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Jenkins KC, Difatta J, Jones EE, Kreutzer KA, Way BM, Phan KL, Gorka SM. Sleep quality impacts the link between reactivity to uncertain threat and anxiety and alcohol use in youth. Psychophysiology 2024; 61:e14490. [PMID: 38217499 PMCID: PMC10922133 DOI: 10.1111/psyp.14490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/25/2023] [Accepted: 09/13/2023] [Indexed: 01/15/2024]
Abstract
Individual differences in reactivity to unpredictable threat (U-threat) have repeatedly been linked to symptoms of anxiety and drinking behavior. An emerging theory is that individuals who are hyper-reactive to U-threat experience chronic anticipatory anxiety, hyperarousal, and are vulnerable to excessive alcohol use via negative reinforcement processes. Notably, anxiety and alcohol use commonly relate to disruptions in sleep behavior and recent findings suggest that sleep quality may impact the link between reactivity to U-threat and psychiatric symptoms and behaviors. The aim of the current study was to examine the unique and interactive effects of reactivity to U-threat and sleep quality on anxiety symptoms and drinking behavior in a cohort of youth, ages 16-19 years. Participants (N = 112) completed a well-validated threat-of-shock task designed to probe individual differences in reactivity to U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded during the task as an index of aversive reactivity. Participants also completed well-validated self-report measures of anxiety and depression symptoms, lifetime alcohol use, and current sleep quality. Results revealed significant startle reactivity to U-threat by sleep quality interactions on anxiety symptoms and lifetime drinking behavior. At high levels of sleep disturbance (only), greater reactivity to U-threat was associated with greater anxiety symptoms and total number of lifetime alcoholic beverages. These results suggest that sensitivity to uncertainty and chronic hyperarousal increases anxiety symptoms and alcohol use behavior, particularly in the context of poor sleep quality.
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Affiliation(s)
- Kathryn C Jenkins
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jordan Difatta
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Emily E Jones
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Kayla A Kreutzer
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Baldwin M Way
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Stephanie M Gorka
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio, USA
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Lewis MW, Bradford DE, Akman E, Frederiks K, Rauch SL, Rosso IM. Unconditioned response to a naturally aversive stimulus is associated with sensitized defensive responding and self-reported fearful traits in a PTSD sample. Psychophysiology 2024; 61:e14473. [PMID: 37919832 DOI: 10.1111/psyp.14473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023]
Abstract
Unconditioned responding (UCR) to a naturally aversive stimulus is associated with defensive responding to a conditioned threat cue (CS+) and a conditioned safety cue (CS-) in trauma-exposed individuals during fear acquisition. However, the relationships of UCR with defensive responses during extinction training, posttraumatic stress disorder (PTSD) symptom severity, and fearful traits in trauma-exposed individuals are not known. In a sample of 100 trauma-exposed adults with a continuum of PTSD severity, we recorded startle responses and skin conductance responses (SCR) during fear acquisition and extinction training using a 140 psi, 250-ms air blast to the larynx as the unconditioned stimulus. We explored dimensional associations of two different measures of UCR (unconditioned startle and unconditioned SCR) with conditioned defensive responding to CS+ and CS-, conditioned fear (CS+ minus CS-), PTSD symptom severity, and a measure of fearful traits (composite of fear survey schedule, anxiety sensitivity index, and Connor-Davidson resilience scale). Unconditioned startle was positively associated with startle potentiation to the threat cue and the safety cue across both learning phases (CS+ Acquisition, CS- Acquisition, CS+ Extinction Training, CS- Extinction Training) and with fearful traits. Unconditioned SCR was positively associated with SCR to the CS+ and CS- and SCR difference score during Acquisition. Neither type of UCR was associated with PTSD symptom severity. Our findings suggest that UCR, particularly unconditioned startle to a naturally aversive stimulus, may inform research on biomarkers and treatment targets for symptoms of pervasive and persistent fear in trauma-exposed individuals.
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Affiliation(s)
- Michael W Lewis
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel E Bradford
- School of Psychological Science, Oregon State University, Oregon, USA
| | - Eylül Akman
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Kevin Frederiks
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Scott L Rauch
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Isabelle M Rosso
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Cruz APM, Castro-Gomes V, Landeira-Fernandez J. An animal model of trait anxiety: Carioca high freezing rats as a model of generalized anxiety disorder. PERSONALITY NEUROSCIENCE 2024; 7:e6. [PMID: 38384665 PMCID: PMC10877273 DOI: 10.1017/pen.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/05/2023] [Accepted: 06/20/2023] [Indexed: 02/23/2024]
Abstract
Despite being one of the main components of anxiety and playing a pivotal role in how an individual perceives and copes with anxiogenic situations or responds to a given treatment, trait anxiety is paradoxically omitted in most animal models of anxiety. This is problematic and particularly more concerning in models that are used to screen drugs and other treatments for specific anxiety disorders and to investigate their neurobiological mechanisms. Our group has been engaged in the search for specific anxiety-related traits in animal models of anxiety. We developed two new lines of rats with strong phenotypic divergence for high (Carioca High-conditioned Freezing [CHF]) and low (Carioca Low-conditioned Freezing [CLF]) trait anxiety as expressed in the contextual fear conditioning paradigm. Here, we summarize key behavioral, pharmacological, physiological, and neurobiological differences in one these lines, the CHF rat line, relative to randomized-cross controls and discuss how far they represent a valid and reliable animal model of generalized anxiety disorder and so high trait anxiety.
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Affiliation(s)
- Antonio Pedro Mello Cruz
- Laboratory of Psychobiology and Behavioral Neuroscience, Institute of Psychology, University of Brasilia, Brasilia, Federal District, Brazil
| | - Vitor Castro-Gomes
- Institute of Psychology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - J. Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Hoge EA, Armstrong CH, Mete M, Oliva I, Lazar SW, Lago TR, Grillon C. Attenuation of Anxiety-Potentiated Startle After Treatment With Escitalopram or Mindfulness Meditation in Anxiety Disorders. Biol Psychiatry 2024; 95:85-92. [PMID: 37331547 DOI: 10.1016/j.biopsych.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Biological markers for anxiety disorders may further understanding of disorder pathophysiology and suggest potential targeted treatments. The fear-potentiated startle (FPS) (a measure of startle to predictable threat) and anxiety-potentiated startle (APS) (startle to unpredictable threat) laboratory paradigm has been used to detect physiological differences in individuals with anxiety disorders compared with nonanxious control individuals, and in pharmacological challenge studies in healthy adults. However, little is known about how startle may change with treatment for anxiety disorders, and no data are available regarding alterations due to mindfulness meditation training. METHODS Ninety-three individuals with anxiety disorders and 66 healthy individuals completed 2 sessions of the neutral, predictable, and unpredictable threat task, which employs a startle probe and the threat of shock to assess moment-by-moment fear and anxiety. Between the two testing sessions, patients received randomized 8-week treatment with either escitalopram or mindfulness-based stress reduction. RESULTS APS, but not FPS, was higher in participants with anxiety disorders compared with healthy control individuals at baseline. Further, there was a significantly greater decrease in APS for both treatment groups compared with the control group, with the patient groups showing reductions bringing them into the range of control individuals at the end of the treatment. CONCLUSIONS Both anxiety treatments (escitalopram and mindfulness-based stress reduction) reduced startle potentiation during unpredictable (APS) but not predictable (FPS) threat. These findings further validate APS as a biological correlate of pathological anxiety and provide physiological evidence for the impact of mindfulness-based stress reduction on anxiety disorders, suggesting that there may be comparable effects of the two treatments on anxiety neurocircuitry.
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Affiliation(s)
- Elizabeth A Hoge
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC.
| | | | - Mihriye Mete
- Center of Biostatistics, Informatics and Data Science, Medstar Health Research Institute, Hyattsville, Maryland
| | - Isabelle Oliva
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tiffany R Lago
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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Seo D, Balderston NL, Berenbaum H, Hur J. The interactive effects of different facets of threat uncertainty and cognitive load in shaping fear and anxiety responses. Psychophysiology 2023; 60:e14404. [PMID: 37559195 DOI: 10.1111/psyp.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 08/11/2023]
Abstract
A large body of research indicates that exaggerated response to uncertainty of a future threat is at the core of anxiety and related disorders, underscoring the need for a better understanding of the underlying mechanisms. Although behavioral and neuroimaging studies have suggested a close relationship between uncertainty responses and cognitive control, little is known about what elements of uncertainty are more or less vulnerable to cognitive modulation in shaping aversive responses. Leveraging a novel paradigm, an n-back working memory task embedded within a modified threat-of-shock paradigm, we examined how the influences of different facets of uncertainty (i.e., occurrence and timing) on psychophysiological responses were modulated by cognitive load. Psychophysiological responses were assessed using the acoustic startle reflex. Replicating prior work, the effects of cognitive load and temporal unpredictability of threat on startle responses were evident. The effect of occurrence unpredictability appears to depend on other factors. Under low cognitive load, startle response was potentiated when both the occurrence and the timing of threat were predictable. Under high cognitive load, startle response was significantly reduced, especially when a threat context involves uncertainty in both temporal and probability domains. These observations provide a framework for refining the model of fear and anxiety and for understanding the etiology of psychological disorders characterized by maladaptive uncertainty responses.
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Affiliation(s)
- Deachul Seo
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Nicholas L Balderston
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Howard Berenbaum
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana-Champaign, Illinois, USA
| | - Juyoen Hur
- Department of Psychology, Yonsei University, Seoul, South Korea
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Groenink L, Verdouw PM, Zhao Y, Ter Heegde F, Wever KE, Bijlsma EY. Pharmacological modulation of conditioned fear in the fear-potentiated startle test: a systematic review and meta-analysis of animal studies. Psychopharmacology (Berl) 2023; 240:2361-2401. [PMID: 36651922 PMCID: PMC10593622 DOI: 10.1007/s00213-022-06307-1] [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: 08/04/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023]
Abstract
RATIONALE AND OBJECTIVES Fear conditioning is an important aspect in the pathophysiology of anxiety disorders. The fear-potentiated startle test is based on classical fear conditioning and over the years, a broad range of drugs have been tested in this test. Synthesis of the available data may further our understanding of the neurotransmitter systems that are involved in the expression of conditioned fear. METHODS Following a comprehensive search in Medline and Embase, we included 68 research articles that reported on 103 drugs, covering 56 different drug classes. The systematic review was limited to studies using acute, systemic drug administration in naive animals. RESULTS Qualitative data synthesis showed that most clinically active anxiolytics, but not serotonin-reuptake inhibitors, reduced cued fear. Anxiogenic drugs increased fear potentiation in 35% of the experiments, reduced fear potentiation in 29% of the experiments, and were without effect in 29% of the experiments. Meta-analyses could be performed for five drug classes and showed that benzodiazepines, buspirone, 5-HT1A agonists, 5-HT1A antagonists, and mGluR2,3 agonists reduced cued conditioned fear. The non-cued baseline startle response, which may reflect contextual anxiety, was only significantly reduced by benzodiazepines and 5-HT1A antagonists. No associations were found between drug effects and methodological characteristics, except for strain. CONCLUSIONS The fear-potentiated startle test appears to have moderate to high predictive validity and may serve as a valuable tool for the development of novel anxiolytics. Given the limited available data, the generally low study quality and high heterogeneity additional studies are warranted to corroborate the findings of this review.
