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Stout DM, Simmons AN, Nievergelt CM, Minassian A, Biswas N, Maihofer AX, Risbrough VB, Baker DG. Deriving psychiatric symptom-based biomarkers from multivariate relationships between psychophysiological and biochemical measures. Neuropsychopharmacology 2022; 47:2252-2260. [PMID: 35347268 PMCID: PMC9630445 DOI: 10.1038/s41386-022-01303-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/18/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022]
Abstract
Identification of biomarkers for psychiatric disorders remains very challenging due to substantial symptom heterogeneity and diagnostic comorbidity, limiting the ability to map symptoms to underlying neurobiology. Dimensional symptom clusters, such as anhedonia, hyperarousal, etc., are complex and arise due to interactions of a multitude of complex biological relationships. The primary aim of the current investigation was to use multi-set canonical correlation analysis (mCCA) to derive biomarkers (biochemical, physiological) linked to dimensional symptoms across the anxiety and depressive spectrum. Active-duty service members (N = 2,592) completed standardized depression, anxiety and posttraumatic stress questionnaires and several psychophysiological and biochemical assays. Using this approach, we identified two phenotype associations between distinct physiological and biological phenotypes. One was characterized by symptoms of dysphoric arousal (anhedonia, anxiety, hypervigilance) which was associated with low blood pressure and startle reactivity. This finding is in line with previous studies suggesting blunted physiological reactivity is associated with subpopulations endorsing anxiety with comorbid depressive features. A second phenotype of anxious fatigue (high anxiety and reexperiencing/avoidance symptoms coupled with fatigue) was associated with elevated blood levels of norepinephrine and the inflammatory marker C-reactive protein in conjunction with high blood pressure. This second phenotype may describe populations in which inflammation and high sympathetic outflow might contribute to anxious fatigue. Overall, these findings support the growing consensus that distinct neuropsychiatric symptom patterns are associated with differential physiological and blood-based biological profiles and highlight the potential of mCCA to reveal important psychiatric symptom biomarkers from several psychophysiological and biochemical measures.
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Affiliation(s)
- Daniel M Stout
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA.
| | - Alan N Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Caroline M Nievergelt
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Arpi Minassian
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nilima Biswas
- Department of Pathology, University of California San Diego, La Jolla, CA, 92093, USA
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dewleen G Baker
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
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Liu Y, Jia LN, Wu H, Jiang W, Wang Q, Wang D, Xiong YB, Ren YP, Ma X, Tang YL. Adjuvant electroconvulsive therapy with antipsychotics is associated with improvement in auditory mismatch negativity in schizophrenia. Psychiatry Res 2022; 311:114484. [PMID: 35245745 DOI: 10.1016/j.psychres.2022.114484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Yi Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li-Na Jia
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Han Wu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wei Jiang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qian Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dan Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yan-Bing Xiong
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yan-Ping Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, United States; Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA 30033, United States
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Brunner LM, Maurer F, Weber K, Weigl J, Milenkovic VM, Rupprecht R, Nothdurfter C, Mühlberger A. Differential effects of the translocator protein 18 kDa (TSPO) ligand etifoxine and the benzodiazepine alprazolam on startle response to predictable threat in a NPU-threat task after acute and short-term treatment. Psychopharmacology (Berl) 2022; 239:2233-2244. [PMID: 35278124 PMCID: PMC9205810 DOI: 10.1007/s00213-022-06111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
RATIONALE Benzodiazepines have been extensively investigated in experimental settings especially after single administration, which mostly revealed effects on unpredictable threat (U-threat) rather than predictable threat (P-threat). Given the need for pharmacological alternatives with a preferable side-effect profile and to better represent clinical conditions, research should cover also other anxiolytics and longer application times. OBJECTIVES The present study compared the acute and short-term effects of the translocator protein 18 kDa (TSPO) ligand etifoxine and the benzodiazepine alprazolam on P-threat and U-threat while controlling for sedation. METHODS Sixty healthy male volunteers, aged between 18 and 55 years, were randomly assigned to receive a daily dose of either 150 mg etifoxine, 1.5 mg alprazolam, or placebo for 5 days. On days 1 and 5 of intake, they performed a NPU-threat task including neutral (N), predictable (P), and unpredictable (U) conditions, while startle responsivity and self-reports were studied. Sedative effects were assessed using a continuous performance test. RESULTS Neither alprazolam nor etifoxine affected startle responsivity to U-threat on any of the testing days. While etifoxine reduced the startle response to P-threat on day 1 of treatment for transformed data, a contrary effect of alprazolam was found for raw values. No effects on self-reports and no evidence of sedation could be observed for either drug. CONCLUSIONS None of the anxiolytic substances had an impact on startle potentiation to U-threat even after several days of intake. The effects of the anxiolytics on startle responsivity to P-threat as well as implications for future studies are discussed.
