Differences between trait fear and trait anxiety: Implications for psychopathology

Emotions during the Covid-19 pandemic: Fear, anxiety, and anger as mediators between threats and policy support and political actions

The Covid-19 pandemic has significantly changed the lives of most people. It has been described as the most severe global health disaster of modern times by the United Nations. No doubt such a major crisis influences what citizens think of different policies, and how they become politically active, not to mention, the forceful emotional experiences that the Covid-19 pandemic brings. This study evaluates how emotions affect support for policies related to restricting the spread of the virus and economic assistance, and how emotions affect intentions to engage politically. In an experiment (N = 1,072), we manipulated emotional reactions to threat by highlighting different aspects of the pandemic. Our findings show that different experimental treatments elicit different emotions, and that fear, anxiety, and anger are all related to policy support and political action intentions, but in different ways. Fear and anger predict support for restrictive policies to limit the spread of the virus, while anxiety predicts support for economic policies. Anger and anxiety, but not fear, increase intentions to engage politically. Hence, we find support for a mechanism where different aspects of the Covid-19 crisis evoke different emotional reactions, which in turn affects policy support and political actions differently.

Practical considerations for testing the effects of cannabidiol on human anxiety

Empirical evidence continues to accumulate suggesting cannabidiol (CBD) may have potential as an anxiolytic. Yet, research in the area is insufficient to support strong inferences. Accordingly, there is a need for additional empirical investigation. Research on the effects of CBD and anxiety requires a working knowledge of both. Understanding of contemporary CBD and anxiety research methods is critical to safely and convincingly test predictions regarding potential anxiolytic effects of CBD. The current paper outlines major design, methods, and safety considerations pertinent both to CBD administration and measuring effects on anxiety outcomes in order to facilitate needed research in this domain.

Anxiety, Compassion and Pride. How Emotions Elicited by the Government's Handling of Covid-19 Influences Health-Promoting Behavior

This article explores how emotions connected to the Government's handling of the Covid-19 outbreak in Sweden relates to behaviors to stop the spread of the virus, and which emotions functions as mediators in this relationship. The Swedish approach to handling the outbreak greatly differed from how many other Western European countries handled the situation and thus makes an important case to study. In a large representative survey (N = 2449), we found that satisfaction with how the Government handled the situation was related to more positive and less negative emotions. Anxiety, compassion and pride mediated the effect of satisfaction on compliance with the national recommendations such that anxiety and compassion increased compliance, while pride decreased it. Importantly though, satisfaction increased compassion and pride, but only compassion led to more compliant behaviors. In fact, satisfaction was indirectly related to less compliant behaviors via anxiety and pride. Shame mediated the effect on the tendency to wear face masks, a behavior that was explicitly not endorsed by the Swedish Public Health Agency. We speculate if the face mask, which was intensely debated, became a politicized symbol of dissatisfaction with the Swedish approach. In sum, it seems that individuals who were dissatisfied with how the government handled the Covid-19 outbreak were in fact engaging more in health-promotional behaviors to stop the spread of the virus.

Development and validation of the Brief Assessment of Distress about Pain

BACKGROUND

The experience of pain is a complex interaction of somatic, behavioural, affective and cognitive components. Negative psychological states (e.g., anxiety, fear and depression) are intertwined with pain and contribute to poorer outcomes for individuals suffering from chronic and acute pain by exacerbating the overall experience of pain and leading to increased dysfunction, disability, and distress. A need exists for efficient assessment of aversive emotional states that are associated with pain.

METHODS

A multistage developmental process included expert judges, two undergraduate samples, and a chronic pain patient sample. The 4-item Brief Assessment of Distress about Pain (BADP) scale was developed to assess anxiety, fear, and depression related to pain, as well as an overall evaluation of distress about pain.

RESULTS

Principal components analyses indicated that the BADP consisted of one factor. Inter-scale correlation coefficients revealed that the BADP was highly related to other measures that assess similar constructs, suggesting evidence for convergent validity. Intra-scale correlation coefficients indicated that the items of the BADP were only moderately associated with each other. Findings also supported evidence for discriminative validity, test-retest reliability, and internal consistency of the BADP.

CONCLUSIONS

The BADP has good psychometric properties as a measure of negative affectivity related to pain. The scale's single negative affectivity item may be useful for screening. The BADP helps address a gap in the literature with regard to a brief measure assessing fear, anxiety, depression, and negative affect in relation to pain. Demonstrated utility in a patient sample indicates the measure is suitable for further clinical study.

SIGNIFICANCE

The BADP provides an efficient, psychometrically-supported means to assess affective distress (i.e., anxiety, fear, depression, and negative affect) associated with pain.

Trajectories of Loneliness and Psychosocial Functioning

The present study examined the relationship between developmental patterns of loneliness and psychosocial functioning among adolescents (9-21 years; N = 110, 52% male). Four-wave longitudinal data were obtained from the Nijmegen Longitudinal Study (NLS) on Infant and Child Development. Loneliness was measured at 9, 13, 16, and 21 years of age and anxiety, depression and self-esteem at 9 and 21 years of age. Using k-means cluster analysis, three trajectories of loneliness were identified as "stable low" (56% of the subjects), "high decreasing" (22% of the subjects), and "low increasing" (22% of the subjects). Importantly, trajectories of loneliness across adolescence significantly predicted psychosocial functioning in young adulthood. Both the "high-decreasing" and "low-increasing" loneliness clusters were associated with higher risk of depression and lower self-esteem compared to the "stable low" loneliness cluster. The "low-increasing" loneliness cluster was associated with higher risk of anxiety compared to the "stable low" loneliness cluster. These results indicate that loneliness in adolescence is a vulnerability that manifests itself in higher levels of anxiety and depression and lower self-esteem in young adulthood.

