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Meeker TJ, Emerson NM, Chien JH, Saffer MI, Bienvenu OJ, Korzeniewska A, Greenspan JD, Lenz FA. During vigilance to painful stimuli: slower response rate is related to high trait anxiety, whereas faster response rate is related to high state anxiety. J Neurophysiol 2021; 125:305-319. [PMID: 33326361 PMCID: PMC8087378 DOI: 10.1152/jn.00492.2020] [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] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/17/2020] [Accepted: 12/11/2020] [Indexed: 12/24/2022] Open
Abstract
A pathological increase in vigilance, or hypervigilance, may be related to pain intensity in some clinical pain syndromes and may result from attention bias to salient stimuli mediated by anxiety. During a continuous performance task where subjects discriminated painful target stimuli from painful nontargets, we measured detected targets (hits), nondetected targets (misses), nondetected nontargets (correct rejections), and detected nontargets (false alarms). Using signal detection theory, we calculated response bias, the tendency to endorse a stimulus as a target, and discriminability, the ability to discriminate a target from nontarget. Owing to the relatively slow rate of stimulus presentation, our primary hypothesis was that sustained performance would result in a more conservative response bias reflecting a lower response rate over time on task. We found a more conservative response bias with time on task and no change in discriminability. We predicted that greater state and trait anxiety would lead to a more liberal response bias. A multivariable model provided partial support for our prediction; high trait anxiety related to a more conservative response bias (lower response rate), whereas high state anxiety related to a more liberal bias. This inverse relationship of state and trait anxiety is consistent with reports of effects of state and trait anxiety on reaction times to threatening stimuli. In sum, we report that sustained attention to painful stimuli was associated with a decrease in the tendency of the subject to respond to any stimulus over time on task, whereas the ability to discriminate target from nontarget remains unchanged.NEW & NOTEWORTHY During a series of painful stimuli requiring subjects to respond to targets, we separated response willingness from ability to discriminate targets from nontargets. Response willingness declined during the task, with no change in subjects' ability to discriminate, consistent with previous vigilance studies. High trait anxious subjects were less willing to respond and showed slower reaction times to hits than low anxious subjects. This study reveals an important role of trait anxiety in pain vigilance.
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Affiliation(s)
- Timothy J Meeker
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Nichole M Emerson
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Jui-Hong Chien
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Mark I Saffer
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | | | - Anna Korzeniewska
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Joel D Greenspan
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
- Department of Neural and Pain Sciences and Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland
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Van Diest I. Interoception, conditioning, and fear: The panic threesome. Psychophysiology 2019; 56:e13421. [DOI: 10.1111/psyp.13421] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/11/2019] [Accepted: 05/16/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Ilse Van Diest
- Health, Behavior & Psychopathology, Faculty of Psychology & Educational Sciences; University of Leuven; Leuven Belgium
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Dynamics of Defensive Response Mobilization to Approaching External Versus Interoceptive Threat. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:525-538. [DOI: 10.1016/j.bpsc.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022]
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Balderston NL, Liu J, Roberson-Nay R, Ernst M, Grillon C. The relationship between dlPFC activity during unpredictable threat and CO 2-induced panic symptoms. Transl Psychiatry 2017; 7:1266. [PMID: 29213110 PMCID: PMC5802456 DOI: 10.1038/s41398-017-0006-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023] Open
Abstract
Panic disorder is characterized by sudden, repeated, and unexpected attacks of intense fear and overwhelming anxiety about when another attack may strike. Patients with panic disorder and healthy individuals with a history of panic attacks show a hypersensitivity to unpredictable threats, suggesting a possible link between panic and sustained anxiety. The purpose of this study was to determine the degree to which induced symptoms of panic relate to fear and anxiety, as well as activity in the neural systems that mediate and regulate these affective states. Psychological and physiological symptoms of panic were assessed during an 8-min 7.5% CO2 challenge task. Psychological, physiological, and neural symptoms of fear and anxiety were measured during two sessions (one psychophysiology and one functional magnetic resonance imaging where subjects experienced several blocks of no threat (N), predictable shock (P), and unpredictable shock (U; NPU threat task). We used a principle component analysis to characterize panic susceptibility (PS), and found that PS significantly predicted dorsolateral prefrontal cortex (dlPFC) activity to the unpredictable cue during the NPU threat task. When examining the weighted beta coefficients from this analysis, we observed that self-reported fear/anxiety during the CO2 challenge negatively loaded onto dlPFC activity during the NPU task. Consistent with this observation, dlPFC activity during the unpredictable cue was also negatively correlated with anxiety during the NPU sessions. Together, these results suggest that panic symptoms and anxiety are regulated by the same prefrontal cognitive control system.
