13-36 adults with MDD. For each experiment, adults with MDD were prescribed only label duloxetine (all experiments), whereas another subset were prescribed escitalopram. We used a KeyNet (both Task derived masks and Key intrinsic Network derived masks) approach to targeting brain systems in a specific match to tasks. The most robust predictors were (Dichter et al., 2010) positive response to anger and (Gong et al., 2011) negative response to fear within relevant anger and fear TaskNets and Salience and Emotion KeyNet (Langenecker et al., 2018) cognitive control (correct rejections) within Inhibition TaskNet (negative) and Cognitive Control KeyNet (positive). Resting state analyses were most robust for Cognitive control Network (positive) and Salience and Emotion Network (negative). Results differed by whether an -fwhm or -acf (more conservative) adjustment for multiple comparisons was used. Together, these results implicate the importance of future studies with larger sample sizes, multidimensional predictive models, and the importance of using empirically derived masks for search areas.

Blunted neural response to gains versus losses associated with both risk-prone and risk-averse behavior in a clinically diverse sample

Reduced responsiveness to reward has been associated with both risk-prone and risk-averse behavior, common features of externalizing and internalizing psychopathology, respectively. Thus, evidence has suggested a potential quadratic relationship (i.e., inverted U) between reward sensitivity and risk-taking propensity. Blunted response to reward compared to loss may therefore demonstrate transdiagnostic utility as it relates to different patterns of maladaptive risk behavior. The current study sought to disentangle the relationship between risk and reward in a clinically diverse sample. In a sample of 210 adults (aged 18-30), the RewP (an ERP indexing differentiation between rewards and losses) was measured during a monetary guessing game, and risk-taking propensity was measured with a behavioral task (i.e., BART) that simulates real-world risk taking. Participants also completed clinical assessments to assess for lifetime psychopathology. Results indicated that there was no linear association between the RewP and risk-taking propensity; however, there was a significant quadratic relationship. Thus, a reduced sensitivity to reward receipt was associated with both risk-prone and risk-averse behavior. There was also a significant quadratic relationship between the RewP and money won during the BART, indicating that being too risk prone or risk averse is disadvantageous and leads to missed reward. Overall, these findings suggested that blunted neural differentiation between gains and losses may contribute to deficits in effectively weighing reward and loss and result in maladaptive risk-taking behavior. These findings support continued examination of reward dysfunction dimensionally in order to better characterize behavioral profiles implicated in clinical phenotypes.

The utility of an RDoC motor domain to understand psychomotor symptoms in depression

Despite the clinical impact of motor symptoms such as agitation or retardation on the course of depression, these symptoms are poorly understood. Novel developments in the field of instrumentation and mobile devices allow for dimensional and continuous recording of motor behavior in various settings, particularly outside the laboratory. Likewise, the use of novel assessments enables to combine multimodal neuroimaging with behavioral measures in order to investigate the neural correlates of motor dysfunction in depression. The research domain criteria (RDoC) framework will soon include a motor domain that will provide a framework for studying motor dysfunction in mood disorders. In addition, new studies within this framework will allow investigators to study motor symptoms across different stages of depression as well as other psychiatric diagnoses. Finally, the introduction of the RDoC motor domain will help test how motor symptoms integrate with the original five RDoC domains (negative valence, positive valence, cognitive, social processes, and arousal/regulation).

A Family Study of the DSM-5 Section III Personality Pathology Model Using the Personality Inventory for the DSM-5 (PID-5)

In Section III of the DSM-5, the American Psychiatric Association (APA) proposes a pathological personality trait model of personality disorders. The recommended assessment instrument is the Personality Inventory for the DSM-5 (PID-5), an empirically derived scale that assesses personality pathology along five domains and 25 facets. Although the PID-5 demonstrates strong convergent validity with other personality measures, no study has examined whether it identifies traits that run in families, another important step toward validating the DSM-5's dimensional model. Using a family study method, we investigated familial associations of PID-5 domain and facet scores in 195 families, examining associations between parents and offspring and across siblings. The Psychoticism, Antagonism, and Detachment domains showed significant familial aggregation, as did facets of Negative Affect and Disinhibition. Results are discussed in the context of personality pathology and family study methodology. The results also help validate the PID-5, given the familial nature of personality traits.

Trait attentional control modulates neurofunctional response to threat distractors in anxiety and depression

Accumulating data suggest attentional control capability varies across psychiatric diagnostic boundaries. The Attentional Control Scale (ACS) assesses self-reported trait attentional control (TAC) and tracks the anterior attention system. Greater TAC is associated with less negative affect, however, its mechanisms in anxiety and depression are poorly understood. Therefore, we examined whether individual differences in TAC modulated top-down mechanisms in a clinical sample. During fMRI, 104 patients with social anxiety, generalized anxiety, and/or major depression and 34 healthy participants completed a validated attentional control paradigm comprising strings of letters superimposed on threatening and neutral face distractors. In the low perceptual load condition, a target letter was in a string of identical letters. In the high load condition, a target letter was in a mixed letter string. Whole-brain regression results for low load revealed more activation to threat (vs. neutral) distractors in the pregenual anterior cingulate cortex was predicted by better TAC (i.e., higher ACS scores). For high load, regression results showed less activation to threat (vs. neutral) distractors in the inferior frontal gyrus was predicted by better TAC. An exploratory whole-brain ANOVA revealed a main effect of group in the superior temporal gyrus and a main effect of perceptual load in parietal, frontal, and limbic regions. No other effects were detected and activation derived from significant ANOVA results did not correlate with ACS scores. In conclusion, regression findings suggest individual differences in brain-behavioral ACS-related activity in frontal structures may be useful in identifying phenotypes in internalizing conditions.