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Affiliation(s)
- Lucianne Groenink
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands.
| | - P Monika Verdouw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands
| | - Yulong Zhao
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands
| | - Freija Ter Heegde
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands
| | - Kimberley E Wever
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands
| | - Elisabeth Y Bijlsma
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands
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Rauch E, Ari C, Kovács Z. Dose-Dependent Beneficial Effect of Ketone Supplement-Evoked Ketosis on Anxiety Level in Female WAG/Rij Rats: Sometimes Less Is More. Nutrients 2023; 15:4412. [PMID: 37892486 PMCID: PMC10610400 DOI: 10.3390/nu15204412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
While one-third of the population can be affected by anxiety disorders during their lifetime, our knowledge of the pathophysiology of these disorders is far from complete. Previously, it has been demonstrated in male animals that exogenous ketone supplement-evoked ketosis can decrease anxiety levels in preclinical rodent models, such as Wistar Albino Glaxo/Rijswijk (WAG/Rij) rats. Thus, in this study, we investigated whether intragastric gavage of the exogenous ketone supplement KEMCT (mix of 1,3-butanediol-acetoacetate diester/ketone ester/KE and medium-chain triglyceride/MCT oil in 1:1 ratio) for 7 days can alter the anxiety levels of female WAG/Rij rats using the light-dark box (LDB) test. We demonstrated that a lower dose of KEMCT (3 g/kg/day) increased blood R-βHB (R-β-hydroxybutyrate) levels and significantly decreased anxiety levels (e.g., increased the time spent in the light compartment) in female WAG/Rij rats on the seventh day of administration. Although the higher KEMCT dose (5 g/kg/day) increased blood R-βHB levels more effectively, compared with the lower KEMCT dose, anxiety levels did not improve significantly. We conclude that ketone supplementation might be an effective strategy to induce anxiolytic effects not only in male but also in female WAG/Rij rats. However, these results suggest that the optimal level may be moderately, not highly, elevated blood R-βHB levels when the goal is to alleviate symptoms of anxiety. More studies are needed to understand the exact mechanism of action of ketone supplementation on anxiety levels and to investigate their use in other animal models and humans for the treatment of anxiety disorders and other mental health conditions.
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Affiliation(s)
- Enikő Rauch
- Department of Biology, Savaria University Centre, Eötvös Loránd University (ELTE), Károlyi Gáspár tér 4, 9700 Szombathely, Hungary; (E.R.); (Z.K.)
- Institute of Biology, University of Pécs, Ifjúság Str. 6, 7624 Pécs, Hungary
| | - Csilla Ari
- Behavioral Neuroscience Research Laboratory, Department of Psychology, University of South Florida, Tampa, FL 33620, USA
- Ketone Technologies LLC, Tampa, FL 33612, USA
| | - Zsolt Kovács
- Department of Biology, Savaria University Centre, Eötvös Loránd University (ELTE), Károlyi Gáspár tér 4, 9700 Szombathely, Hungary; (E.R.); (Z.K.)
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Beckers T, Hermans D, Lange I, Luyten L, Scheveneels S, Vervliet B. Understanding clinical fear and anxiety through the lens of human fear conditioning. NATURE REVIEWS PSYCHOLOGY 2023; 2:233-245. [PMID: 36811021 PMCID: PMC9933844 DOI: 10.1038/s44159-023-00156-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
Fear is an adaptive emotion that mobilizes defensive resources upon confrontation with danger. However, fear becomes maladaptive and can give rise to the development of clinical anxiety when it exceeds the degree of threat, generalizes broadly across stimuli and contexts, persists after the danger is gone or promotes excessive avoidance behaviour. Pavlovian fear conditioning has been the prime research instrument that has led to substantial progress in understanding the multi-faceted psychological and neurobiological mechanisms of fear in past decades. In this Perspective, we suggest that fruitful use of Pavlovian fear conditioning as a laboratory model of clinical anxiety requires moving beyond the study of fear acquisition to associated fear conditioning phenomena: fear extinction, generalization of conditioned fear and fearful avoidance. Understanding individual differences in each of these phenomena, not only in isolation but also in how they interact, will further strengthen the external validity of the fear conditioning model as a tool with which to study maladaptive fear as it manifests in clinical anxiety.
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Affiliation(s)
- Tom Beckers
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Dirk Hermans
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Iris Lange
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Laura Luyten
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Sara Scheveneels
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Bram Vervliet
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Bresin K, Mekawi Y, McDonald JB, Bozzay ML, Heller W, Verona E. Threat effects on attention networks in individuals with a history of externalizing behaviors. Int J Psychophysiol 2023; 183:9-18. [PMID: 36375628 PMCID: PMC10440126 DOI: 10.1016/j.ijpsycho.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022]
Abstract
Research identifying the biobehavioral processes that link threat exposure to cognitive alterations can inform treatments designed to reduce perpetration of stress-induced aggression. The present study attempted to specify the effects of relatively predictable versus unpredictable threat on two attention networks, attentional alerting and executive control. In a sample of adults (n = 74, 35 % identifying as women, Mage = 32.85) with high rates of externalizing behaviors (e.g., substance use, criminal/legal system involvement, aggressivity), we measured event-related brain activity during an attention network test that manipulated cognitive systems activation under relatively unpredictable and predictable threat conditions. Results showed that threat exposure alters attentional alerting and executive control. The predictable threat condition, relative to unpredictable threat, increased visual alerting (N1 amplitude to alert vs. no alert cue conditions) and decreased attention to the task (P3 amplitude to subsequent task-relevant flankers, but these effects did not survive adjusting for multiple tests. In contrast, overall threat and unpredictable threat conditions were associated with faster response time to alert cue (versus no cue) and poorer conflict processing, operationalized as flanker N2 reductions and slower response time to incongruent (versus congruent) flanker trials. These results expand what is known about threat-related modulation of cognition in a sample of individuals with histories of externalizing behaviors.
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Affiliation(s)
- Konrad Bresin
- University of Louisville, Department of Counseling and Human Development, USA; University of Louisville, Department of Psychological and Brain Sciences, USA.
| | - Yara Mekawi
- University of Louisville, Department of Psychological and Brain Sciences, USA
| | | | - Melanie L Bozzay
- Alpert Medical School of Brown University, USA; Providence VA Medical Center, USA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Edelyn Verona
- Department of Psychology, University of South Florida, USA; Center for Justice Research & Policy, University of South Florida, USA
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10
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Newsome P, Ruiz SG, Gold AL, Pine DS, Abend R. Fear-potentiated startle reveals diminished threat extinction in pathological anxiety. Int J Psychophysiol 2023; 183:81-91. [PMID: 36442665 PMCID: PMC9812922 DOI: 10.1016/j.ijpsycho.2022.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/13/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Major theories propose that perturbed threat learning is central to pathological anxiety, but empirical support is inconsistent. Failures to detect associations with anxiety may reflect limitations in quantifying conditioned responses to anticipated threat, and hinder translation of theory into empirical work. In prior work, we could not detect threat-specific anxiety effects on states of conditioned threat using psychophysiology in a large sample of patients and healthy comparisons. Here, we examine the utility of an alternative fear potentiated startle (FPS) scoring in revealing associations between anxiety and threat conditioning and extinction in this dataset. Secondary analyses further explored associations among conditioned threat responses, subcortical morphometry, and treatment outcomes. METHODS Youths and adults with anxiety disorders and healthy comparisons (n = 306; 178 female participants; 8-50 years) previously completed a well-validated differential threat learning paradigm. FPS and skin conductance response (SCR) quantified psychophysiological responses during threat conditioning and extinction. In this report, we examined normalizing raw FPS scores to intertrial intervals (ITI) to address challenges in more common approaches to FPS scoring which could mask group effects. Secondary analyses examined associations between FPS and subcortical morphometry and with response to exposure-based cognitive behavioral therapy in a subsample of patients. RESULTS Patients and comparisons showed comparable differential threat conditioning using FPS and SCR. While SCR suggested comparable extinction between groups, FPS revealed stronger retention of threat contingency during extinction in individuals with anxiety disorders. Extinction indexed with FPS was not associated with age, morphometry, or anxiety treatment outcome. CONCLUSION ITI-normalized FPS may have utility in detecting difficulties in extinguishing conditioned threat responses in anxiety. These findings provide support for extinction theories of anxiety and encourage continued research on aberrant extinction in pathological anxiety.
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Affiliation(s)
- Philip Newsome
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health, Bethesda, MD, USA
| | - Sonia G Ruiz
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health, Bethesda, MD, USA
| | - Rany Abend
- Baruch Ivcher School of Psychology, Reichman University, Israel.
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11
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Bradford DE, Shireman JM, Sant’Ana SJ, Fronk GE, Schneck SE, Curtin JJ. Alcohol's effects during uncertain and uncontrollable stressors in the laboratory. Clin Psychol Sci 2022; 10:885-900. [PMID: 36111103 PMCID: PMC9472562 DOI: 10.1177/21677026211061355] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Alcohol's effects on reactivity to stressors depends on the nature of the stressor and the reactivity being assessed. Research identifying characteristics of stressors that modulate reactivity and clarifies the neurobehavioral, cognitive, and affective components of this reactivity may help prevent, reduce or treat the negative impacts of acute and chronic alcohol use with implications for other psychopathology involving maladaptive reactivity to stressors. We used a novel, multi-measure, cued electric shock stressor paradigm in a greater university community sample of adult recreational drinkers to test how alcohol (N=64), compared to No-alcohol (N=64), effects reactivity to stressors that vary in both their perceived certainty and controllability. Preregistered analyses suggested alcohol significantly dampened subjective anxiety (self-report) and defensive reactivity (startle potentiation) more during uncertain than during certain stressors regardless of controllability, suggesting that stressor uncertainty -but not uncontrollability- may be sufficient to enhance alcohol's stress reactivity dampening and thus negative reinforcement potential.
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Affiliation(s)
- Daniel E. Bradford
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
- School of Psychological Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jack M. Shireman
- Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin, USA
| | - Sarah J. Sant’Ana
- Department of Psychology, University of Wisconsin, Madison, Wisconsin, USA
| | - Gaylen E. Fronk
- Department of Psychology, University of Wisconsin, Madison, Wisconsin, USA
| | - Susan E. Schneck
- Department of Psychology, University of Wisconsin, Madison, Wisconsin, USA
| | - John J. Curtin
- Department of Psychology, University of Wisconsin, Madison, Wisconsin, USA
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Gorka SM, Khorrami KJ, Manzler CA, Phan KL. Acute orexin antagonism selectively modulates anticipatory anxiety in humans: implications for addiction and anxiety. Transl Psychiatry 2022; 12:308. [PMID: 35918313 PMCID: PMC9345881 DOI: 10.1038/s41398-022-02090-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
Research indicates that heightened anticipatory anxiety underlies several forms of psychopathology. Anticipatory anxiety can be reliably and objectively measured in the laboratory using the No-Predictable-Unpredictable (NPU) threat paradigm. The NPU paradigm is an ideal research tool for the NIH 'Fast-Fail' approach of screening promising compounds and testing human target engagement. Evidence from preclinical studies suggests that the hypocretin/orexin (ORX) hypothalamic neuropeptide system is a potential means for modulating anticipatory anxiety and disrupting stress-related alcohol use. The current study tested this question using a psychophysiological probe of the ORX system in humans. We examined whether a single dose of suvorexant (SUV; 10 mg; dual ORX receptor antagonist) can effectively and selectively target a well-validated human laboratory index of exaggerated anticipatory anxiety using a within-subjects placebo-controlled design. A total of twenty-one volunteers completed two laboratory sessions during acute administration of 10 mg SUV or placebo. Across sessions, we administered the NPU paradigm probing sustained anticipatory anxiety and fear while startle eyeblink was recorded as an index of aversive reactivity. Questionnaires assessing mood states and subjective drug effects were also collected. Results indicated SUV was well-tolerated. Compared with placebo, SUV was associated with decreased startle reactivity during anticipatory anxiety but not fear or no-threat conditions. Therefore, SUV selectively and effectively reduced objective indicators of anticipatory anxiety in humans and engaged our laboratory target of psychopathology. ORX antagonism may be a promising strategy for modulating human anxiety and potentially, stress-related alcohol use.
