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Greaves MD, Felmingham KL, Ney LJ, Nicholson EL, Li S, Vervliet B, Harrison BJ, Graham BM, Steward T. Using electrodermal activity to estimate fear learning differences in anxiety: A multiverse analysis. Behav Res Ther 2024; 181:104598. [PMID: 39142133 DOI: 10.1016/j.brat.2024.104598] [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: 03/22/2023] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 08/16/2024]
Abstract
Meta-analyses indicate differences in Pavlovian fear responses between anxious and non-anxious individuals using electrodermal activity (EDA). Recent research, however, has cast doubt on whether these effects are robust to different analytic choices. Using the multiverse approach conceived by Steegen et al. (2016), we surveyed analytic choices typically implemented in clinical fear conditioning research by conducting 1240 analyses reflecting different choice permutations. Only 1.45% of our analyses produced theoretically congruent statistically significant effects, and the strength and direction of the estimated effects varied substantially across EDA processing methods. We conclude that EDA-estimated fear learning differences are vulnerable to researcher degrees of freedom and make recommendations regarding which analytical choices should be approached with a high degree of caution.
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Affiliation(s)
- Matthew D Greaves
- Department of Psychiatry, The University of Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia.
| | - Luke J Ney
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Emma L Nicholson
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Stella Li
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Bram Vervliet
- Laboratory of Biological Psychology, KU Leuven, Belgium; Leuven Brain Institute, KU Leuven, Belgium
| | - Ben J Harrison
- Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Bronwyn M Graham
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Trevor Steward
- Department of Psychiatry, The University of Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
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2
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Machlin L, Sheridan MA, Lurie LA, Kasparek SW, Kim SG, Peverill M, France JM, Robertson MM, Jovanovic T, Lengua LJ, McLaughlin KA. Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study. Psychol Med 2024:1-9. [PMID: 39245946 DOI: 10.1017/s0033291724001569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
BACKGROUND Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth. METHODS The sample includes 170 youths aged 10-13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later. RESULTS Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms. CONCLUSIONS Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.
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Affiliation(s)
- Laura Machlin
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Margaret A Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Lucy A Lurie
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | | | - Stephanie Gyuri Kim
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - John McClellan France
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Madeline M Robertson
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Liliana J Lengua
- Department of Psychology, University of Washington, Seattle, WA, USA
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3
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Wang Y, Becker B, Wang J, Wang Y, Zhang L, Mei Y, Li H, Lei Y. Exaggerated sensitivity to threat and reduced medial prefrontal engagement during threat generalization in reactive aggressive adolescents. Neuroimage 2024; 294:120645. [PMID: 38734156 DOI: 10.1016/j.neuroimage.2024.120645] [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: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/13/2024] Open
Abstract
Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N = 30) and a low aggression (LA) group (N = 31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and eight generalization stimuli (GSs). A scream at 85 dB served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that CSs and GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.
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Affiliation(s)
- Yizhen Wang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Jinxia Wang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Yuanyuan Wang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Liangyou Zhang
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Ying Mei
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Hong Li
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China
| | - Yi Lei
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China.
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4
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Luo RH, Su F, Zhao XY, Cao TH, Liao J, Xue YX, Huang GD, Yang JL. Impairment in acquisition of conditioned fear in people with depressive symptoms. Front Psychol 2024; 15:1384053. [PMID: 38863669 PMCID: PMC11166000 DOI: 10.3389/fpsyg.2024.1384053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024] Open
Abstract
Background Depression is one of the primary global public health issues, and there has been a dramatic increase in depression levels among young people over the past decade. The neuroplasticity theory of depression postulates that a malfunction in neural plasticity, which is responsible for learning, memory, and adaptive behavior, is the primary source of the disorder's clinical manifestations. Nevertheless, the impact of depression symptoms on associative learning remains underexplored. Methods We used the differential fear conditioning paradigm to investigate the effects of depressive symptoms on fear acquisition and extinction learning. Skin conductance response (SCR) is an objective evaluation indicator, and ratings of nervousness, likeability, and unconditioned stimuli (US) expectancy are subjective evaluation indicators. In addition, we used associability generated by a computational reinforcement learning model to characterize the skin conductance response. Results The findings indicate that individuals with depressive symptoms exhibited significant impairment in fear acquisition learning compared to those without depressive symptoms based on the results of the skin conductance response. Moreover, in the discrimination fear learning task, the skin conductance response was positively correlated with associability, as estimated by the hybrid model in the group without depressive symptoms. Additionally, the likeability rating scores improved post-extinction learning in the group without depressive symptoms, and no such increase was observed in the group with depressive symptoms. Conclusion The study highlights that individuals with pronounced depressive symptoms exhibit impaired fear acquisition and extinction learning, suggesting a possible deficit in associative learning. Employing the hybrid model to analyze the learning process offers a deeper insight into the associative learning processes of humans, thus allowing for improved comprehension and treatment of these mental health problems.
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Affiliation(s)
- Rui-Han Luo
- Tianjin Medical University General Hospital, Tianjin, China
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Feng Su
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Xin-Yue Zhao
- Tianjin Medical University General Hospital, Tianjin, China
| | - Tian-Hui Cao
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Liao
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Geng-Di Huang
- Department of Addiction Medicine, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Jian-Li Yang
- Tianjin Medical University General Hospital, Tianjin, China
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
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Schacter HL, Marusak HA, Borg BA, Jovanovic T. Facing ambiguity: Social threat sensitivity mediates the association between peer victimization and adolescent anxiety. Dev Psychopathol 2024; 36:112-120. [PMID: 36200351 PMCID: PMC10151014 DOI: 10.1017/s0954579422001018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Peer victimization is a developmentally salient stressor that elevates adolescents' risk for anxiety disorders. However, modifiable mechanisms that explain this link and can be targeted via therapeutic interventions remain poorly understood. Drawing from psychobiological models implicating aberrant threat sensitivity in the development and maintenance of psychopathology, the current study investigated sensitivity to peer-related social threats as a mechanism underlying the association between peer victimization and anxiety. A sample of 197 dyads of early adolescents (M age = 12.02; 46% female) and parents/guardians (M age = 41.46; 90% female) completed online surveys assessing peer victimization, sensitivity to potential (i.e., ambiguous) social threats, and anxiety. Controlling for potentially confounding demographic and psychosocial factors, both self- and parent-reported peer victimization were positively associated with adolescent anxiety symptoms. Additionally, there were significant indirect effects from self- and parent-reported peer victimization to anxiety via social threat sensitivity. Supplemental analyses indicated unique effects of covert, but not overt, peer victimization on social threat sensitivity and anxiety. The findings provide initial evidence that peer victimization experiences lower adolescents' threshold for interpreting threats in ambiguous social situations, which contributes to heightened anxiety. These results implicate social threat sensitivity as a potential therapeutic target for interrupting links from peer victimization to psychological distress.
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Affiliation(s)
- Hannah L. Schacter
- Wayne State University, Department of Psychology, 5057 Woodward Avenue, Detroit, MI 48202
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI 48202
| | - Hilary A. Marusak
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI 48202
- Wayne State University, Department of Psychiatry and Behavioral Neurosciences, 3901 Chrysler Service Drive, Detroit, MI 48201
| | - Breanna A. Borg
- Wayne State University, Department of Psychiatry and Behavioral Neurosciences, 3901 Chrysler Service Drive, Detroit, MI 48201
| | - Tanja Jovanovic
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI 48202
- Wayne State University, Department of Psychiatry and Behavioral Neurosciences, 3901 Chrysler Service Drive, Detroit, MI 48201
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Fricke S, Seinsche RJ, Neudert MK, Schäfer A, Zehtner RI, Stark R, Hermann A. Neural correlates of context-dependent extinction recall in social anxiety disorder: relevance of intrusions in response to aversive social experiences. Psychol Med 2024; 54:548-557. [PMID: 37553977 DOI: 10.1017/s0033291723002179] [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] [Indexed: 08/10/2023]
Abstract
BACKGROUND There are phenomenological similarities between social anxiety disorder (SAD) and posttraumatic stress disorder, such as a provoking aversive event, posttraumatic stress symptoms (e.g. intrusions) in response to these events and deficient (context-dependent) fear conditioning processes. This study investigated the neural correlates of context-dependent extinction recall and fear renewal in SAD, specifically in patients with intrusions in response to an etiologically relevant aversive social event. METHODS During functional magnetic resonance imaging a two-day context-dependent fear conditioning paradigm was conducted in 54 patients with SAD and 54 healthy controls (HC). This included fear acquisition (context A) and extinction learning (context B) on one day, and extinction recall (context B) as well as fear renewal (contexts C and A) one day later. The main outcome measures were blood oxygen level-dependent responses in regions of interest and skin conductance responses. RESULTS Patients with SAD showed reduced differential conditioned amygdala activation during extinction recall in the safe extinction context and during fear renewal in the acquisition context compared to HC. Patients with clinically relevant intrusions moreover exhibited hypoactivation of the ventromedial prefrontal cortex (vmPFC) during extinction learning, extinction recall, and fear renewal in a novel context, while amygdala activation more strongly decreased during extinction learning and increased during fear renewal in the acquisition context compared with patients without intrusions. CONCLUSIONS Our study provides first evidence that intrusions in SAD are associated with similar deficits in context-dependent regulation of conditioned fear via the vmPFC as previously demonstrated in posttraumatic stress disorder.
