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Lam GN, Cooper J, Lipp OV, Mayo LM, Ney L. Exploration of stress reactivity and fear conditioning on intrusive memory frequency in a conditioned-intrusion paradigm. J Behav Ther Exp Psychiatry 2024; 85:101984. [PMID: 39116644 DOI: 10.1016/j.jbtep.2024.101984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/23/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND AND OBJECTIVES The conditioned-intrusion paradigm was designed to provide insight into the relationship between fear conditioning and intrusive memory formation, which is relevant to understanding posttraumatic stress disorder symptoms and treatment. However, boundary conditions of this new paradigm have not been explored and it is currently not known whether findings from this work are valid in a clinical context. METHODS In the current study, we explored the relationship between stress reactivity to trauma film clips, usual exposure to violent media, renewal of fear conditioning using skin conductance as well as subjective ratings, and the effect of shock versus film clip during conditioning on the frequency of intrusive memories. An adapted fear conditioning paradigm using trauma clips as unconditional stimuli was used, and participants subsequently reported intrusive memories of the trauma clips. RESULTS Skin conductance responses to conditioned stimuli paired with shocks and film clips were significantly higher than conditioned stimuli paired with film clips alone. Subjective stress reactivity, previous exposure to violent media, and film valence rating were associated with the frequency of intrusive memories. No aspects of fear conditioning were associated with intrusive memories, and factor analysis suggested the fear conditioning and stress related to film clip viewing were mostly separate constructs. Similarly, content and triggers of intrusive memories were usually film-clip related rather than conditional stimulus related. LIMITATIONS We did not observe strong conditioning effects of the unconditional stimuli to conditional stimuli, which were shapes rather than high frequency stimuli such as faces. CONCLUSIONS These findings provide potential boundary conditions for this paradigm and suggest multiple ways in which the validity of the paradigm can be tested in the future.
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Affiliation(s)
- Gia Nhi Lam
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Jack Cooper
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Ottmar V Lipp
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Leah M Mayo
- Department of Psychiatry, Mathison Centre for Mental Health Research, and Hotchkiss Brain Institute, University of Calgary, Canada
| | - Luke Ney
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Lommen MJJ, Hoekstra S, van den Brink RHS, Lenaert B. Fear generalization predicts post-traumatic stress symptoms: A two-year follow-up study in Dutch fire fighters. J Anxiety Disord 2024; 103:102855. [PMID: 38484507 DOI: 10.1016/j.janxdis.2024.102855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 01/20/2024] [Accepted: 03/07/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Excessive fear generalization has been associated with pathological anxiety, including posttraumatic stress disorder (PTSD). However, studies investigating the longitudinal relationship between generalization and the development of anxiety symptomatology are scarce. This study aims to test the predictive value of fear generalization for PTSD symptoms in a high-risk profession sample and to explore the relationship between generalization and neuroticism, which are both linked to PTSD. METHOD Longitudinal data from a multi-wave study in 529 Dutch fire-fighters were used. Fear generalization, PTSD symptoms and neuroticism were assessed at baseline. PTSD symptoms were reevaluated at six, 12, 18, and 24 months. Generalization was assessed in a differential conditioning paradigm by measuring expectancies of an aversive outcome when presented with stimuli similar to previously conditioned stimuli. RESULTS Higher expectancy ratings towards stimuli most similar to safety signals predicted PTSD symptoms at follow-up after controlling for baseline PTSD symptoms, whereas higher expectancy ratings towards stimuli most similar to danger signals was associated with neuroticism. Neuroticism weakened the predictive power of fear generalization when considered simultaneously. DISCUSSION These findings suggest that heightened fear generalization is associated with the development of anxiety and trauma-related symptoms. Targeting problematic fear generalization may be a promising intervention approach.
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Affiliation(s)
- Miriam J J Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands.
| | | | - Rob H S van den Brink
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Bert Lenaert
- Department of Life Span Psychology, Faculty of Psychology, Open University, Heerlen, the Netherlands; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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3
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Eyraud N, Bloch S, Brizard B, Pena L, Tharsis A, Surget A, El-Hage W, Belzung C. Influence of Stress Severity on Contextual Fear Extinction and Avoidance in a Posttraumatic-like Mouse Model. Brain Sci 2024; 14:311. [PMID: 38671963 PMCID: PMC11048507 DOI: 10.3390/brainsci14040311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a widespread fear-related psychiatric affection associated with fear extinction impairments and important avoidance behaviors. Trauma-related exposure therapy is the current first-hand treatment for PTSD, yet it needs to be improved to shorten the time necessary to reach remission and increase responsiveness. Additional studies to decipher the neurobiological bases of extinction and effects on PTSD-like symptoms could therefore be of use. However, a PTSD-like animal model exhibiting pronounced PTSD-related phenotypes even after an extinction training directly linked to the fearful event is necessary. Thus, using a contextual fear conditioning model of PTSD, we increased the severity of stress during conditioning to search for effects on extinction acquisition and on pre- and post-extinction behaviors. During conditioning, mice received either two or four electrical shocks while a control group was constituted of mice only exposed to the context. Stressed mice exhibited important fear generalization, high fear reaction to the context and selective avoidance of a contextual reminder even after the extinction protocol. Increasing the number of footshocks did not induce major changes on these behaviors.
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Affiliation(s)
- Noémie Eyraud
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Solal Bloch
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Bruno Brizard
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Laurane Pena
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Antoine Tharsis
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Alexandre Surget
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
| | - Wissam El-Hage
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
- Pôle de Psychiatrie et d’Addictologie, Centre Hospitalier Régional Universitaire de Tours, 37000 Tours, France
| | - Catherine Belzung
- Institut National de la Santé et de la Recherche Médicale (INSERM), Imaging Brain & Neuropsychiatry iBraiN U1253, Université de Tours, 37032 Tours, France
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Peyrot C, Provencher J, Duplessis Marcotte F, Cernik R, Marin MF. Using unconditioned responses to predict fear acquisition, fear extinction learning, and extinction retention patterns: Sex hormone status matters. Behav Brain Res 2024; 459:114802. [PMID: 38081517 DOI: 10.1016/j.bbr.2023.114802] [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: 08/16/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
Following a traumatic event, fear dysregulation can increase the likelihood of developing post-traumatic stress disorder (PTSD). This psychopathology is twice as prevalent in women than in men. High physiological reactivity following trauma may be an early risk indicator for the development of PTSD. Elevated physiological reactivity and low estradiol levels have individually been associated with higher fear acquisition and/or lower extinction retention. Thus, sex hormone status may also modulate fear regulation abilities. However, it is unknown whether these two vulnerability factors interact to modulate fear learning and regulation. Using a fear conditioning and extinction protocol, we examined whether physiological reactivity to the aversive stimulus during fear acquisition training predicted fear responses during fear learning, extinction learning, and extinction retention. We verified whether these associations differed according to sex hormone status. Seventy-seven non-clinical participants were recruited including oral contraceptive users (n = 18), early follicular women (n = 20, [low estradiol]), mid-cycle women (n = 20, [high estradiol]), and men (n = 19). Participants underwent a three-day fear conditioning and extinction protocol (day 1: fear acquisition training; day 2: extinction training; day 3: retention test). Skin conductance responses were recorded. In early follicular women, physiological reactivity predicted conditioned and extinguished stimulus fear responses during all phases. For the remaining women, this effect was only present during fear learning and extinction learning. These findings highlight the importance of considering physiological reactivity and sex hormone status following a traumatic event. This knowledge could aid in the early identification of those at higher risk of developing PTSD.
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Affiliation(s)
- Clémence Peyrot
- Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, H1N 3J4 Montréal, Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, 2900 Édouard-Montpetit boulevard, Montréal, Québec H3T 1J4, Canada.
| | - Jessie Provencher
- Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, H1N 3J4 Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montréal, Québec H2X 2P3, Canada.
| | - Félix Duplessis Marcotte
- Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, H1N 3J4 Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montréal, Québec H2X 2P3, Canada.
| | - Rebecca Cernik
- Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, H1N 3J4 Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montréal, Québec H2X 2P3, Canada.
| | - Marie-France Marin
- Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, H1N 3J4 Montréal, Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, 2900 Édouard-Montpetit boulevard, Montréal, Québec H3T 1J4, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montréal, Québec H2X 2P3, Canada.
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5
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Ney LJ, O'Donohue M, Wang Y, Richardson M, Vasarhelyi A, Lipp OV. The next frontier: Moving human fear conditioning research online. Biol Psychol 2023; 184:108715. [PMID: 37852526 DOI: 10.1016/j.biopsycho.2023.108715] [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: 06/22/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023]
Abstract
Fear conditioning is a significant area of research that has featured prominently among the topics published in Biological Psychology over the last 50 years. This work has greatly contributed to our understanding of human anxiety and stressor-related disorders. While mainly conducted in the laboratory, recently, there have been initial attempts to conduct fear conditioning experiments online, with around 10 studies published on the subject, primarily in the last two years. These studies have demonstrated the potential of online fear conditioning research, although challenges to ensure that this research meets the same methodological standards as in-person experimentation remain, despite recent progress. We expect that in the coming years new outcome measures will become available online including the measurement of eye-tracking, pupillometry and probe reaction time and that compliance monitoring will be improved. This exciting new approach opens new possibilities for large-scale data collection among hard-to-reach populations and has the potential to transform the future of fear conditioning research.
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Affiliation(s)
- Luke J Ney
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia
| | - Matthew O'Donohue
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia
| | - Yi Wang
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia
| | - Mikaela Richardson
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia
| | - Adam Vasarhelyi
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia
| | - Ottmar V Lipp
- School of Psychology and Counselling, Faculty of Health, Queensland University of Australia, Brisbane, Australia.