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Affiliation(s)
- Lisa-Marie Brunner
- Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053, Regensburg, Germany. .,Department of Psychology, Clinical Psychology and Psychotherapy, University Regensburg, Regensburg, Germany.
| | - Franziska Maurer
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Kevin Weber
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Johannes Weigl
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Vladimir M. Milenkovic
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Rainer Rupprecht
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Caroline Nothdurfter
- grid.7727.50000 0001 2190 5763Department of Medicine, Psychiatry and Psychotherapy, University Regensburg, 93053 Regensburg, Germany
| | - Andreas Mühlberger
- grid.7727.50000 0001 2190 5763Department of Psychology, Clinical Psychology and Psychotherapy, University Regensburg, Regensburg, Germany
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Han J, Xiao K, Zhao X. Does Individual Anxiety Play a Mediating Role on the Impact of Psychological Expectation of Class Mobility on Entrepreneurial Choice? Psychol Res Behav Manag 2021; 14:2157-2168. [PMID: 34992477 PMCID: PMC8711240 DOI: 10.2147/prbm.s336559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Under the dual backgrounds of "Chinese dream" and "Mass entrepreneurship and innovation", can psychological expectations influence entrepreneurial activities? There is little literature on this topic. In addition, although psychological expectation can reduce the negative emotions caused by uncertain events, the expectation itself can lead to the activation of related neural circuits and the generation of individual anxiety. According to Maslow's hierarchy of needs, this paper divides the entrepreneurship into the economic status type, the social status type and the self-development type, and attempts to study the psychological mechanism of the psychological expectation of class mobility influencing entrepreneurial choice by constructing the mediating effect model of individual anxiety. METHODS Based on CGSS 2015 data, entrepreneurial choice was obtained through describing the working status. The individual anxiety in the questionnaire is "How often have you felt depressed or disheartened in the past four weeks?". Psychological expectation of class mobility was calculated by subtracting the current subjective class score from the subjective class score 10 years later. Classical mediating effect models were conducted by stata 15.0. RESULTS The psychological expectation of class mobility can promote entrepreneurial behavior. According to sub sample study, individual anxiety plays a partial mediating effect between the psychological expectation of class mobility and economic status type entrepreneurships. No mediating effect of individual anxiety occurs for social status type and self-development type entrepreneurships. CONCLUSION This study provides a psychological mechanism by which the expectation of class mobility affects entrepreneurial choice. The implications are as follows: we should firstly prevent excessive anxiety from triggering irrational entrepreneurship. Secondly, we should establish a fair social mobility mechanism to provide psychological incentives for entrepreneurial groups to flow upward through entrepreneurship. Thirdly, we undertake classification management of entrepreneurial groups and pay attention to social status type and self-development type entrepreneurial.