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Affiliation(s)
- Susanne Fricke
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rosa J Seinsche
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Marie K Neudert
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Axel Schäfer
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Raphaela I Zehtner
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Andrea Hermann
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
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7
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Klein Z, Shner-Livne G, Danon-Kraun S, Ginat-Frolich R, Pine DS, Shechner T. Enhanced late positive potential to conditioned threat cue during delayed extinction in anxious youth. J Child Psychol Psychiatry 2024; 65:215-228. [PMID: 37157184 DOI: 10.1111/jcpp.13814] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Deficits in threat learning relate to anxiety symptoms. Since several anxiety disorders arise in adolescence, impaired adolescent threat learning could contribute to adolescent changes in risk for anxiety. This study compared threat learning among anxious and non-anxious youth using self-reports, peripheral psychophysiology measures, and event-related potentials. Because exposure therapy, the first-line treatment for anxiety disorders, is largely based on principles of extinction learning, the study also examined the link between extinction learning and treatment outcomes among anxious youth. METHODS Clinically anxious (n = 28) and non-anxious (n = 33) youth completed differential threat acquisition and immediate extinction. They returned to the lab a week later to complete a threat generalization test and a delayed extinction task. Following these two experimental visits, anxious youth received exposure therapy for 12 weeks. RESULTS Anxious as compared to non-anxious youth demonstrated elevated cognitive and physiological responses across acquisition and immediate extinction learning, as well as greater threat generalization. In addition, anxious youth showed enhanced late positive potential response to the conditioned threat cue compared to the safety cue during delayed extinction. Finally, aberrant neural response during delayed extinction was associated with poorer treatment outcomes. CONCLUSIONS The study emphasizes differences between anxious and non-anxious youth in threat learning processes and provides preliminary support for a link between neural processing during delayed extinction and exposure-based treatment outcome in pediatric anxiety.
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Affiliation(s)
- Zohar Klein
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Gil Shner-Livne
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Shani Danon-Kraun
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Rivkah Ginat-Frolich
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Daniel S Pine
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
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8
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Zimmermann KS, Richardson R, Baker KD. Developmental changes in functional connectivity between the prefrontal cortex and amygdala following fear extinction. Neurobiol Learn Mem 2023; 205:107847. [PMID: 37865263 DOI: 10.1016/j.nlm.2023.107847] [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: 04/12/2023] [Revised: 09/13/2023] [Accepted: 10/18/2023] [Indexed: 10/23/2023]
Abstract
The amygdala and prefrontal cortex (PFC) undergo dramatic changes in structure, function, and regional connectivity in early life, ultimately stabilizing in early adulthood. Pathways between these two structures underlie many forms of emotional learning, including the extinction of conditioned fear. Here we sought to characterize changes in extinction-related medial PFC (mPFC) → amygdala functional connectivity across development that might explain adolescent impairments in extinction. The retrograde tracer Fluorogold was infused into the amygdala of postnatal day (P)22-23 (juvenile), P31-32 (adolescent), or ≥ P69 (adult) rats, which were then exposed to fear conditioning and extinction training. Brains were collected following extinction or context exposure and processed for expression of pMAPK (as a marker of learning-dependent plasticity) in prelimbic (PL) and infralimbic (IL) amygdala-projecting neurons. Consistent with previous findings, amygdala-projecting mPFC neurons were located primarily in layers (L)II/III and V of the mPFC. We noted that mPFC LII/III projected predominantly to the ipsilateral basolateral amygdala, whereas LV projected bilaterally and targeted multiple amygdalar nuclei. Extinction was not associated with changes in extinction-related plasticity in the PL-amygdala pathways in any age group. No changes were seen in LII/III of the IL, but extinction-related plasticity in LV amygdala-projecting IL neurons decreased linearly across development. These findings suggest that extinction-related functional connectivity between the IL and the amygdala undergoes fundamental changes across development that may contribute to alterations in fear suppression across development.
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Affiliation(s)
- K S Zimmermann
- School of Psychology, UNSW Sydney, New South Wales 2052, Australia
| | - R Richardson
- School of Psychology, UNSW Sydney, New South Wales 2052, Australia
| | - K D Baker
- School of Psychology, UNSW Sydney, New South Wales 2052, Australia.
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9
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Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
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10
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Berg F, Margraf J, Wannemüller A. Calibrating your own fears: Feasibility of a remote fear conditioning paradigm with semi-subjective stimulus calibration and differences in fear learning. Learn Behav 2023; 51:246-261. [PMID: 36239878 PMCID: PMC9568901 DOI: 10.3758/s13420-022-00545-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
Fear conditioning studies have occurred mostly in the laboratory, but recently researchers have started to adapt fear conditioning procedures for remote application. Standardization of aversive stimulus material not causing unnecessarily strong discomfort remains an issue especially relevant to research without experimental supervision. The present study introduces a novel semi-subjective method to calibrate aversive sounds in a remotely conducted fear conditioning paradigm. To demonstrate feasibility and proof of concept, 165 participants completed the paradigm, calibrating the loudness of an aversive sound without the guidance of an experimental instructor. This study also aimed to replicate existing findings of participant groups that differed in their early CS-UCS contingency awareness. Participants were classified as Accurate (UCS more likely after the CS+ than CS-), Poor (UCS more likely after the CS- than CS+, or UCS unlikely after either CS), and Threat Biased (UCS equally likely after the CS+ and CS-). Results indicated both the feasibility and efficacy of the paradigm, with participants showing typical patterns of fear learning. Threat Biased participants showed significantly higher uncertainty towards safety signals. There were no differences between the groups in terms of personality traits, thus questioning whether these attributes mediate differences in fear learning and the emergence of anxiety disorders. Using semi-subjective sound calibration appears to be functional, and future studies may consider implementing the new method when remotely administering fear conditioning paradigms.
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Affiliation(s)
- Frederic Berg
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Massenbergstraße 9, 44787, Bochum, Germany.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Massenbergstraße 9, 44787, Bochum, Germany
| | - André Wannemüller
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Massenbergstraße 9, 44787, Bochum, Germany
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Abend R. Understanding anxiety symptoms as aberrant defensive responding along the threat imminence continuum. Neurosci Biobehav Rev 2023; 152:105305. [PMID: 37414377 PMCID: PMC10528507 DOI: 10.1016/j.neubiorev.2023.105305] [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: 07/09/2022] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
Threat-anticipatory defensive responses have evolved to promote survival in a dynamic world. While inherently adaptive, aberrant expression of defensive responses to potential threat could manifest as pathological anxiety, which is prevalent, impairing, and associated with adverse outcomes. Extensive translational neuroscience research indicates that normative defensive responses are organized by threat imminence, such that distinct response patterns are observed in each phase of threat encounter and orchestrated by partially conserved neural circuitry. Anxiety symptoms, such as excessive and pervasive worry, physiological arousal, and avoidance behavior, may reflect aberrant expression of otherwise normative defensive responses, and therefore follow the same imminence-based organization. Here, empirical evidence linking aberrant expression of specific, imminence-dependent defensive responding to distinct anxiety symptoms is reviewed, and plausible contributing neural circuitry is highlighted. Drawing from translational and clinical research, the proposed framework informs our understanding of pathological anxiety by grounding anxiety symptoms in conserved psychobiological mechanisms. Potential implications for research and treatment are discussed.
