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Funkhouser CJ, Katz AC, Meissel EEE, Stevens ES, Weinberg A, Nabb CB, Shankman SA. Associations Between Repetitive Negative Thinking and Habituation of Defensive Responding Within and Between Sessions. AFFECTIVE SCIENCE 2022; 3:616-627. [PMID: 36385910 PMCID: PMC9537406 DOI: 10.1007/s42761-022-00121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic risk factor for internalizing psychopathology, and theoretical models suggest that RNT may maintain symptoms by interfering with psychophysiological habituation. The present study therefore examined associations between RNT and habituation within and between study sessions. Community members (N=86) completed a habituation task involving exposure to acoustic probes at up to five sessions spaced 7 days apart on average. Eyeblink startle response was measured using the electromyography startle magnitude. Self-reported anxiety was assessed before and after the habituation task at each session. Multilevel growth curve modeling indicated that RNT was associated with a higher "floor" (i.e., asymptote) of startle responding as evidenced by reduced within-session startle habituation at later sessions. Results suggest that RNT may disrupt startle habituation and are consistent with theoretical models proposing that RNT sustains physiological activation to support avoidance of negative emotional contrasts or perceived future threats. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00121-w.
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Affiliation(s)
- Carter J. Funkhouser
- Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St, Chicago, IL 60607 USA
| | - Andrea C. Katz
- VA Puget Sound Health Care System, Seattle Division, 1660 South Columbian Way, Seattle, WA 98108 USA
| | - Emily E. E. Meissel
- Department of Psychology, San Diego State University/University of California San Diego, 6363 Alvarado Ct, San Diego, CA 92120 USA
| | | | - Anna Weinberg
- Department of Psychology, McGill University, 2001 McGill College Ave., Montreal, Quebec, H3A 1G1 Canada
| | - Carver B. Nabb
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lake Shore Dr, Chicago, IL 60611 USA
| | - Stewart A. Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lake Shore Dr, Chicago, IL 60611 USA
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Teferi M, Makhoul W, Deng ZD, Oathes DJ, Sheline Y, Balderston NL. Continuous Theta Burst Stimulation to the Right Dorsolateral Prefrontal Cortex may increase Potentiated Startle in healthy individuals. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022. [PMID: 37519467 PMCID: PMC10382694 DOI: 10.1016/j.bpsgos.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Convergent neuroimaging and neuromodulation studies implicate the right dorsolateral prefrontal cortex (dlPFC) as a key region involved in anxiety-cognition interactions. However, neuroimaging data are correlational, and neuromodulation studies often lack appropriate methodological controls. Accordingly, this work was designed to explore the role of right prefrontal cognitive control mechanisms in the expression/regulation of anxiety using continuous theta-burst transcranial magnetic stimulation (cTBS) and threat of unpredictable shock. Based on prior neuromodulation studies, we hypothesized that the right dlPFC contributed to anxiety expression, and that cTBS should downregulate this expression. Methods We measured potentiated startle and performance on the Sternberg working memory paradigm in 28 healthy participants before and after 4 sessions (600 pulses/session) of active or sham cTBS. Stimulation was individualized to the right dlPFC site of maximal working memory-related activity and optimized using electric-field modeling. Results Compared with sham cTBS, active cTBS, which is thought to induce long-term depression-like synaptic changes, increased startle during threat of shock, but the effect was similar for predictable and unpredictable threat. As a measure of target (dis)engagement, we also showed that active but not sham cTBS decreased accuracy on the Sternberg task. Conclusions Counter to our initial hypothesis, cTBS to the right dlPFC made individuals more anxious, rather than less anxious. Although preliminary, these results are unlikely to be due to transient effects of the stimulation, because anxiety was measured 24 hours after cTBS. In addition, these results are unlikely to be due to off-target effects, because target disengagement was evident from the Sternberg performance data.