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Affiliation(s)
- Junhui Han
- School of Economics and Management, Taiyuan University of Technology, Jinzhong, People’s Republic of China
| | - Kemin Xiao
- School of Economics and Management, Taiyuan University of Technology, Jinzhong, People’s Republic of China
| | - Xiaoqiong Zhao
- School of Economics and Management, Taiyuan University of Technology, Jinzhong, People’s Republic of China
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Stout DM, Powell S, Kangavary A, Acheson DT, Nievergelt CM, Kash T, Simmons AN, Baker DG, Risbrough VB. Dissociable impact of childhood trauma and deployment trauma on affective modulation of startle. Neurobiol Stress 2021; 15:100362. [PMID: 34258336 PMCID: PMC8259305 DOI: 10.1016/j.ynstr.2021.100362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Trauma disorders are often associated with alterations in aversive anticipation and disruptions in emotion/fear circuits. Heightened or blunted anticipatory responding to negative cues in adulthood may be due to differential trauma exposure during development, and previous trauma exposure in childhood may also modify effects of subsequent trauma in adulthood. The aim of the current investigation was to examine the contributions of childhood trauma on affective modulation of startle before and after trauma exposure in adulthood (a combat deployment). Adult male participants from the Marine Resilience Study with (n = 1145) and without (n = 1312) a history of reported childhood trauma completed an affective modulation of startle task to assess aversive anticipation. Affective startle response was operationalized by electromyography (EMG) recording of the orbicularis oculi muscle in response to acoustic stimuli when anticipating positive and negative affective images. Startle responses to affective images were also assessed. Testing occurred over three time-points; before going on a 7 month combat deployment and 3 and 6 months after returning from deployment. Startle response when anticipating negative images was greater compared to pleasant images across all three test periods. Across all 3 time points, childhood trauma was consistently associated with significantly blunted startle when anticipating negative images, suggesting reliable effects of childhood trauma on aversive anticipation. Conversely, deployment trauma was associated with increased startle reactivity post-deployment compared to pre-deployment, which was independent of childhood trauma and image valence. These results support the hypothesis that trauma exposure during development vs. adulthood may have dissociable effects on aversive anticipation and arousal mechanisms. Further study in women and across more refined age groups is needed to test generalizability and identify potential developmental windows for these differential effects.
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Affiliation(s)
- Daniel M. Stout
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Susan Powell
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Dean T. Acheson
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Caroline M. Nievergelt
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Alan N. Simmons
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Dewleen G. Baker
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Victoria B. Risbrough
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
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6
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Nilsonne G, Tamm S, Golkar A, Olsson A, Sörman K, Howner K, Kristiansson M, Ingvar M, Petrovic P. Oxazepam and cognitive reappraisal: A randomised experiment. PLoS One 2021; 16:e0249065. [PMID: 33886568 PMCID: PMC8061924 DOI: 10.1371/journal.pone.0249065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive reappraisal is a strategy for emotional regulation, important in the context of anxiety disorders. It is not known whether anxiolytic effects of benzodiazepines affect cognitive reappraisal. Aims We aimed to investigate the effect of 25 mg oxazepam on cognitive reappraisal. Methods In a preliminary investigation, 33 healthy male volunteers were randomised to oxazepam or placebo, and then underwent an experiment where they were asked to use cognitive reappraisal to upregulate or downregulate their emotional response to images with negative or neutral emotional valence. We recorded unpleasantness ratings, skin conductance, superciliary corrugator muscle activity, and heart rate. Participants completed rating scales measuring empathy (Interpersonal Reactivity Index, IRI), anxiety (State-Trait Anxiety Inventory, STAI), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and psychopathy (Psychopathy Personality Inventory-Revised, PPI-R). Results Upregulation to negative-valence images in the cognitive reappraisal task caused increased unpleasantness ratings, corrugator activity, and heart rate compared to downregulation. Upregulation to both negative- and neutral-valence images caused increased skin conductance responses. Oxazepam caused lower unpleasantness ratings to negative-valence stimuli, but did not interact with reappraisal instruction on any outcome. Self-rated trait empathy was associated with stronger responses to negative-valence stimuli, whereas self-rated psychopathic traits were associated with weaker responses to negative-valence stimuli. Conclusions While 25 mg oxazepam caused lower unpleasantness ratings in response to negative-valence images, we did not observe an effect of 25 mg oxazepam on cognitive reappraisal.