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Affiliation(s)
- Nicholas L. Balderston
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Jeffrey Liu
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Roxann Roberson-Nay
- 0000 0004 0458 8737grid.224260.0Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA USA
| | - Monique Ernst
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Christian Grillon
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
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Ceunen E, Vlaeyen JWS, Van Diest I. On the Origin of Interoception. Front Psychol 2016; 7:743. [PMID: 27242642 PMCID: PMC4876111 DOI: 10.3389/fpsyg.2016.00743] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/05/2016] [Indexed: 01/12/2023] Open
Abstract
Over the course of a century, the meaning of interoception has changed from the restrictive to the inclusive. In its inclusive sense, it bears relevance to every individual via its link to emotion, decision making, time-perception, health, pain, and various other areas of life. While the label for the perception of the body state changes over time, the need for an overarching concept remains. Many aspects can make any particular interoceptive sensation unique and distinct from any other interoceptive sensation. This can range from the sense of agency, to the physical cause of a sensation, the ontogenetic origin, the efferent innervation, and afferent pathways of the tissue involved amongst others. In its overarching meaning, interoception primarily is a product of the central nervous system, a construct based on an integration of various sources, not per se including afferent information. This paper proposes a definition of interoception as based on subjective experience, and pleas for the use of specific vocabulary in addressing the many aspects that contribute to it.
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Affiliation(s)
- Erik Ceunen
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, LeuvenBelgium
- Research Group on Self Regulation and Health, Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development, FLSHASE, University of Luxembourg, WalferdangeLuxembourg
| | - Johan W. S. Vlaeyen
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, LeuvenBelgium
| | - Ilse Van Diest
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, LeuvenBelgium
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Löw A, Weymar M, Hamm AO. When Threat Is Near, Get Out of Here. Psychol Sci 2015; 26:1706-16. [DOI: 10.1177/0956797615597332] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 07/02/2015] [Indexed: 11/16/2022] Open
Abstract
When detecting a threat, humans and other animals engage in defensive behaviors and supporting physiological adjustments that vary with threat imminence and potential response options. In the present study, we shed light on the dynamics of defensive behaviors and associated physiological adjustments in humans using multiple psychophysiological and brain measures. When participants were exposed to a dynamically approaching, uncontrollable threat, attentive freezing was augmented, as indicated by an increase in skin conductance, fear bradycardia, and potentiation of the startle reflex. In contrast, when participants had the opportunity to actively avoid the approaching threat, attention switched to response preparation, as indicated by an inhibition of the startle magnitude and by a sharp drop of the probe-elicited P3 component of the evoked brain potentials. These new findings on the dynamics of defensive behaviors form an important intersection between animal and human research and have important implications for understanding fear and anxiety-related disorders.
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Affiliation(s)
- Andreas Löw
- Department of Biological and Clinical Psychology, University of Greifswald
| | - Mathias Weymar
- Department of Biological and Clinical Psychology, University of Greifswald
| | - Alfons O. Hamm
- Department of Biological and Clinical Psychology, University of Greifswald
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Effects of anxiety sensitivity and expectations on the modulation of the startle eyeblink response during a caffeine challenge. Psychopharmacology (Berl) 2015; 232:3403-16. [PMID: 26173609 DOI: 10.1007/s00213-015-3996-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/10/2015] [Indexed: 10/23/2022]
Abstract
RATIONALE The way in which the tendency to fear somatic arousal sensations (anxiety sensitivity), in interaction with the created expectations regarding arousal induction, might affect defensive responding to a symptom provocation challenge is not yet understood. OBJECTIVES The present study investigated the effect of anxiety sensitivity on autonomic arousal, startle eyeblink responses, and reported arousal and alertness to expected vs. unexpected caffeine consumption. METHODS To create a match/mismatch of expected and experienced arousal, high and low anxiety sensitive participants received caffeine vs. no drug either mixed in coffee (expectation of arousal induction) or in bitter lemon soda (no expectation of arousal induction) on four separate occasions. Autonomic arousal (heart rate, skin conductance level), respiration (end-tidal CO2, minute ventilation), defensive reflex responses (startle eyeblink), and reported arousal and alertness were recorded prior to, immediately and 30 min after beverage ingestion. RESULTS Caffeine increased ventilation, autonomic arousal, and startle response magnitudes. Both groups showed comparable levels of autonomic and respiratory responses. The startle eyeblink responses were decreased when caffeine-induced arousal occurred unexpectedly, e.g., after administering caffeine in bitter lemon. This effect was more accentuated in high anxiety sensitive persons. Moreover, in high anxiety sensitive persons, the expectation of arousal (coffee consumption) led to higher subjective alertness when administering caffeine and increased arousal even if no drug was consumed. CONCLUSIONS Unexpected symptom provocation leads to increased attention allocation toward feared arousal sensations in high anxiety sensitive persons. This finding broadens our understanding of modulatory mechanisms in defensive responding to bodily symptoms.