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6
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Dymond S, Xia W, Lloyd K, Schlund MW, Zuj DV. Working hard to avoid: Fixed-ratio response effort and maladaptive avoidance in humans. Q J Exp Psychol (Hove) 2023; 76:1889-1912. [PMID: 36112817 DOI: 10.1177/17470218221127660] [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: 07/20/2023]
Abstract
Maladaptive avoidance of safe stimuli is a defining feature of anxiety and related disorders. Avoidance may involve physical effort or the completion of a fixed series of responses to prevent occurrence of, or cues associated with, the aversive event. Understanding the role of response effort in the acquisition and extinction of avoidance may facilitate the development of new clinical treatments for maladaptive avoidance. Despite this, little is known about the impact of response effort on extinction-resistant avoidance in humans. Here, we describe findings from two laboratory-based treatment studies designed to investigate the impact of high and low response effort on the extinction (Experiment 1) and return (Experiment 2) of avoidance. Response effort was operationalised as completion of fixed-ratio (FR) reinforcement schedules for both danger and safety cues in a multi-cue avoidance paradigm with behavioural, self-report, and physiology measures. Completion of the FR response requirements cancelled upcoming shock presentations following danger cues and had no impact on the consequences that followed safety cues. Both experiments found persistence of high response-effort avoidance across danger and safety cues and sustained (Experiment 1) and reinstated (Experiment 2) levels of fear and threat expectancy. Skin conductance responses evoked by all cues were similar across experiments. The present findings and paradigm have implications for translational research on maladaptive anxious coping and treatment development.
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Affiliation(s)
- Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
| | - Weike Xia
- School of Psychology, Swansea University, Swansea, UK
| | - Keith Lloyd
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Michael W Schlund
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Daniel V Zuj
- School of Psychology, Swansea University, Swansea, UK
- School of Psychological Sciences, University of Tasmania, Launceston, TAS, Australia
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7
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Ney LJ, Nichols DS, Lipp OV. Fear conditioning depends on the nature of the unconditional stimulus and may be related to hair levels of endocannabinoids. Psychophysiology 2023; 60:e14297. [PMID: 36959707 PMCID: PMC10909444 DOI: 10.1111/psyp.14297] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
The replicability of fear conditioning research has come under recent scrutiny, with increasing acknowledgment that the use of differing materials and methods may lead to incongruent results. Direct comparisons between the main two unconditional stimuli used in fear conditioning - an electric shock or a loud scream-are scarce, and yet these stimuli are usually used interchangeably. In the present study, we tested whether a scream, a shock, or an unpredictable combination of the two affected fear acquisition, extinction, and return of fear amongst healthy participants (N = 109, 81 female). We also collected hair samples and tested the relationship between fear conditioning and hair endocannabinoid levels. Our findings suggest that, although subjective ratings of pleasantness, arousal, and anxiety were similar regardless of the unconditional stimuli used, skin conductance responses were significantly lower for stimuli paired with the scream compared to a shock alone. Further, reducing the predictability of the unconditional stimulus reduced habituation of skin conductance responses during acquisition and reacquisition, but did not produce stronger conditioning compared to shock alone. Exploratory analyses suggested that hair endocannabinoids were associated with overall physiological arousal during fear conditioning, as well as higher return of fear to the threat cue, but not to the safety cue. These findings have multiple implications for the design and replicability of fear conditioning research and provide the first evidence for an association between hair levels of endocannabinoids and human fear conditioning.
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Affiliation(s)
- Luke J. Ney
- School of Psychology and CounsellingQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - David S. Nichols
- Central Science LaboratoryUniversity of TasmaniaHobartTasmaniaAustralia
| | - Ottmar V. Lipp
- School of Psychology and CounsellingQueensland University of TechnologyBrisbaneQueenslandAustralia
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8
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Cintado MÁ, González G, Cárcel L, De la Casa LG. Unconditioned and conditioned anxiolytic effects of Sodium Valproate on flavor neophobia and fear conditioning. PLoS One 2023; 18:e0279511. [PMID: 37418453 PMCID: PMC10328238 DOI: 10.1371/journal.pone.0279511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/16/2023] [Indexed: 07/09/2023] Open
Abstract
In three experiments with rats, we analyzed the potential anxiolytic effects of sodium valproate, an anticonvulsant drug that has shown additional pharmacodynamic effects in animal models, including anxiolytic action. Since previous results have revealed that injecting valproate before allowing animals to consume a novel flavor solution resulted in an attenuation of neophobia, we predicted a similar effect when the novel flavor is presented on a drug-free trial in the presence of a context previously associated with the drug. In line with this hypothesis, in our first experiment we observed a reduction in neophobia to a novel flavor for those animals tested in the presence of the context associated with Sodium Valproate. However, a control group that received the drug before being allowed access to the novel flavor showed a significant reduction in consumption. Experiment 2 revealed that the unconditioned effects of the drug include a deleterious effect on the animals' locomotor activity that probably interferes with drinking behavior. Finally, in a third experiment, we directly tested the potential anxiolytic properties of sodium valproate by injecting the drug before implementing a fear conditioning procedure. These findings are explained in terms of the unconditioned anxiolytic action of the drug and the formation of an association between the context and the effects of the drug that evokes a conditioned response reminiscent of such anxiolytic effect.
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Affiliation(s)
- María Ángeles Cintado
- Laboratory of Animal Behavior & Neuroscience, Dpt. Experimental Psychology, Seville University, Seville, Spain
| | | | - Lucía Cárcel
- Laboratory of Animal Behavior & Neuroscience, Dpt. Experimental Psychology, Seville University, Seville, Spain
| | - Luis Gonzalo De la Casa
- Laboratory of Animal Behavior & Neuroscience, Dpt. Experimental Psychology, Seville University, Seville, Spain
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Allen MT. Weaker situations: Uncertainty reveals individual differences in learning: Implications for PTSD. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023:10.3758/s13415-023-01077-5. [PMID: 36944865 DOI: 10.3758/s13415-023-01077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 03/23/2023]
Abstract
Few individuals who experience trauma develop posttraumatic stress disorder (PTSD). Therefore, the identification of individual differences that signal increased risk for PTSD is important. Lissek et al. (2006) proposed using a weak rather than a strong situation to identify individual differences. A weak situation involves less-salient cues as well as some degree of uncertainty, which reveal individual differences. A strong situation involves salient cues with little uncertainty, which produce consistently strong responses. Results from fear conditioning studies that support this hypothesis are discussed briefly. This review focuses on recent findings from three learning tasks: classical eyeblink conditioning, avoidance learning, and a computer-based task. These tasks are interpreted as weaker learning situations in that they involve some degree of uncertainty. Individual differences in learning based on behavioral inhibition, which is a risk factor for PTSD, are explored. Specifically, behaviorally inhibited individuals and rodents (i.e., Wistar Kyoto rats), as well as individuals expressing PTSD symptoms, exhibit enhanced eyeblink conditioning. Behaviorally inhibited rodents also demonstrate enhanced avoidance responding (i.e., lever pressing). Both enhanced eyeblink conditioning and avoidance are most evident with schedules of partial reinforcement. Behaviorally inhibited individuals also performed better on reward and punishment trials than noninhibited controls in a probabilistic category learning task. Overall, the use of weaker situations with uncertain relationships may be more ecologically valid than learning tasks in which the aversive event occurs on every trial and may provide more sensitivity for identifying individual differences in learning for those at risk for, or expressing, PTSD symptoms.
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Affiliation(s)
- M Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA.
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10
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Online counterconditioning with COVID-19-relevant stimuli in lockdown: Impact on threat expectancy, fear, and persistent avoidance. J Behav Ther Exp Psychiatry 2023; 78:101801. [PMID: 36435543 PMCID: PMC9682106 DOI: 10.1016/j.jbtep.2022.101801] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 09/12/2022] [Accepted: 10/29/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES In counterconditioning, a conditioned aversive stimulus (CS) is paired with an appetitive stimulus to reduce fear and avoidance. Findings are, however, mixed on the relative impact of counterconditioning versus standard extinction, where the CS is presented in the absence of the aversive event. This analogue treatment study investigated the impact of counterconditioning relative to standard extinction on threat expectancy, fear, and persistent avoidance with an online fear-conditioning task conducted with COVID-19-relevant appetitive stimuli during the pandemic. METHODS Following habituation, in which two CSs (male faces wearing face-coverings) were presented in the absence of the unconditioned stimulus (US; a loud female scream), participants (n = 123) underwent threat-conditioning where one stimulus (CS+) was followed by the US and another (CS-) was not. In avoidance learning, the US could be prevented by making a simple response in the presence of the CS+. Next, participants received either counterconditioning in which trial-unique positively rated images of scenes from before the COVID-19 pandemic and its associated restrictions (e.g., hugging others and holding hands) were presented with the CS + or no-counterconditioning (i.e., extinction). In the final test phase, avoidance was available, and all US deliveries were withheld. RESULTS Counterconditioning led to diminished threat expectancy and reduced avoidance relative to no-counterconditioning. Fear ratings did not differ between groups. LIMITATIONS No physiological measures were obtained. CONCLUSIONS Implemented online during the pandemic with COVID-19-relevant appetitive stimuli, counterconditioning was effective at reducing persistent avoidance and threat expectancy.
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11
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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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12
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Bauer EP. Sex differences in fear responses: Neural circuits. Neuropharmacology 2023; 222:109298. [PMID: 36328063 PMCID: PMC11267399 DOI: 10.1016/j.neuropharm.2022.109298] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
Women have increased vulnerability to PTSD and anxiety disorders compared to men. Understanding the neurobiological underpinnings of these disorders is critical for identifying risk factors and developing appropriate sex-specific interventions. Despite the clear clinical relevance of an examination of sex differences in fear responses, the vast majority of pre-clinical research on fear learning and memory formation has exclusively used male animals. This review highlights sex differences in context and cued fear conditioning, fear extinction and fear generalization with a focus on the neural circuits underlying these behaviors in rodents. There are mixed reports of behavioral sex differences in context and cued fear conditioning paradigms, which can depend upon the behavioral indices of fear. However, there is greater evidence of differential activation of the hippocampus, amygdalar nuclei and the prefrontal cortical regions in male and female rodents during context and cued fear conditioning. The bed nucleus of the stria terminalis (BNST), a sexually dimorphic structure, is of particular interest as it differentially contributes to fear responses in males and females. In addition, while the influence of the estrous cycle on different phases of fear conditioning is delineated, the clearest modulatory effect of estrogen is on fear extinction processes. Examining the variability in neural responses and behavior in both sexes should increase our understanding of how that variability contributes to the neurobiology of affective disorders. This article is part of the Special Issue on 'Fear, anxiety and PTSD'.