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Affiliation(s)
- Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- * E-mail:
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Oxford, Oxford, England
| | - Armita Golkar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Andreas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Karolina Sörman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Howner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Harlé KM, Simmons AN, Norman SB, Spadoni AD. Neural affective mechanisms associated with treatment responsiveness in veterans with PTSD and comorbid alcohol use disorder. Psychiatry Res Neuroimaging 2020; 305:111172. [PMID: 32927371 PMCID: PMC8486287 DOI: 10.1016/j.pscychresns.2020.111172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
Post-traumatic stress disorder (PTSD) is associated with neuro-physiological abnormalities reflecting increased anticipatory anxiety and reactivity to traumatic cues. It remains unclear whether neural mechanisms associated with PTSD treatment responsiveness, i.e. hyperactivation of the affective salience network in the brain, extend to a comorbid PTSD and substance use disorder population. Thirty-one Veterans with PTSD and co-occurring alcohol use disorder (AUD) were randomly assigned to either prolonged exposure or a non-exposure based treatment. They completed an affective anticipation task while undergoing fMRI, immediately prior and after completing treatment. After controlling for type and length of treatment, larger reduction of PTSD symptoms was associated with decreased anticipatory activation to negative trauma-related cues in the right pre-Supplementary Motor Area (pre-SMA), a region associated with emotion regulation. Smaller reduction in PTSD severity was associated with enhanced anticipatory activation to those cues within the right para-hippocampal region, an affective processing region. Our findings suggest that post-treatment reductions in anticipatory reactivity to trauma-related cues in the pre-SMA and para-hippocampal area are associated with larger PTSD symptom reduction in individuals with co-occurring PTSD and AUD. These results may offer neurofeedback training targets as an alternative to or enhancement of other PTSD treatment modalities in this population.
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Affiliation(s)
- Katia M Harlé
- VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
| | - Alan N Simmons
- VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Sonya B Norman
- VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Andrea D Spadoni
- VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
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Neural correlates of aversive anticipation: An activation likelihood estimate meta-analysis across multiple sensory modalities. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:1379-1390. [DOI: 10.3758/s13415-019-00747-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Stout DM, Acheson DT, Moore TM, Gur RC, Baker DG, Geyer MA, Risbrough VB. Individual variation in working memory is associated with fear extinction performance. Behav Res Ther 2018; 102:52-59. [PMID: 29331727 PMCID: PMC6182776 DOI: 10.1016/j.brat.2018.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 12/08/2017] [Accepted: 01/04/2018] [Indexed: 12/20/2022]
Abstract
PTSD has been associated consistently with abnormalities in fear acquisition and extinction learning and retention. Fear acquisition refers to learning to discriminate between threat and safety cues. Extinction learning reflects the formation of a new inhibitory-memory that competes with a previously learned threat-related memory. Adjudicating the competition between threat memory and the new inhibitory memory during extinction may rely, in part, on cognitive processes such as working memory (WM). Despite significant shared neural circuits and signaling pathways the relationship between WM, fear acquisition, and extinction is poorly understood. Here, we analyzed data from a large sample of healthy Marines who underwent an assessment battery including tests of fear acquisition, extinction learning, and WM (N-back). Fear potentiated startle (FPS), fear expectancy ratings, and self-reported anxiety served as the primary dependent variables. High WM ability (N = 192) was associated with greater CS + fear inhibition during the late block of extinction and greater US expectancy change during extinction learning compared to individuals with low WM ability (N = 204). WM ability was not associated with magnitude of fear conditioning/expression. Attention ability was unrelated to fear acquisition or extinction supporting specificity of WM associations with extinction. These results support the conclusion that individual differences in WM may contribute to regulating fear responses.