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Correa KA, Li LY, Nelson BD, Shankman SA. Event-related potentials to acoustic startle probes during unpredictable threat are associated with individual differences in intolerance of uncertainty. Int J Psychophysiol 2022; 174:66-75. [PMID: 35143906 PMCID: PMC8923991 DOI: 10.1016/j.ijpsycho.2022.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
Individual differences in sensitivity to unpredictable threat may be a critical mechanism for internalizing psychopathology phenotypes. The present study examined whether the startle probe-elicited N100 and P300 during unpredictable threat - two event-related potentials indexing early and elaborative attentional processing of unpredictable threat - may be endophenotypes for internalizing psychopathology, including fear and distress/misery disorders and intolerance of uncertainty (IU), a clinical trait that is transdiagnostically associated with internalizing disorders. A large sample of adult siblings (N = 375) completed the no, predictable, and unpredictable threat task, during which the N100 and P300 were recorded. Relative to the no threat condition, N100 was more strongly enhanced in anticipation of unpredictable than predictable threat while P300 was suppressed to both predictable and unpredictable threat. While neither N100 enhancement nor P300 suppression to unpredictable threat was associated with fear or distress/misery disorders, they were negatively linked to inhibitory IU (a facet of IU). Thus, individuals high in inhibitory IU showed reduced attentional engagement with the threatening context when it was unpredictable. Further, N100 enhancement and, to a lesser degree, P300 suppression to unpredictable threat showed familial aggregation - a key criterion for determining whether a biomarker is an endophenotype. In sum, N100 enhancement and P300 suppression to unpredictable threat may be endophenotypes for dimensional measures of internalizing psychopathology.
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Affiliation(s)
- Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
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Correa KA, Carrillo V, Funkhouser CJ, Shenberger ER, Shankman SA. Ethnic differences in behavioral and physiological indicators of sensitivity to threat. J Anxiety Disord 2022; 85:102508. [PMID: 34864540 PMCID: PMC8760157 DOI: 10.1016/j.janxdis.2021.102508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/26/2021] [Accepted: 11/20/2021] [Indexed: 01/03/2023]
Abstract
The clinical presentation of anxiety may differ between Hispanics/Latinx (H/L) and non-H/L, although findings on ethnic differences in self-reported anxiety symptoms have been mixed. Fewer studies have focused on ethnic differences in quick and relatively automatic laboratory-assessed indicators of anxiety symptoms, which have the potential to be more objective indicators than self-report. Therefore, the present study examined ethnic differences in two laboratory-assessed indicators of threat sensitivity (an important transdiagnostic mechanism of anxiety): attentional bias to threat and electromyography startle reactivity to threat. White H/L (n = 117) and White non-H/L (n = 168) adults who were matched on demographics and lifetime psychopathology (including anxiety) completed a dot-probe task to assess attentional bias to threat and the No-Predictable-Unpredictable threat (NPU) task to assess startle reactivity to threat. Results indicated that H/L displayed less Slow OrientationRB (β = -0.27, p = 0.032, R2β∗ = 0.02), and increased Slow DisengagementRB (β = 0.31, p = 0.016, R2β∗ = 0.02) compared to non-H/L. H/L exhibited blunted overall startle compared to non-H/L (β = -0.30, p = 0.014, R2β∗ = 0.02), but groups did not differ in startle reactivity to either predictable or unpredictable threat. In summary, H/L and non-H/L may differ in their experience and presentation of anxiety symptoms and such differences may vary across indicators of sensitivity to threat.