Endocannabinoids, cannabinoids and the regulation of anxiety

Cannabis has been used for hundreds of years, with its ability to dampen feelings of anxiety often reported as a primary reason for use. Only recently has the specific role cannabinoids play in anxiety been thoroughly investigated. Here we discuss the body of evidence describing how endocannabinoids and exogenous cannabinoids are capable of regulating the generation and termination of anxiety states. Disruption of the endogenous cannabinoid (eCB) system following genetic manipulation, pharmacological intervention or stress exposure reliably leads to the generation of an anxiety state. On the other hand, upregulation of eCB signaling is capable of alleviating anxiety-like behaviors in multiple paradigms. When considering exogenous cannabinoid administration, cannabinoid receptor 1 (CB1) agonists have a biphasic, dose-dependent effect on anxiety such that low doses are anxiolytic while high doses are anxiogenic, a phenomenon that is evident in both rodent models and humans. Translational studies investigating a loss of function mutation in the gene for fatty acid amide hydrolase, the enzyme responsible for metabolizing AEA, have also shown that AEA signaling regulates anxiety in humans. Taken together, evidence reviewed here has outlined a convincing argument for cannabinoids being powerful regulators of both the manifestation and amelioration of anxiety symptoms, and highlights the therapeutic potential of targeting the eCB system for the development of novel classes of anxiolytics. This article is part of the special issue on 'Cannabinoids'.

Unconventional anxiety pharmacology in zebrafish: Drugs beyond traditional anxiogenic and anxiolytic spectra

Anxiety is the most prevalent brain disorder and a common cause of human disability. Animal models are critical for understanding anxiety pathogenesis and its pharmacotherapy. The zebrafish (Danio rerio) is increasingly utilized as a powerful model organism in anxiety research and anxiolytic drug screening. High similarity between human, rodent and zebrafish molecular targets implies shared signaling pathways involved in anxiety pathogenesis. However, mounting evidence shows that zebrafish behavior can be modulated by drugs beyond conventional anxiolytics or anxiogenics. Furthermore, these effects may differ from human and/or rodent responses, as such 'unconventional' drugs may affect zebrafish behavior despite having no such profiles (or exerting opposite effects) in humans or rodents. Here, we discuss the effects of several putative unconventional anxiotropic drugs (aspirin, lysergic acid diethylamide (LSD), nicotine, naloxone and naltrexone) and their potential mechanisms of action in zebrafish. Emphasizing the growing utility of zebrafish models in CNS drug discovery, such unconventional anxiety pharmacology may provide important, evolutionarily relevant insights into complex regulation of anxiety in biological systems. Albeit seemingly complicating direct translation from zebrafish into clinical phenotypes, this knowledge may instead foster the development of novel CNS drugs, eventually facilitating innovative treatment of patients based on novel 'unconventional' targets identified in fish models.

Physical Activity, Boredom and Fear of COVID-19 Among Adolescents in Germany

Background

The effectiveness of physical activity (PA) as an intervention against anxiety disorders and depression is undeniable in clinical psychology. Therefore, the question arose whether these effects also occur when a fear stimulus, like the COVID-19 pandemic, affects otherwise healthy adolescents. Boredom is closely linked to symptoms of fear and anxiety, but the connection between PA, boredom and fear is partly unclear.

Methods

A cross-sectional online study was conducted that involved 122 students. Participants were 13–19 years old (M_age = 15.83, SD = 1.73). The survey was available online from April 27th to May 3rd, 2020. At this time, schools in Germany had already been closed for 6 weeks. A self-report questionnaire was used to measure physical activity, boredom, and fear of COVID-19. A multiple linear regression model was conducted.

Results

The reported fear of COVID-19 significantly correlates with total PA, quantity of strenuous PA, and boredom. Furthermore, a significant regression equation was found. The variables boredom, PA, and age contribute significantly to predicting the fear of COVID-19 [R² = 0.127, F(3,118) = 6.876, p < 0.000], among adolescents.

Conclusion

Our results indicate that there is an association between PA, boredom and the quarantine experience of adolescents. Students who were physically more active, especially with strenuous intensity, did not feel bored and showed less fear of COVID-19.

Design of Fear and Anxiety of COVID-19 Assessment Tool in Spanish Adult Population

The aim of this study was to develop a specific scale to measure anxiety and fear levels in the general Spanish population. For this, a transcultural adaptation to Spanish of the fear of coronavirus disease 2019 (COVID-19) scale, in its original version of 10 items, was carried out. Then, the Anxiety and Fear of COVID-19 Assessment Scale (AMICO, for its acronym in Spanish) was designed by translating the tool and Delphi technique into three rounds. Ten experts participated voluntarily, and inter-observer match rates and the reliability study of the designed scale were calculated. A pilot study was carried out with the final version of the scale for the validity and reliability study. The instrument did not raise problems in semantic and cultural terms during the first and second rounds of the translation process, with an overall weighted Kappa value of 0.9. In the third round, eight new items were designed and consensual, obtaining a weighted overall value of 0.89. The pilot study sample was made up of 445 subjects, of which 60.3% were women with a mean age of 46.2 years. The final version consisted of 16 items, 2 factors, and a Cronbach's alpha value of 0.92. The AMICO scale was developed to assess the level of anxiety and fear of COVID-19 and proved to be valid and reliable for its use in the adult Spanish population.

Reappraising fear: is up-regulation more efficient than down-regulation?

Catastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.

Anxiety: phenomenology, epidemiology, and risk factors during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic

The COVID-19 coronavirus pandemic in 2020 led to significant negative social consequences associated inter alia with adverse effects on mental health. One of the most common mental illness is anxiety disorders, the rise in which is characteristic of social upheaval periods. This paper analyzes the problem of anxiety, reviews information on the epidemiology of anxiety, on the factors and mechanisms of its development. It unveils the association of anxiety with addictive disorders, lifestyle factors, and traumatic childhood experience and highlights the problem of increased anxiety in the context of the novel coronavirus COVID-19 pandemics in Russia.