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Affiliation(s)
- Stephanie M. Gorka
- grid.412332.50000 0001 1545 0811Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370 W. 9th Avenue, Columbus, OH 43210 USA ,grid.261331.40000 0001 2285 7943Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - Kia J. Khorrami
- grid.412332.50000 0001 1545 0811Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370 W. 9th Avenue, Columbus, OH 43210 USA ,grid.261331.40000 0001 2285 7943Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - Charles A. Manzler
- grid.412332.50000 0001 1545 0811Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370 W. 9th Avenue, Columbus, OH 43210 USA ,grid.261331.40000 0001 2285 7943Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - K. Luan Phan
- grid.412332.50000 0001 1545 0811Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370 W. 9th Avenue, Columbus, OH 43210 USA
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Teferi M, Makhoul W, Deng ZD, Oathes DJ, Sheline Y, Balderston NL. Continuous Theta Burst Stimulation to the Right Dorsolateral Prefrontal Cortex may increase Potentiated Startle in healthy individuals. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022. [PMID: 37519467 PMCID: PMC10382694 DOI: 10.1016/j.bpsgos.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Convergent neuroimaging and neuromodulation studies implicate the right dorsolateral prefrontal cortex (dlPFC) as a key region involved in anxiety-cognition interactions. However, neuroimaging data are correlational, and neuromodulation studies often lack appropriate methodological controls. Accordingly, this work was designed to explore the role of right prefrontal cognitive control mechanisms in the expression/regulation of anxiety using continuous theta-burst transcranial magnetic stimulation (cTBS) and threat of unpredictable shock. Based on prior neuromodulation studies, we hypothesized that the right dlPFC contributed to anxiety expression, and that cTBS should downregulate this expression. Methods We measured potentiated startle and performance on the Sternberg working memory paradigm in 28 healthy participants before and after 4 sessions (600 pulses/session) of active or sham cTBS. Stimulation was individualized to the right dlPFC site of maximal working memory-related activity and optimized using electric-field modeling. Results Compared with sham cTBS, active cTBS, which is thought to induce long-term depression-like synaptic changes, increased startle during threat of shock, but the effect was similar for predictable and unpredictable threat. As a measure of target (dis)engagement, we also showed that active but not sham cTBS decreased accuracy on the Sternberg task. Conclusions Counter to our initial hypothesis, cTBS to the right dlPFC made individuals more anxious, rather than less anxious. Although preliminary, these results are unlikely to be due to transient effects of the stimulation, because anxiety was measured 24 hours after cTBS. In addition, these results are unlikely to be due to off-target effects, because target disengagement was evident from the Sternberg performance data.
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14
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Correa KA, Li LY, Nelson BD, Shankman SA. Event-related potentials to acoustic startle probes during unpredictable threat are associated with individual differences in intolerance of uncertainty. Int J Psychophysiol 2022; 174:66-75. [PMID: 35143906 PMCID: PMC8923991 DOI: 10.1016/j.ijpsycho.2022.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
Individual differences in sensitivity to unpredictable threat may be a critical mechanism for internalizing psychopathology phenotypes. The present study examined whether the startle probe-elicited N100 and P300 during unpredictable threat - two event-related potentials indexing early and elaborative attentional processing of unpredictable threat - may be endophenotypes for internalizing psychopathology, including fear and distress/misery disorders and intolerance of uncertainty (IU), a clinical trait that is transdiagnostically associated with internalizing disorders. A large sample of adult siblings (N = 375) completed the no, predictable, and unpredictable threat task, during which the N100 and P300 were recorded. Relative to the no threat condition, N100 was more strongly enhanced in anticipation of unpredictable than predictable threat while P300 was suppressed to both predictable and unpredictable threat. While neither N100 enhancement nor P300 suppression to unpredictable threat was associated with fear or distress/misery disorders, they were negatively linked to inhibitory IU (a facet of IU). Thus, individuals high in inhibitory IU showed reduced attentional engagement with the threatening context when it was unpredictable. Further, N100 enhancement and, to a lesser degree, P300 suppression to unpredictable threat showed familial aggregation - a key criterion for determining whether a biomarker is an endophenotype. In sum, N100 enhancement and P300 suppression to unpredictable threat may be endophenotypes for dimensional measures of internalizing psychopathology.
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Affiliation(s)
- Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
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15
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Hall OT, Phan KL, Gorka S. Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults. J Trauma Stress 2022; 35:148-158. [PMID: 34263960 PMCID: PMC8760364 DOI: 10.1002/jts.22709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/10/2021] [Accepted: 04/21/2021] [Indexed: 02/03/2023]
Abstract
Early life adversity (ELA) increases the risk of problematic alcohol use and alcohol use disorder (AUD). However, it is unclear why some but not all ELA-exposed individuals develop problematic alcohol use. Research is needed to determine how this environmental risk factor interacts with underlying neurobehavioral vulnerabilities to problem alcohol use. Hypersensitivity to uncertain threats (U-threat) has been posited as an endophenotype for AUD that might aid in the refinement of mechanistic models of problematic alcohol use. Therefore, U-threat hypersensitivity requires examination as a possible individual difference factor that facilitates problematic alcohol use among ELA-exposed individuals. We examined the unique and interactive effects of ELA and U-threat reactivity on problem drinking and depressive and anxiety symptom severity. Participants (N = 131) completed a well-validated threat-of-shock task, and startle eyeblink potentiation was recorded to index aversive responding. Individuals also completed self-report measures of alcohol use, anxiety, and depressive symptoms. Results demonstrated a positive association between ELA and higher levels of problematic alcohol use at high levels of U-threat reactivity, β = .75, t = 3.93, p < .001. Conversely, at low levels of U-threat reactivity, ELA exposure was negatively associated with problematic alcohol use, β = -.49, t = -2.30, p = .023. There was no significant ELA x U-Threat reactivity interaction on anxiety or depression. U-threat response strongly interacts with ELA exposure, affecting the direction of the association between ELA and problem drinking. U-threat reactivity may be a promising target for the prevention and treatment of problematic drinking among ELA-exposed individuals.
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Affiliation(s)
- O. Trent Hall
- Department of Psychiatry and Behavioral Health the Ohio State University Wexner Medical Center Columbus Ohio USA
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health the Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Stephanie Gorka
- Department of Psychiatry and Behavioral Health the Ohio State University Wexner Medical Center Columbus Ohio USA
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16
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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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Khorrami KJ, Manzler CA, Kreutzer KA, Gorka SM. Neural and Self-report Measures of Sensitivity to Uncertainty as Predictors of COVID-Related Negative Affect. Psychiatry Res 2022; 319:111414. [PMID: 34902781 PMCID: PMC8608787 DOI: 10.1016/j.pscychresns.2021.111414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/11/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has been a period of unprecedented uncertainty. Research indicates individuals differ in their response to uncertainty and these differences are mediated by anterior insula (aINS) function. Those most sensitive to uncertainty are likely vulnerable to negative affect in the context of the pandemic. The current study was designed to directly test this question using both neural and self-reported measures of sensitivity to uncertainty. Fifty-nine volunteers completed a task designed to probe neural response to anticipation of predictable (P-) and unpredictable (U-) threat-of-electric-shock during functional magnetic resonance imaging and a self-report measure of intolerance of uncertainty (IU). Approximately two years later, during the peak of the pandemic, participants reported their emotional reactions to the COVID-19 crisis. Multilevel mixed models revealed that greater aINS activation to U-threat and greater self-reported IU were independent predictors of increased COVID-related negative affect. These findings were significant when adjusting for biological sex and depression and anxiety symptom severity. The results add to a growing literature demonstrating that individual differences in response to uncertainty have a robust impact on mood and functioning. Results also highlight that individuals highly sensitive to uncertainty may be at increased risk for poor mental health during the ongoing pandemic.
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Affiliation(s)
- Kia J Khorrami
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370W. 9th Avenue, Columbus, OH 43210 USA; Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - Charles A Manzler
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370W. 9th Avenue, Columbus, OH 43210 USA; Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - Kayla A Kreutzer
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370W. 9th Avenue, Columbus, OH 43210 USA; Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA
| | - Stephanie M Gorka
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370W. 9th Avenue, Columbus, OH 43210 USA; Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210 USA.
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18
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Cross-species anxiety tests in psychiatry: pitfalls and promises. Mol Psychiatry 2022; 27:154-163. [PMID: 34561614 PMCID: PMC8960405 DOI: 10.1038/s41380-021-01299-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022]
Abstract
Behavioural anxiety tests in non-human animals are used for anxiolytic drug discovery, and to investigate the neurobiology of threat avoidance. Over the past decade, several of them were translated to humans with three clinically relevant goals: to assess potential efficacy of candidate treatments in healthy humans; to develop diagnostic tests or biomarkers; and to elucidate the pathophysiology of anxiety disorders. In this review, we scrutinise these promises and compare seven anxiety tests that are validated across species: five approach-avoidance conflict tests, unpredictable shock anticipation, and the social intrusion test in children. Regarding the first goal, three tests appear suitable for anxiolytic drug screening in humans. However, they have not become part of the drug development pipeline and achieving this may require independent confirmation of predictive validity and cost-effectiveness. Secondly, two tests have shown potential to measure clinically relevant individual differences, but their psychometric properties, predictive value, and clinical applicability need to be clarified. Finally, cross-species research has not yet revealed new evidence that the physiology of healthy human behaviour in anxiety tests relates to the physiology of anxiety symptoms in patients. To summarise, cross-species anxiety tests could be rendered useful for drug screening and for development of diagnostic instruments. Using these tests for aetiology research in healthy humans or animals needs to be queried and may turn out to be unrealistic.
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19
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Correa KA, Carrillo V, Funkhouser CJ, Shenberger ER, Shankman SA. Ethnic differences in behavioral and physiological indicators of sensitivity to threat. J Anxiety Disord 2022; 85:102508. [PMID: 34864540 PMCID: PMC8760157 DOI: 10.1016/j.janxdis.2021.102508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/26/2021] [Accepted: 11/20/2021] [Indexed: 01/03/2023]
Abstract
The clinical presentation of anxiety may differ between Hispanics/Latinx (H/L) and non-H/L, although findings on ethnic differences in self-reported anxiety symptoms have been mixed. Fewer studies have focused on ethnic differences in quick and relatively automatic laboratory-assessed indicators of anxiety symptoms, which have the potential to be more objective indicators than self-report. Therefore, the present study examined ethnic differences in two laboratory-assessed indicators of threat sensitivity (an important transdiagnostic mechanism of anxiety): attentional bias to threat and electromyography startle reactivity to threat. White H/L (n = 117) and White non-H/L (n = 168) adults who were matched on demographics and lifetime psychopathology (including anxiety) completed a dot-probe task to assess attentional bias to threat and the No-Predictable-Unpredictable threat (NPU) task to assess startle reactivity to threat. Results indicated that H/L displayed less Slow OrientationRB (β = -0.27, p = 0.032, R2β∗ = 0.02), and increased Slow DisengagementRB (β = 0.31, p = 0.016, R2β∗ = 0.02) compared to non-H/L. H/L exhibited blunted overall startle compared to non-H/L (β = -0.30, p = 0.014, R2β∗ = 0.02), but groups did not differ in startle reactivity to either predictable or unpredictable threat. In summary, H/L and non-H/L may differ in their experience and presentation of anxiety symptoms and such differences may vary across indicators of sensitivity to threat.