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Affiliation(s)
- Elizabeth P Bauer
- Departments of Biology and Neuroscience & Behavior, Barnard College of Columbia University, 3009 Broadway, New York, NY, 10027, United States.
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Schenker MT, Ince S, Ney LJ, Hsu CMK, Zuj DV, Jordan AS, Nicholas CL, Felmingham KL. Sex differences in the effect of subjective sleep on fear conditioning, extinction learning, and extinction recall in individuals with a range of PTSD symptom severity. Behav Res Ther 2022; 159:104222. [PMID: 36327524 DOI: 10.1016/j.brat.2022.104222] [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: 05/10/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
Sleep has been found to play a key role in fear conditioning, extinction learning and extinction recall, and sleep disturbances are linked to many mental disorders including post-traumatic stress disorder (PTSD). Previous studies examining associations between sleep and fear or extinction processes primarily focused on objectively measured sleep architecture. Little research has so far focused on subjective sleep measures and particularly in clinical populations, which often experience subjectively poor sleep, including PTSD. Here we investigated whether subjective sleep disturbance, sleep onset latency, wake after sleep onset or sleep efficiency were related to fear conditioning, extinction learning or extinction recall in a large sample of individuals with a range of PTSD symptom severity (n = 248). Overall, we did not find that subjective sleep was associated with fear conditioning or extinction processes. However, exploratory analyses examining the moderating effect of sex found that shorter sleep onset latency and greater sleep efficiency were associated with improved extinction recall in women with higher PTSD symptom severity. This suggests that less time falling asleep and longer time asleep while in bed may be protective in highly symptomatic women against the commonly observed impaired extinction recall in PTSD. More studies are needed to explore sex-specific effects further.
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Affiliation(s)
- Maya T Schenker
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Sevil Ince
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Luke J Ney
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia; School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Chia-Ming K Hsu
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
| | - Daniel V Zuj
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia; School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
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14
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Putica A, Felmingham KL, Garrido MI, O'Donnell ML, Van Dam NT. A predictive coding account of value-based learning in PTSD: Implications for precision treatments. Neurosci Biobehav Rev 2022; 138:104704. [PMID: 35609683 DOI: 10.1016/j.neubiorev.2022.104704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/05/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
While there are a number of recommended first-line interventions for posttraumatic stress disorder (PTSD), treatment efficacy has been less than ideal. Generally, PTSD treatment models explain symptom manifestation via associative learning, treating the individual as a passive organism - acted upon - rather than self as agent. At their core, predictive coding (PC) models introduce the fundamental role of self-conceptualisation and hierarchical processing of one's sensory context in safety learning. This theoretical article outlines how predictive coding models of emotion offer a parsimonious framework to explain PTSD treatment response within a value-based decision-making framework. Our model integrates the predictive coding elements of the perceived: self, world and self-in the world and how they impact upon one or more discrete stages of value-based decision-making: (1) mental representation; (2) emotional valuation; (3) action selection and (4) outcome valuation. We discuss treatment and research implications stemming from our hypotheses.
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Affiliation(s)
- Andrea Putica
- Phoenix Australia Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Marta I Garrido
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Meaghan L O'Donnell
- Phoenix Australia Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Nicholas T Van Dam
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
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15
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Espinosa L, Bonsall MB, Becker N, Holmes EA, Olsson A. Pavlovian threat conditioning can generate intrusive memories that persist over time. Behav Res Ther 2022; 157:104161. [DOI: 10.1016/j.brat.2022.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
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16
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Ney LJ, O'Donohue MP, Lowe BG, Lipp OV. Angry and fearful compared to happy or neutral faces as conditional stimuli in human fear conditioning: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 139:104756. [PMID: 35779627 DOI: 10.1016/j.neubiorev.2022.104756] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/03/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
Abstract
Some previous research has shown stronger acquisition and impaired extinction of fear conditioned to angry or fearful compared to happy or neutral face conditional stimuli (CS) - a difference attributed to biological 'preparedness'. A systematic review and meta-analysis of fear conditioning studies comparing face CSs of differing expressions identified thirty studies, eighteen of which were eligible for meta-analysis. Skin conductance responses were larger to angry or fearful faces compared to happy or neutral faces during habituation, acquisition and extinction. Significant differences in differential conditioning between angry, fearful, neutral, and happy face CSs were also found, but differences were more prominent between angry and neutral faces compared to angry/fearful and happy faces. This is likely due to lower arousal elicited by neutral compared to happy faces, which may be more salient as CSs. The findings suggest there are small to moderate differences in differential conditioning when angry or fearful compared to happy or neutral faces are used as CSs. These findings have implications for fear conditioning study design and the preparedness theory.
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Affiliation(s)
- Luke J Ney
- School of Psychology and Counselling, Queensland University of Technology, Australia.
| | - Matthew P O'Donohue
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Benjamin G Lowe
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Ottmar V Lipp
- School of Psychology and Counselling, Queensland University of Technology, Australia
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17
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Ney LJ, Laing PAF, Steward T, Zuj DV, Dymond S, Harrison B, Graham B, Felmingham KL. Methodological implications of sample size and extinction gradient on the robustness of fear conditioning across different analytic strategies. PLoS One 2022; 17:e0268814. [PMID: 35609058 PMCID: PMC9128987 DOI: 10.1371/journal.pone.0268814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Fear conditioning paradigms are critical to understanding anxiety-related disorders, but studies use an inconsistent array of methods to quantify the same underlying learning process. We previously demonstrated that selection of trials from different stages of experimental phases and inconsistent use of average compared to trial-by-trial analysis can deliver significantly divergent outcomes, regardless of whether the data is analysed with extinction as a single effect, as a learning process over the course of the experiment, or in relation to acquisition learning. Since small sample sizes are attributed as sources of poor replicability in psychological science, in this study we aimed to investigate if changes in sample size influences the divergences that occur when different kinds of fear conditioning analyses are used. We analysed a large data set of fear acquisition and extinction learning (N = 379), measured via skin conductance responses (SCRs), which was resampled with replacement to create a wide range of bootstrapped databases (N = 30, N = 60, N = 120, N = 180, N = 240, N = 360, N = 480, N = 600, N = 720, N = 840, N = 960, N = 1080, N = 1200, N = 1500, N = 1750, N = 2000) and tested whether use of different analyses continued to produce deviating outcomes. We found that sample size did not significantly influence the effects of inconsistent analytic strategy when no group-level effect was included but found strategy-dependent effects when group-level effects were simulated. These findings suggest that confounds incurred by inconsistent analyses remain stable in the face of sample size variation, but only under specific circumstances with overall robustness strongly hinging on the relationship between experimental design and choice of analyses. This supports the view that such variations reflect a more fundamental confound in psychological science-the measurement of a single process by multiple methods.
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Affiliation(s)
- Luke J. Ney
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia
| | - Patrick A. F. Laing
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Victoria, Australia
| | - Trevor Steward
- School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Daniel V. Zuj
- School of Psychology, Swansea University, Wales, United Kingdom
| | - Simon Dymond
- School of Psychology, Swansea University, Wales, United Kingdom
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Ben Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Victoria, Australia
| | - Bronwyn Graham
- School of Psychology, University of New South Wales, New South Wales, Australia
| | - Kim L. Felmingham
- School of Psychological Sciences, University of Melbourne, Victoria, Australia
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18
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Cameron G, Zuj DV, Dymond S, Quigley M. Remote, online assessment of avoidance learning. LEARNING AND MOTIVATION 2022. [DOI: 10.1016/j.lmot.2022.101805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Combining the trauma film and fear conditioning paradigms: A theoretical review and meta-analysis with relevance to PTSD. Behav Res Ther 2022; 152:104081. [DOI: 10.1016/j.brat.2022.104081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 01/01/2023]
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20
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Maples-Keller J, Watkins LE, Nylocks KM, Yasinski C, Coghlan C, Black K, Jovanovic T, Rauch SA, Rothbaum BO, Norrholm SD. Acquisition, extinction, and return of fear in veterans in intensive outpatient prolonged exposure therapy: A fear-potentiated startle study. Behav Res Ther 2022; 154:104124. [PMID: 35642990 DOI: 10.1016/j.brat.2022.104124] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 11/02/2022]
Abstract
Prolonged exposure (PE) therapy is a first-line treatment for posttraumatic stress disorder (PTSD) and involves repeated presentation of trauma-related cues without aversive outcomes. A primary learning mechanism of PE is fear extinction (new learning that a dangerous cue is now safe) and its retention (maintaining this new learning over time). Extant research suggests extinction is impaired in PTSD patients. In this study, we employed an established fear-potentiated startle-based paradigm to examine fear acquisition, extinction learning and retention before and after completion of intensive outpatient treatment. First, PTSD patients undergoing PE (n = 55) were compared to trauma-exposed patients without PTSD (n = 57). We identified excessive fear in PTSD patients during acquisition and extinction before treatment compared to non-PTSD patients. At post-treatment, we examined the return of fear after extinction in PTSD patients showing high or low treatment response to PE (≥50% change in PTSD symptom severity vs. < 50%). High PE responders maintained fear extinction learning whereas low PE responders showed significant return of fear at post-treatment. These results replicate and extend previous findings of impaired extinction in PTSD and provide support for the proposed theoretical link between fear extinction and PE response.