Attentional Processing of Disgust and Fear and Its Relationship With Contamination-Based Obsessive-Compulsive Symptoms: Stronger Response Urgency to Disgusting Stimuli in Disgust-Prone Individuals

Disgust has recently been characterized as a low-urgency emotion, particularly compared to fear. The aim of the present study is to clarify whether behavioral inhibition during disgust engagement is characteristic of a low-urgency emotion and thus indicates self-imposed attentional avoidance in comparison to fear. Therefore, 54 healthy participants performed an emotional go/no-go task with disgust- and fear-relevant as well as neutral pictures. Furthermore, heart rate activity and facial muscle activity on the fear-specific m. corrugator supercilli and the disgust-specific m. levator labii were assessed. The results partially support the temporal urgency hypothesis of disgust. The emotion conditions significantly differed in emotional engagement and in the facial muscle activity of the m. levator labii as expected. However, contrary to our expectations, no differences between the emotion conditions regarding behavioral inhibition as well as heart rate change could be found. Furthermore, individuals with a higher-trait disgust proneness showed faster reactions and higher activity of the m. levator labii in response to disgust stimuli. The results show that different trait levels influence attentional engagement and physiological parameters but have only a small effect on behavioral inhibition.

An experimental investigation into the mediating role of pain-related fear in boosting nocebo hyperalgesia

Nocebo hyperalgesia refers to increases in perceived pain that putatively result from negative expectations regarding a nocebo stimulus (eg, an inert treatment, compared with no treatment). The precise cognitive-emotional factors contributing to the origins of nocebo effects are poorly understood. We aimed to test the effects of experimentally induced pain-related fear on the acquisition and extinction of nocebo hyperalgesia in healthy participants (N = 72). Acquisition and extinction of nocebo hyperalgesia were compared between a group receiving standard nocebo conditioning (Control group) and 2 groups receiving distinct fear inductions: high intensity of pain stimulations (High-pain group) or a threat manipulation (High-threat group). During nocebo acquisition, the Control and High-threat groups were administered thermal pain stimulations of moderate intensity paired with sham electrical stimulation (nocebo trials), whereas high pain intensity was administered to the High-pain group. During extinction, equivalent pain intensities were administered across all trials. Pain-related fear was measured by eyeblink startle electromyography and self-report. Nocebo hyperalgesia occurred in all groups. Nocebo effects were significantly larger in the High-pain group than those in the Control group. This effect was mediated by self-reported fear, but not by fear-potentiated startle. Groups did not differ in the extinction rate. However, only the High-pain group maintained significant nocebo responses at the end of extinction. Anticipatory pain-related fear induced through a threat manipulation did not amplify nocebo hyperalgesia. These findings suggest that fear of high pain may be a key contributor to the amplification of nocebo hyperalgesia, only when high pain is experienced and not when it is merely anticipated.

Caries treatment in a four-year-old boy using hypnosis - a case report

This clinical case report demonstrates the successful application of hypnosis in an anxious four-year-old boy in whom two primary molars were treated with a composite filling. The almost 16-minute pediatric dental treatment was performed without complications and without interruptions. It could be shown that hypnosis can be used for the pediatric dental treatment of decayed primary tooth lesions. In the specific individual case hypnosis was not only used adjuvant but as an alternative to local anesthesia. A dental anxiety reducing effect and an elimination of pain perception were observed, so that the treatment was possible without anesthesia. It was also found that the communication and rapport between the practitioner and the four-year-old child were improved using hypnosis. There is still a need for high quality studies on the numerous positive effects that hypnosis has on pediatric dental treatment.

Adaptation of the Cuban version of the Coronavirus Anxiety Scale

This study explores the psychometric properties of the Cuban version of Coronavirus Anxiety Scale (CAS). The sample comprised 376 Cuban participants. Concurrent validity and reliability were examined. A confirmatory factor analysis was performed. The CAS showed excellent psychometric characteristics. The internal consistency was very good (α = 0.88). There was a positive correlation between the CAS and the FCV-19S and an inverse association between anxiety and self-perceived quality of health. The results confirmed the presence of a single factor. The CAS is a valid and reliable instrument to explore the experience of anxiety in the Cuban population.

Behavioral Immune System Responses to Coronavirus: A Reinforcement Sensitivity Theory Explanation of Conformity, Warmth Toward Others and Attitudes Toward Lockdown

Behavioral immune system (BIS) describes psychological mechanisms that detect cues to infectious pathogens in the immediate environment, trigger disease-relevant responses and facilitate behavioral avoidance/escape. BIS activation elicits a perceived vulnerability to disease (PVD) which can result in conformity with social norms. However, a response to superficial cues can result in aversive responses to people that pose no actual threat, leading to an aversion to unfamiliar others, and likelihood of prejudice. Pathogen-neutralizing behaviors, therefore, have implications for social interaction as well as illness behaviors and responses to health communications. In this study, we investigate how PVD influences conformity, attitudes to other people and to lockdown regulations through the lens of the Reinforcement Sensitivity Theory (RST). RST describes personality in terms of biologically-driven approach and avoidance motivations which support personal goals. Participants from the United Kingdom public (N = 605) completed an RST personality questionnaire and then read either (a) coronavirus morbidity-mortality statistics and current United Kingdom government lifestyle regulations, (b) just the regulations (as presented in most government publicity materials), or (c) no information at all. They all completed the Perceived Vulnerability to Disease scale to assess BIS-relevant Germ Aversion and Perceived Infectability, followed by questions measuring social conformity, warmth toward others and attitudes toward lockdown measures. Significantly lower PVD scores were observed in the no-information condition, with the other conditions showing no difference. In terms of RST, approach behaviors related to goal-drive persistence work alongside fear in explaining conformity to social norms. Reward related approach behaviors partially explained warmth toward others, indicating that social rewards gained through interaction continue to be strong drivers of behavior. We found no role for RST traits in attitudes toward lockdown. Overall, coronavirus-related behavior is not driven purely by fear, but also by social and/or protection goals regulated by approach motivation. This study presents new insights into public perceptions of coronavirus and government regulated lifestyle restrictions, helping to explain social behaviors in terms of biologically driven mechanisms. Such understanding is vital if we are to successfully motivate public behavior to constrain spread of the virus.