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Affiliation(s)
- Kelly A Correa
- University of Illinois at Chicago, United States; Northwestern University, United States
| | | | - Carter J Funkhouser
- University of Illinois at Chicago, United States; Northwestern University, United States
| | - Elyse R Shenberger
- University of Illinois at Chicago, United States; Northwestern University, United States
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Lago TR, Brownstein MJ, Page E, Beydler E, Manbeck A, Beale A, Roberts C, Balderston N, Damiano E, Pineles SL, Simon N, Ernst M, Grillon C. The novel vasopressin receptor (V1aR) antagonist SRX246 reduces anxiety in an experimental model in humans: a randomized proof-of-concept study. Psychopharmacology (Berl) 2021; 238:2393-2403. [PMID: 33970290 PMCID: PMC8376758 DOI: 10.1007/s00213-021-05861-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
RATIONALE Arginine vasopressin (AVP) is a neuropeptide that modulates both physiological and emotional responses to threat. Until recently, drugs that target vasopressin receptors (V1a) in the human central nervous system were unavailable. The development of a novel V1a receptor antagonist, SRX246, permits the experimental validation of vasopressin's role in the regulation of anxiety and fear in humans. OBJECTIVES Here, we examined the effects of SRX246 in a proof-of-concept translational paradigm of fear (phasic response to imminent threat) and anxiety (prolonged response to potential threat). METHODS Healthy volunteers received both SRX246 and placebo in a randomized, double-blind, counter-balanced order separated by a 5-7-day wash-out period. Threat consisted of unpleasant electric shocks. The "NPU" threat test probed startle reactivity during predictable threat (i.e., fear-potentiated startle) and unpredictable threat (i.e., anxiety-potentiated startle). RESULTS As predicted, SRX246 decreased anxiety-potentiated startle independent of fear-potentiated startle. CONCLUSIONS As anxiety-potentiated startle is elevated in anxiety and trauma-associated disorders and decreased by traditional anxiolytics such as SSRIs and benzodiazepines, the V1a receptor is a promising novel treatment target.
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Affiliation(s)
- Tiffany R Lago
- National Institute of Mental Health, Bethesda, MD, USA.
- VA Boston Healthcare System, Boston, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | | | - Emily Page
- National Institute of Mental Health, Bethesda, MD, USA
| | - Emily Beydler
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Alexis Beale
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Nicholas Balderston
- National Institute of Mental Health, Bethesda, MD, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Eve Damiano
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
| | - Suzanne L Pineles
- Boston University School of Medicine, Boston, MA, USA
- National Center, PTSD At VA Boston Healthcare System, Boston, MA, USA
| | - Neal Simon
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
- Lehigh University, Bethelhem, PA, USA
| | - Monique Ernst
- National Institute of Mental Health, Bethesda, MD, USA
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6
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Low-frequency parietal repetitive transcranial magnetic stimulation reduces fear and anxiety. Transl Psychiatry 2020; 10:68. [PMID: 32066739 PMCID: PMC7026136 DOI: 10.1038/s41398-020-0751-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/23/2022] Open
Abstract
Anxiety disorders are the most prevalent mental disorders, with few effective neuropharmacological treatments, making treatments development critical. While noninvasive neuromodulation can successfully treat depression, few treatment targets have been identified specifically for anxiety disorders. Previously, we showed that shock threat increases excitability and connectivity of the intraparietal sulcus (IPS). Here we tested the hypothesis that inhibitory repetitive transcranial magnetic stimulation (rTMS) targeting this region would reduce induced anxiety. Subjects were exposed to neutral, predictable, and unpredictable shock threat, while receiving double-blinded, 1 Hz active or sham IPS rTMS. We used global brain connectivity and electric-field modelling to define the single-subject targets. We assessed subjective anxiety with online ratings and physiological arousal with the startle reflex. Startle stimuli (103 dB white noise) probed fear and anxiety during the predictable (fear-potentiated startle, FPS) and unpredictable (anxiety-potentiated startle, APS) conditions. Active rTMS reduced both FPS and APS relative to both the sham and no stimulation conditions. However, the online anxiety ratings showed no difference between the stimulation conditions. These results were not dependent on the laterality of the stimulation, or the subjects' perception of the stimulation (i.e. active vs. sham). Results suggest that reducing IPS excitability during shock threat is sufficient to reduce physiological arousal related to both fear and anxiety, and are consistent with our previous research showing hyperexcitability in this region during threat. By extension, these results suggest that 1 Hz parietal stimulation may be an effective treatment for clinical anxiety, warranting future work in anxiety patients.