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21
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Genetic influences on central and peripheral nervous system activity during fear conditioning. Transl Psychiatry 2022; 12:95. [PMID: 35260551 PMCID: PMC8904491 DOI: 10.1038/s41398-022-01861-w] [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: 08/25/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/25/2022] Open
Abstract
Fear conditioning is an evolutionarily conserved type of learning serving as a model for the acquisition of situationally induced anxiety. Brain function supporting fear conditioning may be genetically influenced, which in part could explain genetic susceptibility for anxiety following stress exposure. Using a classical twin design and functional magnetic resonance imaging, we evaluated genetic influences (h2) on brain activity and standard autonomic measures during fear conditioning. We found an additive genetic influence on mean brain activation (h2 = 0.34) and autonomic responses (h2 = 0.24) during fear learning. The experiment also allowed estimation of the genetic influence on brain activation during safety learning (h2 = 0.55). The mean safety, but not fear, related brain activation was genetically correlated with autonomic responses. We conclude that fear and safety learning processes, both involved in anxiety development, are moderately genetically influenced as expressed both in the brain and the body.
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22
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Carpenter JK, Bragdon L, Pineles SL. Conditioned physiological reactivity and PTSD symptoms across the menstrual cycle: Anxiety sensitivity as a moderator. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2022; 14:453-461. [PMID: 35175083 PMCID: PMC8857506 DOI: 10.1037/tra0001129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is often associated with heightened physiological reactivity during fear conditioning procedures, but results vary across studies. This study examined whether anxiety sensitivity (AS), or the fear of arousal-related sensations, strengthens the relationship between PTSD symptoms and skin conductance responses (SCR) during fear conditioning and extinction. Because gonadal hormones implicated in fear learning fluctuate across the menstrual cycle, the stability of these relationships in women was examined in 2 distinct menstrual cycle phases. METHOD Thirty-two trauma-exposed women, half of whom had PTSD, completed the Clinician-Administered PTSD Scale, Anxiety Sensitivity Inventory, and a fear conditioning and extinction paradigm during the midluteal (mLP) and early-follicular (eFP) menstrual cycle phases. RESULTS In the mLP, stronger SCR to stimuli paired with shock (CS +) during fear acquisition significantly predicted greater PTSD symptoms only when AS was high and after removing an outlier. This appeared driven by effects on Numbing and Hyperarousal symptom clusters. Other hypothesized interactions between AS and CS responses were not significant. However, in the eFP, differential SCR between the CS + and CS- during extinction predicted significantly greater PTSD symptoms, and there was a trend for this effect being stronger as AS increased. CONCLUSIONS Results offer preliminary evidence that high AS contributes to a stronger relationship between SCR during fear acquisition and PTSD symptoms, at least among women in the mLP. Further research investigating the impact of individual differences in traits such as AS on the relationship between conditioned fear responses and PTSD symptoms is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Joseph K. Carpenter
- National Center for Posttraumatic Stress Disorder, Women’s Health Sciences Division,Veterans Affairs (VA) Boston Healthcare System,Boston University School of Medicine
| | - Laura Bragdon
- Veterans Affairs (VA) Boston Healthcare System,New York University School of Medicine
| | - Suzanne L. Pineles
- National Center for Posttraumatic Stress Disorder, Women’s Health Sciences Division,Veterans Affairs (VA) Boston Healthcare System,Boston University School of Medicine
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23
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Sussman TJ, Posner J, Jackowski AP, Correa A, Hoffmann EV, Porto de Oliveira Peruzzi F, Grecco FR, Nitzsche SH, Mesquita ME, Foester BU, Benatti di Cillo F, Mello MF, Coelho Milani AC. The relationship between recent PTSD secondary to sexual assault, hippocampal volume and resting state functional connectivity in adolescent girls. Neurobiol Stress 2022; 17:100441. [PMID: 35257017 PMCID: PMC8897602 DOI: 10.1016/j.ynstr.2022.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/09/2022] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Improved understanding of the time course of neural changes associated with adolescent PTSD would elucidate the development of the disorder and could inform approaches to treatment. We compared hippocampal volumes and resting state functional connectivity (RSFC) in adolescent girls with post-traumatic stress disorder (PTSD) secondary to sexual assault, within six months of onset and age- and gender-matched, non-trauma exposed healthy controls (HCs) in São Paulo, Brazil. We also examined the relationship between pre- and post-treatment PTSD symptoms and RSFC. Method We collected brain structure, RSFC, and PTSD symptoms in 30 adolescents with PTSD (mean age: 15.7 ± 1.04 years) and 21 HCs (mean age: 16.2 ± 1.21 years) at baseline. We collected repeated measures in 21 participants with PTSD following treatment; 9 participants dropped out. Hippocampal volume and RSFC from hippocampal and default mode network (DMN) seeds were compared between participants with PTSD and HCs. We examined associations between within-subject changes in RSFC and PTSD symptoms following treatment. Results No hippocampal volumetric differences between groups were found. Compared to HCs, adolescents with recent PTSD had reduced RSFC between hippocampus and the lateral parietal node of the DMN, encompassing the angular gyrus, peak coordinates: −38, −54, 16; 116 voxels; peak F1,47 = 31.76; FDR corrected p = 0.038. Improvements in PTSD symptoms were associated with increased RSFC between hippocampus and part of the lateral parietal node of the DMN, peak coordinates: −38, −84, 38; 316 voxels; peak F1,47 = 40.28; FDR corrected p < 0.001. Conclusion Adolescents with recent PTSD had reduced hippocampal-DMN RSFC, while no group differences in hippocampal volume were found, suggesting that hippocampal function, but not structure, is altered early in the course of PSTD. Following treatment, hippocampal-DMN RSFC increased with symptom improvement and may indicate an important neural mechanism related to successful PTSD treatment.
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Affiliation(s)
- Tamara J. Sussman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY, 10032, USA
- Corresponding author. 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Jonathan Posner
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY, 10032, USA
| | - Andrea Parolin Jackowski
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Adriana Correa
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Elis Viviane Hoffmann
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Fernanda Porto de Oliveira Peruzzi
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Fernando Rodrigues Grecco
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Samara Hipolito Nitzsche
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Maria Eugenia Mesquita
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Bernd Uwe Foester
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Felipe Benatti di Cillo
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Marcelo Feijo Mello
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
| | - Ana Carolina Coelho Milani
- Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil
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24
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Friesen E, Michael T, Schäfer SK, Sopp MR. COVID-19-related distress is associated with analogue PTSD symptoms after exposure to an analogue stressor. Eur J Psychotraumatol 2022; 13:2127185. [PMID: 36353527 PMCID: PMC9640168 DOI: 10.1080/20008066.2022.2127185] [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: 11/06/2022] Open
Abstract
Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.
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Affiliation(s)
- Edith Friesen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sarah K Schäfer
- Leibniz Institute for Resilience Research, Research Group Lieb, Leibniz Association, Mainz, Germany
| | - M Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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25
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Comparing three extinction methods to reduce fear expression and generalization. Behav Brain Res 2021; 420:113714. [PMID: 34906608 DOI: 10.1016/j.bbr.2021.113714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 01/19/2023]
Abstract
Fear extinction is easy to achieve but difficult to maintain, as evidenced by the relapse of fear after extinction. Counterconditioning and novelty-facilitated extinction have been shown to interfere with fear expression without erasing it. Because of the similarity between the two extinction paradigms, we extended the standard extinction, which merely omitted the expected threat outcomes after exposure to original threat cues. The modified paradigm provided a stimulus (neutral picture or positive picture) to replace the omitted threat outcomes during extinction. Sixty-four healthy volunteers were randomized into three groups for a three-day procedure: fear acquisition (day 1), fear extinction (day 2), and fear recall and generalization test (day 3). Our results showed the modified extinction paradigm failed to prevent fear expression in spontaneous recovery and reinstatement tests. However, novelty-facilitated extinction showed powerful effects in preventing fear generalization. Besides, there was a negative correlation between spontaneous recovery index and emotion regulation scores. We speculated that emotion and prediction error may be important factors influencing fear extinction and affect fear recall and generalization. Overall, this study suggests that novelty-facilitated extinction had a superior effect in preventing fear generalization, providing new perspectives for enhancing the effect of exposure therapy.
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26
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Ney LJ, Crombie KM, Mayo LM, Felmingham KL, Bowser T, Matthews A. Translation of animal endocannabinoid models of PTSD mechanisms to humans: Where to next? Neurosci Biobehav Rev 2021; 132:76-91. [PMID: 34838529 DOI: 10.1016/j.neubiorev.2021.11.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
The endocannabinoid system is known to be involved in mechanisms relevant to PTSD aetiology and maintenance, though this understanding is mostly based on animal models of the disorder. Here we review how human paradigms can successfully translate animal findings to human subjects, with the view that substantially increased insight into the effect of endocannabinoid signalling on stress responding, emotional and intrusive memories, and fear extinction can be gained using modern paradigms and methods for assessing the state of the endocannabinoid system in PTSD.