Intergenerational transmission of anxiety: linking parental anxiety to infant autonomic hyperarousal and fearful temperament

BACKGROUND

Autonomic hyperarousal has been proposed as a dispositional risk factor for anxiety disorders (ADs). Therefore, we studied physiological arousal in offspring of fathers and mothers with and without ADs and whether infant hyperarousal predicts subsequent fearful temperament.

METHODS

Infants (N = 128; age = 4 months) did a novel stimuli task (exposure to visual, olfactory, and acoustic stimuli and an unfamiliar male) and a habituation task (exposure to a repeated acoustic stimulus). Heart rate (HR) and heart rate variability (HRV) were measured during baseline, stimuli and post-stimuli rest. Parents' AD status and severity were measured using a diagnostic interview and their fearful temperament using a questionnaire. Child fearful temperament was measured at 4 months, 1 year and 2.5 years with observations during structured tasks.

RESULTS

Parents' fearful temperament (significant in the habituation task), AD status (significant in the novel stimuli task) and AD severity (significant in both tasks) predicted a higher HR in their infants. Infants' higher HR reactivity to novel stimuli and diminished HR recovery at 4 months predicted a more fearful temperament during infancy and toddlerhood. Infants' higher HR at 4 months predicted a more fearful temperament at 2.5 years.

CONCLUSIONS

Parental prenatal anxiety (disorders) predicted infants' autonomic arousal, which in turn predicted later fearful temperament in children. Outcomes suggest that autonomic hyperarousal is a dispositional risk factor of ADs.

Coronavirus Anxiety Scale: A New Instrument to Measure Anxiety Symptoms Associated with COVID-19

Background: The purpose of this study was to adapt and validate the Coronavirus Anxiety Scale in a sample of Hispanic residents in Puerto Rico. This instrument is a brief mental health screening to identify anxiety symptoms associated with COVID-19. Method: An availability sampling and a sample of 327 Spanish-speaking participants were used. Results: Psychometric analyses confirmed that the scale has a one-dimensional structure and solid reliability (Ω = .93) and validity. The five items met fair discrimination values, demonstrating that the instrument can distinguish between people with anxiety symptoms associated with COVID-19 and those without symptoms. According to the analyses performed, the cut-off points to identify significant symptoms of coronavirus anxiety was ≥ 10. The prevalence of significant symptoms of coronavirus anxiety was 15.29% (n = 50). Conclusions: These results support the scale as a useful and valid tool for clinical research and practice.

Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory

The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.

Anxiety and the Neurobiology of Temporally Uncertain Threat Anticipation

When extreme, anxiety-a state of distress and arousal prototypically evoked by uncertain danger-can be debilitating. Uncertain anticipation is a shared feature of situations that elicit signs and symptoms of anxiety across psychiatric disorders, species, and assays. Despite the profound significance of anxiety for human health and wellbeing, the neurobiology of uncertain-threat anticipation remains unsettled. Leveraging a paradigm adapted from animal research and optimized for fMRI signal decomposition, we examined the neural circuits engaged during the anticipation of temporally uncertain and certain threat in 99 men and women. Results revealed that the neural systems recruited by uncertain and certain threat anticipation are anatomically colocalized in frontocortical regions, extended amygdala, and periaqueductal gray. Comparison of the threat conditions demonstrated that this circuitry can be fractionated, with frontocortical regions showing relatively stronger engagement during the anticipation of uncertain threat, and the extended amygdala showing the reverse pattern. Although there is widespread agreement that the bed nucleus of the stria terminalis and dorsal amygdala-the two major subdivisions of the extended amygdala-play a critical role in orchestrating adaptive responses to potential danger, their precise contributions to human anxiety have remained contentious. Follow-up analyses demonstrated that these regions show statistically indistinguishable responses to temporally uncertain and certain threat anticipation. These observations provide a framework for conceptualizing anxiety and fear, for understanding the functional neuroanatomy of threat anticipation in humans, and for accelerating the development of more effective intervention strategies for pathological anxiety.SIGNIFICANCE STATEMENT Anxiety-an emotion prototypically associated with the anticipation of uncertain harm-has profound significance for public health, yet the underlying neurobiology remains unclear. Leveraging a novel neuroimaging paradigm in a relatively large sample, we identify a core circuit responsive to both uncertain and certain threat anticipation, and show that this circuitry can be fractionated into subdivisions with a bias for one kind of threat or the other. The extended amygdala occupies center stage in neuropsychiatric models of anxiety, but its functional architecture has remained contentious. Here we demonstrate that its major subdivisions show statistically indistinguishable responses to temporally uncertain and certain threat. Collectively, these observations indicate the need to revise how we think about the neurobiology of anxiety and fear.

Reduced Multivoxel Pattern Similarity of Vicarious Neural Pain Responses in Psychopathy

Psychopathy is a personality construct characterized by interpersonal callousness, boldness, and disinhibition, traits that vary continuously across the population and are linked to impaired empathic responding to others' distress and suffering. Following suggestions that empathy reflects neural self-other mapping-for example, the similarity of neural responses to experienced and observed pain, measurable at the voxel level-we used a multivoxel approach to assess associations between psychopathy and empathic neural responses to pain. During fMRI scanning, 21 community-recruited participants varying in psychopathy experienced painful pressure stimulation and watched a live video of a stranger undergoing the same stimulation. As total psychopathy, coldheartedness, and self-centered impulsivity increased, multivoxel similarity of vicarious and experienced pain in the left anterior insula decreased, effects that were not observed following an empathy prompt. Our data provide preliminary evidence that psychopathy is characterized by disrupted spontaneous empathic representations of others' pain that may be reduced by instructions to empathize.