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Affiliation(s)
- Rany Abend
- School of Psychology, Reichman University, P.O. Box 167, Herzliya 4610101, Israel; Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
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12
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Dou H, Lei Y, Pan Y, Li H, Astikainen P. Impact of observational and direct learning on fear conditioning generalization in humans. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110650. [PMID: 36181957 DOI: 10.1016/j.pnpbp.2022.110650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/12/2022] [Accepted: 09/25/2022] [Indexed: 11/28/2022]
Abstract
Humans gain knowledge about threats not only from their own experiences but also from observing others' behavior. A neutral stimulus is associated with a threat stimulus for several times and the neutral stimulus will evoke fear responses, which is known as fear conditioning. When encountering a new event that is similar to one previously associated with a threat, one may feel afraid and produce fear responses. This is called fear generalization. Previous studies have mostly focused on fear conditioning and generalization based on direct learning, but few have explored how observational fear learning affects fear conditioning and generalization. To the best of our knowledge, no previous study has focused on the neural correlations of fear conditioning and generalization based on observational learning. In the present study, 58 participants performed a differential conditioning paradigm in which they learned the associations between neutral cues (i.e., geometric figures) and threat stimuli (i.e., electric shock). The learning occurred on their own (i.e., direct learning) and by observing other participant's responses (i.e., observational learning); the study used a within-subjects design. After each learning condition, a fear generalization paradigm was conducted by each participant independently while their behavioral responses (i.e., expectation of a shock) and electroencephalography (EEG) recordings or responses were recorded. The shock expectancy ratings showed that observational learning, compared to direct learning, reduced the differentiation between the conditioned threatening stimuli and safety stimuli and the increased shock expectancy to the generalization stimuli. The EEG indicated that in fear learning, threatening conditioned stimuli in observational and direct learning increased early discrimination (P1) and late motivated attention (late positive potential [LPP]), compared with safety conditioned stimuli. In fear generalization, early discrimination, late motivated attention, and orienting attention (alpha-event-related desynchronization [alpha-ERD]) to generalization stimuli were reduced in the observational learning condition. These findings suggest that compared to direct learning, observational learning reduces differential fear learning and increases the generalization of fear, and this might be associated with reduced discrimination and attentional function related to generalization stimuli.
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Affiliation(s)
- Haoran Dou
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China; Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China.
| | - Yafeng Pan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Hong Li
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China; School of Psychology, South China Normal University, Guangzhou, China
| | - Piia Astikainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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13
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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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14
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Bryant RA. Is Fear Extinction Impairment Central to Psychopathology? Curr Top Behav Neurosci 2023; 64:195-212. [PMID: 37668874 DOI: 10.1007/7854_2023_439] [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] [Indexed: 09/06/2023]
Abstract
As discussed in this chapter, there have been enormous advances in our understanding of how anxiety disorders develop, are maintained, and can be treated. Many of these advances have been the result of translational studies using fear conditioning and extinction models. Despite these successes, we recognize, as a field, that there are important limitations in the extent to which extinction can explain how anxiety disorders and behaviors remit. Clinically speaking, the outstanding challenge for treatment of anxiety disorders is to improve the current suboptimal success rates. Over the past 30 years, we have not improved our treatment success rates despite employing many pharmacological and pharmacological strategies. While extinction and related fear circuitry mechanisms most certainly appear to play a role in treatment of anxiety disorders, they are also apparently insufficient to fully accommodate the varied responses individuals exhibit with this treatment approach. Increasingly diverse and innovative approaches are needed that accommodate the multitude of change mechanisms involved in treating anxiety. However, this is not to suggest ignoring the key role that extinction and memory updating processes play in overcoming anxiety.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
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15
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Kitt ER, Odriozola P, Gee DG. Extinction Learning Across Development: Neurodevelopmental Changes and Implications for Pediatric Anxiety Disorders. Curr Top Behav Neurosci 2023; 64:237-256. [PMID: 37532964 DOI: 10.1007/7854_2023_430] [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] [Indexed: 08/04/2023]
Abstract
Alterations in extinction learning relate to the development and maintenance of anxiety disorders across the lifespan. While exposure therapy, based on principles of extinction, can be highly effective for treating anxiety, many patients do not show sufficient improvement following treatment. In particular, evidence suggests that exposure therapy does not work sufficiently for up to 40% of children who receive this evidence-based treatment.Importantly, fear learning and extinction, as well as the neural circuitry supporting these processes, undergo dynamic changes across development. An improved understanding of developmental changes in extinction learning and the associated neural circuitry may help to identify targets to improve treatment response in clinically anxious children and adolescents. In this chapter, we provide a brief overview of methods used to study fear learning and extinction in developmental populations. We then review what is currently known about the developmental changes that occur in extinction learning and related neural circuitry. We end this chapter with a discussion of the implications of these neurodevelopmental changes for the characterization and treatment of pediatric anxiety disorders.
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Affiliation(s)
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, CT, USA.
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16
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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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17
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Peng Y, Knotts JD, Young KS, Bookheimer SY, Nusslock R, Zinbarg RE, Kelley NJ, Echiverri-Cohen AM, Craske MG. Threat Neurocircuitry Predicts the Development of Anxiety and Depression Symptoms in a Longitudinal Study. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:102-110. [PMID: 35031524 DOI: 10.1016/j.bpsc.2021.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Owing to high heterogeneity and comorbidity, the shared and unique neural mechanisms underlying the development of anxiety and major depressive disorders remain unclear. Using a dimensional model describing shared versus unique symptoms associated with anxiety and depression, this study investigated how longitudinal changes in symptom dimensions relate to threat neurocircuitry. METHODS Participants were 18- to 19-year-olds (N = 279, 186 females) who completed self-report measures of anxiety and depression at baseline and at 10, 20, and 30 months. Linear slopes of symptom dimensions of general distress, fear, and anhedonia-apprehension were estimated through a trilevel factorial model. In addition, functional magnetic resonance imaging scans were obtained while participants performed Pavlovian fear conditioning tasks at baseline and 30 months, including three phases of fear acquisition, extinction, and extinction recall. Neural responses in regions of interest related to threat neural circuitry (e.g., amygdala, ventromedial prefrontal cortex, and subgenual anterior cingulate cortex) were extracted. RESULTS Linear mixed models used to estimate relationships between changes of symptom dimensions and neural responses revealed two major findings: 1) greater neural responses to threatening stimuli during fear acquisition at baseline were associated with a greater increase in fear symptoms during the 30-month prospective period; and 2) elevated neural responses to the extinguished stimulus during extinction recall at 30 months were negatively associated with changes in general distress, suggesting that greater increases in general distress are associated with larger deficits in extinction memory. CONCLUSIONS These findings improve our understanding of pathophysiological pathways underlying the development of anxiety and depression, while separating symptom dimensions that are shared versus unique between the two disorders.