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Affiliation(s)
- Luke J Ney
- School of Psychological Sciences, University of Tasmania, Australia; School of Psychology and Counselling, Queensland University of Technology, Australia.
| | - Kevin M Crombie
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, United States
| | - Leah M Mayo
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Science, Linköping University, Sweden
| | - Kim L Felmingham
- Department of Psychological Sciences, University of Melbourne, Australia
| | | | - Allison Matthews
- School of Psychological Sciences, University of Tasmania, Australia
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27
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Ney LJ, Matthews A, Hsu CMK, Zuj DV, Nicholson E, Steward T, Nichols D, Graham B, Harrison B, Bruno R, Felmingham K. Cannabinoid polymorphisms interact with plasma endocannabinoid levels to predict fear extinction learning. Depress Anxiety 2021; 38:1087-1099. [PMID: 34151472 DOI: 10.1002/da.23170] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The endocannabinoid system is gaining increasing attention as a favorable target for improving posttraumatic stress disorder (PTSD) treatments. Exposure therapy is the gold-standard treatment for PTSD, and fear extinction learning is a key concept underlying successful exposure. METHODS This study examined the role of genetic endocannabinoid polymorphisms in a fear extinction paradigm with PTSD compared to healthy participants (N = 220). Participants provided saliva for genotyping, completed a fear conditioning and extinction task, with blood samples taken before and after the task (n = 57). Skin conductance was the outcome and was analyzed using mixed models. RESULTS Results for cannabinoid receptor type 1 polymorphisms suggested that minor alleles of rs2180619 and rs1049353 were associated with poorer extinction learning in PTSD participants. The minor allele of the fatty acid amide hydrolase (FAAH) polymorphism rs324420 was associated with worse extinction in PTSD participants. Subanalysis of healthy participants (n = 57) showed the FAAH rs324420 genotype effect was dependent on plasma arachidonoyl ethanolamide (AEA) level, but not oleoylethanolamide or 2-arachidonoyl glycerol. Specifically, higher but not lower AEA levels in conjunction with the minor allele of FAAH rs324420 were associated with better extinction learning. CONCLUSIONS These findings provide translational evidence that cannabinoid receptor 1 and AEA are involved in extinction learning in humans. FAAH rs324420's effect on fear extinction is moderated by AEA plasma level in healthy controls. These findings imply that FAAH inhibitors may be effective for targeting anxiety in PTSD, but this effect needs to be explored further in clinical populations.
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Affiliation(s)
- Luke J Ney
- School of Psychology, University of Tasmania, Hobart, Australia
| | | | | | - Daniel V Zuj
- Department of Psychology, Swansea University, Wales, United Kingdom
| | - Emma Nicholson
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Trevor Steward
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - David Nichols
- Central Science Laboratory, University of Tasmania, Hobart, Australia
| | - Bronwyn Graham
- School of Psychology, The University of New South Wales, Kensington, Australia
| | - Ben Harrison
- Department of Psychiatry, Melbourne Neuropsychiatry Center, University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, Australia
| | - Kim Felmingham
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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28
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Berg H, Hunt C, Cooper SE, Olatunji BO, Lissek S. Generalization of conditioned disgust and the attendant maladaptive avoidance: Validation of a novel paradigm and effects of trait disgust-proneness. Behav Res Ther 2021; 146:103966. [PMID: 34560412 DOI: 10.1016/j.brat.2021.103966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 11/28/2022]
Abstract
Overgeneralization of conditioned fear to safe stimuli that resemble a previously-learned threat-cue is a well-studied correlate of clinical anxiety, yet whether conditioned disgust generalizes remains unknown, as does the extent to which such generalization is associated with disgust-related traits and maladaptive outcomes. The present study addresses this gap by adapting a validated fear-generalization paradigm to assess conditioned disgust and behavioral avoidance to a disgust-cue (CS+) paired with a disgusting video clip, and safe generalization stimuli parametrically varying in perceptual similarity to CS+. For comparison, levels of fear generalization were also assessed using the original fear-generalization paradigm. In both paradigms, costly and unnecessary avoidance to safe threat-cue approximations analogues maladaptive outcomes of generalization. In the disgust paradigm only, disgust-proneness was associated with elevated perceived risk to safe stimuli and increases in the extent to which such elevations were accompanied by maladaptive avoidance. Comparable levels of generalization, and positive associations between generalization and maladaptive avoidance, were found across disgust and fear paradigms. Results confirm that conditioned disgust is subject to generalization, implicate generalized disgust as a source of maladaptive avoidance particularly among those prone to disgust, and suggest a potential role for these processes in the etiology and maintenance of disgust-related disorders.
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Affiliation(s)
- Hannah Berg
- Department of Psychology, University of Minnesota - Twin Cities, 75 E River Rd, Minneapolis, MN, 55455, USA.
| | - Christopher Hunt
- Department of Psychology, University of Minnesota - Twin Cities, 75 E River Rd, Minneapolis, MN, 55455, USA.
| | - Samuel E Cooper
- Department of Psychology, University of Minnesota - Twin Cities, 75 E River Rd, Minneapolis, MN, 55455, USA.
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, PMB 407817, 2301 Vanderbilt Place, Nashville, TN, 37240, USA.
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota - Twin Cities, 75 E River Rd, Minneapolis, MN, 55455, USA.
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Hsu CMK, Ney LJ, Honan C, Felmingham KL. Gonadal steroid hormones and emotional memory consolidation: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 130:529-542. [PMID: 34517034 DOI: 10.1016/j.neubiorev.2021.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Anxiety and stress-related disorders are more prevalent in women and associated with negative emotional memory consolidation as well as impaired fear extinction recall. Recent research has identified a role of gonadal steroid hormones in influencing emotional memories and fear extinction, however most individual studies have small samples and employed various protocols. A systematic review and meta-analysis were conducted on studies that examined sex hormones (estrogen, progesterone, testosterone, allopregnanolone, dehydroepiandrosterone) on four aspects of memory, namely, intentional recall (k = 13), recognition memory (k = 7), intrusive memories (k = 9), and extinction recall (k = 11). The meta-analysis on natural cycling women revealed that progesterone level was positively associated with negative recall and negative intrusive memories, and this effect on intentional recall was enhanced under stress induction. Estradiol level was positively associated with extinction recall. This study reveals an important role of progesterone and estradiol in influencing emotional memory consolidation. It highlights the need to control for these hormonal effects and examine progesterone and estradiol concurrently across all menstrual phases in future emotional memory paradigms.
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Affiliation(s)
- Chia-Ming K Hsu
- School of Psychological Sciences, University of Tasmania, Australia.
| | - Luke J Ney
- School of Psychological Sciences, University of Tasmania, Australia
| | - Cynthia Honan
- School of Psychological Sciences, University of Tasmania, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
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Ney LJ, Matthews A, Nicholson E, Zuj D, Ken Hsu CM, Steward T, Graham B, Harrison B, Nichols D, Felmingham K. BDNF genotype Val66Met interacts with acute plasma BDNF levels to predict fear extinction and recall. Behav Res Ther 2021; 145:103942. [PMID: 34340176 DOI: 10.1016/j.brat.2021.103942] [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: 02/20/2021] [Revised: 06/17/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023]
Abstract
Brain-derived neurotropic factor (BDNF) is a potent regulator of memory processes and is believed to influence the consolidation of fear extinction memories. No previous human study has tested the effect of unstimulated BDNF on fear extinction recall, and no study has tested the association between plasma BDNF levels and psychophysiological responding during an extinction paradigm. We tested the association between fear responses during a 2-day differential conditioning, extinction and extinction recall paradigm and Val66Met genotype in a group of healthy participants (N = 191). There were no group differences during habituation or acquisition. Met allele carriers compared to Val homozygotes displayed higher responses to the CS + compared to the CS- during extinction learning and had higher responding to both the CS+ and CS- during extinction recall. Plasma levels of BDNF protein that were collected in a sub-sample of the group (n = 56) moderated the effect of Met allele presence, such that lower BDNF level was associated with higher skin conductance response in the Met but not Val group to the CS+ during extinction learning and to both the CS+ and CS- during extinction recall. The current results extend previous observations of a Val66Met effect during fear extinction learning to extinction recall and show for the first time that these effects are moderated by plasma BDNF level.
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Affiliation(s)
- Luke John Ney
- School of Psychological Sciences, University of Tasmania, Australia.
| | - Allison Matthews
- School of Psychological Sciences, University of Tasmania, Australia
| | - Emma Nicholson
- School of Psychological Sciences, University of Melbourne, Australia
| | - Daniel Zuj
- Department of Psychology, Swansea University, United Kingdom
| | | | - Trevor Steward
- School of Psychological Sciences, University of Melbourne, Australia
| | - Bronwyn Graham
- School of Psychology, University of New South Wales, Australia
| | - Ben Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Australia
| | - David Nichols
- Central Science Laboratory, University of Tasmania, Australia
| | - Kim Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
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Morriss J, Zuj DV, Mertens G. The role of intolerance of uncertainty in classical threat conditioning: Recent developments and directions for future research. Int J Psychophysiol 2021; 166:116-126. [PMID: 34097936 DOI: 10.1016/j.ijpsycho.2021.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 11/25/2022]
Abstract
Intolerance of uncertainty (IU), the tendency to find uncertainty aversive, is an important transdiagnostic dimension in mental health disorders. Over the last decade, there has been a surge of research on the role of IU in classical threat conditioning procedures, which serve as analogues to the development, treatment, and relapse of anxiety, obsessive-compulsive, and trauma- and stressor-related disorders. This review provides an overview of the existing literature on IU in classical threat conditioning procedures. The review integrates findings based on the shared or discrete parameters of uncertainty embedded within classical threat conditioning procedures. Under periods of unexpected uncertainty, where threat and safety contingencies change, high IU, over other self-reported measures of anxiety, is specifically associated with poorer threat extinction learning and retention, as well as overgeneralisation. Under periods of estimation and expected uncertainty, where the parameters of uncertainty are being learned or have been learned, such as threat acquisition training and avoidance learning, the findings are mixed for IU. These findings provide evidence that individual differences in IU play a significant role in maintaining learned fear and anxiety, particularly under volatile environments. Recommendations for future research are outlined, with discussion focusing on how parameters of uncertainty can be better defined to capture how IU is involved in the maintenance of learned fear and anxiety. Such work will be crucial for understanding the role of IU in neurobiological models of uncertainty-based maintenance of fear and anxiety and inform translational work aiming to improve the diagnosis and treatment of relevant psychopathology.