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Affiliation(s)
- Kelly A Correa
- University of Illinois at Chicago, United States; Northwestern University, United States
| | | | - Carter J Funkhouser
- University of Illinois at Chicago, United States; Northwestern University, United States
| | - Elyse R Shenberger
- University of Illinois at Chicago, United States; Northwestern University, United States
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20
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Ramakrishnan N, Lijffijt M, Green CE, Balderston NL, Murphy N, Grillon C, Iqbal T, Vo-Le B, O’Brien B, Murrough JW, Swann AC, Mathew SJ. Neurophysiological and clinical effects of the NMDA receptor antagonist lanicemine (BHV-5500) in PTSD: A randomized, double-blind, placebo-controlled trial. Depress Anxiety 2021; 38:1108-1119. [PMID: 34254405 PMCID: PMC8560553 DOI: 10.1002/da.23194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with hyperarousal and stress reactivity, features consistent with behavioral sensitization. In this Phase 1b, parallel-arm, randomized, double-blind, placebo-controlled trial, we tested whether the selective low-trapping N-methyl-D-aspartate receptor (NMDAR) antagonist [Lanicemine (BHV-5500)] blocks expression of behavioral sensitization. METHODS Twenty-four participants with elevated anxiety potentiated startle (APS) and moderate-to-severe PTSD symptoms received three infusions of lanicemine 1.0 mg/ml (100 mg) or matching placebo (0.9% saline) (1:1 ratio), over a 5-day period. The primary outcome was change in APS from baseline to end of third infusion. We also examined changes in EEG gamma-band oscillatory activity as measures of NMDAR target engagement and explored Clinician-Administered PTSD Scale (CAPS-5) hyperarousal scores. RESULTS Lanicemine was safe and well-tolerated with no serious adverse events. Using Bayesian statistical inference, the posterior probability that lanicemine outperformed placebo on APS T-score after three infusions was 38%. However, after the first infusion, there was a 90% chance that lanicemine outperformed placebo in attenuating APS T-score by a standardized effect size more than 0.4. CONCLUSION We demonstrated successful occupancy of lanicemine on NMDAR using gamma-band EEG and effects on hyperarousal symptoms (Cohen's d = 0.75). While lanicemine strongly attenuated APS following a single infusion, differential changes from placebo after three infusions was likely obscured by habituation effects. To our knowledge, this is the first use of APS in the context of an experimental medicine trial of a NMDAR antagonist in PTSD. These findings support selective NMDAR antagonism as a viable pharmacological strategy for salient aspects of PTSD.
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Affiliation(s)
- Nithya Ramakrishnan
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,Corresponding Authors: Nithya Ramakrishnan, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. , (713)798-7768; Sanjay J. Mathew, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. (713) 798-5877
| | - Marijn Lijffijt
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | | | | | - Nicholas Murphy
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,The Menninger Clinic, Houston, TX, USA
| | | | - Tabish Iqbal
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Brittany Vo-Le
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Brittany O’Brien
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - James W. Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Department of Neuroscience, Icahn School of Medicine at Mount Sinai
| | - Alan C. Swann
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Sanjay J. Mathew
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,The Menninger Clinic, Houston, TX, USA,Corresponding Authors: Nithya Ramakrishnan, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. , (713)798-7768; Sanjay J. Mathew, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. (713) 798-5877
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21
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Cooper SE, Dunsmoor JE. Fear conditioning and extinction in obsessive-compulsive disorder: A systematic review. Neurosci Biobehav Rev 2021; 129:75-94. [PMID: 34314751 PMCID: PMC8429207 DOI: 10.1016/j.neubiorev.2021.07.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/04/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
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Affiliation(s)
- Samuel E Cooper
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
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22
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Lago TR, Brownstein MJ, Page E, Beydler E, Manbeck A, Beale A, Roberts C, Balderston N, Damiano E, Pineles SL, Simon N, Ernst M, Grillon C. The novel vasopressin receptor (V1aR) antagonist SRX246 reduces anxiety in an experimental model in humans: a randomized proof-of-concept study. Psychopharmacology (Berl) 2021; 238:2393-2403. [PMID: 33970290 PMCID: PMC8376758 DOI: 10.1007/s00213-021-05861-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
RATIONALE Arginine vasopressin (AVP) is a neuropeptide that modulates both physiological and emotional responses to threat. Until recently, drugs that target vasopressin receptors (V1a) in the human central nervous system were unavailable. The development of a novel V1a receptor antagonist, SRX246, permits the experimental validation of vasopressin's role in the regulation of anxiety and fear in humans. OBJECTIVES Here, we examined the effects of SRX246 in a proof-of-concept translational paradigm of fear (phasic response to imminent threat) and anxiety (prolonged response to potential threat). METHODS Healthy volunteers received both SRX246 and placebo in a randomized, double-blind, counter-balanced order separated by a 5-7-day wash-out period. Threat consisted of unpleasant electric shocks. The "NPU" threat test probed startle reactivity during predictable threat (i.e., fear-potentiated startle) and unpredictable threat (i.e., anxiety-potentiated startle). RESULTS As predicted, SRX246 decreased anxiety-potentiated startle independent of fear-potentiated startle. CONCLUSIONS As anxiety-potentiated startle is elevated in anxiety and trauma-associated disorders and decreased by traditional anxiolytics such as SSRIs and benzodiazepines, the V1a receptor is a promising novel treatment target.
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Affiliation(s)
- Tiffany R Lago
- National Institute of Mental Health, Bethesda, MD, USA.
- VA Boston Healthcare System, Boston, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | | | - Emily Page
- National Institute of Mental Health, Bethesda, MD, USA
| | - Emily Beydler
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Alexis Beale
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Nicholas Balderston
- National Institute of Mental Health, Bethesda, MD, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Eve Damiano
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
| | - Suzanne L Pineles
- Boston University School of Medicine, Boston, MA, USA
- National Center, PTSD At VA Boston Healthcare System, Boston, MA, USA
| | - Neal Simon
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
- Lehigh University, Bethelhem, PA, USA
| | - Monique Ernst
- National Institute of Mental Health, Bethesda, MD, USA
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23
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Hessl D, Libero L, Schneider A, Kerns C, Winder-Patel B, Heath B, Lee J, Coleman C, Sharma N, Solomon M, Nordahl CW, Amaral DG. Fear Potentiated Startle in Children With Autism Spectrum Disorder: Association With Anxiety Symptoms and Amygdala Volume. Autism Res 2020; 14:450-463. [PMID: 33372389 DOI: 10.1002/aur.2460] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 12/16/2022]
Abstract
Atypical responses to fearful stimuli and the presence of various forms of anxiety are commonly seen in children with autism spectrum disorder (ASD). The fear potentiated startle paradigm (FPS), which has been studied both in relation to anxiety and as a probe for amygdala function, was carried out in 97 children aged 9-14 years including 48 (12 female) with ASD and 49 (14 female) with typical development (TD). In addition, exploratory analyses were conducted examining the association between FPS and amygdala volume as assessed with magnetic resonance imaging in a subset of the children with ASD with or without an anxiety disorder with available MRI data. While the startle latency was increased in the children with ASD, there was no group difference in FPS. FPS was not significantly associated with traditional Diagnostic and Statistical Manual (DSM) or "autism distinct" forms of anxiety. Within the autism group, FPS was negatively correlated with amygdala volume. Multiple regression analyses revealed that the association between FPS and anxiety severity was significantly moderated by the size of the amygdala, such that the association between FPS and anxiety was significantly more positive in children with larger amygdalas than smaller amygdalas. These findings highlight the heterogeneity of emotional reactivity associated with ASD and the difficulties in establishing biologically meaningful probes of altered brain function. LAY SUMMARY: Many children with autism spectrum disorder (ASD) have additional problems such as anxiety that can greatly impact their lives. How these co-occurring symptoms develop is not well understood. We studied the amygdala, a region of the brain critical for processing fear and a laboratory method called fear potentiated startle for measuring fear conditioning, in children with ASD (with and without an anxiety disorder) and typically developing children. Results showed that the connection between fear conditioning and anxiety is dependent on the size of the amygdala in children with ASD.
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Affiliation(s)
- David Hessl
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Lauren Libero
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Andrea Schneider
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Connor Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Breanna Winder-Patel
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Brianna Heath
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Joshua Lee
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Cory Coleman
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Natasha Sharma
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Marjorie Solomon
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Christine Wu Nordahl
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - David G Amaral
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
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24
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Luyck K, Scheyltjens I, Nuttin B, Arckens L, Luyten L. c-Fos expression following context conditioning and deep brain stimulation in the bed nucleus of the stria terminalis in rats. Sci Rep 2020; 10:20529. [PMID: 33239732 PMCID: PMC7688637 DOI: 10.1038/s41598-020-77603-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022] Open
Abstract
Deep brain stimulation (DBS) in the bed nucleus of the stria terminalis (BST), a region implicated in the expression of anxiety, shows promise in psychiatric patients, but its effects throughout the limbic system are largely unknown. In male Wistar rats, we first evaluated the neural signature of contextual fear (N = 16) and next, of the anxiolytic effects of high-frequency electrical stimulation in the BST (N = 31), by means of c-Fos protein expression. In non-operated animals, we found that the left medial anterior BST displayed increased c-Fos expression in anxious (i.e., context-conditioned) versus control subjects. Moreover, control rats showed asymmetric expression in the basolateral amygdala (BLA) (i.e., higher intensities in the right hemisphere), which was absent in anxious animals. The predominant finding in rats receiving bilateral BST stimulation was a striking increase in c-Fos expression throughout much of the left hemisphere, which was not confined to the predefined regions of interest. To conclude, we found evidence for lateralized c-Fos expression during the expression of contextual fear and anxiolytic high-frequency electrical stimulation of the BST, particularly in the medial anterior BST and BLA. In addition, we observed an extensive and unexpected left-sided c-Fos spread following bilateral stimulation in the BST.
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Affiliation(s)
- Kelly Luyck
- Experimental Neurosurgery and Neuroanatomy, KU Leuven, UZ Herestraat 49, PB 7003, 3000, Leuven, Belgium
| | - Isabelle Scheyltjens
- Animal Physiology and Neurobiology, KU Leuven, Naamsestraat, PB 2467, 3000, Leuven, Belgium
- VIB Center for Inflammation Research, Vrije Universiteit Brussel, Myeloid Cell Immunology, Pleinlaan 2, 1050, Brussel, Belgium
| | - Bart Nuttin
- Experimental Neurosurgery and Neuroanatomy, KU Leuven, UZ Herestraat 49, PB 7003, 3000, Leuven, Belgium
| | - Lutgarde Arckens
- Animal Physiology and Neurobiology, KU Leuven, Naamsestraat, PB 2467, 3000, Leuven, Belgium
- Leuven Brain Institute, Herestraat 49, PB 1021, 3000, Leuven, Belgium
| | - Laura Luyten
- Experimental Neurosurgery and Neuroanatomy, KU Leuven, UZ Herestraat 49, PB 7003, 3000, Leuven, Belgium.