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Affiliation(s)
- Yujia Peng
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China; Institute for Artificial Intelligence, Peking University, Beijing, China; Beijing Institute for General Artificial Intelligence, Beijing, China; Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Jeffrey D Knotts
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire
| | - Katherine S Young
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Social, Genetic and Development Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; NIHR Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, Illinois; Family Institute at Northwestern University, Evanston, Illinois
| | - Nicholas J Kelley
- Department of Psychology, Northwestern University, Evanston, Illinois; Department of Psychology, University of Southampton, Southampton, United Kingdom
| | | | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
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18
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TSURKAN-SAIFULINA YULIIA, AKSANI YULIIA. Theoretical Investigation of the Features of Current Fears of Modern Young People. SCIENTIFIC BULLETIN OF MUKACHEVO STATE UNIVERSITY SERIES “PEDAGOGY AND PSYCHOLOGY” 2022. [DOI: 10.52534/msu-pp.8(2).2022.74-80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The relevance of the study is conditioned by the rapid indicators of fear among young people, which has a destructive effect on psychological health, physical condition, social and professional development. The purpose of the study is to analyse the concept of “fear”, investigate its forms and origin, identify current fears among modern youth, and interpret them. Determination of ways to prevent the occurrence of fear, disposal, and its control. To investigate the features of the manifestation of current fears of modern youth, methods are used that are qualitatively combined and form a common concrete result, namely: empirical (quantitative research using an online survey), comparative, introspection, and interpretation. The results of this study are aimed at clearly defining the concept of fear, exploring its varieties, and identifying forms of fear. Theoretically, it is presented how fear can affect the development of personality, influence view of life, values, and self-determination in the professional and social environment. With the help of theoretical analysis, the specific features of the manifestation of fear in young people are compared based on Ukrainian and international experience. The results of an empirical study are demonstrated, and the most common fears of modern youth are identified. The findings are aimed at identifying ways to prevent the occurrence of fear, using corrective techniques for internal control, and determining the physiological and psychological manifestations of fear that can be controlled by willpower. This paper is not only a theoretical explanation of the existence of fear, but also it has preventive significance for those who want to take control of their own emotions and displace those categories of fear that prevent them from living a full life.
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19
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Burleigh L, Jiang X, Greening SG. Fear in the Theater of the Mind: Differential Fear Conditioning With Imagined Stimuli. Psychol Sci 2022; 33:1423-1439. [PMID: 35895306 DOI: 10.1177/09567976221086513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many symptoms of anxiety and posttraumatic stress disorder are elicited by fearful mental imagery. Yet little is known about how visual imagery of conditioned stimuli (CSs) affects the acquisition of differential fear conditioning. Across three experiments with younger human adults (Experiment 1: n = 33, Experiment 2: n = 27, Experiment 3: n = 26), we observed that participants acquired differential fear conditioning to both viewed and imagined percepts serving as the CSs, as measured via self-reported fear and skin conductance responses. Additionally, this differential conditioning generalized across CS-percept modalities such that differential conditioning acquired in response to visual percepts generalized to the corresponding imagined percepts and vice versa. This is novel evidence that perceived and imagined stimuli engage learning processes in very similar ways and is consistent with the theory that mental imagery is depictive and recruits neural resources shared with visual perception. Our findings also provide new insight into the mechanisms of anxiety and related disorders.
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Affiliation(s)
- Lauryn Burleigh
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University
| | - Xinrui Jiang
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University
| | - Steven G Greening
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University.,Department of Psychology, Brain and Cognitive Sciences, University of Manitoba
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20
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Role of noradrenergic arousal for fear extinction processes in rodents and humans. Neurobiol Learn Mem 2022; 194:107660. [PMID: 35870717 DOI: 10.1016/j.nlm.2022.107660] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 01/22/2023]
Abstract
Fear extinction is a learning mechanism that is pivotal for the inhibition of fear responses towards cues or contexts that no longer predict the occurrence of a threat. Failure of fear extinction leads to fear expression under safe conditions and is regarded to be a cardinal characteristic of many anxiety-related disorders and posttraumatic stress disorder. Importantly, the neurotransmitter noradrenaline was shown to be a potent modulator of fear extinction. Rodent studies demonstrated that excessive noradrenaline transmission after acute stress opens a time window of vulnerability, in which fear extinction learning results in attenuated long-term extinction success. In contrast, when excessive noradrenergic transmission subsides, well-coordinated noradrenaline transmission is necessary for the formation of a long-lasting extinction memory. In addition, emerging evidence suggests that the neuropeptide corticotropin releasing hormone (CRF), which strongly regulates noradrenaline transmission under conditions of acute stress, also impedes long-term extinction success. Recent rodent work - using sophisticated methods - provides evidence for a hypothetical mechanistic framework of how noradrenaline and CRF dynamically orchestrate the neural fear and extinction circuitry to attenuate or to improve fear extinction and extinction recall. Accordingly, we review the evidence from rodent studies linking noradrenaline and CRF to fear extinction learning and recall and derive the hypothetical mechanistic framework of how different levels of noradrenaline and CRF may create a time window of vulnerability which impedes successful long-term fear extinction. We also address evidence from human studies linking noradrenaline and fear extinction success. Moreover, we accumulate emerging approaches to non-invasively measure and manipulate the noradrenergic system in healthy humans. Finally, we emphasize the importance of future studies to account for sex (hormone) differences when examining the interaction between fear extinction, noradrenaline, and CRF. To conclude, NA's effects on fear extinction recall strongly depend on the arousal levels at the onset of fear extinction learning. Our review aimed at compiling the available (mainly rodent) data in a neurobiological framework, suited to derive testable hypotheses for future work in humans.
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21
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Roberts C, Apergis-Schoute AM, Bruhl A, Nowak M, Baldwin DS, Sahakian BJ, Robbins TW. Threat reversal learning and avoidance habits in generalised anxiety disorder. Transl Psychiatry 2022; 12:216. [PMID: 35641488 PMCID: PMC9156703 DOI: 10.1038/s41398-022-01981-3] [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: 08/01/2021] [Revised: 04/26/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022] Open
Abstract
Avoidance and heightened responses to perceived threats are key features of anxiety disorders. These disorders are characterised by inflexibility in dynamically updating behavioural and physiological responses to aversively conditioned cues or environmental contexts which are no longer objectively threatening, often manifesting in perseverative avoidance. However, less is known about how anxiety disorders might differ in adjusting to threat and safety shifts in the environment or how idiosyncratic avoidance responses are learned and persist. Twenty-eight patients with generalised anxiety disorder (GAD), without DSM co-morbidities, and 27 matched healthy controls were administered two previously established paradigms: Pavlovian threat reversal and shock avoidance habits through overtraining (assessed following devaluation with measures of perseverative responding). For both tasks we used subjective report scales and skin conductance responses (SCR). In the Pavlovian threat reversal task, patients with GAD showed a significantly overall higher SCR as well as a reduced differential SCR response compared to controls in the early but not late reversal phase. During the test of habitual avoidance responding, GAD patients did not differ from controls in task performance, habitual active avoidance responses during devaluation, or corresponding SCR during trials, but showed a trend toward more abstract confirmatory subjective justifications for continued avoidance following the task. GAD patients exhibited significantly greater skin conductance responses to signals of threat than controls, but did not exhibit the major deficits in reversal and safety signal learning shown previously by patients with OCD. Moreover, this patient group, again unlike OCD patients, did not show evidence of altered active avoidance learning or enhanced instrumental avoidance habits. Overall, these findings indicate no deficits in instrumental active avoidance or persistent avoidance habits, despite enhanced responses to Pavlovian threat cues in GAD. They suggest that GAD is characterised by passive, and not excessively rigid, avoidance styles.
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Affiliation(s)
- Clark Roberts
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.5335.00000000121885934Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Annemieke M. Apergis-Schoute
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK ,grid.9918.90000 0004 1936 8411Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Annette Bruhl
- grid.412004.30000 0004 0478 9977University Hospital of Zurich, Zurich, Switzerland
| | - Magda Nowak
- grid.5491.90000 0004 1936 9297Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
| | - David S. Baldwin
- grid.5491.90000 0004 1936 9297Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK ,grid.7836.a0000 0004 1937 1151University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Barbara J. Sahakian
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.5335.00000000121885934Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Trevor W. Robbins
- grid.5335.00000000121885934Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK ,grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK
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22
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Abend R, Burk D, Ruiz SG, Gold AL, Napoli JL, Britton JC, Michalska KJ, Shechner T, Winkler AM, Leibenluft E, Pine DS, Averbeck BB. Computational modeling of threat learning reveals links with anxiety and neuroanatomy in humans. eLife 2022; 11:66169. [PMID: 35473766 PMCID: PMC9197395 DOI: 10.7554/elife.66169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Influential theories implicate variations in the mechanisms supporting threat learning in the severity of anxiety symptoms. We use computational models of associative learning in conjunction with structural imaging to explicate links among the mechanisms underlying threat learning, their neuroanatomical substrates, and anxiety severity in humans. We recorded skin-conductance data during a threat-learning task from individuals with and without anxiety disorders (N=251; 8-50 years; 116 females). Reinforcement-learning model variants quantified processes hypothesized to relate to anxiety: threat conditioning, threat generalization, safety learning, and threat extinction. We identified the best-fitting models for these processes and tested associations among latent learning parameters, whole-brain anatomy, and anxiety severity. Results indicate that greater anxiety severity related specifically to slower safety learning and slower extinction of response to safe stimuli. Nucleus accumbens gray-matter volume moderated learning-anxiety associations. Using a modeling approach, we identify computational mechanisms linking threat learning and anxiety severity and their neuroanatomical substrates.