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Grillon C, Robinson OJ, Cornwell B, Ernst M. Modeling anxiety in healthy humans: a key intermediate bridge between basic and clinical sciences. Neuropsychopharmacology 2019; 44:1999-2010. [PMID: 31226707 PMCID: PMC6897969 DOI: 10.1038/s41386-019-0445-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 12/11/2022]
Abstract
Animal models of anxiety disorders are important for elucidating neurobiological defense mechanisms. However, animal models are limited when it comes to understanding the more complex processes of anxiety that are unique to humans (e.g., worry) and to screen new treatments. In this review, we outline how the Experimental Psychopathology approach, based on experimental models of anxiety in healthy subjects, can mitigate these limitations and complement research in animals. Experimental psychopathology can bridge basic research in animals and clinical studies, as well as guide and constrain hypotheses about the nature of psychopathology, treatment mechanisms, and treatment targets. This review begins with a brief review of the strengths and limitations of animal models before discussing the need for human models of anxiety, which are especially necessary to probe higher-order cognitive processes. This can be accomplished by combining anxiety-induction procedures with tasks that probe clinically relevant processes to identify neurocircuits that are potentially altered by anxiety. The review then discusses the validity of experimental psychopathology and introduces a methodological approach consisting of five steps: (1) select anxiety-relevant cognitive or behavioral operations and associated tasks, (2) identify the underlying neurocircuits supporting these operations in healthy controls, 3) examine the impact of experimental anxiety on the targeted operations in healthy controls, (4) utilize findings from step 3 to generate hypotheses about neurocircuit dysfunction in anxious patients, and 5) evaluate treatment mechanisms and screen novel treatments. This is followed by two concrete illustrations of this approach and suggestions for future studies.
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Affiliation(s)
- Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA.
| | - Oliver J Robinson
- University College London, Institute of Cognitive Neuroscience, London, UK
| | - Brian Cornwell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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Lee YC, Fine A, Protsenko E, Massarotti E, Edwards RR, Mawla I, Napadow V, Loggia ML. Brain Correlates of Continuous Pain in Rheumatoid Arthritis as Measured by Pulsed Arterial Spin Labeling. Arthritis Care Res (Hoboken) 2019; 71:308-318. [PMID: 29781581 DOI: 10.1002/acr.23601] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/15/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Central nervous system pathways involving pain modulation shape the pain experience in patients with chronic pain. The aims of this study were to understand the mechanisms underlying pain in patients with rheumatoid arthritis (RA) and to identify brain signals that may serve as imaging markers for developing targeted treatments for RA-related pain. METHODS Patients with RA and matched control subjects underwent functional magnetic resonance imaging, using pulsed arterial spin labeling. The imaging conditions included 1) resting state, 2) low-intensity stimulus, and 3) high-intensity stimulus. Stimuli consisted of mechanical pressure applied to metacarpophalangeal (MCP) joints with an automated cuff inflator. The low-intensity stimulus was inflation to 30 mm Hg. The high-intensity stimulus was the amount of pressure required to achieve a pain intensity rating of 40 on a 100-point scale for each RA patient, with the same amount of pressure used in the matched control. RESULTS Among RA patients, regional cerebral blood flow (rCBF) in the medial frontal cortex and dorsolateral prefrontal cortex increased during both low-pressure and high-pressure stimulation. No rCBF changes were observed in pain-free controls. Region-of-interest analyses in RA patients showed that baseline rCBF in the medial frontal cortex was negatively correlated with the pressure required for the high-intensity stimulus and positively correlated with pain induced by the low-intensity stimulus. Baseline rCBF was also marginally correlated with disease activity). Regional CBF during high pain was positively correlated with pain severity and pain interference. CONCLUSION In response to clinically relevant joint pain evoked by pressure applied to the MCP joint, neural processing in the medial frontal cortex increases and is directly associated with clinical pain in patients with RA.