- Leuven Brain Institute, Herestraat 49, PB 1021, 3000, Leuven, Belgium.
- Centre for Psychology of Learning and Experimental Psychopathology, KU Leuven, Tiensestraat 102, PB 3712, 3000, Leuven, Belgium.
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25
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Grillon C, Ernst M. A way forward for anxiolytic drug development: Testing candidate anxiolytics with anxiety-potentiated startle in healthy humans. Neurosci Biobehav Rev 2020; 119:348-354. [PMID: 33038346 DOI: 10.1016/j.neubiorev.2020.09.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022]
Abstract
This review introduces a research strategy that may radically transform the pursuit of new anxiolytics, via the use of human models of anxiety in healthy individuals. Despite enormous investments in developing novel pharmacological treatments for anxiety disorders, pharmacotherapy for these conditions remains suboptimal. Most candidate anxiolytics from animal studies fail in clinical trials. We propose an additional screening step to help select candidate anxiolytics before launching clinical trials. This intermediate step moves the evidence for the potential anxiolytic property of candidate drugs from animals to humans, using experimental models of anxiety in healthy individuals. Anxiety-potentiated startle is a robust translational model of anxiety. The review of its face, construct, and predictive validity as well as its psychometric properties in humans establishes it as a promising tool for anxiolytic drug development. In conclusion, human models of anxiety may stir a faster, more efficient path for the development of clinically effective anxiolytics.
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Affiliation(s)
- Christian Grillon
- National Institute of Mental Health, Section on the Neurobiology of Fear and Anxiety, Building 15K, Room 203, Bethesda, MD 20814 USA.
| | - Monique Ernst
- National Institute of Mental Health, Section on the Neurobiology of Fear and Anxiety, Building 15K, Room 203, Bethesda, MD 20814 USA.
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26
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Ross M, Rausch Q, Vandenberg B, Mason G. Hens with benefits: Can environmental enrichment make chickens more resilient to stress? Physiol Behav 2020; 226:113077. [PMID: 32738316 DOI: 10.1016/j.physbeh.2020.113077] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
Abstract
Resilience, the degree to which individuals are physiologically and behaviourally impacted by stressors, can be enhanced by positive experiences (e.g. positive moods in human, environmental enrichment in rodents). Such effects are important for human health, but could also have important animal welfare implications in terms of farm, laboratory and zoo animals' abilities to cope with stressors. Here we investigated whether enrichments can increase resilience in chickens, the world's most abundant agricultural animal. The stress reactivity of laying hens housed for 5-6 weeks in enriched environments was compared to that of controls housed in smaller, emptier, less preferred pens, via: 1) startle reflex amplitudes to an abrupt, intense sensory stimulus (a light flash); and 2) autonomic responses to restraint and the sudden appearance of a novel object, assessed from decreases in comb temperature. Startle amplitudes were consistently reduced in the enriched hens, exerted with around one sixth the force seen in control hens. Maximum comb temperature decreases, and latencies for comb temperatures to return to prestress levels, also both fell by around a third. Enrichment thus reduced hens' intrinsic behavioural and physiological responses to standardized stressors (doing so even outside the home pen), just as occurs in laboratory rodents. Enrichment also reduced baseline comb temperature, suggesting that this could be a non-invasive indicator of welfare. Altered judgment biases did not seem to be the mechanism. Further work should now investigate the processes underlying the apparently enhanced stress resilience of animals housed in preferred conditions, and also investigate baseline comb temperature as a chronic stress indicator in poultry.
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Affiliation(s)
- Misha Ross
- Department of Animal Biosciences, University of Guelph 50 Stone Road East Guelph, Ontario, N1G 2W1 Canada
| | - Quinn Rausch
- Department of Population Medicine, University of Guelph 50 Stone Road East Guelph, Ontario, N1G 2W1 Canada
| | - Brittany Vandenberg
- Ontario Veterinary College (Class of 2022), University of Guelph 50 Stone Road East Guelph, Ontario, N1G 2W1 Canada
| | - Georgia Mason
- Department of Integrative Biology, University of Guelph 50 Stone Road East Guelph, Ontario, N1G 2W1 Canada.
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27
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Differentiating anxiety from fear: an experimental-pharmacological approach. PERSONALITY NEUROSCIENCE 2020; 3:e6. [PMID: 32596627 PMCID: PMC7303801 DOI: 10.1017/pen.2020.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 12/11/2022]
Abstract
Gray’s theory of personality postulates that fear and anxiety are distinct emotional systems with only the latter being sensitive to anxiolytic drugs. His work was mainly based on animal research, and translational studies validating his theory are scarce. Previous work in humans showed an influence of the benzodiazepine lorazepam on both systems, however, dependent on dosage (1 and 2 mg) and personality differences in negative emotionality. The present study aims to replicate these findings, and in addition tests the drug threshold effect by introducing a lower dosage of 0.5 mg lorazepam. Fifty healthy adults (23 males, agemean 22.40, SD ± 3.68) participated in an experimental threat-avoidance paradigm designed to dissociate risk assessment intensity (RAI, reflecting anxiety) and flight intensity (FI, reflecting fear) and completed two self-report questionnaires assessing facets of negative emotionality (Spielberger State Trait Anxiety Inventory and Fear Survey Schedule). In a randomized placebo-controlled within-subjects design, 0.5 and 1 mg of lorazepam were applied per os. Saccadic peak velocity was assessed by means of eye-tracking in order to control for sedating drug effects. Results showed the expected and specific anxiolytic effect of lorazepam on RAI, however, only in the 0.5 mg condition. FI was not influenced by lorazepam, and previous findings of interaction effects of lorazepam with self-reported negative emotionality could not be corroborated. Overall, this study demonstrates anxiolytic effects of lorazepam in dosages ≤1 mg in the absence of a drug effect on fear using a translational behavioural task. However, a putative moderating role of personality on defensive behaviour has to be clarified in future research.
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28
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Esser R, Fuss J, Haaker J. Initial evidence for pharmacological modulation of observational threat learning by the GABAergic, but not the noradrenergic system in humans. Behav Res Ther 2020; 129:103605. [DOI: 10.1016/j.brat.2020.103605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/27/2020] [Accepted: 03/09/2020] [Indexed: 12/20/2022]
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29
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Gorka SM, Kreutzer KA, Petrey KM, Radoman M, Phan KL. Behavioral and neural sensitivity to uncertain threat in individuals with alcohol use disorder: Associations with drinking behaviors and motives. Addict Biol 2020; 25:e12774. [PMID: 31173426 PMCID: PMC6898728 DOI: 10.1111/adb.12774] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/10/2019] [Accepted: 04/14/2019] [Indexed: 12/14/2022]
Abstract
A developing theory is that individuals with alcohol use disorder (AUD) display exaggerated reactivity to threats that are uncertain (U-threat), which facilitates excessive drinking as a means of avoidance-based coping. There is a promising initial behavioral evidence supporting this theory; however, the neural bases of reactivity to U-threat in individuals with AUD have not been examined. The extent to which biomarkers of U-threat reactivity map onto drinking behaviors and coping motives for alcohol use is also unknown. The current study therefore examined group differences in behavioral and neural reactivity to U-threat in adults with and without AUD. The study also tested whether behavior and brain responses to U-threat correlate with problematic drinking and coping motivated drinking. Volunteers (n = 65) with and without a history of AUD (38 AUD, 27 controls) were included and completed a well-validated threat-of-shock task to probe responses to U-threat and predictable threat (P-threat) while startle eyeblink potentiation was collected. Individuals also completed a newly designed, analogous version of the task during functional magnetic resonance imaging (fMRI). Results indicated that individuals with AUD displayed greater startle magnitude during U-threat, but not P-threat, and greater right insula and dorsal anterior cingulate cortex (dACC) activation during both forms of threat compared with controls. Startle magnitude and insula activation during U-threat positively correlated with self-reported problem drinking and coping motives for alcohol use. Findings demonstrate that individuals with AUD display exaggerated sensitivity to U-threat at the behavioral and neural level and that these multimethod biomarkers tap into negative reinforcement processes of alcohol abuse.
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Affiliation(s)
- Stephanie M. Gorka
- Department of Psychiatry, University of Illinois-Chicago, 1601 West Taylor Street, Chicago, IL 60612
- University of Illinois-Chicago, Center for Alcohol Research in Epigenetics (CARE), 1601 West Taylor Street, Chicago, IL 60612
- Department of Psychology, University of Illinois-Chicago, 1007 West Harrison St. (M/C 285), Chicago, IL 60607
| | - Kayla A. Kreutzer
- Department of Psychiatry, University of Illinois-Chicago, 1601 West Taylor Street, Chicago, IL 60612
| | - Kelsey M. Petrey
- Department of Psychiatry, University of Illinois-Chicago, 1601 West Taylor Street, Chicago, IL 60612
| | - Milena Radoman
- Department of Psychiatry, University of Illinois-Chicago, 1601 West Taylor Street, Chicago, IL 60612
- University of Illinois-Chicago; Department of Anatomy and Cell Biology & the Graduate Program in Neuroscience, 808 S. Wood Street, Chicago, IL 60612
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois-Chicago, 1601 West Taylor Street, Chicago, IL 60612
- Department of Psychology, University of Illinois-Chicago, 1007 West Harrison St. (M/C 285), Chicago, IL 60607
- Jesse Brown VA Medical Center; Mental Health Service Line, 820 S. Damen Avenue, Chicago, IL 60612
- University of Illinois-Chicago; Department of Anatomy and Cell Biology & the Graduate Program in Neuroscience, 808 S. Wood Street, Chicago, IL 60612
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30
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Scalabrini A, Mucci C, Angeletti LL, Northoff G. The Self and its World: A Neuro-Ecological and Temporo-Spatial Account of Existential Fear. CLINICAL NEUROPSYCHIATRY 2020; 17:46-58. [PMID: 34908967 PMCID: PMC8629082 DOI: 10.36131/clinicalnpsych20200203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 11/25/2022]
Abstract
The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world–brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.
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Affiliation(s)
- Andrea Scalabrini
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy
| | - Clara Mucci
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy
| | - Lorenzo Lucherini Angeletti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Georg Northoff
- The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario, Canada K1Z 7K4.,Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China.,TMU Research Centre for Brain and Consciousness, Shuang Hospital, Taipei Medical University, No. 250 Wu-Xing Street, 11031 Taipei, Taiwan.,Graduate Institute of Humanities in Medicine, Taipei Medical University, No. 250 Wu-Xing Street, 11031 Taipei, Taiwan
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31
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Mechanistic link between right prefrontal cortical activity and anxious arousal revealed using transcranial magnetic stimulation in healthy subjects. Neuropsychopharmacology 2020; 45:694-702. [PMID: 31791039 PMCID: PMC7021903 DOI: 10.1038/s41386-019-0583-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/08/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023]
Abstract
Much of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS). In a within-subject, crossover experiment, the study measured anxiety in healthy subjects before and after a session of 10 Hz rTMS to the right dorsolateral prefrontal cortex (dlPFC). It used threat of predictable and unpredictable shock to induce anxiety and anxiety potentiated startle to assess anxiety. Counter to our hypotheses, results showed an increase in anxiety-potentiated startle following active but not sham rTMS. These results suggest a mechanistic link between right dlPFC activity and physiological anxiety expression. This result supports current models of prefrontal asymmetry in affect, and lays the groundwork for further exploration into the cortical mechanisms mediating anxiety, which may lead to novel anxiety treatments.