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Affiliation(s)
- Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Diana Burk
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
| | - Sonia G Ruiz
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University, Providence, United States
| | - Julia L Napoli
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
| | - Jennifer C Britton
- Department of Psychology, University of Miami, Coral Gables, United States
| | - Kalina J Michalska
- Department of Psychology, University of California, Riverside, Riverside, United States
| | - Tomer Shechner
- Psychology Department, University of Haifa, Haifa, Israel
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, United States
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Besthesda, United States
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, United States
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23
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Maresh K, Papageorgiou A, Ridout D, Harrison N, Mandy W, Skuse D, Muntoni F. Development of a novel startle response task in Duchenne muscular dystrophy. PLoS One 2022; 17:e0264091. [PMID: 35439255 PMCID: PMC9017900 DOI: 10.1371/journal.pone.0264091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022] Open
Abstract
Duchenne muscular dystrophy (DMD), an X-linked childhood-onset muscular dystrophy caused by loss of the protein dystrophin, can be associated with neurodevelopmental, emotional and behavioural problems. A DMD mouse model also displays a neuropsychiatric phenotype, including increased startle responses to threat which normalise when dystrophin is restored in the brain. We hypothesised that startle responses may also be increased in humans with DMD, which would have potential translational therapeutic implications. To investigate this, we first designed a novel discrimination fear-conditioning task and tested it in six healthy volunteers, followed by male DMD (n = 11) and Control (n = 9) participants aged 7–12 years. The aims of this methodological task development study were to: i) confirm the task efficacy; ii) optimise data processing procedures; iii) determine the most appropriate outcome measures. In the task, two neutral visual stimuli were presented: one ‘safe’ cue presented alone; one ‘threat’ cue paired with a threat stimulus (aversive noise) to enable conditioning of physiological startle responses (skin conductance response, SCR, and heart rate). Outcomes were the unconditioned physiological startle responses to the initial threat, and retention of conditioned responses in the absence of the threat stimulus. We present the protocol development and optimisation of data processing methods based on empirical data. We found that the task was effective in producing significantly higher physiological startle SCR in reinforced ‘threat’ trials compared to ‘safe’ trials (P < .001). Different data extraction methods were compared and optimised, and the optimal sampling window was derived empirically. SCR amplitude was the most effective physiological outcome measure when compared to SCR area and change in heart rate, with the best profile on data processing, the least variance, successful conditioned response retention (P = .01) and reliability assessment in test-retest analysis (rho = .86). The definition of this novel outcome will allow us to study this response in a DMD population.
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Affiliation(s)
- Kate Maresh
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- MRC Centre for Neuromuscular Diseases, UCL, London, United Kingdom
| | - Andriani Papageorgiou
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Deborah Ridout
- Department of Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, United Kingdom
| | - Neil Harrison
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - William Mandy
- Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - David Skuse
- Department of Behavioural and Brain Sciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- MRC Centre for Neuromuscular Diseases, UCL, London, United Kingdom
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, United Kingdom
- * E-mail:
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Klein Z, Abend R, Shmuel S, Shechner T. Unique Associations between Conditioned Cognitive and Physiological Threat Responses and Facets of Anxiety Symptomatology in Youth. Biol Psychol 2022; 170:108314. [PMID: 35301083 DOI: 10.1016/j.biopsycho.2022.108314] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
This study examined associations between anxiety symptomatology and cognitive and physiological threat responses during threat learning in a large sample of children and adolescents. Anxiety symptomatology severity along different dimensions (generalized anxiety, separation anxiety, social anxiety, and panic symptoms) was measured using parental and self-reports. Participants completed differential threat acquisition and extinction using an age-appropriate threat conditioning task. They then returned to the lab after 7-10 days to complete an extinction recall task that also assessed threat generalization. Results indicated that more severe overall anxiety was associated with greater cognitive and physiological threat responses during acquisition, extinction, and extinction recall. During acquisition and extinction, all anxiety dimensions manifested greater cognitive threat responses, while panic, separation anxiety, and social anxiety symptoms, but not generalized anxiety, were related to heightened physiological threat responses. In contrast, when we assessed generalization of cognitive threat responses, we found only generalized anxiety symptoms were associated with greater threat response generalization. The study provides preliminary evidence of specificity in threat responses during threat learning across youth with different anxiety symptoms.
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Affiliation(s)
- Zohar Klein
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Israel
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD 20892, USA
| | - Shahar Shmuel
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Israel
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Israel.
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25
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Fear conditioning and stimulus generalization in association with age in children and adolescents. Eur Child Adolesc Psychiatry 2022; 31:1581-1590. [PMID: 33983460 PMCID: PMC9532335 DOI: 10.1007/s00787-021-01797-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/01/2021] [Indexed: 10/26/2022]
Abstract
The aim of the study was to investigate age-related differences in fear learning and generalization in healthy children and adolescents (n = 133), aged 8-17 years, using an aversive discriminative fear conditioning and generalization paradigm adapted from Lau et al. (2008). In the current task, participants underwent 24 trials of discriminative conditioning of two female faces with neutral facial expressions, with (CS+) or without (CS-) a 95-dB loud female scream, presented simultaneously with a fearful facial expression (US). The discriminative conditioning was followed by 72 generalization trials (12 CS+, 12 GS1, 12 GS2, 12 GS3, 12 GS4, and 12 CS-): four generalization stimuli depicting gradual morphs from CS+ to CS- in 20%-steps were created for the generalization phases. We hypothesized that generalization in children and adolescents is negatively correlated with age. The subjective ratings of valence, arousal, and US expectancy (the probability of an aversive noise following each stimulus), as well as skin conductance responses (SCRs) were measured. Repeated-measures ANOVAs on ratings and SCR amplitudes were calculated with the within-subject factors stimulus type (CS+, CS-, GS1-4) and phase (Pre-Acquisition, Acquisition 1, Acquisition 2, Generalization 1, Generalization 2). To analyze the modulatory role of age, we additionally calculated ANCOVAs considering age as covariate. Results indicated that (1) subjective and physiological responses were generally lower with increasing age irrespective to the stimulus quality, and (2) stimulus discrimination improved with increasing age paralleled by reduced overgeneralization in older individuals. Longitudinal follow-up studies are required to analyze fear generalization with regard to brain maturational aspects and clarify whether overgeneralization of conditioned fear promotes the development of anxiety disorders or vice versa.
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Abend R, Ruiz SG, Bajaj MA, Harrewijn A, Linke JO, Atlas LY, Winkler AM, Pine DS. Threat imminence reveals links among unfolding of anticipatory physiological response, cortical-subcortical intrinsic functional connectivity, and anxiety. Neurobiol Stress 2022; 16:100428. [PMID: 35036479 PMCID: PMC8749274 DOI: 10.1016/j.ynstr.2022.100428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 12/12/2022] Open
Abstract
Excessive expression of fear responses in anticipation of threat occurs in anxiety, but understanding of underlying pathophysiological mechanisms is limited. Animal research indicates that threat-anticipatory defensive responses are dynamically organized by threat imminence and rely on conserved circuitry. Insight from basic neuroscience research in animals on threat imminence could guide mechanistic research in humans mapping abnormal function in this circuitry to aberrant defensive responses in pathological anxiety. 50 pediatric anxiety patients and healthy-comparisons (33 females) completed an instructed threat-anticipation task whereby cues signaled delivery of painful (threat) or non-painful (safety) thermal stimulation. Temporal changes in skin-conductance indexed anxiety effects on anticipatory responding as function of threat imminence. Multivariate network analyses of resting-state functional connectivity data from a subsample were used to identify intrinsic-function correlates of anticipatory-response dynamics, within a specific, distributed network derived from translational research on defensive responding. By considering threat imminence, analyses revealed specific anxiety effects. Importantly, pathological anxiety was associated with excessive deployment of anticipatory physiological response as threat, but not safety, outcomes became more imminent. Magnitude of increase in threat-anticipatory physiological responses corresponded with magnitude of intrinsic connectivity within a cortical-subcortical circuit. Moreover, more severe anxiety was associated with stronger associations between anticipatory physiological responding and connectivity that ventromedial prefrontal cortex showed with hippocampus and basolateral amygdala, regions implicated in animal models of anxiety. These findings link basic and clinical research, highlighting variations in intrinsic function in conserved defensive circuitry as a potential pathophysiological mechanism in anxiety.