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Affiliation(s)
- Yvonne C Lee
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alexander Fine
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ekaterina Protsenko
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elena Massarotti
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert R Edwards
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ishtiaq Mawla
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vitaly Napadow
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Marco L Loggia
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Radoman M, Phan KL, Gorka SM. Neural correlates of predictable and unpredictable threat in internalizing psychopathology. Neurosci Lett 2019; 701:193-201. [PMID: 30825592 PMCID: PMC6476657 DOI: 10.1016/j.neulet.2019.02.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Abstract
Converging lines of evidence suggest that heightened responding to unpredictable threat may be an important neurobiological marker of internalizing psychopathology (IP). Prior data also indicate that aversive responding to uncertainty may be mediated by hyperactivation of several brain regions within the frontolimbic circuit, namely the anterior insula (aINS) and the dorsal anterior cingulate cortex (dACC). To date, however, the majority of this research has been focused on individual diagnoses and it is unclear whether abnormal neural reactivity to unpredictable threat is observed within heterogeneous, transdiagnostic IP patient populations, as theory would suggest. The aim of the current study was to therefore examine the neural correlates of temporally unpredictable (U) and predictable (P) threat in a sample of healthy controls (n = 24) and patients with a broad range of IP diagnoses (n = 51). We also examined whether symptom severity measures of fear and distress/misery dimensions correlated with neural reactivity to U- and P-threat. All participants completed a modified version of a well-validated threat-of-shock task during functional magnetic resonance imaging (fMRI). Across all participants, U- and P-threat elicited heightened activation in the aINS and brainstem, while P-threat alone also activated the dACC. Relative to healthy controls, patients displayed greater activation in the right aINS during U-threat, and greater right brainstem activation during P-threat. In addition, we found that brainstem activity during U-threat correlated with fear, but not distress/misery, psychopathology. Taken together, these preliminary results suggest that exaggerated aINS reactivity during U-threat and brainstem reactivity during P-threat may have the potential to become important transdiagnostic biomarkers of IP; however, future research efforts are needed to corroborate and expand the present findings.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.
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Funkhouser CJ, Correa KA, Carrillo VL, Klemballa DM, Shankman SA. The time course of responding to aversiveness in females with a history of non-suicidal self-injury. Int J Psychophysiol 2019; 141:1-8. [PMID: 31028756 DOI: 10.1016/j.ijpsycho.2019.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/27/2019] [Accepted: 04/24/2019] [Indexed: 01/26/2023]
Abstract
Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Two prominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may lead to increased risk for suicide. Several laboratory studies examining the relationship between physiological habituation and suicide attempt history have yielded mixed results, potentially due to their use of broad measures of physiological arousal and/or focus on specific psychopathologies. However, no studies have examined the association between the time course (e.g., habituation, initial reactivity) of responding to aversiveness and NSSI, which may help to elucidate psychophysiological mechanisms of NSSI. Therefore, we examined habituation and initial reactivity to aversiveness (indexed by the time course of acoustic startle reflex, a well-validated measure of defensive responding) in three groups of young adult females - those with a history of NSSI, psychiatric controls matched on potential confounds (e.g., psychopathology, trauma history, demographics), and healthy controls. Results indicated that individuals with a history of NSSI exhibited blunted initial reactivity and marginally slower habituation to aversiveness relative to the two control groups. The NSSI group's insensitivity to aversiveness may reflect prior psychophysiological habituation, and may be a mechanism through which prior NSSI exposure leads to increased risk for suicidal behavior.
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Affiliation(s)
- Carter J Funkhouser
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Vivian L Carrillo
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - David M Klemballa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Stewart A Shankman
- Department of Psychology, University of Illinois at Chicago, United States of America; Department of Psychiatry, University of Illinois at Chicago, United States of America; Department of Psychiatry and Behavioral Sciences, Northwestern University, United States of America.
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11
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Lago TR, Hsiung A, Leitner BP, Duckworth CJ, Chen KY, Ernst M, Grillon C. Exercise decreases defensive responses to unpredictable, but not predictable, threat. Depress Anxiety 2018; 35:868-875. [PMID: 29637654 PMCID: PMC6314494 DOI: 10.1002/da.22748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Research supports the anxiolytic effect of exercise, but the mechanism underlying this effect is unclear. This study examines the influence of exercise in healthy controls on two distinct defensive states implicated in anxiety disorders: fear, a phasic response to a predictable threat, and anxiety, a sustained response to an unpredictable threat. METHODS Thirty-four healthy volunteers (17 male, age M = 26.18, SD = 5.6) participated in sessions of exercise (biking at 60-70% of heart rate reserve) and control (biking at 10-20% of heart rate reserve) activity for 30 min, separated by 1 week. Threat responses were measured by eyeblink startle and assessed with the "Neutral-Predictable-Unpredictable threat test," which includes a neutral (N) and two threat conditions, one with predictable (P) and one with unpredictable (U) shock. RESULTS Results show that exercise versus control activity reduces startle potentiation during unpredictable threat (P = .031), but has no effect on startle potentiation during predictable threat (P = .609). CONCLUSIONS These results suggest that exercise reduces defensive response to unpredictable, but not predictable, threat, a dissociation that may help inform clinical indications for this behavioral intervention, as well as provide clues to its underlying neurobehavioral mechanisms.