Dysregulated brain salience within a triple network model in high trait anxiety individuals: A pilot EEG functional connectivity study

Although previous studies have reported the association between large-scale brain networks alterations and pathological anxiety, abnormalities in the dynamic interaction among the triple network model in anxiety disorders and, especially, in trait anxiety is still poorly explored. Thus, the main aim of the current study was to investigate triple network functional dynamics in subjects with high trait anxiety during resting state (RS) through electroencephalography (EEG) connectivity. Twenty-three individuals with high-trait-anxiety (HTA) and forty-five participants with low-trait-anxiety (LTA) were enrolled. EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA). Compared to LTA participants, HTA subjects showed a decrease of alpha connectivity within the salience network (SN), between the dorsal anterior cingulate cortex (dACC) and both left and right anterior insula (AI). Furthermore, SN functional connectivity strength was negatively correlated with higher trait anxiety, even when controlling for potential confounding variables (e.g., depressive and obsessive-compulsive symptoms). Taken together, our results point out a specific functional connectivity pattern in HTA individuals, which consists in a dysfunctional communication within the SN, specifically in the AI-dACC pathway. This functional pattern could underline, at rest, saliency detection and brain correlates of altereted emotion regulation and cognitive control processes typically involved in anxiety.

Individual differences in anxiety and automatic amygdala response to fearful faces: A replication and extension of Etkin et al. (2004)

Trait anxiety refers to the stable tendency to attend to threats and experience fears and worries across many situations. According to the widely noticed, pioneering investigation by Etkin et al. (2004) trait anxiety is strongly associated with reactivity in the right basolateral amygdala to non-conscious threat. Although this observation was based on a sample of only 17 individuals, no replication effort has been reported yet. We reexamined automatic amygdala responsiveness as a function of anxiety in a large sample of 107 participants. Besides self-report instruments, we administered an indirect test to assess implicit anxiety. To assess early, automatic stages of emotion processing, we used a color-decision paradigm presenting brief (33 ms) and backward-masked fearful facial expressions. N = 56 participants were unaware of the presence of masked faces. In this subset of unaware participants, the relationship between trait anxiety and basolateral amygdala activation by fearful faces was successfully replicated in region of interest analyses. Additionally, a relation of implicit anxiety with masked fear processing in the amygdala and temporal gyrus was observed. We provide evidence that implicit measures of affect can be valuable predictors of automatic brain responsiveness and may represent useful additions to explicit measures. Our findings support a central role of amygdala reactivity to non-consciously perceived threat in understanding and predicting dispositional anxiety, i.e. the frequency of spontaneously occurring anxiety in everyday life.

The correlation of patients' anxiety after a liver or kidney transplantation with functional and self-reported work ability

Organ transplantation has become the treatment of choice for end-stage organ failure, including renal and liver failure. The benefits of patient employment after transplantation are numerous, but factors determining the ability to work among these patients are not clearly defined. The growing interest in these factors has strong practical implications for organizations creating vocational rehabilitation programs. Given the interconnection between psychological and physical functioning in patients after transplantation, the present study examined the impact of anxiety on vocational rehabilitation and its relationship with functional tests. A total of 100 patients after liver or kidney transplantation underwent functional tests, including the 6-minute walking test and 30-second chair stand test (30"CST), and psychological tests, specifically the Inventory of Physical Activity Objectives, Work Ability Index, and State-Train Anxiety Inventory. Working ability was affected by psychological factors. State and trait anxiety exhibited inverse relationships with subjective readiness to occupational activity (P < .001, r = -.59 and P < .001, r = -.56, respectively). The level of anxiety was negatively related to the results of the 30"CST. State-Train Anxiety Inventory, State Anxiety subscale and State-Train Anxiety Inventory, State-Trait Anxiety subscale vs 30"CST: P < .001, r = -.43 P < .001, r = -.44). Thus, state and trait anxiety influence perceived work ability and partially functional status. These observations may indicate the potential benefits of including psychologists in interdisciplinary teams for physical and especially vocational rehabilitation of patients after liver or kidney transplantation.

Interactions between anxiety subtypes, personality characteristics, and emotional regulation skills as predictors of future work outcomes

INTRODUCTION

This study examined long-term predictive links between different types of anxiety in late adolescence and work-related outcomes in young adulthood. The presence of adaptive personality traits and positive emotion regulation and coping skills were hypothesized to buffer these associations, reducing the negative effects of anxiety on future work outcomes.

METHODS

Hypotheses were tested using multi-reporter data from a community sample of 184 youth in the United States followed from ages 17-30. Trait anxiety, anxious arousal, rejection sensitivity, and implicit rejection were each examined in late adolescence as predictors of work-related ambition, work performance, job satisfaction, and career satisfaction in young adulthood. Conscientiousness, grit, emotion regulation (ER) and coping skills were examined as potential moderators.

RESULTS

Although trait anxiety was the only anxiety variable directly predictive of work outcomes in regression analyses, personality variables and ER skills interacted with multiple types of anxiety to predict work outcomes. Interestingly, findings reflected a pattern in which a combination of greater conscientiousness and greater anxiety, and greater ER skills and greater anxiety, predicted more positive work outcomes.

CONCLUSIONS

These findings not only suggest that the development of traits such as conscientiousness and ER skills may be helpful for youth with higher levels of anxiety, but also that higher levels of anxiety, when appropriately balanced by other qualities, may be adaptive for promoting positive career development for some youth.

Neurobiological links between stress and anxiety

Stress and anxiety have intertwined behavioral and neural underpinnings. These commonalities are critical for understanding each state, as well as their mutual interactions. Grasping the mechanisms underlying this bidirectional relationship will have major clinical implications for managing a wide range of psychopathologies. After briefly defining key concepts for the study of stress and anxiety in pre-clinical models, we present circuit, as well as cellular and molecular mechanisms involved in either or both stress and anxiety. First, we review studies on divergent circuits of the basolateral amygdala (BLA) underlying emotional valence processing and anxiety-like behaviors, and how norepinephrine inputs from the locus coeruleus (LC) to the BLA are responsible for acute-stress induced anxiety. We then describe recent studies revealing a new role for mitochondrial function within the nucleus accumbens (NAc), defining individual trait anxiety in rodents, and participating in the link between stress and anxiety. Next, we report findings on the impact of anxiety on reward encoding through alteration of circuit dynamic synchronicity. Finally, we present work unravelling a new role for hypothalamic corticotropin-releasing hormone (CRH) neurons in controlling anxiety-like and stress-induce behaviors. Altogether, the research reviewed here reveals circuits sharing subcortical nodes and underlying the processing of both stress and anxiety. Understanding the neural overlap between these two psychobiological states, might provide alternative strategies to manage disorders such as post-traumatic stress disorder (PTSD).