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32
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Low-frequency parietal repetitive transcranial magnetic stimulation reduces fear and anxiety. Transl Psychiatry 2020; 10:68. [PMID: 32066739 PMCID: PMC7026136 DOI: 10.1038/s41398-020-0751-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/23/2022] Open
Abstract
Anxiety disorders are the most prevalent mental disorders, with few effective neuropharmacological treatments, making treatments development critical. While noninvasive neuromodulation can successfully treat depression, few treatment targets have been identified specifically for anxiety disorders. Previously, we showed that shock threat increases excitability and connectivity of the intraparietal sulcus (IPS). Here we tested the hypothesis that inhibitory repetitive transcranial magnetic stimulation (rTMS) targeting this region would reduce induced anxiety. Subjects were exposed to neutral, predictable, and unpredictable shock threat, while receiving double-blinded, 1 Hz active or sham IPS rTMS. We used global brain connectivity and electric-field modelling to define the single-subject targets. We assessed subjective anxiety with online ratings and physiological arousal with the startle reflex. Startle stimuli (103 dB white noise) probed fear and anxiety during the predictable (fear-potentiated startle, FPS) and unpredictable (anxiety-potentiated startle, APS) conditions. Active rTMS reduced both FPS and APS relative to both the sham and no stimulation conditions. However, the online anxiety ratings showed no difference between the stimulation conditions. These results were not dependent on the laterality of the stimulation, or the subjects' perception of the stimulation (i.e. active vs. sham). Results suggest that reducing IPS excitability during shock threat is sufficient to reduce physiological arousal related to both fear and anxiety, and are consistent with our previous research showing hyperexcitability in this region during threat. By extension, these results suggest that 1 Hz parietal stimulation may be an effective treatment for clinical anxiety, warranting future work in anxiety patients.
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33
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Grillon C, Robinson OJ, Cornwell B, Ernst M. Modeling anxiety in healthy humans: a key intermediate bridge between basic and clinical sciences. Neuropsychopharmacology 2019; 44:1999-2010. [PMID: 31226707 PMCID: PMC6897969 DOI: 10.1038/s41386-019-0445-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 12/11/2022]
Abstract
Animal models of anxiety disorders are important for elucidating neurobiological defense mechanisms. However, animal models are limited when it comes to understanding the more complex processes of anxiety that are unique to humans (e.g., worry) and to screen new treatments. In this review, we outline how the Experimental Psychopathology approach, based on experimental models of anxiety in healthy subjects, can mitigate these limitations and complement research in animals. Experimental psychopathology can bridge basic research in animals and clinical studies, as well as guide and constrain hypotheses about the nature of psychopathology, treatment mechanisms, and treatment targets. This review begins with a brief review of the strengths and limitations of animal models before discussing the need for human models of anxiety, which are especially necessary to probe higher-order cognitive processes. This can be accomplished by combining anxiety-induction procedures with tasks that probe clinically relevant processes to identify neurocircuits that are potentially altered by anxiety. The review then discusses the validity of experimental psychopathology and introduces a methodological approach consisting of five steps: (1) select anxiety-relevant cognitive or behavioral operations and associated tasks, (2) identify the underlying neurocircuits supporting these operations in healthy controls, 3) examine the impact of experimental anxiety on the targeted operations in healthy controls, (4) utilize findings from step 3 to generate hypotheses about neurocircuit dysfunction in anxious patients, and 5) evaluate treatment mechanisms and screen novel treatments. This is followed by two concrete illustrations of this approach and suggestions for future studies.
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Affiliation(s)
- Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA.
| | - Oliver J Robinson
- University College London, Institute of Cognitive Neuroscience, London, UK
| | - Brian Cornwell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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Acute prazosin administration does not reduce stressor reactivity in healthy adults. Psychopharmacology (Berl) 2019; 236:3371-3382. [PMID: 31197436 PMCID: PMC6832815 DOI: 10.1007/s00213-019-05297-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/02/2019] [Indexed: 12/19/2022]
Abstract
RATIONALE Norepinephrine plays a critical role in the stress response. Clarifying the psychopharmacological effects of norepinephrine manipulation on stress reactivity in humans has important implications for basic neuroscience and treatment of stress-related psychiatric disorders, such as posttraumatic stress disorder and alcohol use disorders. Preclinical research implicates the norepinephrine alpha-1 receptor in responses to stressors. The No Shock, Predictable Shock, Unpredictable Shock (NPU) task is a human laboratory paradigm that is well positioned to test cross-species neurobiological stress mechanisms and advance experimental therapeutic approaches to clinical trials testing novel treatments for psychiatric disorders. OBJECTIVES We hypothesized that acute administration of prazosin, a noradrenergic alpha-1 antagonist, would have a larger effect on reducing stress reactivity during unpredictable, compared to predictable, stressors in the NPU task. METHODS We conducted a double-blind, placebo-controlled, crossover randomized controlled trial in which 64 healthy adults (32 female) completed the NPU task at two visits (2 mg prazosin vs. placebo). RESULTS A single acute dose of 2 mg prazosin did not reduce stress reactivity in a healthy adult sample. Neither NPU startle potentiation nor self-reported anxiety was reduced by prazosin (vs. placebo) during unpredictable (vs. predictable) stressors. CONCLUSIONS Further research is needed to determine whether this failure to translate preclinical neuroscience to human laboratory models is due to methodological factors (e.g., acute vs. chronic drug administration, brain penetration, study population) and/or suggests limited clinical utility of noradrenergic alpha-1 antagonists for treating stress-related psychiatric disorders.
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Stevens ES, Lieberman L, Funkhouser CJ, Correa KA, Shankman SA. Startle during threat longitudinally predicts functional impairment independent of DSM diagnoses. Psychiatry Res 2019; 279:207-215. [PMID: 30853118 PMCID: PMC6713600 DOI: 10.1016/j.psychres.2019.02.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Heightened responsivity to unpredictable, and perhaps predictable, threat characterizes some internalizing disorders and may be vulnerability factors for psychopathology as well. However, few studies have directly tested whether individual differences in unpredictable and/or predictable threat responding longitudinally predict symptoms of psychopathology and functional outcomes. Examining functioning is particularly important given that functioning is separable from symptoms of psychopathology. The present study examined whether electromyography startle measures of predictable and/or unpredictable threat responding was associated with interviewer-assessed symptoms of internalizing psychopathology and functional impairment at baseline (n = 409) and one-year follow-up (n = 104). Elevated startle responding to unpredictable and predictable threat longitudinally predicted a worsening of functioning over time and this effect was independent of change of symptoms over time. Importantly, threat responding at baseline predicted functional impairment during the follow-up independent of the effects of DSM-defined fear-based (e.g., panic disorder) or distress-misery (e.g., major depressive disorder) internalizing disorders. These findings provide initial support for the incremental validity of neurobiological vulnerability markers of threat responding over and above DSM disorders and highlight the importance of distinguishing functional outcomes from symptom outcomes.
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Affiliation(s)
| | - Lynne Lieberman
- Department of Psychology, University of Illinois at Chicago, IL, USA
| | | | - Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, IL, USA
| | - Stewart A Shankman
- Department of Psychology, University of Illinois at Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
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Blechert J, Michael T, Wilhelm FH. Video-Based Analysis of Bodily Startle and Subsequent Emotional Facial Expression in Posttraumatic Stress Disorder. J Exp Psychopathol 2019; 4:435-447. [PMID: 31156801 PMCID: PMC6542659 DOI: 10.5127/jep.030712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Exaggerated startle is a core hyperarousal symptom of Posttraumatic Stress Disorder (PTSD). Observational studies on the characteristics of this response are strikingly lacking. Previous research has demonstrated that detailed video analysis of facial and bodily responses to startling stimuli enables the differentiation of an initial, primarily reflexive response and a secondary, primary emotional response. We exposed PTSD patients (n = 34) and trauma-exposed but healthy participants (TE group, n = 26) to startling electric stimuli while acquiring observational behavioral, psychophysiological, and experiential measures. Videographic results indicate that PTSD patients' initial bodily startle response was stronger than in the TE group, and their secondary facial expression was more negatively valenced, largely due to elevated anger expression. Videographic assessment of primary and secondary startle responses provides a new window into reflexive and emotional functioning of PTSD and may therefore complement existing startle measures. PTSD treatments should address bodily startle, negative symptom appraisals, and anger more specifically.
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Affiliation(s)
- Jens Blechert
- Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Austria
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Campus, D-66123 Saarbrücken
| | - Frank H. Wilhelm
- Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Austria
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Radoman M, Phan KL, Gorka SM. Neural correlates of predictable and unpredictable threat in internalizing psychopathology. Neurosci Lett 2019; 701:193-201. [PMID: 30825592 PMCID: PMC6476657 DOI: 10.1016/j.neulet.2019.02.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Abstract
Converging lines of evidence suggest that heightened responding to unpredictable threat may be an important neurobiological marker of internalizing psychopathology (IP). Prior data also indicate that aversive responding to uncertainty may be mediated by hyperactivation of several brain regions within the frontolimbic circuit, namely the anterior insula (aINS) and the dorsal anterior cingulate cortex (dACC). To date, however, the majority of this research has been focused on individual diagnoses and it is unclear whether abnormal neural reactivity to unpredictable threat is observed within heterogeneous, transdiagnostic IP patient populations, as theory would suggest. The aim of the current study was to therefore examine the neural correlates of temporally unpredictable (U) and predictable (P) threat in a sample of healthy controls (n = 24) and patients with a broad range of IP diagnoses (n = 51). We also examined whether symptom severity measures of fear and distress/misery dimensions correlated with neural reactivity to U- and P-threat. All participants completed a modified version of a well-validated threat-of-shock task during functional magnetic resonance imaging (fMRI). Across all participants, U- and P-threat elicited heightened activation in the aINS and brainstem, while P-threat alone also activated the dACC. Relative to healthy controls, patients displayed greater activation in the right aINS during U-threat, and greater right brainstem activation during P-threat. In addition, we found that brainstem activity during U-threat correlated with fear, but not distress/misery, psychopathology. Taken together, these preliminary results suggest that exaggerated aINS reactivity during U-threat and brainstem reactivity during P-threat may have the potential to become important transdiagnostic biomarkers of IP; however, future research efforts are needed to corroborate and expand the present findings.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.