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Affiliation(s)
- Jayne Morriss
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Daniel V Zuj
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Swansea, UK
| | - Gaëtan Mertens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
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Sleep and fear conditioning, extinction learning and extinction recall: A systematic review and meta-analysis of polysomnographic findings. Sleep Med Rev 2021; 59:101501. [PMID: 34090064 DOI: 10.1016/j.smrv.2021.101501] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/30/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022]
Abstract
Sleep may contribute to the long-lasting consolidation and processing of emotional memories. Experimental fear conditioning and extinction paradigms model the development, maintenance, and treatment of anxiety disorders. The literature provides compelling evidence for the involvement of rapid eye movement (REM) sleep in the consolidation of such memories. This meta-analysis correlated polysomnographic sleep findings with psychophysiological reactivity to the danger (CS+) and safety stimuli (CS-), to clarify the specific role of sleep stages before and after fear conditioning, extinction learning and extinction recall. Overall, there was evidence that more pre-learning sleep stage two and less slow wave sleep was associated with higher psychophysiological reactivity to the safety stimulus during extinction learning. Preliminary evidence found here support the role of REM sleep during the post-extinction consolidation sleep phase in clinical populations with disrupted sleep, but not in healthy controls. Furthermore, the meta-regressions found that sex moderated the associations between sleep and psychophysiological reactivity throughout the paradigm providing evidence for diverging correlations in male and females. Specifically, increased post-extinction REM was associated with poorer extinction and safety recall in females while the opposite was found in males. These results have implications for future research in the role of sleep in emotional memory processing.
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Aarts I, Vriend C, Snoek A, van den End A, Blankers M, Beekman ATF, Dekker J, van den Heuvel OA, Thomaes K. Neural correlates of treatment effect and prediction of treatment outcome in patients with PTSD and comorbid personality disorder: study design. Borderline Personal Disord Emot Dysregul 2021; 8:13. [PMID: 33947471 PMCID: PMC8097786 DOI: 10.1186/s40479-021-00156-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/09/2021] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Neural alterations related to treatment outcome in patients with both post-traumatic stress disorder (PTSD) and comorbid personality disorder are unknown. Here we describe the protocol for a neuroimaging study of treatment of patients with PTSD and comorbid borderline (BPD) or cluster C (CPD) personality disorder traits. Our specific aims are to 1) investigate treatment-induced neural alterations, 2) predict treatment outcome using structural and functional magnetic resonance imaging (MRI) and 3) study neural alterations associated with BPD and CPD in PTSD patients. We hypothesize that 1) all treatment conditions are associated with normalization of limbic and prefrontal brain activity and hyperconnectivity in resting-state brain networks, with additional normalization of task-related activation in emotion regulation brain areas in the patients who receive trauma-focused therapy and personality disorder treatment; 2) Baseline task-related activation, together with structural brain measures and clinical variables predict treatment outcome; 3) dysfunction in task-related activation and resting-state connectivity of emotion regulation areas is comparable in PTSD patients with BPD or CPD, with a hypoconnected central executive network in patients with PTSD+BPD. METHODS We aim to include pre- and post-treatment 3 T-MRI scans in 40 patients with PTSD and (sub) clinical comorbid BPD or CPD. With an expected attrition rate of 50%, at least 80 patients will be scanned before treatment. MRI scans for 30 matched healthy controls will additionally be acquired. Patients with PTSD and BPD were randomized to either EMDR-only or EMDR combined with Dialectical Behaviour Therapy. Patients with PTSD and CPD were randomized to Imaginary Rescripting (ImRs) or to ImRs combined with Schema Focused Therapy. The scan protocol consists of a T1-weighted structural scan, resting state fMRI, task-based fMRI during an emotional face task and multi-shell diffusion weighted images. For data analysis, multivariate mixed-models, regression analyses and machine learning models will be used. DISCUSSION This study is one of the first to use neuroimaging measures to predict and better understand treatment response in patients with PTSD and comorbid personality disorders. A heterogeneous, naturalistic sample will be included, ensuring generalizability to a broad group of treatment seeking PTSD patients. TRIAL REGISTRATION Clinical Trials, NCT03833453 & NCT03833531 . Retrospectively registered, February 2019.
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Affiliation(s)
- Inga Aarts
- Sinai Centrum, Amstelveen, The Netherlands.
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands.
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands.
| | - Chris Vriend
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Aishah Snoek
- Sinai Centrum, Amstelveen, The Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Arne van den End
- Sinai Centrum, Amstelveen, The Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Matthijs Blankers
- Arkin Research, Amsterdam, the Netherlands
- Trimbos Institute, Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
- GGZinGeest, Department of Psychiatry, Amsterdam, The Netherlands
| | - Jack Dekker
- Arkin Research, Amsterdam, the Netherlands
- VU University, Faculty of Behavioural and Movement Sciences, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Kathleen Thomaes
- Sinai Centrum, Amstelveen, The Netherlands
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
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Engel S, Schumacher S, Niemeyer H, Kuester A, Burchert S, Klusmann H, Rau H, Willmund GD, Knaevelsrud C. Associations between oxytocin and vasopressin concentrations, traumatic event exposure and posttraumatic stress disorder symptoms: group comparisons, correlations, and courses during an internet-based cognitive-behavioural treatment. Eur J Psychotraumatol 2021; 12:1886499. [PMID: 33968321 PMCID: PMC8078934 DOI: 10.1080/20008198.2021.1886499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is characterized by impairments in extinction learning and social behaviour, which are targeted by trauma-focused cognitive behavioural treatment (TF-CBT). The biological underpinnings of TF-CBT can be better understood by adding biomarkers to the clinical evaluation of interventions. Due to their involvement in social functioning and fear processing, oxytocin and arginine vasopressin might be informative biomarkers for TF-CBT, but to date, this has never been tested. Objective: To differentiate the impact of traumatic event exposure and PTSD symptoms on blood oxytocin and vasopressin concentrations. Further, to describe courses of PTSD symptoms, oxytocin and vasopressin during an internet-based TF-CBT and explore interactions between these parameters. Method: We compared oxytocin and vasopressin between three groups of active and former male service members of the German Armed Forces (n = 100): PTSD patients (n = 39), deployed healthy controls who experienced a deployment-related traumatic event (n = 33) and non-deployed healthy controls who never experienced a traumatic event (n = 28). PTSD patients underwent a 5-week internet-based TF-CBT. We correlated PTSD symptoms with oxytocin and vasopressin before treatment onset. Further, we analysed courses of PTSD symptoms, oxytocin and vasopressin from pre- to post-treatment and 3 months follow-up, as well as interactions between the three parameters. Results: Oxytocin and vasopressin did not differ between the groups and were unrelated to PTSD symptoms. PTSD symptoms were highly stable over time, whereas the endocrine parameters were not, and they also did not change in mean. Oxytocin and vasopressin were not associated with PTSD symptoms longitudinally. Conclusions: Mainly due to their insufficient intraindividual stability, single measurements of endogenous oxytocin and vasopressin concentrations are not informative biomarkers for TF-CBT. We discuss how the stability of these biomarkers might be increased and how they could be better related to the specific impairments targeted by TF-CBT.
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Affiliation(s)
- Sinha Engel
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Helen Niemeyer
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Annika Kuester
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Sebastian Burchert
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Hannah Klusmann
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Heinrich Rau
- Department for Military Mental Health, German Armed Forces, Military Hospital Berlin, Berlin, Germany
| | - Gerd-Dieter Willmund
- Department for Military Mental Health, German Armed Forces, Military Hospital Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
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Ney LJ, Akhurst J, Bruno R, Laing PAF, Matthews A, Felmingham KL. Dopamine, endocannabinoids and their interaction in fear extinction and negative affect in PTSD. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110118. [PMID: 32991952 DOI: 10.1016/j.pnpbp.2020.110118] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/03/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022]
Abstract
There currently exist few frameworks for common neurobiology between reexperiencing and negative cognitions and mood symptoms of PTSD. Adopting a dopaminergic framework for PTSD unites many aspects of unique symptom clusters, and this approach also links PTSD symptomology to common comorbidities with a common neurobiological deficiency. Here we review the dopamine literature and incorporate it with a growing field of research that describes both the contribution of endocannabinoids to fear extinction and PTSD, as well as the interactions between dopaminergic and endocannabinoid systems underlying this disorder. Based on current evidence, we outline an early, preliminary model that links re-experiencing and negative cognitions and mood in PTSD by invoking the interaction between endocannabinoid and dopaminergic signalling in the brain. These interactions between PTSD, dopamine and endocannabinoids may have implications for future therapies for treatment-resistant and comorbid PTSD patients.
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Affiliation(s)
- Luke J Ney
- School of Psychology, University of Tasmania, Australia.
| | - Jane Akhurst
- School of Psychology, University of Tasmania, Australia
| | | | - Patrick A F Laing
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Australia
| | | | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
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Van Schuerbeek A, Vanderhasselt MA, Baeken C, Pierre A, Smolders I, Van Waes V, De Bundel D. Effects of repeated anodal transcranial direct current stimulation on auditory fear extinction in C57BL/6J mice. Brain Stimul 2021; 14:250-260. [PMID: 33454396 DOI: 10.1016/j.brs.2021.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Trauma-based psychotherapy is a first line treatment for post-traumatic stress disorder (PTSD) but not all patients achieve long-term remission. Transcranial direct current stimulation (tDCS) received considerable attention as a neuromodulation method that may improve trauma-based psychotherapy. OBJECTIVE We explored the effects of repeated anodal tDCS over the prefrontal cortex (PFC) on fear extinction in mice as a preclinical model for trauma-based psychotherapy. METHODS We performed auditory fear conditioning with moderate or high shock intensity on C57BL6/J mice. Next, mice received anodal tDCS (0.2 mA, 20 min) or sham stimulation over the PFC twice daily for five consecutive days. Extinction training was performed by repeatedly exposing mice to the auditory cue the day after the last stimulation session. Early and late retention of extinction were evaluated one day and three weeks after extinction training respectively. RESULTS We observed no significant effect of tDCS on the acquisition or retention of fear extinction in mice subjected to fear conditioning with moderate intensity. However, when the intensity of fear conditioning was high, tDCS significantly lowered freezing during the acquisition of extinction, regardless of the extinction protocol. Moreover, when tDCS was combined with a strong extinction protocol, we also observed a significant improvement of early extinction recall. Finally, we found that tDCS reduced generalized fear induced by contextual cues when the intensity of conditioning is high and extinction training limited. CONCLUSIONS Our data provide a rationale to further explore anodal tDCS over the PFC as potential support for trauma-based psychotherapy for PTSD.