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Affiliation(s)
- Tiffany R Lago
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Abigail Hsiung
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Brooks P Leitner
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Courtney J Duckworth
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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Stevens ES, Weinberg A, Nelson BD, Meissel EEE, Shankman SA. The effect of panic disorder versus anxiety sensitivity on event-related potentials during anticipation of threat. J Anxiety Disord 2018; 54:1-10. [PMID: 29291580 PMCID: PMC5820143 DOI: 10.1016/j.janxdis.2017.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 11/14/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022]
Abstract
Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies have been mixed. Predictability of threat, an important feature of threat processing, may have contributed to these mixed findings. Additionally, anxiety sensitivity, a dimensional trait associated with PD, may yield stronger associations with cognitive processes than categorical diagnoses of PD. In this study, 171 participants with PD and/or depression and healthy controls completed a task that differentiated anticipation of predictable vs. unpredictable shocks, while startle eyeblink and event-related potentials (ERPs [N100, P300]) were recorded. In all participants, relative to the control condition, probe N100 was enhanced to both predictable and unpredictable threat, whereas P300 suppression was unique to predictable threat. Probe N100, but not P300, was associated with startle eyeblink during both threatening conditions, and was strongest for unpredictable threat. PD was not associated with ERPs, but anxiety sensitivity (physical concerns) was positively associated with probe N100 (indicating reduced responding) in the unpredictable condition independent of PD diagnosis. Vulnerability to panic-related psychopathology may be characterized by aberrant early processing of threat, which may be especially evident during anticipation of unpredictable threats.
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Affiliation(s)
| | - Anna Weinberg
- Department of Psychology, McGill University, Quebec, Canada
| | | | | | - Stewart A. Shankman
- Department of Psychology, University of Illinois at Chicago, IL, USA,Corresponding author. University of Illinois at Chicago, Department of Psychology, Chicago, Illinois, 60607 United States, (S. Shankman)
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Klumpp H, Shankman SA. Using Event-Related Potentials and Startle to Evaluate Time Course in Anxiety and Depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:10-18. [PMID: 29397073 DOI: 10.1016/j.bpsc.2017.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 12/31/2022]
Abstract
The National Institute of Mental Health's Research Domain Criteria initiative is a research framework designed toward understanding psychopathology as abnormalities of dimensional neurobehavioral constructs rather than in terms of DSM-defined categories. Research Domain Criteria constructs within the negative valence domain are particularly relevant for understanding anxiety and depressive disorders, which are pervasive, debilitating, and characterized by negative processing bias. One important direction for Research Domain Criteria research is investigating processes and parameters related to the time course (or chronometry) of negative valenced constructs. Two reliable methods for assessing chronometry are event-related potentials (ERPs) and startle blink. In this qualitative review, we examine ERP and startle studies of individuals with anxiety or depression or individuals vulnerable to affective disorders. The aim of the review is to highlight how these methods can inform the role of chronometry in the spectrum of anxiety and depression. ERP studies examining different chronometry facets of negative valenced responses have shown that transdiagnostic groups of individuals with internalizing psychopathologies exhibit abnormalities at early stages of processing. Startle reactivity studies have robustly differentiated fear-based disorders (e.g., panic disorder, social phobia) from other anxiety disorders (e.g., generalized anxiety disorder) and have also shown that different internalizing phenotypes exhibit different patterns of habituation. Findings lend support to the value of ERP and startle measures in identifying groups that cut across conventional classification systems. We also highlight methodological issues that can aid in the validity and reproducibility of ERP and startle findings and, ultimately, in the goal of developing more precise models of anxiety and depression.
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Affiliation(s)
- Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois; Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Stewart A Shankman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois; Department of Psychology, University of Illinois at Chicago, Chicago, Illinois.