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Affiliation(s)
- Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sonia G. Ruiz
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
- Department of Psychology, Yale University, New Haven, CT, 06511, USA
| | - Mira A. Bajaj
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Julia O. Linke
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Lauren Y. Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Anderson M. Winkler
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
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27
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Tseng WL, Abend R, Gold AL, Brotman MA. Neural correlates of extinguished threat recall underlying the commonality between pediatric anxiety and irritability. J Affect Disord 2021; 295:920-929. [PMID: 34706463 PMCID: PMC8554134 DOI: 10.1016/j.jad.2021.08.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/28/2021] [Accepted: 08/28/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Anxiety and irritability frequently co-occur in youth and are mediated by aberrant threat responses. However, empirical evidence on neural mechanisms underlying this co-occurrence is limited. To address this, we apply data-driven latent phenotyping to data from a prior report of a well-validated threat extinction recall fMRI paradigm. METHODS Participants included 59 youth (28 anxiety disorder, 31 healthy volunteers; Mage=13.15 yrs) drawn from a transdiagnostic sample of 331 youth, in which bifactor analysis was conducted to derive latent factors representing shared vs. unique variance of dimensionally-assessed anxiety and irritability. Participants underwent threat conditioning and extinction. Approximately three weeks later, during extinction recall fMRI, participants made threat-safety discriminations under two task conditions: current threat appraisal and explicit recall of threat contingencies. Linear mixed-effects analyses examined associations of a "negative affectivity" factor reflecting shared anxiety and irritability variance with whole-brain activation and task-dependent amygdala connectivity. RESULTS During recall of threat-safety contingencies, higher negative affectivity was associated with greater prefrontal (ventrolateral/ventromedial, dorsolateral, orbitofrontal), motor, temporal, parietal, and occipital activation. During threat appraisal, higher negative affectivity was associated with greater amygdala-inferior parietal lobule connectivity to threat/safety ambiguity. LIMITATIONS Sample included only healthy youth and youth with anxiety disorders. Results may not generalize to other diagnoses for which anxiety and irritability are also common, and our negative affectivity factor should be interpreted as anxiety disorders with elevated irritability. Reliability of some subfactors was poor. CONCLUSIONS Aberrant amygdala-prefrontal-parietal circuitry during extinction recall of threat-safety stimuli may be a mechanism underlying the co-occurrence of pediatric anxiety and irritability.
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Affiliation(s)
- Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, Yale University, 230 S. Frontage Road, New Haven, CT 06519, USA.
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD 20854, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD 20854, USA
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28
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Bisby MA, Stylianakis AA, Baker KD, Richardson R. Fear extinction learning and retention during adolescence in rats and mice: A systematic review. Neurosci Biobehav Rev 2021; 131:1264-1274. [PMID: 34740753 DOI: 10.1016/j.neubiorev.2021.10.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
Despite exposure-based treatments being recommended for anxiety disorders, these treatments are ineffective for over half of all adolescents who receive them. The limited efficacy of exposure during adolescence may be driven by a deficit in extinction. Although indications of diminished extinction learning during adolescence were first reported over 10 years ago, these findings have yet to be reviewed and compared. This review (k = 34) found a stark inter-species difference in extinction performance: studies of adolescent mice reported deficits in extinction learning and retention of both cued and context fear. In contrast, studies of adolescent rats only reported poor extinction retention specific to cued fear. Adolescent mice and rats appeared to have only one behavioral outcome in common, being poor extinction retention of cued fear. These findings suggest that different behavioral phenotypes are present across rodent species in adolescence and highlight that preclinical work in rats and mice is not interchangeable. Further investigation of these differences offers the opportunity to better understand the etiology, maintenance, and treatment of fear-based disorders.
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Affiliation(s)
- Madelyne A Bisby
- School of Psychology, UNSW Sydney, Sydney, 2052, NSW, Australia; eCentreClinic, School of Psychological Sciences, Faculty of Medicine and Health, Macquarie University, Sydney, 2109, NSW, Australia.
| | | | - Kathryn D Baker
- School of Psychology, UNSW Sydney, Sydney, 2052, NSW, Australia
| | - Rick Richardson
- School of Psychology, UNSW Sydney, Sydney, 2052, NSW, Australia
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29
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Mullins JL, Zhou E, Glenn DE, Moroney E, Lee SS, Michalska KJ. Paternal expressed emotion influences psychobiological indicators of threat and safety learning in daughters: A preliminary study. Dev Psychobiol 2021; 63:e22205. [PMID: 34674231 DOI: 10.1002/dev.22205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 12/27/2022]
Abstract
This preliminary study examined the association of children's anxiety, paternal expressed emotion (EE), and their interaction with psychophysiological indices of children's threat and safety learning. Participants included 24 father-daughter dyads. Daughters (ages 8-13 years, 100% Latina) self-reported their anxiety levels and completed a differential threat conditioning and extinction paradigm, during which psychophysiological responding was collected. Fathers completed a Five-Minute Speech Sample, from which paternal EE (i.e., criticism, emotional overinvolvement) was assessed. Anxiety-dependent associations emerged between paternal EE and individual differences in daughters' psychophysiological responding to safety signals during threat conditioning. Paternal EE was positively associated with psychophysiological responding to safety in daughters with high and mean, but not low, levels of anxiety. Although previous work suggests that chronic harsh maternal parenting is a potential risk factor for children's general threat and safety learning, these preliminary findings implicate milder forms of negative parenting behavior in fathers, particularly for highly anxious children.
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Affiliation(s)
- Jordan L Mullins
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Elayne Zhou
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Dana E Glenn
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Elizabeth Moroney
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Steve S Lee
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Kalina J Michalska
- Department of Psychology, University of California, Riverside, Riverside, California, USA
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30
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Klein Z, Ginat-Frolich R, Barry TJ, Shechner T. Effects of increased attention allocation to threat and safety stimuli on fear extinction and its recall. J Behav Ther Exp Psychiatry 2021; 72:101640. [PMID: 33607462 DOI: 10.1016/j.jbtep.2021.101640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 01/24/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Attention plays an important role in the treatment of anxiety. Increased attention to threat has been shown to yield improved treatment outcomes in anxious patients following exposure-based therapy. This study examined whether increasing attention to learned stimuli during fear extinction, an experimental analogue for exposure-based treatments, could improve extinction learning and its maintenance. METHODS Sixty-five healthy adults were randomized into experimental or control conditions. All completed a differential fear conditioning task. During extinction, a subtle attentional manipulation was implemented in the experimental group, designed to increase participants' attention to both threat and safety cues. Three days later, an extinction recall test was conducted using the original cues and two perceptually similar morphs. RESULTS Fear conditioning was achieved in both behavioral and psychophysiological measures. In addition, between-group differences emerged during extinction. The experimental group exhibited increased attention to stimuli and lower fear responses in physiological measure than the control group. Similarly, during extinction recall, the experimental group exhibited lower startle responses than the control group. Last, across groups, attending to the safety cue during extinction was associated with lower self-reported risk of the two generalization morphs displayed during extinction recall. LIMITATIONS Skin conductance response (SCR) was not measured during extinction recall. Future research should include both SCR and additional generalization morphs so as to allow for the examination of more subtle individual differences. CONCLUSIONS Results indicate that the attentional manipulation increased attention allocation to stimuli during extinction; this, in turn, affected fear-related physiological response.