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Pinkney V, Wickens R, Bamford S, Baldwin DS, Garner M. Defensive eye-blink startle responses in a human experimental model of anxiety. J Psychopharmacol 2014; 28:874-80. [PMID: 24899597 PMCID: PMC4876426 DOI: 10.1177/0269881114532858] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Inhalation of low concentrations of carbon dioxide (CO2) triggers anxious behaviours in rodents via chemosensors in the amygdala, and increases anxiety, autonomic arousal and hypervigilance in healthy humans. However, it is not known whether CO2 inhalation modulates defensive behaviours coordinated by this network in humans. We examined the effect of 7.5% CO2 challenge on the defensive eye-blink startle response. A total of 27 healthy volunteers completed an affective startle task during inhalation of 7.5% CO2 and air. The magnitude and latency of startle eye-blinks were recorded whilst participants viewed aversive and neutral pictures. We found that 7.5% CO2 increased state anxiety and raised concurrent measures of skin conductance and heart rate (HR). CO2 challenge did not increase startle magnitude, but slowed the onset of startle eye-blinks. The effect of CO2 challenge on HR covaried with its effects on both subjective anxiety and startle latency. Our findings are discussed with reference to startle profiles during conditions of interoceptive threat, increased cognitive load and in populations characterised by anxiety, compared with acute fear and panic.
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Affiliation(s)
| | - Robin Wickens
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Susan Bamford
- Psychology, University of Southampton, Southampton, UK
| | - David S Baldwin
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Matthew Garner
- Psychology, University of Southampton, Southampton, UK Clinical and Experimental Sciences, University of Southampton, Southampton, UK
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Alius MG, Pané-Farré CA, Löw A, Hamm AO. Modulation of the blink reflex and P3 component of the startle response during an interoceptive challenge. Psychophysiology 2014; 52:140-8. [DOI: 10.1111/psyp.12295] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/25/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Manuela G. Alius
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
| | | | - Andreas Löw
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
| | - Alfons O. Hamm
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
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Ceunen E, Zaman J, Vlaeyen JWS, Dankaerts W, Van Diest I. Effect of seated trunk posture on eye blink startle and subjective experience: comparing flexion, neutral upright posture, and extension of spine. PLoS One 2014; 9:e88482. [PMID: 24516664 PMCID: PMC3917889 DOI: 10.1371/journal.pone.0088482] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/08/2014] [Indexed: 11/18/2022] Open
Abstract
Postures are known to be able to affect emotion and motivation. Much less is known about whether (affective) modulation of eye blink startle occurs following specific postures. The objective of the current study was to explore this. Participants in the present study were requested to assume three different sitting postures: with the spine flexed (slouched), neutral upright, and extended. Each posture was assumed for four minutes, and was followed by the administration of brief self-report questionnaires before proceeding to the next posture. The same series of postures and measures were repeated prior to ending the experiment. Results indicate that, relative to the other postures, the extended sitting posture was associated with an increased startle, was more unpleasant, arousing, had smaller levels of dominance, induced more discomfort, and was perceived as more difficult. The upright and flexed sitting postures differed in the level of self-reported positive affect, but not in eye blink startle amplitudes.
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Affiliation(s)
- Erik Ceunen
- Research Group Health Psychology, KU Leuven (University of Leuven), Leuven, Belgium
| | - Jonas Zaman
- Research Group Health Psychology, KU Leuven (University of Leuven), Leuven, Belgium
| | - Johan W. S. Vlaeyen
- Research Group Health Psychology, KU Leuven (University of Leuven), Leuven, Belgium
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Wim Dankaerts
- Research Group on Musculoskeletal Rehabilitation, KU Leuven (University of Leuven), Leuven, Belgium
| | - Ilse Van Diest
- Research Group Health Psychology, KU Leuven (University of Leuven), Leuven, Belgium
- * E-mail:
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