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Affiliation(s)
- Daniel M Stout
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA
| | - Dean T Acheson
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA
| | - Tyler M Moore
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Philadelphia Veterans Administration Medical Center, Philadelphia, PA 19104, USA
| | - Dewleen G Baker
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA; Research Service, VA San Diego Healthcare system, San Diego, CA 92161, USA
| | - Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA.
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10
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Straus LD, Acheson DT, Risbrough VB, Drummond SPA. Sleep Deprivation Disrupts Recall of Conditioned Fear Extinction. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:123-129. [PMID: 28758152 DOI: 10.1016/j.bpsc.2016.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Learned fear is crucial in the development and maintenance of posttraumatic stress disorder (PTSD) and other anxiety disorders, and extinction of learned fear is necessary for response to exposure-based treatments. In humans, research suggests disrupted sleep impairs consolidation of extinction, though no studies have examined this experimentally using total sleep deprivation. METHODS Seventy-one healthy controls underwent a paradigm to acquire conditioned fear to a visual cue. Twenty-four hours after fear conditioning, participants underwent extinction learning. Twenty-four hours after extinction learning, participants underwent extinction recall. Participants were randomized to three groups: 1) well-rested throughout testing ("normal sleep"; n = 21); 2) 36 hours total sleep deprivation before extinction learning ("pre-extinction deprivation"; n = 25); or 3) 36 hours total sleep deprivation after extinction learning and before extinction recall ("post-extinction deprivation"; n = 25). The groups were compared on blink EMG reactivity to the condition stimulus during extinction learning and recall. RESULTS There were no differences among the three groups during extinction learning. During extinction recall, the pre-extinction deprivation group demonstrated significantly less extinction recall than the normal sleep group. There was no significant difference between the normal sleep and post-extinction deprivation group during extinction recall. Results indicated sleep deprivation prior to extinction training significantly disrupts extinction recall. CONCLUSIONS These findings suggest that (1) sleep deprivation in the immediate aftermath of trauma could be a potential contributor to PTSD development and maintenance via interference with natural extinction processes and (2) management of sleep symptoms should be considered during extinction-based therapy.
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Affiliation(s)
- Laura D Straus
- San Diego State University / University of California San Diego Joint Doctoral Program in Clinical Psychology. 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA.,Research Service, San Diego Veterans Affairs Healthcare System (SDVAHS). 3350 La Jolla Village Dr, San Diego, CA 92161, USA
| | - Dean T Acheson
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs. 3350 La Jolla Village Dr, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego. 9500 Gilman Drive, MC 0603, La Jolla, CA 92093, USA
| | - Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs. 3350 La Jolla Village Dr, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego. 9500 Gilman Drive, MC 0603, La Jolla, CA 92093, USA
| | - Sean P A Drummond
- Monash Institute of Cognitive and Clinical Neurosciences. Clayton, VIC 3800, Australia.,School of Psychological Sciences, Monash University. Clayton, VIC 3800, Australia.,Department of Psychiatry, University of California San Diego. 9500 Gilman Drive, MC 0603, La Jolla, CA 92093, USA
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Glenn DE, Acheson DT, Geyer MA, Nievergelt CM, Baker DG, Risbrough VB. HIGH AND LOW THRESHOLD FOR STARTLE REACTIVITY ASSOCIATED WITH PTSD SYMPTOMS BUT NOT PTSD RISK: EVIDENCE FROM A PROSPECTIVE STUDY OF ACTIVE DUTY MARINES. Depress Anxiety 2016; 33:192-202. [PMID: 26878585 DOI: 10.1002/da.22475] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/03/2015] [Accepted: 01/24/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Heightened startle response is a symptom of PTSD, but evidence for exaggerated startle in PTSD is inconsistent. This prospective study aimed to clarify whether altered startle reactivity represents a trait risk-factor for developing PTSD or a marker of current PTSD symptoms. METHODS Marines and Navy Corpsmen were assessed before (n = 2,571) and after (n = 1,632) deployments to Iraq or Afghanistan