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Affiliation(s)
- Zohar Klein
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Abba Hushi 199, Mt Carmel, Haifa, Israel
| | - Rivkah Ginat-Frolich
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Abba Hushi 199, Mt Carmel, Haifa, Israel
| | - Tom J Barry
- Department of Psychology, The University of Hong Kong, Hong Kong. the Institute of Psychiatry, Psychology, & Neuroscience, King's College, London, UK
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Abba Hushi 199, Mt Carmel, Haifa, Israel.
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31
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Susman ES, Weissman DG, Sheridan MA, McLaughlin KA. High vagal tone and rapid extinction learning as potential transdiagnostic protective factors following childhood violence exposure. Dev Psychobiol 2021; 63:e22176. [PMID: 34423415 PMCID: PMC8410650 DOI: 10.1002/dev.22176] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 01/19/2023]
Abstract
Childhood exposure to violence is strongly associated with psychopathology. High resting respiratory sinus arrhythmia (RSA) is associated with lower levels of psychopathology in children exposed to violence. High RSA may help to protect against psychopathology by facilitating fear extinction learning, allowing more flexible autonomic responses to learned threat and safety cues. In this study, 165 youth (79 female, aged 9-17; 86 exposed to violence) completed assessments of violence exposure, RSA, and psychopathology, and a fear extinction learning task; 134 participants returned and completed psychopathology assessments 2 years later. Resting RSA moderated the longitudinal association of violence exposure with post-traumatic stress disorder (PTSD) symptoms and externalizing psychopathology, such that the association was weaker among youths with higher RSA. Higher skin conductance responses (SCR) during extinction learning to the threat cue (CS+) was associated with higher internalizing symptoms at follow-up and greater SCR to the safety cue (CS-) was associated with higher PTSD, internalizing, and externalizing symptoms, as well as the p-factor, controlling for baseline symptoms. Findings suggest that higher RSA may protect against emergence of psychopathology among children exposed to violence. Moreover, difficulty extinguishing learned threat responses and elevated autonomic responses to safety cues may be associated with risk for future psychopathology.
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Affiliation(s)
- Eli S. Susman
- Department of Psychology, Harvard University, Cambridge, MA
| | | | - Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
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32
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Emerging Domain-Based Treatments for Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:716-725. [PMID: 33451677 DOI: 10.1016/j.biopsych.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
Domain-specific cognitive training treatments for pediatric anxiety disorders rely on accurate and reliable identification of specific underlying deficits and biases in neurocognitive functions. Once identified, such biases can serve as specific targets for therapeutic intervention. Clinical translations typically reflect mechanized training protocols designed to rectify the identified biases. Here, we review and synthesize research on key neurocognitive processes that emerge as potential targets for specialized cognitive training interventions in pediatric anxiety disorders in the domains of attention, interpretation, error monitoring, working memory, and fear learning. For each domain, we describe the current status of target establishment (i.e., an association between pediatric anxiety and a specific neurocognitive process), and then review extant translational efforts regarding these targets and the evidence supporting their clinical utility in youths. We then localize each of the domains within the path leading to efficacious, evidence-supported treatments for pediatric anxiety, providing a roadmap for future research. The review indicates that specific cognitive targets in pediatric anxiety have been established in all the reviewed domains except for fear learning, where a clear target is yet to be elucidated. In contrast, evidence for clinical efficacy emerged only in the threat-related attention domain, with some preliminary findings in the domains of interpretation and working memory. The path to clinical translation in the domain of error monitoring is yet unclear. Implications and potential avenues for future research and translation are discussed.
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33
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Treanor M, Rosenberg BM, Craske MG. Pavlovian Learning Processes in Pediatric Anxiety Disorders: A Critical Review. Biol Psychiatry 2021; 89:690-696. [PMID: 33220917 PMCID: PMC9027721 DOI: 10.1016/j.biopsych.2020.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 09/06/2020] [Indexed: 12/31/2022]
Abstract
Deficits in associative and Pavlovian learning are thought to lie at the center of anxiety-related disorders. However, the majority of studies have been carried out in adult populations. The aim of this review was to critically examine the behavioral and neuroimaging literature on Pavlovian learning in pediatric anxiety disorders. We conclude that although there is evidence for deficits in Pavlovian processes (e.g., heightened reactivity to safety cues in anxious samples), the extant literature suffers from key methodological and theoretical issues. We conclude with theoretical and methodological recommendations for future research in order to further elucidate the role of Pavlovian learning in the etiology, maintenance, and treatment of pediatric anxiety disorders.
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Affiliation(s)
- Michael Treanor
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
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34
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Abend R, Bajaj MA, Harrewijn A, Matsumoto C, Michalska KJ, Necka E, Palacios-Barrios EE, Leibenluft E, Atlas LY, Pine DS. Threat-anticipatory psychophysiological response is enhanced in youth with anxiety disorders and correlates with prefrontal cortex neuroanatomy. J Psychiatry Neurosci 2021; 46:E212-E221. [PMID: 33703868 PMCID: PMC8061736 DOI: 10.1503/jpn.200110] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/27/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022] Open
Abstract
Background Threat anticipation engages neural circuitry that has evolved to promote defensive behaviours; perturbations in this circuitry could generate excessive threat-anticipation response, a key characteristic of pathological anxiety. Research into such mechanisms in youth faces ethical and practical limitations. Here, we use thermal stimulation to elicit pain-anticipatory psychophysiological response and map its correlates to brain structure among youth with anxiety and healthy youth. Methods Youth with anxiety (n = 25) and healthy youth (n = 25) completed an instructed threat-anticipation task in which cues predicted nonpainful or painful thermal stimulation; we indexed psychophysiological response during the anticipation and experience of pain using skin conductance response. High-resolution brain-structure imaging data collected in another visit were available for 41 participants. Analyses tested whether the 2 groups differed in their psychophysiological cue-based pain-anticipatory and pain-experience responses. Analyses then mapped psychophysiological response magnitude to brain structure. Results Youth with anxiety showed enhanced psychophysiological response specifically during anticipation of painful stimulation (b = 0.52, p = 0.003). Across the sample, the magnitude of psychophysiological anticipatory response correlated negatively with the thickness of the dorsolateral prefrontal cortex (pFWE < 0.05); psychophysiological response to the thermal stimulation correlated positively with the thickness of the posterior insula (pFWE < 0.05). Limitations Limitations included the modest sample size and the cross-sectional design. Conclusion These findings show that threat-anticipatory psychophysiological response differentiates youth with anxiety from healthy youth, and they link brain structure to psychophysiological response during pain anticipation and experience. A focus on threat anticipation in research on anxiety could delineate relevant neural circuitry.
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Affiliation(s)
- Rany Abend
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Mira A Bajaj
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Anita Harrewijn
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Chika Matsumoto
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Kalina J Michalska
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Elizabeth Necka
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Esther E Palacios-Barrios
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Ellen Leibenluft
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Lauren Y Atlas
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
| | - Daniel S Pine
- From the Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Abend, Bajaj, Harrewijn, Matsumoto, Leibenluft, Pine); the Department of Psychology, University of California Riverside, Riverside, CA (Michalaska); the 3 National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD (Necka, Atlas); and the 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA (Palacios-Barrios)
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Harrewijn A, Kitt ER, Abend R, Matsumoto C, Odriozola P, Winkler AM, Leibenluft E, Pine DS, Gee DG. Comparing neural correlates of conditioned inhibition between children with and without anxiety disorders - A preliminary study. Behav Brain Res 2021; 399:112994. [PMID: 33160010 PMCID: PMC7855938 DOI: 10.1016/j.bbr.2020.112994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/21/2022]
Abstract
Cognitive-behavioral therapy (CBT), a first-line treatment for pediatric anxiety disorders, is based on principles of threat learning and extinction. However, CBT does not work sufficiently for up to 40% of clinically anxious youth. The neural and behavioral correlates of conditioned inhibition might provide promising targets for attempts to improve CBT response. During conditioned inhibition, threat and safety cues appear together, forming a safety compound. Here, we test whether this safety compound elicits a reduced fear response compared to pairing the threat cue with a novel cue (novel compound). The current pilot study compares behavioral, physiological, and neural correlates of conditioned inhibition between children with (n = 17, Mage = 13.09, SDage = 3.05) and without (n = 18, Mage = 14.49, SDage = 2.38) anxiety disorders. Behavioral and physiological measures did not differ between children with and without anxiety disorders during fear acquisition. During testing, children with anxiety disorders showed overall higher skin conductance response and expected to hear the aversive sound following the novel compound more often than children without anxiety disorders. Children with anxiety disorders showed more activity in the right ventromedial prefrontal cortex (vmPFC) to the safety versus novel compound. Children without anxiety disorders showed the opposite pattern - more right vmPFC activity to the novel versus safety compound (F(1,31) = 5.40, p = 0.03). No group differences manifested within the amygdala, dorsal anterior cingulate cortex, or hippocampus. These pilot findings suggest a feasible approach for examining conditioned inhibition in pediatric anxiety disorders. If replicated in larger samples, findings may implicate perturbed conditioned inhibition in pediatric anxiety disorders and provide targets for CBT.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA.