Predicting the affective tone of everyday dreams: A prospective study of state and trait variables

Although emotions are reported in a large majority of dreams, little is known about the factors that account for night-to-night and person-to-person variations in people’s experience of dream affect. We investigated the relationship between waking trait and state variables and dream affect by testing multilevel models intended to predict the affective valence of people’s everyday dreams. Participants from the general population completed measures of personality and trauma history followed by a three-week daily journal in which they noted dream recall, valence of dreamed emotions and level of perceived stress for the day as well as prior to sleep onset. Within-subject effects accounted for most of the explained variance in the reported valence of dream affect. Trait anxiety was the only variable that significantly predicted dream emotional valence at the between-subjects level. In addition to highlighting the need for more fine-grained measures in this area of research, our results point to methodological limitations and biases associated with retrospective estimates of general dream affect and bring into focus state variables that may best explain observed within-subject variance in emotions experienced in everyday dreams.

Placebo analgesia induced by verbal suggestion in the context of experimentally induced fear and anxiety

The role of state anxiety and state fear in placebo effects is still to be determined. We aimed to investigate the effect of fear of movement-related pain (FMRP) and contextual pain related anxiety (CPRA) on the magnitude of placebo analgesia induced by verbal suggestion. Fifty-six female participants completed a modified voluntary joystick movement paradigm (VJMP) where half participated in a predictable pain condition (PC), in which one of the joystick movements is always followed by pain and the other movement is never followed by pain, and half in an unpredictable pain condition (UC), in which pain was delivered unpredictably. By varying the level of pain predictability, FMRP and CPRA were induced in PC and UC respectively. Colour stimuli were presented at the beginning of each trail. Half of the participants were verbally informed that the green or red colour indicated less painful stimuli (experimental groups), the other half did not receive any suggestion (control groups). We measured self-reported pain intensity, expectancy of pain intensity (PC only), pain related fear and anxiety (eyeblink startle response and self-ratings) and avoidance behaviour (movement-onset latency and duration). The results indicate that the placebo effect was successfully induced in both experimental conditions. In the PC, the placebo effect was predicted by expectancy. Despite the fact that FMRP and CPRA were successfully induced, no difference was found in the magnitude of the placebo effect between PC and UC. Concluding, we did not find a divergent effect of fear and anxiety on placebo analgesia.

Modeling Relations Between Triarchic Biobehavioral Traits and DSM Internalizing Disorder Dimensions

The biobehavioral traits of the triarchic model of psychopathy have well-known correlates with externalizing psychopathology. Although evidence also suggests associations with internalizing disorders, research has yet to formally model relationships between dimensions of internalizing psychopathology and triarchic traits. Employing a sample of 218 adults (50.2% female), the current study used confirmatory factor analysis to characterize how triarchic trait dimensions-delineated using different scale operationalizations-relate to internalizing when modeled as a single broad factor, and as distinct fear and distress subfactors. Findings demonstrated (a) robust opposing relations for triarchic boldness (+) and disinhibition (-), and an interactive association for the two, with general internalizing, along with a modest negative relationship for meanness; and (b) distinct associations for the three triarchic trait dimensions with fear and distress subfactors of internalizing. This work clarifies how facets of psychopathy relate to the internalizing psychopathology spectrum and provides a means for interfacing this spectrum with biological variables.

Increased similarity of neural responses to experienced and empathic distress in costly altruism

Empathy—affective resonance with others’ sensory or emotional experiences—is hypothesized to be an important precursor to altruism. However, it is not known whether real-world altruists’ heightened empathy reflects true self-other mapping of multi-voxel neural response patterns. We investigated this relationship in adults who had engaged in extraordinarily costly real-world altruism: donating a kidney to a stranger. Altruists and controls completed fMRI testing while anticipating and experiencing pain, and watching as a stranger anticipated and experienced pain. Machine learning classifiers tested for shared representation between experienced and observed distress. Altruists exhibited more similar representations of experienced and observed fearful anticipation spontaneously and following an empathy prompt in anterior insula and anterior/middle cingulate cortex, respectively, suggesting heightened empathic proclivities and abilities for fear. During pain epochs, altruists were distinguished by spontaneous empathic responses in anterior insula, anterior/mid-cingulate cortex and supplementary motor area, but showed no difference from controls after the empathy prompt. These findings (1) link shared multi-voxel representations of the distress of self and others to real-world costly altruism, (2) reinforce distinctions between empathy for sensory states like pain and anticipatory affective states like fear, and (3) highlight the importance of differentiating between the proclivity and ability to empathize.

Pregnancy outcomes in women with severe fear of childbirth

OBJECTIVE

To compare pregnancy outcomes for women with and without severe fear of childbirth (FOC) reported in the second trimester of pregnancy.

METHODS

In a prospective cohort study, 389 singleton pregnancies were followed up using medical records of participants in a study investigating FOC in Cork, Republic of Ireland. FOC was measured using the Wijma Delivery Experience Questionnaire Part A (W-DEQ A). Severe FOC was defined as W-DEQ A ≥ 85, moderate FOC, W-DEQ-A 66-84 and low FOC, W-DEQ A 0-65. Outcome measures were birthweight, birthweight centile, gestational age, and Apgar scores at 1 min and Apgar at 5 min. Linear regression was used to assess the association between FOC and each outcome measure with adjustment for maternal age, smoking, parity and marital status.