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38
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Hefner KR, Starr MJ, Curtin JJ. Heavy marijuana use but not deprivation is associated with increased stressor reactivity. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 127:348-358. [PMID: 29745700 DOI: 10.1037/abn0000344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Although stressors appear to motivate marijuana use, and marijuana use, in turn, is believed to induce stress system neuroadaptations, relatively little empirical work has explicitly tested for stress neuroadaptations associated with heavy marijuana use. We examined stressor reactivity to threat of unpredictable electric shock via startle potentiation among heavy marijuana users and a control group that reported minimal history of marijuana use. Heavy marijuana users were randomly assigned to 3 days of marijuana deprivation or no deprivation. This design allowed us to test contrasts for heavy (vs. minimal) use and deprivation (vs. no deprivation) on stressor reactivity. Heavy marijuana users (both deprived and nondeprived) displayed increased startle potentiation during threat of unpredictable electric shock relative to minimal use controls. In contrast, marijuana deprivation had no effect on startle potentiation. Startle potentiation was also increased among users who reported greater stress-coping motives for their marijuana use and users with cannabis use disorder diagnoses. To our knowledge, this is the 1st study to demonstrate increased reactivity to unpredictable stressors among heavy marijuana users. However, comparable increased unpredictable stressor reactivity among patients with alcohol and other substance use disorders has been previously documented. This relationship to heavy marijuana use is consistent with predictions from rodent addiction models regarding stress neuroadaptations following heavy, chronic drug use but could also represent an etiologically relevant premorbid risk characteristic. Finally, the clinical import of unpredictable stressor reactivity is reinforced by its relationships with stress-coping motives and cannabis use disorder status. (PsycINFO Database Record
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Affiliation(s)
| | - Mark J Starr
- Department of Psychology, University of Wisconsin-Madison
| | - John J Curtin
- Department of Psychology, University of Wisconsin-Madison
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39
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Zhao Y, Bijlsma EY, ter Heegde F, Verdouw MP, Garssen J, Newman-Tancredi A, Groenink L. Activation of somatodendritic 5-HT 1A autoreceptors reduces the acquisition and expression of cued fear in the rat fear-potentiated startle test. Psychopharmacology (Berl) 2019; 236:1171-1185. [PMID: 30539269 PMCID: PMC6591185 DOI: 10.1007/s00213-018-5124-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/14/2018] [Indexed: 11/29/2022]
Abstract
RATIONALE Fear conditioning is an important factor in the etiology of anxiety disorders. Previous studies have demonstrated a role for serotonin (5-HT)1A receptors in fear conditioning. However, the relative contribution of somatodendritic 5-HT1A autoreceptors and post-synaptic 5-HT1A heteroreceptors in fear conditioning is still unclear. OBJECTIVE To determine the role of pre- and post-synaptic 5-HT1A receptors in the acquisition and expression of cued and contextual conditioned fear. METHODS We studied the acute effects of four 5-HT1A receptor ligands in the fear-potentiated startle test. Male Wistar rats were injected with the 5-HT1A receptors biased agonists F13714 (0-0.16 mg/kg, IP), which preferentially activates somatodendritic 5-HT1A autoreceptors, or F15599 (0-0.16 mg/kg, IP), which preferentially activates cortical post-synaptic 5-HT1A heteroreceptors, with the prototypical 5-HT1A receptor agonist R(+)8-OH-DPAT (0-0.3 mg/kg, SC) or the 5-HT1A receptor antagonist WAY100,635 (0-1.0 mg/kg, SC). RESULTS F13714 (0.16 mg/kg) and R(+)-8-OH-DPAT (0.03 mg/kg) injected before training reduced cued fear acquisition. Pre-treatment with F15599 or WAY100,635 had no effect on fear learning. In the fear-potentiated startle test, F13714 (0.04-0.16 mg/kg) and R(+)-8-OH-DPAT (0.1-0.3 mg/kg) reduced the expression of cued and contextual fear, whereas F15599 had no effect. WAY100,635 (0.03-1.0 mg/kg) reduced the overall startle response. CONCLUSIONS The current findings indicate that activation of somatodendritic 5-HT1A autoreceptors reduces cued fear learning, whereas 5-HT1A receptors seem not involved in contextual fear learning. Moreover, activation of somatodendritic 5-HT1A autoreceptors may reduce cued and contextual fear expression, whereas we found no evidence for the involvement of cortical 5-HT1A heteroreceptors in the expression of conditioned fear.
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Affiliation(s)
- Yulong Zhao
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Elisabeth Y. Bijlsma
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Freija ter Heegde
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Monika P. Verdouw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - J. Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | | | - Lucianne Groenink
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands. .,Brain Center Rudolf Magnus (BCRM), UMC Utrecht, Utrecht, The Netherlands.
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40
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Zhao Y, Bijlsma EY, Verdouw MP, Groenink L. No effect of sex and estrous cycle on the fear potentiated startle response in rats. Behav Brain Res 2018; 351:24-33. [DOI: 10.1016/j.bbr.2018.05.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 12/13/2022]
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41
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Lago TR, Hsiung A, Leitner BP, Duckworth CJ, Chen KY, Ernst M, Grillon C. Exercise decreases defensive responses to unpredictable, but not predictable, threat. Depress Anxiety 2018; 35:868-875. [PMID: 29637654 PMCID: PMC6314494 DOI: 10.1002/da.22748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Research supports the anxiolytic effect of exercise, but the mechanism underlying this effect is unclear. This study examines the influence of exercise in healthy controls on two distinct defensive states implicated in anxiety disorders: fear, a phasic response to a predictable threat, and anxiety, a sustained response to an unpredictable threat. METHODS Thirty-four healthy volunteers (17 male, age M = 26.18, SD = 5.6) participated in sessions of exercise (biking at 60-70% of heart rate reserve) and control (biking at 10-20% of heart rate reserve) activity for 30 min, separated by 1 week. Threat responses were measured by eyeblink startle and assessed with the "Neutral-Predictable-Unpredictable threat test," which includes a neutral (N) and two threat conditions, one with predictable (P) and one with unpredictable (U) shock. RESULTS Results show that exercise versus control activity reduces startle potentiation during unpredictable threat (P = .031), but has no effect on startle potentiation during predictable threat (P = .609). CONCLUSIONS These results suggest that exercise reduces defensive response to unpredictable, but not predictable, threat, a dissociation that may help inform clinical indications for this behavioral intervention, as well as provide clues to its underlying neurobehavioral mechanisms.
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Affiliation(s)
- Tiffany R Lago
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Abigail Hsiung
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Brooks P Leitner
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Courtney J Duckworth
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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42
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Bennett KP, Dickmann JS, Larson CL. If or when? Uncertainty's role in anxious anticipation. Psychophysiology 2018; 55:e13066. [PMID: 29384197 PMCID: PMC6013348 DOI: 10.1111/psyp.13066] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 01/25/2023]
Abstract
Uncertainty is often associated with subjective distress and a potentiated anxiety response. Occurrence uncertainty, or the inability to predict if a threat will occur, has rarely been compared experimentally with temporal uncertainty, or the inability to predict when a threat will occur. The current study aimed to (a) directly compare the anxiogenic effects of anticipating these two types of uncertain threat, as indexed by the eyeblink startle response, and (b) assess the relationship between startle response to occurrence and temporal uncertainty and individual differences in self-reported intolerance of uncertainty and anxiety. The findings indicated that anticipation during occurrence uncertainty elicited a larger startle response than anticipating a certain threat, but anticipation during temporal uncertainty was superior at potentiating startle blink overall. Additional analyses of the effects of order and habituation further highlighted temporal uncertainty's superiority in eliciting greater startle responding. This suggests that, while uncertainty is physiologically anxiety provoking, some level of certainty that the threat will occur enhances the robustness of the physiological anxiety response. However, self-reported anxiety was equivalent for temporal and occurrence uncertainty, suggesting that, while defensive responding may be more affected by temporal uncertainty, people perceive both types of uncertainty as anxiogenic. Individual differences in the intolerance of uncertainty and other anxiety measures were not related to anticipatory startle responsivity during any of the conditions.
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Affiliation(s)
- Ken P. Bennett
- Department of Psychology, University of Wisconsin – Milwaukee
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43
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Zhao Y, Bijlsma EY, Verdouw PM, Garssen J, Groenink L. The contribution of contextual fear in the anxiolytic effect of chlordiazepoxide in the fear-potentiated startle test. Behav Brain Res 2018; 353:57-61. [PMID: 29969605 DOI: 10.1016/j.bbr.2018.06.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
This study evaluated the extent to which a reduction in contextual fear contributes to the anxiolytic effect of benzodiazepines in the fear-potentiated startle response. To this end, chlordiazepoxide, an anxiolytic often used as positive control in preclinical drug studies, and zolpidem, known to have sedative properties and to be devoid of anxiolytic effects, were tested in two contexts: the same context as training had taken place and an alternative context. In addition, the level of muscle relaxation was assessed in a grip strength test. Chlordiazepoxide (2.5-10 mg/kg) decreased the fear-potentiated startle response, confirming its anxiolytic activity. In addition, it dose-dependently decreased the overall startle response in the same, but not the alternative context, and did not affect grip strength, indicating that chlordiazepoxide inhibits contextual fear in the absence of non-specific drug effects. Zolpidem (1.0-10 mg/kg) reduced the overall startle response in both contexts equally and decreased grip strength, indicating that its effects on fear-potentiated startle are due to non-specific drug effects, and not anxiolytic effects. The present findings show that chlordiazepoxide reduces contextual conditioned fear in the absence of non-specific drug effects. In addition, they show that training and testing rats in different contexts makes it possible to distinguish between cued, contextual and non-specific drug effects. As exaggerated contextual fear conditioning contributes to the fear generalization processes implicated in pathological anxiety, focus in screening of anxiolytic effects could be directed more towards the suppression of contextual fear and, therefore, this approach would be a valuable addition to standard preclinical screening.
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Affiliation(s)
- Yulong Zhao
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, Netherlands
| | - Elisabeth Y Bijlsma
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, Netherlands.
| | - P Monika Verdouw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, Netherlands
| | - Lucianne Groenink
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, Netherlands
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44
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Stevens ES, Weinberg A, Nelson BD, Meissel EEE, Shankman SA. The effect of panic disorder versus anxiety sensitivity on event-related potentials during anticipation of threat. J Anxiety Disord 2018; 54:1-10. [PMID: 29291580 PMCID: PMC5820143 DOI: 10.1016/j.janxdis.2017.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 11/14/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022]
Abstract
Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies have been mixed. Predictability of threat, an important feature of threat processing, may have contributed to these mixed findings. Additionally, anxiety sensitivity, a dimensional trait associated with PD, may yield stronger associations with cognitive processes than categorical diagnoses of PD. In this study, 171 participants with PD and/or depression and healthy controls completed a task that differentiated anticipation of predictable vs. unpredictable shocks, while startle eyeblink and event-related potentials (ERPs [N100, P300]) were recorded. In all participants, relative to the control condition, probe N100 was enhanced to both predictable and unpredictable threat, whereas P300 suppression was unique to predictable threat. Probe N100, but not P300, was associated with startle eyeblink during both threatening conditions, and was strongest for unpredictable threat. PD was not associated with ERPs, but anxiety sensitivity (physical concerns) was positively associated with probe N100 (indicating reduced responding) in the unpredictable condition independent of PD diagnosis. Vulnerability to panic-related psychopathology may be characterized by aberrant early processing of threat, which may be especially evident during anticipation of unpredictable threats.