| | - Elizabeth R Kitt
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Chika Matsumoto
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, Connecticut 06511, USA
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, Connecticut 06511, USA
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Odriozola P, Gee DG. Learning About Safety: Conditioned Inhibition as a Novel Approach to Fear Reduction Targeting the Developing Brain. Am J Psychiatry 2021; 178:136-155. [PMID: 33167673 PMCID: PMC7951569 DOI: 10.1176/appi.ajp.2020.20020232] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Adolescence is a peak time for the onset of psychiatric disorders, with anxiety disorders being the most common and affecting as many as 30% of youths. A core feature of anxiety disorders is difficulty regulating fear, with evidence suggesting deficits in extinction learning and corresponding alterations in frontolimbic circuitry. Despite marked changes in this neural circuitry and extinction learning throughout development, interventions for anxious youths are largely based on principles of extinction learning studied in adulthood. Safety signal learning, based on conditioned inhibition of fear in the presence of a cue that indicates safety, has been shown to effectively reduce anxiety-like behavior in animal models and attenuate fear responses in healthy adults. Cross-species evidence suggests that safety signal learning involves connections between the ventral hippocampus and the prelimbic cortex in rodents or the dorsal anterior cingulate cortex in humans. Particularly because this pathway follows a different developmental trajectory than fronto-amygdala circuitry involved in traditional extinction learning, safety cues may provide a novel approach to reducing fear in youths. In this review, the authors leverage a translational framework to bring together findings from studies in animal models and humans and to bridge the gap between research on basic neuroscience and clinical treatment. The authors consider the potential application of safety signal learning for optimizing interventions for anxious youths by targeting the biological state of the developing brain. Based on the existing cross-species literature on safety signal learning, they propose that the judicious use of safety cues may be an effective and neurodevelopmentally optimized approach to enhancing treatment outcomes for youths with anxiety disorders.
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Affiliation(s)
| | - Dylan G. Gee
- Department of Psychology, Yale University, New Haven, Conn
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Pöhlchen D, Leuchs L, Binder FP, Blaskovich B, Nantawisarakul T, Topalidis P, Brückl TM, Norrholm SD, Jovanovic T, Spoormaker VI, Binder EB, Czisch M, Erhardt A, Grandi NC, Ilic-Cocic S, Lucae S, Sämann P, Tontsch A. No robust differences in fear conditioning between patients with fear-related disorders and healthy controls. Behav Res Ther 2020; 129:103610. [DOI: 10.1016/j.brat.2020.103610] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
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Abend R, Gold AL, Britton JC, Michalska KJ, Shechner T, Sachs JF, Winkler AM, Leibenluft E, Averbeck BB, Pine DS. Anticipatory Threat Responding: Associations With Anxiety, Development, and Brain Structure. Biol Psychiatry 2020; 87:916-925. [PMID: 31955915 PMCID: PMC7211142 DOI: 10.1016/j.biopsych.2019.11.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/16/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND While translational theories link neurodevelopmental changes in threat learning to pathological anxiety, findings from studies in patients inconsistently support these theories. This inconsistency may reflect difficulties in studying large patient samples with wide age ranges using consistent methods. A dearth of imaging data in patients further limits translational advances. We address these gaps through a psychophysiology and structural brain imaging study in a large sample of patients across the lifespan. METHODS A total of 351 participants (8-50 years of age; 209 female subjects; 195 healthy participants and 156 medication-free, treatment-seeking patients with anxiety) completed a differential threat conditioning and extinction paradigm that has been validated in pediatric and adult populations. Skin conductance response indexed psychophysiological response to conditioned (CS+, CS-) and unconditioned threat stimuli. Structural magnetic resonance imaging data were available for 250 participants. Analyses tested anxiety and age associations with psychophysiological response in addition to associations between psychophysiology and brain structure. RESULTS Regardless of age, patients and healthy comparison subjects demonstrated comparable differential threat conditioning and extinction. The magnitude of skin conductance response to both conditioned stimulus types differentiated patients from comparison subjects and covaried with dorsal prefrontal cortical thickness; structure-response associations were moderated by anxiety and age in several regions. Unconditioned responding was unrelated to anxiety and brain structure. CONCLUSIONS Rather than impaired threat learning, pathological anxiety involves heightened skin conductance response to potential but not immediately present threats; this anxiety-related potentiation of anticipatory responding also relates to variation in brain structure. These findings inform theoretical considerations by highlighting anticipatory response to potential threat in anxiety.
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Affiliation(s)
- Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Andrea L. Gold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Pediatric Anxiety Research Center, Bradley Hospital, Riverside, RI
| | | | | | - Tomer Shechner
- Psychology Department, University of Haifa, Haifa, Israel
| | | | - Anderson M. Winkler
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Bruno B. Averbeck
- Laboratory of Neuropsychology, National Institute of Mental Health, National Institutes of
Health, Bethesda, MD
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
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Gee DG, Kribakaran S. Developmental Differences in Neural Responding to Threat and Safety: Implications for Treating Youths With Anxiety. Am J Psychiatry 2020; 177:378-380. [PMID: 32354263 DOI: 10.1176/appi.ajp.2020.20020225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Dylan G Gee
- Department of Psychology, Yale University, New Haven, Conn
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Wickramasuriya DS, Faghih RT. A mixed filter algorithm for sympathetic arousal tracking from skin conductance and heart rate measurements in Pavlovian fear conditioning. PLoS One 2020; 15:e0231659. [PMID: 32324756 PMCID: PMC7179889 DOI: 10.1371/journal.pone.0231659] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/29/2020] [Indexed: 01/09/2023] Open
Abstract
Pathological fear and anxiety disorders can have debilitating impacts on individual patients and society. The neural circuitry underlying fear learning and extinction has been known to play a crucial role in the development and maintenance of anxiety disorders. Pavlovian conditioning, where a subject learns an association between a biologically-relevant stimulus and a neutral cue, has been instrumental in guiding the development of therapies for treating anxiety disorders. To date, a number of physiological signal responses such as skin conductance, heart rate, electroencephalography and cerebral blood flow have been analyzed in Pavlovian fear conditioning experiments. However, physiological markers are often examined separately to gain insight into the neural processes underlying fear acquisition. We propose a method to track a single brain-related sympathetic arousal state from physiological signal features during fear conditioning. We develop a state-space formulation that probabilistically relates features from skin conductance and heart rate to the unobserved sympathetic arousal state. We use an expectation-maximization framework for state estimation and model parameter recovery. State estimation is performed via Bayesian filtering. We evaluate our model on simulated and experimental data acquired in a trace fear conditioning experiment. Results on simulated data show the ability of our proposed method to estimate an unobserved arousal state and recover model parameters. Results on experimental data are consistent with skin conductance measurements and provide good fits to heartbeats modeled as a binary point process. The ability to track arousal from skin conductance and heart rate within a state-space model is an important precursor to the development of wearable monitors that could aid in patient care. Anxiety and trauma-related disorders are often accompanied by a heightened sympathetic tone and the methods described herein could find clinical applications in remote monitoring for therapeutic purposes.
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Affiliation(s)
- Dilranjan S. Wickramasuriya
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
| | - Rose T. Faghih
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
- * E-mail:
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