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Parisi EA, Hajcak G, Aneziris E, Nelson BD. Effects of anticipated emotional category and temporal predictability on the startle reflex. Int J Psychophysiol 2017; 119:67-72. [DOI: 10.1016/j.ijpsycho.2017.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 03/12/2017] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
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Lieberman L, Stevens ES, Funkhouser CJ, Weinberg A, Sarapas C, Huggins AA, Shankman SA. How many blinks are necessary for a reliable startle response? A test using the NPU-threat task. Int J Psychophysiol 2017; 114:24-30. [PMID: 28163133 DOI: 10.1016/j.ijpsycho.2017.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 01/17/2017] [Accepted: 01/31/2017] [Indexed: 12/19/2022]
Abstract
Emotion-modulated startle is a frequently used method in affective science. Although there is a growing literature on the reliability of this measure, it is presently unclear how many startle responses are necessary to obtain a reliable signal. The present study therefore evaluated the reliability of startle responding as a function of number of startle responses (NoS) during a widely used threat-of-shock paradigm, the NPU-threat task, in a clinical (N=205) and non-clinical (N=92) sample. In the clinical sample, internal consistency was also examined independently for healthy controls vs. those with panic disorder and/or major depression and retest reliability was assessed as a function of NoS. Although results varied somewhat by diagnosis and for retest reliability, the overall pattern of results suggested that six startle responses per condition were necessary to obtain acceptable reliability in clinical and non-clinical samples during this threat-of-shock paradigm in the present study.
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Affiliation(s)
- Lynne Lieberman
- University of Illinois at Chicago, Department of Psychology, Chicago, IL 60657, United States
| | - Elizabeth S Stevens
- University of Illinois at Chicago, Department of Psychology, Chicago, IL 60657, United States
| | - Carter J Funkhouser
- University of Illinois at Chicago, Department of Psychology, Chicago, IL 60657, United States
| | - Anna Weinberg
- McGill University, Department of Psychology, Montreal, QB, Canada
| | - Casey Sarapas
- University of Illinois at Chicago, Department of Psychology, Chicago, IL 60657, United States
| | - Ashley A Huggins
- University of Wisconsin, Department of Psychology, Milwaukee, WI 53211, United States
| | - Stewart A Shankman
- University of Illinois at Chicago, Department of Psychology, Chicago, IL 60657, United States.
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Gorka SM, Hee D, Lieberman L, Mittal VA, Phan KL, Shankman SA. Reactivity to uncertain threat as a familial vulnerability factor for alcohol use disorder. Psychol Med 2016; 46:3349-3358. [PMID: 27624067 DOI: 10.1017/s0033291716002415] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND When sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals who exhibit heightened reactivity to U-threat at baseline are motivated to use alcohol as a means of avoidance-based coping, setting the stage for excessive drinking. To date, however, no study has attempted to characterize the dispositional nature of exaggerated reactivity to U-threat and test whether it is a vulnerability factor or exclusively a disease marker of problematic alcohol use. METHOD The current investigation utilized a family study design to address these gaps by examining whether (1) reactivity to U-threat is associated with risk for problematic alcohol use, defined by family history of alcohol use disorder (AUD) and (2) reactivity to U-threat is correlated amongst adult biological siblings. A total of 157 families, and 458 individuals, participated in the study and two biological siblings completed a threat-of-shock task designed to probe reactivity to U-threat and predictable threat (P-threat). Startle potentiation was collected as an index of aversive responding. RESULTS Within biological siblings, startle potentiation to U-threat [intraclass correlation (ICC) = 0.35] and P-threat (ICC = 0.63) was significantly correlated. In addition, independent of an individuals' own AUD status, startle potentiation to U-threat, but not P-threat, was positively associated with risk for AUD (i.e. AUD family history). CONCLUSION This suggests that heightened reactivity to U-threat may be a familial vulnerability factor for problematic drinking and a novel prevention target for AUD.