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Affiliation(s)
- Andries Van Schuerbeek
- Department of Pharmaceutical Sciences, Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Marie-Anne Vanderhasselt
- Department of Experimental Clinical and Health Psychology, Universiteit Gent - C, Heymanslaan 10, 9000, Gent, Belgium.
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Universiteit Gent - C, Heymanslaan 10, 9000, Gent, Belgium; Department of Psychiatry, UZBrussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Anouk Pierre
- Department of Pharmaceutical Sciences, Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Ilse Smolders
- Department of Pharmaceutical Sciences, Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Vincent Van Waes
- Laboratory of Clinical and Integrative Neuroscience, EA481, Université Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25030, Besancon, Cedex, France.
| | - Dimitri De Bundel
- Department of Pharmaceutical Sciences, Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
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Auditory fear conditioning alters neural gain in the cochlear nucleus: a wireless neural recording study in freely behaving rats. Neuronal Signal 2020; 4:NS20200009. [PMID: 33274069 PMCID: PMC7681204 DOI: 10.1042/ns20200009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/17/2022] Open
Abstract
Anxiety disorders involve distorted perception of the world including increased saliency of stress-associated cues. However, plasticity in the initial sensory regions of the brain following a fearful experience has never been examined. The cochlear nucleus (CN) is the first station in the central auditory system, with heterogeneous collections of neurons that not only project to but also receive projections from cortico-limbic regions, suggesting a potential for experience-dependent plasticity. Using wireless neural recordings in freely behaving rats, we demonstrate for the first time that neural gain in the CN is significantly altered by fear conditioning to auditory sequences. Specifically, the ventral subnuclei significantly increased firing rate to the conditioned tone sequence, while the dorsal subnuclei significantly decreased firing rate during the conditioning session overall. These findings suggest subregion-specific changes in the balance of inhibition and excitation in the CN as a result of conditioning experience. Heart rate was measured as the conditioned response (CR), which showed that while pre-conditioned stimulus (CS) responding did not change across baseline and conditioning sessions, significant changes in heart rate were observed to the tone sequence followed by shock. Heart-rate findings support acquisition of conditioned fear. Taken together, the present study presents first evidence for potential experience-dependent changes in auditory perception that involve novel plasticity within the first site of processing auditory information in the brain.
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Ney LJ, Vicario CM, Nitsche MA, Felmingham KL. Timing matters: Transcranial direct current stimulation after extinction learning impairs subsequent fear extinction retention. Neurobiol Learn Mem 2020; 177:107356. [PMID: 33278591 DOI: 10.1016/j.nlm.2020.107356] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/01/2020] [Accepted: 11/29/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has previously been shown to improve fear extinction learning and retention when administered prior to or during extinction learning. This study investigates whether tDCS immediately following extinction learning improves efficacy of extinction memory retention. METHODS 30 participants completed a 2-day fear learning and extinction paradigm, where they acquired fear of a stimulus conditioned to an aversive electric shock on day 1. Extinction learning occurred on day 1, with tDCS or sham tDCS administered immediately following the learning phase. Participants returned for a second day test of extinction memory recall. Skin conductance was measured as the primary outcome. RESULTS/CONCLUSIONS Participants in the tDCS group showed impaired fear extinction retention on day 2, marked by significant generalisation of fear to the safety stimulus. This contrasts with earlier studies showing improved extinction retention when stimulation occurred during encoding of extinction learning, compared to immediate consolidation as in our study. These findings may have important implications for the use of tDCS during exposure therapy for anxiety and trauma disorders.
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Affiliation(s)
- Luke J Ney
- School of Psychology, University of Tasmania, Australia.
| | - Carmelo M Vicario
- University of Messina, Department of Scienze Cognitive Della Formazione e Degli Studi Culturali, Messina, Italy.
| | - Michael A Nitsche
- Deptartment of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
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Jovanovic T, Stenson AF, Thompson N, Clifford A, Compton A, Minton S, van Rooij SJF, Stevens JS, Lori A, Nugent N, Gillespie CF, Bradley B, Ressler KJ. Impact of ADCYAP1R1 genotype on longitudinal fear conditioning in children: interaction with trauma and sex. Neuropsychopharmacology 2020; 45:1603-1608. [PMID: 32590837 PMCID: PMC7421882 DOI: 10.1038/s41386-020-0748-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
Dysregulated fear conditioned responses have been associated with PTSD in adults, with increased fear-potentiated startle (FPS) serving as a potential intermediate phenotype for PTSD risk. This phenotype has also been associated with stress-related ADCYAP1R1 gene variants in adult women. However, FPS and genotype have not yet been examined during development. The aim of this study was to examine developmental changes in fear conditioning, and to see whether these changes were impacted by genotype and trauma. Differential fear conditioning using FPS was tested in n = 63 children ages 8-13 at two visits (V1, V2) 1 year apart. Startle response was measured using electromyograph recordings of the eyeblink muscle. The rs2267735 SNP of the ADCYAP1R1 gene was extracted from genome-wide (GWAS) analyses. Trauma exposure was assessed using the Violence Exposure Scale-Revised (VEX-R). We found significant Visit by Genotype interactions, with CC genotype increasing FPS from V1 to V2. At V2 there was a Genotype by Violence interaction, with higher FPS in the CC vs G allele groups among those with higher violence exposure (F = 17.46, p = 0.0002). Females with the CC genotype had higher FPS compared to G allele females (F = 12.09, p = 0.002); there were no effects of genotype in males. This study showed Gene × Environment × Development and Gene × Sex effects of ADCYAP1R1 in a high-risk pediatric population. Those with the CC genotype and high levels of violence exposure, as well as females with the CC genotype, showed the greatest conditioned fear responses in adolescence.
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Affiliation(s)
- Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
| | - Anaïs F. Stenson
- grid.254444.70000 0001 1456 7807Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI USA
| | - Nadia Thompson
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Aimee Clifford
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Alisha Compton
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Sean Minton
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Sanne J. F. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Adriana Lori
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Nicole Nugent
- grid.40263.330000 0004 1936 9094Departments of Psychiatry and Pediatrics Brown Medical School, Providence, RI USA
| | - Charles F. Gillespie
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Bekh Bradley
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA ,grid.414026.50000 0004 0419 4084Atlanta VA Medical Center, Decatur, GA 30033 USA
| | - Kerry J. Ressler
- grid.38142.3c000000041936754XMcLean Hospital, Harvard Medical School, Belmont, MA 02478 USA
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40
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Zuj DV, Xia W, Lloyd K, Vervliet B, Dymond S. Negative reinforcement rate and persistent avoidance following response-prevention extinction. Behav Res Ther 2020; 133:103711. [PMID: 32829190 DOI: 10.1016/j.brat.2020.103711] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/18/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
Persistent avoidance may be influenced by prior negative reinforcement rate (i.e., how effective the response is at controlling threat). In clinical settings, the effectiveness of extinction-based methods for treating anxiety-related avoidance may be impacted by prior reinforcement rate. Here, we conducted a laboratory-based treatment study to investigate the persistence of avoidance following response-prevention extinction (RPE) when prior avoidance had been differentially effective at cancelling shock. Participants in three negative reinforcement rate groups (100%, 50%, and 0%) completed a validated avoidance conditioning paradigm involving Pavlovian fear extinction, RPE, and re-extinction phases. It was hypothesised that partially reinforced avoidance would lead to diminished resistance to fear extinction following response prevention, compared to continuously- or never-reinforced avoidance. Persistent avoidance was related to prior negative reinforcement rate, with higher rates more resistant to extinction. These findings illustrate the role of reinforcement rate in the persistence of avoidance and may aid understanding of treatment relapse.
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Affiliation(s)
- Daniel V Zuj
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, United Kingdom
| | - Weike Xia
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, United Kingdom
| | - Keith Lloyd
- Swansea University Medical School, Swansea University, Singleton Campus, Swansea, SA2 8PP, United Kingdom
| | - Bram Vervliet
- Laboratory of Biological Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium
| | - Simon Dymond
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, United Kingdom; Department of Psychology, Reykjavík University, Menntavegur 1, KU Leuven, 101, Reykjavík, Iceland.
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41
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Ney LJ, Laing PA, Steward T, Zuj DV, Dymond S, Felmingham KL. Inconsistent analytic strategies reduce robustness in fear extinction via skin conductance response. Psychophysiology 2020; 57:e13650. [DOI: 10.1111/psyp.13650] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Luke John Ney
- School of Psychology University of Tasmania Hobart TAS Australia
| | - Patrick A.F. Laing
- Melbourne Neuropsychiatry Centre Department of Psychiatry University of Melbourne & Melbourne Health Carlton VIC Australia
| | - Trevor Steward
- School of Psychological Sciences University of Melbourne Carlton VIC Australia
| | - Daniel V. Zuj
- Department of Psychology Swansea University Swansea UK
| | - Simon Dymond
- Department of Psychology Swansea University Swansea UK
- Department of Psychology Reykjavik University Reykjavik Iceland
| | - Kim L. Felmingham
- School of Psychological Sciences University of Melbourne Carlton VIC Australia
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42
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Park CHJ, Ganella DE, Perry CJ, Kim JH. Dissociated roles of dorsal and ventral hippocampus in recall and extinction of conditioned fear in male and female juvenile rats. Exp Neurol 2020; 329:113306. [DOI: 10.1016/j.expneurol.2020.113306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/15/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022]
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43
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Suarez-Jimenez B, Albajes-Eizagirre A, Lazarov A, Zhu X, Harrison BJ, Radua J, Neria Y, Fullana MA. Neural signatures of conditioning, extinction learning, and extinction recall in posttraumatic stress disorder: a meta-analysis of functional magnetic resonance imaging studies. Psychol Med 2020; 50:1442-1451. [PMID: 31258096 PMCID: PMC9624122 DOI: 10.1017/s0033291719001387] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Establishing neurobiological markers of posttraumatic stress disorder (PTSD) is essential to aid in diagnosis and treatment development. Fear processing deficits are central to PTSD, and their neural signatures may be used as such markers. METHODS Here, we conducted a meta-analysis of seven Pavlovian fear conditioning fMRI studies comparing 156 patients with PTSD and 148 trauma-exposed healthy controls (TEHC) using seed-based d-mapping, to contrast neural correlates of experimental phases, namely conditioning, extinction learning, and extinction recall. RESULTS Patients with PTSD, as compared to TEHCs, exhibited increased activation in the anterior hippocampus (extending to the amygdala) and medial prefrontal cortex during conditioning; in the anterior hippocampus-amygdala regions during extinction learning; and in the anterior hippocampus-amygdala and medial prefrontal areas during extinction recall. Yet, patients with PTSD have shown an overall decreased activation in the thalamus during all phases in this meta-analysis. CONCLUSION Findings from this metanalysis suggest that PTSD is characterized by increased activation in areas related to salience and threat, and lower activation in the thalamus, a key relay hub between subcortical areas. If replicated, these fear network alterations may serve as objective diagnostic markers for PTSD, and potential targets for novel treatment development, including pharmacological and brain stimulation interventions. Future longitudinal studies are needed to examine whether these observed network alteration in PTSD are the cause or the consequence of PTSD.