Neural Responsiveness to Reward as an Index of Depressive Symptom Change Following Cognitive-Behavioral Therapy and SSRI Treatment

OBJECTIVE

Reward positivity (RewP), a neurophysiologic index of reward responsivity, is consistently reduced in participants with depression and, to a lesser extent, anxiety. It remains unknown, however, whether RewP can be altered as psychiatric symptoms change with treatment. The current study addressed this question by examining differences in RewP within patients before and after 12 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) or cognitive-behavioral therapy (CBT). We also examined the utility of RewP as a predictor of symptom change during CBT and SSRI treatment.

METHODS

Participants were recruited between 2014 and 2017 and included adults with a primary DSM-5 anxiety or depressive disorder (n = 63) and healthy controls (n = 25). At baseline and 12 weeks, participants completed a monetary award task while electroencephalogram (EEG) was recorded. Between EEG sessions, patients completed CBT or SSRI treatment.

RESULTS

At baseline, higher levels of depressive symptoms were associated with a more attenuated RewP. We found no significant differences between patients and healthy controls in the degree of RewP change across the 12 weeks; however, among patients, the extent of increase in RewP robustly correlated with the extent of decline in depressive (t = -2.21, P = .03) and anxiety (t = -2.57, P = .02) symptoms following CBT and SSRI treatment. Additionally, a more attenuated RewP at baseline predicted a greater reduction in depressive symptoms following treatment with SSRIs (t = -2.04, P < .05), but not after CBT.

CONCLUSIONS

These findings highlight neural responsiveness to reward as both a mechanism and a predictor of depressive symptom change that may be used serve as an objective index of symptom improvement.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT01903447.

Psychological Distress Among Smokers in the United States: 2008-2014

Introduction

Decline in smoking in the United States has slowed over the past 25 years. Mental health problems are common among smokers, and may be an impediment to quitting and remaining abstinent. The study investigated the relationship between serious (past-30-day) psychological distress (SPD) and smoking, estimated trends in the prevalence of SPD among current, former, and never smokers in the United States from 2008 to 2014, and investigated whether heterogeneity in these trends varied by sociodemographic characteristics.

Methods

Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N = 270 227). SPD and smoking in the past 30 days were examined using logistic regression models among adults 18 and older. The prevalence of SPD was examined annually among current, former, and never smokers from 2008 to 2014.

Results

SPD increased among smokers in the United States from 2008 to 2014. An increase in SPD was more rapid among non-daily smokers than daily smokers. The prevalence of SPD was higher among younger smokers, those with less formal education and lower annual family income and higher among current smokers than former and never smokers. The relationships between SPD and smoking were stronger among smokers with higher education levels and annual family income.

Conclusions

Our findings suggest an increase in SPD among smokers over time and that as smoking has declined, those with SPD are comprising a greater proportion of the remaining smokers. Results suggest that mental health must be integrated into mainstream tobacco control efforts.

Implications

The greater prevalence and increasing rate of Serious Psychological Distress among smokers, relative to former- and never-smokers, from 2008 to 2014 provides support that the greater mental health burden among smokers may be contributing to the slowed reduction in smoking prevalence in the United States. In addition, relationships between SPD and smoking were consistently stronger among smokers with higher levels of education and annual family income. Such results suggest the necessity of incorporating mental health treatments in tobacco use reduction efforts.

Effect of Comorbid Post-Traumatic Stress Disorder and Panic Disorder on Defensive Responding

Abstract. Although panic disorder (PD) and post-traumatic stress disorder (PTSD) are characterized by heightened sensitivity to threat, no study to date has examined the effect of comorbid PD and PTSD on defensive responding. The present study probed startle eyeblink response to an acoustic probe in three groups of participants recruited from the community: (1) healthy individuals (n = 63), (2) individuals with PD without PTSD (n = 62), and (3) individuals with comorbid PD and PTSD (n = 24). Results indicated that PD individuals without PTSD exhibited greater sensitivity to threat relative to controls, and comorbid individuals displayed attenuated sensitivity to threat relative to PD individuals without PTSD (both ps < .05). The results are discussed in the context of the anxiety disorder spectrum, which postulates that anxiety disorders exist on a continuum spanning from specific/simple fear to broad distress, with defensive responding decreasing as distress increases.

Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM-5 (SCID)

This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test-retest reliability, and concurrent and predictive validity) than categorical diagnoses. Participants (N = 234) were recruited from the community and clinics. Retest reliability and prospective predictive validity (symptoms and functioning 1 year later) were examined in subsamples of participants. Dimensional severity scales were created from an adapted version of the SCID for both current and lifetime major depression, alcohol, substance, post-traumatic stress disorder, panic, agoraphobia, social anxiety, specific phobia, obsessive-compulsive disorder, and generalized anxiety disorder. The SCID's severity scales demonstrated substantial internal consistency (all Cronbach's αs >.80), test-retest reliability, and concurrent and predictive validity. Symptom severity scales demonstrated significant incremental validity over and above categorical diagnoses for both current and prospective outcomes. The psychometric properties of SCID-identified symptom scales were far superior to the psychometrics of categorical diagnoses for both current and lifetime psychopathology. These results highlight the feasibility and utility of the SCID to assess reliable and valid symptom severity dimensions of both current and lifetime psychopathology.

The effect of panic disorder versus anxiety sensitivity on event-related potentials during anticipation of threat

Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies have been mixed. Predictability of threat, an important feature of threat processing, may have contributed to these mixed findings. Additionally, anxiety sensitivity, a dimensional trait associated with PD, may yield stronger associations with cognitive processes than categorical diagnoses of PD. In this study, 171 participants with PD and/or depression and healthy controls completed a task that differentiated anticipation of predictable vs. unpredictable shocks, while startle eyeblink and event-related potentials (ERPs [N100, P300]) were recorded. In all participants, relative to the control condition, probe N100 was enhanced to both predictable and unpredictable threat, whereas P300 suppression was unique to predictable threat. Probe N100, but not P300, was associated with startle eyeblink during both threatening conditions, and was strongest for unpredictable threat. PD was not associated with ERPs, but anxiety sensitivity (physical concerns) was positively associated with probe N100 (indicating reduced responding) in the unpredictable condition independent of PD diagnosis. Vulnerability to panic-related psychopathology may be characterized by aberrant early processing of threat, which may be especially evident during anticipation of unpredictable threats.

Using Event-Related Potentials and Startle to Evaluate Time Course in Anxiety and Depression

The National Institute of Mental Health's Research Domain Criteria initiative is a research framework designed toward understanding psychopathology as abnormalities of dimensional neurobehavioral constructs rather than in terms of DSM-defined categories. Research Domain Criteria constructs within the negative valence domain are particularly relevant for understanding anxiety and depressive disorders, which are pervasive, debilitating, and characterized by negative processing bias. One important direction for Research Domain Criteria research is investigating processes and parameters related to the time course (or chronometry) of negative valenced constructs. Two reliable methods for assessing chronometry are event-related potentials (ERPs) and startle blink. In this qualitative review, we examine ERP and startle studies of individuals with anxiety or depression or individuals vulnerable to affective disorders. The aim of the review is to highlight how these methods can inform the role of chronometry in the spectrum of anxiety and depression. ERP studies examining different chronometry facets of negative valenced responses have shown that transdiagnostic groups of individuals with internalizing psychopathologies exhibit abnormalities at early stages of processing. Startle reactivity studies have robustly differentiated fear-based disorders (e.g., panic disorder, social phobia) from other anxiety disorders (e.g., generalized anxiety disorder) and have also shown that different internalizing phenotypes exhibit different patterns of habituation. Findings lend support to the value of ERP and startle measures in identifying groups that cut across conventional classification systems. We also highlight methodological issues that can aid in the validity and reproducibility of ERP and startle findings and, ultimately, in the goal of developing more precise models of anxiety and depression.

Integrated cross-network connectivity of amygdala, insula, and subgenual cingulate associated with facial emotion perception in healthy controls and remitted major depressive disorder

Emotion perception deficits could be due to disrupted connectivity of key nodes in the salience and emotion network (SEN), including the amygdala, subgenual anterior cingulate cortex (sgACC), and insula. We examined SEN resting-state (rs-)fMRI connectivity in rMDD in relation to Facial Emotion Perception Test (FEPT) performance. Fifty-two medication-free people ages 18 to 23 years participated. Twenty-seven had major depressive disorder (MDD) in remission (rMDD, 10 males), as MDD is associated with emotion perception deficits and alterations in rsfMRI. Twenty-five healthy controls (10 males) also participated. Participants completed the FEPT during fMRI, in addition to an 8-minute eyes-open resting-state scan. Seed regions of interest were defined in the amygdala, anterior insula and sgACC. Multiple regression analyses co-varied diagnostic group, sex and movement parameters. Emotion perception accuracy was positively associated with connectivity between amygdala seeds and regions primarily in the SEN and cognitive control network (CCN), and also the default mode network (DMN). Accuracy was also positively associated with connectivity between the sgACC seeds and other SEN regions, and the DMN, particularly for the right sgACC. Connectivity negatively associated with emotion perception was mostly with regions outside of these three networks, other than the left insula and part of the DMN. This study is the first to our knowledge to demonstrate relationships between facial emotion processing and resting-state connectivity with SEN nodes and between SEN nodes and regions located within other neural networks.