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Affiliation(s)
- S M Gorka
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
| | - D Hee
- Department of Psychology,University of Illinois at Chicago,Chicago, IL,USA
| | - L Lieberman
- Department of Psychology,University of Illinois at Chicago,Chicago, IL,USA
| | - V A Mittal
- Department of Psychology,Northwestern University,Evanston, IL,USA
| | - K L Phan
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
| | - S A Shankman
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
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Gorka SM, Lieberman L, Shankman SA, Phan KL. Startle potentiation to uncertain threat as a psychophysiological indicator of fear-based psychopathology: An examination across multiple internalizing disorders. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 126:8-18. [PMID: 27868423 DOI: 10.1037/abn0000233] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Heightened reactivity to uncertain threat (U-threat) is an important individual difference factor that may characterize fear-based internalizing psychopathologies (IPs) and distinguish them from distress/misery IPs. To date, however, the majority of existing research examining reactivity to U-threat has been within individuals with panic disorder and major depressive disorder (MDD) and no prior study has directly tested this hypothesis across multiple IPs. The current study therefore explored whether heightened reactivity to U-threat is a psychophysiological indicator of fear-based psychopathology across 5 groups: current (a) social anxiety disorder (SAD); (b) specific phobia (SP); (c) generalized anxiety disorder (GAD); (d) MDD; and (c) individuals with no history of psychopathology (controls). All 160 adults completed a well-validated threat-of-shock task designed to probe responses to predictable (P-) and U-threat. Startle eyeblink potentiation was recorded as an index of aversive arousal. Results indicated that individuals with SAD and SP evidenced greater startle potentiation to U-threat, but not P-threat, relative to individuals with GAD, MDD, and controls (who did not differ). The current findings, along with the prior panic disorder and MDD literature, suggest that heightened reactivity to U-threat is a psychophysiological indicator of fear-based disorders and could represent a neurobiological organizing principle for internalizing psychopathology. The findings also suggest that individuals with fear disorders generally display a hypersensitivity to uncertain aversive events, which could contribute to their psychopathology. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - K Luan Phan
- Department of Psychiatry, University of Illinois-Chicago
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Gorka SM, Lieberman L, Phan KL, Shankman SA. Association between problematic alcohol use and reactivity to uncertain threat in two independent samples. Drug Alcohol Depend 2016; 164:89-96. [PMID: 27173662 PMCID: PMC4893928 DOI: 10.1016/j.drugalcdep.2016.04.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent laboratory studies have shown that acute alcohol intoxication selectively and effectively dampens aversive responding to uncertain threat. An emerging hypothesis is that individuals who exhibit heightened reactivity to uncertain threat may be especially motivated to use alcohol to dampen their distress, setting the stage for negative reinforcement processes to drive excessive alcohol use. However, no study to date has directly examined whether current problematic drinkers exhibit heightened reactivity to uncertain threat as would be expected. METHODS The present study was therefore designed to examine the association between current problematic alcohol use and reactivity to uncertain threat during sobriety in two, independent samples. In Study 1 (n=221) and Study 2 (n=74), adult participants completed the same well-validated threat-of-shock task which separately probes responses to temporally predictable and unpredictable threat. Startle potentiation was measured as an index of aversive responding. Problematic alcohol use was defined as number of binge episodes within the past 30days in Study 1 and total scores on a self-report measure of hazardous drinking in Study 2. RESULTS As hypothesized, across both studies greater levels of problematic drinking were associated with greater startle potentiation to unpredictable threat. In Study 2, hazardous drinking scores were also positively associated with startle potentiation to predictable threat. CONCLUSIONS The findings are notably consistent with the notion that heightened reactivity to uncertain threat is an important individual difference factor associated with the onset and/or maintenance of problematic drinking behaviors and may therefore be a novel prevention and intervention target.
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Affiliation(s)
- Stephanie M. Gorka
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,Corresponding author. (S.M. Gorka)
| | - Lynne Lieberman
- University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States
| | - K. Luan Phan
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States,Jesse Brown VA Medical Center, Mental Health Service Line, 820 S. Damen Avenue, Chicago, IL 60612, United States,University of Illinois-Chicago, Department of Anatomy and Cell Biology, and The Graduate Program in Neuroscience, 808 S. Wood Street Chicago, IL 60612, United States
| | - Stewart A. Shankman
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States
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