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Affiliation(s)
| | - Anna Weinberg
- Department of Psychology, McGill University, Quebec, Canada
| | | | | | - Stewart A. Shankman
- Department of Psychology, University of Illinois at Chicago, IL, USA,Corresponding author. University of Illinois at Chicago, Department of Psychology, Chicago, Illinois, 60607 United States, (S. Shankman)
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45
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Kovács Z, D'Agostino DP, Ari C. Anxiolytic Effect of Exogenous Ketone Supplementation Is Abolished by Adenosine A1 Receptor Inhibition in Wistar Albino Glaxo/Rijswijk Rats. Front Behav Neurosci 2018. [PMID: 29520223 PMCID: PMC5827672 DOI: 10.3389/fnbeh.2018.00029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Anxiety disorders are one of the most common mental health problems worldwide, but the exact pathophysiology remains largely unknown. It has been demonstrated previously that administration of exogenous ketone supplement KSMCT (ketone salt/KS + medium chain triglyceride/MCT oil) by intragastric gavage for 7 days decreased the anxiety level in genetically absence epileptic Wistar Albino Glaxo/Rijswijk (WAG/Rij) rats. To investigate the potential role of the adenosinergic system in the pathomechanism of anxiety we tested whether the inhibition of adenosine A1 receptors (A1Rs) influence the anxiolytic effect of the exogenous ketone supplement. As A1Rs may mediate such an effect, in the present study we used a specific A1R antagonist, DPCPX (1,3-dipropyl-8-cyclopentylxanthine) to test whether it modulates the anxiolytic effect of sub-chronically (7 days) applied KSMCT in the previously tested animal model by using elevated plus maze (EPM) test. We administered KSMCT (2.5 g/kg/day) alone by intragastric gavage and in combination with intraperitoneally (i.p.) injected of DPCPX in two doses (lower: 0.15 mg/kg, higher: 0.25 mg/kg). Control groups represented i.p saline and water gavage with or without i.p. DPCPX administration (2.5 g/kg/day). After treatments, the level of blood glucose and beta-hydroxybutyrate (βHB), as well as body weight were recorded. KSMCT alone significantly increased the time spent in the open arms and decreased the time spent in the closed arms, supporting our previous results. Injection of lower dose of DPCPX decreased, while higher dose of DPCPX abolished the effect of KSMCT administration on EPM. Blood βHB levels were significantly increased after administration of KSMCT, while DPCPX did not change the KSMCT induced increase in blood βHB levels. These results demonstrate that A1R inhibition modified (decreased) the anti-anxiety effect of KSMCT administration implying that the adenosinergic system, likely via A1Rs, may modulate the exogenous ketone supplement induced anxiolytic influence.
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Affiliation(s)
- Zsolt Kovács
- Savaria Department of Biology, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Dominic P D'Agostino
- Department of Molecular Pharmacology and Physiology, Metabolic Medicine Research Laboratory, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.,Institute for Human and Machine Cognition, Ocala, FL, United States
| | - Csilla Ari
- Department of Molecular Pharmacology and Physiology, Metabolic Medicine Research Laboratory, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.,Department of Psychology, Hyperbaric Neuroscience Research Laboratory, University of South Florida, Tampa, FL, United States
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46
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Bradley MM, Zlatar ZZ, Lang PJ. Startle reflex modulation during threat of shock and "threat" of reward. Psychophysiology 2018; 55:10.1111/psyp.12989. [PMID: 28881032 PMCID: PMC5773360 DOI: 10.1111/psyp.12989] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/26/2017] [Accepted: 08/07/2017] [Indexed: 01/05/2023]
Abstract
During threat of shock, the startle reflex is potentiated, suggesting modulation by defensive mobilization. To determine whether startle potentiation is specific to aversive anticipation, startle reflexes were measured in the context of either aversive or appetitive anticipation in a between-subject study. Participants wore a device on the wrist that could deliver electrical shock (n = 49), or vibrotactile stimulation indicating monetary reward (n = 48). Cues signaling "threat" or "safe" periods were presented alone, or accompanied by presentation of affective and neutral pictures on half of the trials. Results indicated that the startle reflex was significantly potentiated when anticipating either shock or reward, compared to safe periods, both when no picture was presented, as well as during picture viewing. The difference between threat and safety in both reflex magnitude and skin conductance changes was larger for those anticipating shock, suggesting that the aversive context was more motivationally engaging. The pattern of reflex modulation as a function of picture valence varied under threat and safety, but was identical in the shock and reward groups, consistent with a hypothesis that anticipation of either aversive or appetitive events prompts heightened perceptual vigilance, potentiating the acoustic startle reflex.
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Affiliation(s)
- Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, Florida, USA
| | - Zvinka Z Zlatar
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, Florida, USA
| | - Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, Florida, USA
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Kaye JT, Bradford DE, Magruder KP, Curtin JJ. Probing for Neuroadaptations to Unpredictable Stressors in Addiction: Translational Methods and Emerging Evidence. J Stud Alcohol Drugs 2017; 78:353-371. [PMID: 28499100 DOI: 10.15288/jsad.2017.78.353] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Stressors clearly contribute to addiction etiology and relapse in humans, but our understanding of specific mechanisms remains limited. Rodent models of addiction offer the power, flexibility, and precision necessary to delineate the causal role and specific mechanisms through which stressors influence alcohol and other drug use. This review describes a program of research using startle potentiation to unpredictable stressors that is well positioned to translate between animal models and clinical research with humans on stress neuroadaptations in addiction. This research rests on a solid foundation provided by three separate pillars of evidence from (a) rodent behavioral neuroscience on stress neuroadaptations in addiction, (b) rodent affective neuroscience on startle potentiation, and (c) human addiction and affective science with startle potentiation. Rodent stress neuroadaptation models implicate adaptations in corticotropin-releasing factor and norepinephrine circuits within the central extended amygdala following chronic alcohol and other drug use that mediate anxious behaviors and stress-induced reinstatement among drug-dependent rodents. Basic affective neuroscience indicates that these same neural mechanisms are involved in startle potentiation to unpredictable stressors in particular (vs. predictable stressors). We believe that synthesis of these evidence bases should focus us on the role of unpredictable stressors in addiction etiology and relapse. Startle potentiation in unpredictable stressor tasks is proposed to provide an attractive and flexible test bed to encourage tight translation and reverse translation between animal models and human clinical research on stress neuroadaptations. Experimental therapeutics approaches focused on unpredictable stressors hold high promise to identify, repurpose, or refine pharmacological and psychosocial interventions for addiction.
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Affiliation(s)
- Jesse T Kaye
- University of Wisconsin-Madison, Madison, Wisconsin
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Bradford DE, Motschman CA, Starr MJ, Curtin JJ. Alcohol's effects on emotionally motivated attention, defensive reactivity and subjective anxiety during uncertain threats. Soc Cogn Affect Neurosci 2017; 12:1823-1832. [PMID: 28985425 PMCID: PMC5714195 DOI: 10.1093/scan/nsx095] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 12/19/2022] Open
Abstract
Developing a better understanding of how and under what circumstances alcohol affects the emotions, cognitions and neural functions that precede and contribute to dangerous behaviors during intoxication may help to reduce their occurrence. Alcohol intoxication has recently been shown to reduce defensive reactivity and anxiety more during uncertain vs certain threat. However, alcohol's effects on emotionally motivated attention to these threats are unknown. Alcohol may disrupt both affective response to and attentional processing of uncertain threats making intoxicated individuals less able to avoid dangerous and costly behaviors. To test this possibility, we examined the effects of a broad range of blood alcohol concentrations on 96 participants' sub-cortically mediated defensive reactivity (startle potentiation), retrospective subjective anxiety (self-report) and cortically assessed emotionally motivated attention (probe P3 event related potential) while they experienced visually cued uncertain and certain location electric shock threat. As predicted, alcohol decreased defensive reactivity and subjective anxiety more during uncertain vs certain threat. In a novel finding, alcohol dampened emotionally motivated attention during uncertain but not certain threat. This effect appeared independent of alcohol's effects on defensive reactivity and subjective anxiety. These results suggest that alcohol intoxication dampens processing of uncertain threats while leaving processing of certain threats intact.
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Affiliation(s)
- Daniel E Bradford
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, USA
| | - Courtney A Motschman
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Mark J Starr
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, USA
| | - John J Curtin
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, USA
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Gorka SM, Lieberman L, Klumpp H, Kinney KL, Kennedy AE, Ajilore O, Francis J, Duffecy J, Craske MG, Nathan J, Langenecker S, Shankman SA, Phan KL. Reactivity to unpredictable threat as a treatment target for fear-based anxiety disorders. Psychol Med 2017; 47:2450-2460. [PMID: 28436351 DOI: 10.1017/s0033291717000964] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Heightened reactivity to unpredictable threat (U-threat) is a core individual difference factor underlying fear-based psychopathology. Little is known, however, about whether reactivity to U-threat is a stable marker of fear-based psychopathology or if it is malleable to treatment. The aim of the current study was to address this question by examining differences in reactivity to U-threat within patients before and after 12-weeks of selective serotonin reuptake inhibitors (SSRIs) or cognitive-behavioral therapy (CBT). METHODS Participants included patients with principal fear (n = 22) and distress/misery disorders (n = 29), and a group of healthy controls (n = 21) assessed 12-weeks apart. A well-validated threat-of-shock task was used to probe reactivity to predictable (P-) and U-threat and startle eyeblink magnitude was recorded as an index of defensive responding. RESULTS Across both assessments, individuals with fear-based disorders displayed greater startle magnitude to U-threat relative to healthy controls and distress/misery patients (who did not differ). From pre- to post-treatment, startle magnitude during U-threat decreased only within the fear patients who received CBT. Moreover, within fear patients, the magnitude of decline in startle to U-threat correlated with the magnitude of decline in fear symptoms. For the healthy controls, startle to U-threat across the two time points was highly reliable and stable. CONCLUSIONS Together, these results indicate that startle to U-threat characterizes fear disorder patients and is malleable to treatment with CBT but not SSRIs within fear patients. Startle to U-threat may therefore reflect an objective, psychophysiological indicator of fear disorder status and CBT treatment response.
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Affiliation(s)
- S M Gorka
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - L Lieberman
- Department of Psychology,University of Illinois-Chicago,1007 West Harrison St. (M/C 285) Chicago, IL 60607,USA
| | - H Klumpp
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - K L Kinney
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - A E Kennedy
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - O Ajilore
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - J Francis
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - J Duffecy
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - M G Craske
- Department of Psychology,University of California,Los Angeles, Franz Hall - Box 95156 Los Angeles, CA 90094,USA
| | - J Nathan
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - S Langenecker
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - S A Shankman
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - K L Phan
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
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The Unpredictive Brain Under Threat: A Neurocomputational Account of Anxious Hypervigilance. Biol Psychiatry 2017; 82:447-454. [PMID: 28838469 PMCID: PMC5584579 DOI: 10.1016/j.biopsych.2017.06.031] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anxious hypervigilance is marked by sensitized sensory-perceptual processes and attentional biases to potential danger cues in the environment. How this is realized at the neurocomputational level is unknown but could clarify the brain mechanisms disrupted in psychiatric conditions such as posttraumatic stress disorder. Predictive coding, instantiated by dynamic causal models, provides a promising framework to ground these state-related changes in the dynamic interactions of reciprocally connected brain areas. METHODS Anxiety states were elicited in healthy participants (n = 19) by exposure to the threat of unpredictable, aversive shocks while undergoing magnetoencephalography. An auditory oddball sequence was presented to measure cortical responses related to deviance detection, and dynamic causal models quantified deviance-related changes in effective connectivity. Participants were also administered alprazolam (double-blinded, placebo-controlled crossover) to determine whether the cortical effects of threat-induced anxiety are reversed by acute anxiolytic treatment. RESULTS Deviant tones elicited increased auditory cortical responses under threat. Bayesian analyses revealed that hypervigilant responding was best explained by increased postsynaptic gain in primary auditory cortex activity as well as modulation of feedforward, but not feedback, coupling within a temporofrontal cortical network. Increasing inhibitory gamma-aminobutyric acidergic action with alprazolam reduced anxiety and restored feedback modulation within the network. CONCLUSIONS Threat-induced anxiety produced unbalanced feedforward signaling in response to deviations in predicable sensory input. Amplifying ascending sensory prediction error signals may optimize stimulus detection in the face of impending threats. At the same time, diminished descending sensory prediction signals impede perceptual learning and may, therefore, underpin some of the deleterious effects of anxiety on higher-order cognition.
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