RESULTS

There was no statistically significant difference in mean birthweight (mean difference = -0.03; [95% CI: -444.69, 315.82]), mean birthweight centile (mean difference = 0.03; [95%CI: -15.97, 23.53]), or mean gestational age (mean difference = -0.06; [95%CI: -11.69, 4.82]) in women with severe FOC (n = 18) compared with women with low FOC (n = 371). In the adjusted models, there was only a slight correlation between severe FOC and Apgar scores at 1 min (mean difference = -0.09 [95%CI: -1.28, 0.32]) and Apgar scores at 5 min (mean difference = -0.18 [95%CI: -1.16, 1.08]).

CONCLUSION

While a slight association was noted between severe FOC and Apgar scores, overall findings are reassuring and could inform educational interventions which may alleviate FOC. Awareness of FOC for health care professionals is vital to consider women's mental well-being.

Can worry and physiological anxiety uniquely predict children and adolescents' academic achievement and intelligence?

When exploring the relationship anxiety has with IQ, academic achievement studies often rely on diagnostic groups or total scores for an anxiety measure. The differential effects caused by anxiety dimensions, as well as their interactions, were examined with an exploratory method. This study examined the main effect of worry and physiological anxiety as predictors of youths' academic and cognitive functioning. Two samples of youth that presented to an out-patient clinic (n = 121, M = 10.59, SD = 2.78, range = 6-16; n = 92, M = 10.07, SD = 2.76, range = 6-16) were administered well-established performance measures of academic and intellectual functioning, along with a measurement of anxiety. In an exploratory analysis, the interaction between worry and physiological anxiety was the only significant effect, robust across all academic composites and intelligence indices. Physiological anxiety had a differential relationship with academic achievement domains (and processing speed) dependent on levels of worry; low-levels of worry were predictive of improved scores at high, but not low-, levels of physiological anxiety. In contrast, high-, but not low-, levels of physiological anxiety were associated with lower scores when accompanied by elevated levels of worry when predicting intelligence indices.

Implicitly and explicitly assessed anxiety: No relationships with recognition of and brain response to facial emotions

Trait anxiety, the disposition to experience anxiety, is known to facilitate perception of threats. Trait anxious individuals seem to identify threatening stimuli such as fearful facial expressions more accurately, especially when presented under temporal constraints. In past studies on anxiety and emotion face recognition, only self-report or explicit measures of anxiety have been administered. Implicit measures represent indirect tests allowing to circumvent problems associated with self-report. In our study, we made use of implicit in addition to explicit measures to investigate the relationships of trait anxiety with recognition of and brain response to emotional faces. 75 healthy young volunteers had to identify briefly presented (67 ms) fearful, angry, happy, and neutral facial expressions masked by neutral faces while undergoing functional magnetic resonance imaging. The Implicit Association Test, the State-Trait Anxiety Inventory and the Beck Anxiety Inventory were applied as implicit and explicit measures of trait anxiety. After corrections for multiple testing, neither implicitly nor explicitly measured anxiety correlated with recognition of emotional facial expressions. Moreover, implicitly and explicitly assessed anxiety was not linked to brain response to emotional faces. Our data suggest links between discrimination accuracy and brain response to facial emotions. Activation of the caudate nucleus seems be of particular importance for recognizing fear and happiness from facial expressions. Processes of somatosensory resonance appear to be involved in identifying fear from facial expressions. The present data indicate that, regardless of assessment method, trait anxiety does not affect the recognition of fear or other emotions as has been proposed previously.

Psychopathy and Internalizing Psychopathology: A Triarchic Model Perspective

Methodological and conceptual differences across studies have impeded our understanding of the relationship between psychopathy and internalizing psychopathology. To shed further light on this question, we undertook correlational and structural-modeling analyses of data from two samples to characterize how facets of psychopathy relate to internalizing psychopathology when assessed using multidimensional measures of each construct (i.e., Triarchic Psychopathy Measure, Inventory of Depression and Anxiety Symptoms). Participants for Study 1 were 470 undergraduates and community-dwelling adults who completed these measures in self-report form; participants for Study 2 were 301 community-dwelling adults who completed informant-rating versions of these measures (as applied to a known-other). Across samples, analyses revealed sharply contrasting associations for the three triarchic-model facets with internalizing psychopathology and its subdomains, with boldness relating negatively in most cases, disinhibition relating positively in most cases, and meanness exhibiting mostly null associations. Results provide a nuanced picture of associations between psychopathic symptomatology and internalizing problems.

The role of emotions in cancer patients' decision-making

INTRODUCTION

Despite the attempt to make decisions based on evidence, doctors still have to consider patients' choices which often involve other factors. In particular, emotions seem to influence the way that options and the surrounding information are interpreted and used.

OBJECTIVE

The objective of the present review is to provide a brief overview of research on decision making and cancer with a specific focus on the role of emotions.

METHOD

Thirty-nine studies were identified and analysed. Most of the studies investigated anxiety and fear. Worry was the other psychological factor that, together with anxiety, played a crucial role in cancer-related decision-making.

RESULTS

The roles of fear, anxiety and worry were described for detection behaviour, diagnosis, choice about prevention and curative treatments and help-seeking behaviour. Results were inconsistent among the studies. Results stressed that cognitive appraisal and emotional arousal (emotion's intensity level) interact in shaping the decision. Moderate levels of anxiety and worry improved decision-making, while low and high levels tended to have no effect or a hindering effect on decision making. Moderating factors played an under-investigated role.

CONCLUSIONS

Decision making is a complex non-linear process that is affected by several factors, such as, for example, personal knowledge, past experiences, individual differences and certainly emotions. Research studies should investigate further potential moderators of the effect of emotions on cancer-related choice. Big data and machine learning could be a good opportunity to test the interaction between a large amount of factors that is not feasible in traditional research. New technologies such as eHealth and virtual reality can offer support for the regulation of emotions and decision making.