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Affiliation(s)
- Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | | | - Amit Lazarov
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Ben J. Harrison
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - Joaquim Radua
- FIDMAG Germanes Hospitalàries, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Institute of Psychiatry, King’s College London, De Crespigny Park, London, UK
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Miquel A. Fullana
- FIDMAG Germanes Hospitalàries, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain
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44
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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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45
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Woon EP, Seibert TA, Urbanczyk PJ, Ng KH, Sangha S. Differential effects of prior stress on conditioned inhibition of fear and fear extinction. Behav Brain Res 2019; 381:112414. [PMID: 31891742 DOI: 10.1016/j.bbr.2019.112414] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/14/2019] [Accepted: 12/02/2019] [Indexed: 01/22/2023]
Abstract
Resistant and generalized fear are hallmark symptoms of Post-Traumatic Stress Disorder (PTSD). Given PTSD is highly comorbid with addiction disorders indicates a maladaptive interaction between fear and reward circuits. To investigate learning processes underlying fear, reward and safety, we trained male rats to discriminate among a fear cue paired with footshock, a reward cue paired with sucrose and an explicit safety cue co-occurring with the fear cue in which no footshocks were delivered. In an attempt to emulate aspects of PTSD, we pre-exposed male rats to a stressor (15 unsignaled footshocks) before training them to fear, reward and safety cues, and subsequent fear and reward extinction. Prior stress did not produce any significant impairments on conditioned inhibition to a safety cue compared to non-stressed controls. However, in subsequent fear extinction, prior stress profoundly impaired fear reduction to an extinguished fear cue. Prior stress also significantly reduced reward seeking to a reward-associated cue throughout training. Together, our data show that prior stress did not affect conditioned inhibition of fear to the same extent as impairing fear extinction. These results have interesting implications on how safety circuits are organized and impacted by stress, leading to possibly new avenues of research on mechanisms of stress disorders, such as PTSD.
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Affiliation(s)
| | | | | | - Ka H Ng
- Department of Psychological Sciences, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA
| | - Susan Sangha
- Department of Psychological Sciences, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA.
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46
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Haaker J, Maren S, Andreatta M, Merz CJ, Richter J, Richter SH, Meir Drexler S, Lange MD, Jüngling K, Nees F, Seidenbecher T, Fullana MA, Wotjak CT, Lonsdorf TB. Making translation work: Harmonizing cross-species methodology in the behavioural neuroscience of Pavlovian fear conditioning. Neurosci Biobehav Rev 2019; 107:329-345. [PMID: 31521698 PMCID: PMC7822629 DOI: 10.1016/j.neubiorev.2019.09.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/08/2019] [Accepted: 09/11/2019] [Indexed: 12/22/2022]
Abstract
Translational neuroscience bridges insights from specific mechanisms in rodents to complex functions in humans and is key to advance our general understanding of central nervous function. A prime example of translational research is the study of cross-species mechanisms that underlie responding to learned threats, by employing Pavlovian fear conditioning protocols in rodents and humans. Hitherto, evidence for (and critique of) these cross-species comparisons in fear conditioning research was based on theoretical viewpoints. Here, we provide a perspective to substantiate these theoretical concepts with empirical considerations of cross-species methodology. This meta-research perspective is expected to foster cross-species comparability and reproducibility to ultimately facilitate successful transfer of results from basic science into clinical applications.
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Affiliation(s)
- Jan Haaker
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Stephen Maren
- Department of Psychological and Brain Sciences and Institute for Neuroscience, Texas A&M University, College Station, TX, 77843, USA
| | - Marta Andreatta
- Department of Psychology, University of Würzburg, Würzburg, Germany; Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Netherlands
| | - Christian J Merz
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - S Helene Richter
- Department of Behavioural Biology, University of Münster, Münster, Germany
| | - Shira Meir Drexler
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Germany
| | - Maren D Lange
- Institute of Physiology I, University of Münster, Münster, Germany
| | - Kay Jüngling
- Institute of Physiology I, University of Münster, Münster, Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Miquel A Fullana
- Institute of Neurosciences, Hospital Clinic, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Carsten T Wotjak
- Neuronal Plasticity Research Group, Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, 80804, Munich, Germany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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47
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Pivac N. Theranostic approach to PTSD. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:260-262. [PMID: 30707987 DOI: 10.1016/j.pnpbp.2019.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nela Pivac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Bijenicka cesta 54, 10000 Zagreb, Croatia.
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48
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Allen M, Handy J, Miller D, Servatius R. Avoidance learning and classical eyeblink conditioning as model systems to explore a learning diathesis model of PTSD. Neurosci Biobehav Rev 2019; 100:370-386. [DOI: 10.1016/j.neubiorev.2019.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 01/09/2023]
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49
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Allen MT, Myers CE, Beck KD, Pang KCH, Servatius RJ. Inhibited Personality Temperaments Translated Through Enhanced Avoidance and Associative Learning Increase Vulnerability for PTSD. Front Psychol 2019; 10:496. [PMID: 30967806 PMCID: PMC6440249 DOI: 10.3389/fpsyg.2019.00496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 02/20/2019] [Indexed: 12/22/2022] Open
Abstract
Although many individuals who experience a trauma go on to develop post-traumatic stress disorder (PTSD), the rate of PTSD following trauma is only about 15-24%. There must be some pre-existing conditions that impart increased vulnerability to some individuals and not others. Diathesis models of PTSD theorize that pre-existing vulnerabilities interact with traumatic experiences to produce psychopathology. Recent work has indicated that personality factors such as behavioral inhibition (BI), harm avoidance (HA), and distressed (Type D) personality are vulnerability factors for the development of PTSD and anxiety disorders. These personality temperaments produce enhanced acquisition or maintenance of associations, especially avoidance, which is a criterion symptom of PTSD. In this review, we highlight the evidence for a relationship between these personality types and enhanced avoidance and associative learning, which may increase risk for the development of PTSD. First, we provide the evidence confirming a relationship among BI, HA, distressed (Type D) personality, and PTSD. Second, we present recent findings that BI is associated with enhanced avoidance learning in both humans and animal models. Third, we will review evidence that BI is also associated with enhanced eyeblink conditioning in both humans and animal models. Overall, data from both humans and animals suggest that these personality traits promote enhanced avoidance and associative learning, as well as slowing of extinction in some training protocols, which all support the learning diathesis model. These findings of enhanced learning in vulnerable individuals can be used to develop objective behavioral measures to pre-identify individuals who are more at risk for development of PTSD following traumatic events, allowing for early (possibly preventative) intervention, as well as suggesting possible therapies for PTSD targeted on remediating avoidance or associative learning. Future work should explore the neural substrates of enhanced avoidance and associative learning for behaviorally inhibited individuals in both the animal model and human participants.
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Affiliation(s)
- Michael Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, United States
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
| | - Catherine E. Myers
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin D. Beck
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin C. H. Pang
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Richard J. Servatius
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
- Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, Syracuse, NY, United States
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, United States
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50
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Asok A, Hijazi J, Harvey LR, Kosmidis S, Kandel ER, Rayman JB. Sex Differences in Remote Contextual Fear Generalization in Mice. Front Behav Neurosci 2019; 13:56. [PMID: 30967765 PMCID: PMC6439350 DOI: 10.3389/fnbeh.2019.00056] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/06/2019] [Indexed: 12/21/2022] Open
Abstract
The generalization of fear is adaptive in that it allows an animal to respond appropriately to novel threats that are not identical to previous experiences. In contrast, the overgeneralization of fear is maladaptive and is a hallmark of post-traumatic stress disorder (PTSD), a psychiatric illness that is characterized by chronic symptomatology and a higher incidence in women compared to men. Therefore, understanding the neural basis of fear generalization at remote time-points in female animals is of particular translational relevance. However, our understanding of the neurobiology of fear generalization is largely restricted to studies employing male mice and focusing on recent time-points (i.e., within 24-48 h following conditioning). To address these limitations, we examined how male and female mice generalize contextual fear at remote time intervals (i.e., 3 weeks after conditioning). In agreement with earlier studies of fear generalization at proximal time-points, we find that the test order of training and generalization contexts is a critical determinant of generalization and context discrimination, particularly for female mice. However, tactile elements that are present during fear conditioning are more salient for male mice. Our study highlights long-term sex differences in defensive behavior between male and female mice and may provide insight into sex differences in the processing and retrieval of remote fear memory observed in humans.
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Affiliation(s)
- Arun Asok
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Joud Hijazi
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Lucas R. Harvey
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Stylianos Kosmidis
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Eric R. Kandel
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
- Howard Hughes Medical Institute, Columbia University, New York, NY, United States
- Kavli Institute for Brain Science, Columbia University, New York, NY, United States
| | - Joseph B. Rayman
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
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