with the Clinician-Administered PTSD Scale (CAPS). A predeployment startle-threshold task was completed with startle probes presented over 80-114 dB[A] levels. Latent class mixture modeling identified three growth classes of startle performance: "high," "low," and "moderate" threshold classes. Zero-inflated negative binomial regression was used to assess relationships between predeployment startle threshold and pre- and postdeployment psychiatric symptoms. RESULTS At predeployment, the low-threshold class had higher PTSD symptom scores. Relative to the moderate-threshold class, low-threshold class membership was associated with decreased likelihood of being symptom-free at predeployment, based on CAPS, with particular associations with numbing and hyperarousal subscales, whereas high-threshold class membership was associated with more severe predeployment PTSD symptoms, in particular avoidance. Associations between low-threshold membership and CAPS symptoms were independent from measures of trauma burden, whereas associations between high-threshold membership and CAPS were not. Predeployment startle threshold did not predict postdeployment symptoms. CONCLUSIONS This study found that both low startle threshold (heightened reactivity) and high startle threshold (blunted reactivity) were associated with greater current PTSD symptomatology, suggesting that startle reactivity is associated with current PTSD rather than a risk marker for developing PTSD.
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Affiliation(s)
- Daniel E Glenn
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Services, San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | - Dean T Acheson
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Services, San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | - Mark A Geyer
- Department of Psychiatry, University of California, San Diego, California.,Research Service, San Diego Veterans Affairs Healthcare System, San Diego, California
| | - Caroline M Nievergelt
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Services, San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | - Dewleen G Baker
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Services, San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | - Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Services, San Diego, California.,Department of Psychiatry, University of California, San Diego, California
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Risbrough VB, Glenn DE, Baker DG. On the Road to Translation for PTSD Treatment: Theoretical and Practical Considerations of the Use of Human Models of Conditioned Fear for Drug Development. Curr Top Behav Neurosci 2015; 28:173-96. [PMID: 27311760 DOI: 10.1007/7854_2015_5010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The use of quantitative, laboratory-based measures of threat in humans for proof-of-concept studies and target development for novel drug discovery has grown tremendously in the last 2 decades. In particular, in the field of posttraumatic stress disorder (PTSD), human models of fear conditioning have been critical in shaping our theoretical understanding of fear processes and importantly, validating findings from animal models of the neural substrates and signaling pathways required for these complex processes. Here, we will review the use of laboratory-based measures of fear processes in humans including cued and contextual conditioning, generalization, extinction, reconsolidation, and reinstatement to develop novel drug treatments for PTSD. We will primarily focus on recent advances in using behavioral and physiological measures of fear, discussing their sensitivity as biobehavioral markers of PTSD symptoms, their response to known and novel PTSD treatments, and in the case of d-cycloserine, how well these findings have translated to outcomes in clinical trials. We will highlight some gaps in the literature and needs for future research, discuss benefits and limitations of these outcome measures in designing proof-of-concept trials, and offer practical guidelines on design and interpretation when using these fear models for drug discovery.
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Affiliation(s)
- Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, San Diego, VA, USA. .,Department of Psychiatry, University of California San Diego, 9500 Gilman Dr. MC0804, La Jolla, San Diego, CA, 92093, USA.
| | - Daniel E Glenn
- Center of Excellence for Stress and Mental Health, San Diego, VA, USA
| | - Dewleen G Baker
- Center of Excellence for Stress and Mental Health, San Diego, VA, USA.,Department of Psychiatry, University of California San Diego, 9500 Gilman Dr. MC0804, La Jolla, San Diego, CA, 92093, USA
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