Taurine modulates the stress response in zebrafish

The zebrafish (Danio rerio) is used as an emergent model organism to investigate the behavioral and physiological responses to stress. The anxiolytic-like effects of taurine in zebrafish support the existence of different mechanisms of action, which can play a role in preventing stress-related disorders (i.e., modulation of GABA_A, strychnine-sensitive glycine, and NMDA receptors, as well as antioxidant properties). Herein, we investigate whether taurine modulates some behavioral and biochemical responses in zebrafish acutely submitted to chemical and mechanical stressors. We pretreated zebrafish for 1 h in beakers at 42, 150, and 400 mg/L taurine. Fish were later acutely exposed to a chemical stressor (conspecific alarm substance) or to a mechanical stressor (net chasing), which elicits escaping responses and aversive behaviors. Locomotion, exploration, and defensive-like behaviors were measured using the novel tank and the light-dark tests. Biochemical (brain oxidative stress-related parameters) and whole-body cortisol levels were also quantified. We showed that taurine prevents anxiety/fear-like behaviors and protein carbonylation and dampens the cortisol response following acute stress in zebrafish. In summary, our results demonstrate a protective role of taurine against stress-induced behavioral and biochemical changes, thereby reinforcing the growing utility of zebrafish models to investigate the neuroprotective actions of taurine in vertebrates.

Default mode network alterations in individuals with high-trait-anxiety: An EEG functional connectivity study

BACKGROUND

Although several researches investigated Default Mode Network (DMN) alterations in individuals with anxiety disorders, up to now no studies have investigated DMN functional connectivity in non-clinical individuals with high-trait-anxiety using quantitative electroencephalography (EEG). Here, the main aim was to extend previous findings investigating the association between trait anxiety and DMN EEG functional connectivity.

METHODS

Twenty-three individuals with high-trait-anxiety and twenty-four controls were enrolled. EEG was recorded during 5 min of resting state (RS). EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA).

RESULTS

Compared to controls, individuals with high-trait-anxiety showed a decrease of theta connectivity between right medial prefrontal cortex (mPFC) and right posterior cingulate/retrosplenial cortex. A decrease of beta connectivity was also observed between right mPFC and right anterior cingulate cortex. Furthermore, DMN functional connectivity strength was negatively related with STAI-T total score (i.e., lower connectivity was associated with higher trait anxiety), even when controlling for potential confounding variables (i.e., sex, age, and general psychopathology).

LIMITATIONS

Small sample size makes it difficult to draw definitive conclusions. Furthermore, we did not assess state variation of anxiety, which make our interpretation specific to trait anxiety.

CONCLUSIONS

Taken together, our results suggest that high-trait-anxiety individuals fail to synchronize DMN during RS, reflecting a possible top-down cognitive control deficit. These results may help in the understanding of the individual differences in functional brain networks associated with trait anxiety, a crucial aim in the prevention and in the early etiology understanding of clinical anxiety and related sequelae.

Hippocampal network oscillations at the interplay between innate anxiety and learned fear

The hippocampus plays a central role as a hub for episodic memory and as an integrator of multimodal sensory information in time and space. Thereby, it critically determines contextual setting and specificity of episodic memories. It is also a key site for the control of innate anxiety states and involved in psychiatric diseases with heightened anxiety and generalized fear memory such as post-traumatic stress disorder (PTSD). Expression of both innate "unlearned" anxiety and "learned" fear requires contextual processing and engagement of a brain-wide network including the hippocampus together with the amygdala and medial prefrontal cortex. Strikingly, the hippocampus is also the site of emergence of oscillatory rhythms that coordinate information processing and filtering in this network. Here, we review data on how the hippocampal network oscillations and their coordination with amygdalar and prefrontal oscillations are engaged in innate threat evaluation. We further explore how such innate oscillatory communication might have an impact on contextualization and specificity of "learned" fear. We illustrate the partial overlap of fear and anxiety networks that are built by the hippocampus in conjunction with amygdala and prefrontal cortex. We further propose that (mal)-adaptive interplay via (dis)-balanced oscillatory communication between the anxiety network and the fear network may determine the strength of fear memories and their resistance to extinction.

Applying a Cognitive Neuroscience Perspective to Disruptive Behavior Disorders: Implications for Schools

A cognitive neuroscience perspective seeks to understand behavior, in this case disruptive behavior disorders (DBD), in terms of dysfunction in cognitive processes underpinned by neural processes. While this type of approach has clear implications for clinical mental health practice, it also has implications for school-based assessment and intervention with children and adolescents who have disruptive behavior and aggression. This review articulates a cognitive neuroscience account of DBD by discussing the neurocognitive dysfunction related to emotional empathy, threat sensitivity, reinforcement-based decision-making, and response inhibition. The potential implications for current and future classroom-based assessments and interventions for students with these deficits are discussed.

Moderating Effects of Harm Avoidance on Resting-State Functional Connectivity of the Anterior Insula

As an index of behavioral inhibition and an individual’s propensity to avoid, rather than seek, potentially dangerous situations, harm avoidance has been linked to internalizing psychopathology. Altered connectivity within intrinsic functional neural networks (i.e., default mode [DMN], central executive [CEN] and salience networks [SN]) has been related to internalizing psychopathology; however, less is known about the effects of harm avoidance on functional connectivity within and between these networks. Importantly, harm avoidance may be distinguishable from trait anxiety and have clinical relevance as a risk factor for internalizing psychopathology. A sample of young adults (n = 99) completed a resting state functional magnetic resonance imaging (fMRI) scan and self-report measures of harm avoidance and trait anxiety. Whole brain seed-to-voxel and seed-to-network connectivity analyses were conducted using anterior insula seeds to examine associations between harm avoidance/trait anxiety and connectivity. After adjusting for sex and age, there was a significant negative effect of harm avoidance on connectivity between the anterior insula and clusters in the precuneus/posterior cingulate cortex (PCC) left superior/middle frontal gyrus, dorsal anterior cingulate cortex (dACC) and bilateral inferior parietal lobule (IPL)/angular gyrus. Seed-to-network analyses indicated a negative effect of harm avoidance on connectivity between the right anterior insula and anterior and posterior DMN. There were no effects of trait anxiety on functional connectivity of the anterior insula. Overall, the results indicate that individual differences in harm avoidance relate to disruptions in internetwork connectivity that may contribute to deficits in appropriately modulating attentional focus.