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Hauck A, Michael T, Issler TC, Klein S, Lass-Hennemann J, Ferreira de Sá DS. Can glucose facilitate fear exposure? Randomized, placebo-controlled trials on the effects of glucose administration on fear extinction processes. Behav Res Ther 2024; 178:104553. [PMID: 38728832 DOI: 10.1016/j.brat.2024.104553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024]
Abstract
Previous studies showed that glucose has beneficial effects on memory function and can enhance contextual fear learning. To derive potential therapeutic interventions, further research is needed regarding the effects of glucose on fear extinction. In two experimental studies with healthy participants (Study 1: N = 68, 39 females; Study 2: N = 89, 67 females), we investigated the effects of glucose on fear extinction learning and its consolidation. Participants completed a differential fear conditioning paradigm consisting of acquisition, extinction, and return of fear tests: reinstatement, and extinction recall. US-expectancy ratings, skin conductance response (SCR), and fear potentiated startle (FPS) were collected. Participants were pseudorandomized and double-blinded to one of two groups: They received either a drink containing glucose or saccharine 20 min before (Study 1) or immediately after extinction (Study 2). The glucose group showed a significantly stronger decrease in differential FPS during extinction (Study 1) and extinction recall (Study 2). Additionally, the glucose group showed a significantly lower contextual anxiety at test of reinstatement (Study 2). Our findings provide first evidence that glucose supports the process of fear extinction, and in particular the consolidation of fear extinction memory, and thus has potential as a beneficial adjuvant to extinction-based treatments. Registered through the German Clinical Trials Registry (https://www.bfarm.de/EN/BfArM/Tasks/German-Clinical-Trials-Register/_node.html; Study 1: DRKS00010550; Study 2: DRKS00018933).
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Affiliation(s)
- Alexander Hauck
- 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
| | - Tobias C Issler
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Steven Klein
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Diana S Ferreira de Sá
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany.
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2
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Wilson S, Benning SD, Racine SE. Examining relationships among thin-ideal internalization, eating pathology, and motivational reactions to high- and low-calorie food. Appetite 2022; 178:106258. [DOI: 10.1016/j.appet.2022.106258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/18/2022] [Accepted: 07/24/2022] [Indexed: 11/02/2022]
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Racine SE, Suissa-Rocheleau L, Martin SJ, Benning SD. Implicit and explicit motivational responses to high- and low-calorie food in women with disordered eating. Int J Psychophysiol 2020; 159:37-46. [PMID: 33245920 DOI: 10.1016/j.ijpsycho.2020.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022]
Abstract
Eating disorders and their symptoms are thought to be associated with altered motivational responding to food. Binge eating may relate to increased reward reactivity, restrictive eating may be associated with increased threat and/or decreased reward reactivity, and the combination of these symptoms within an individual may be linked to motivational conflict to food. Using both implicit (i.e., physiological) and explicit (i.e., self-reported) measures, we tested these hypotheses in 88 women with binge eating only, restrictive eating only, both binge eating and restrictive eating, or no eating pathology. Participants viewed and rated high-calorie food, low-calorie food, and emotional images while startle eye blink and postauricular reflexes were measured. Arousal and craving, but not valence, ratings were significantly greater for high- than low-calorie food. Startle blink reflexes during all food images were significantly lower than during neutral images, whereas only high-calorie foods related to greater postauricular reactivity than neutral images. Eating pathology group did not predict implicit and explicit motivational reactions to food. Exploratory dimensional analyses revealed that rating low-calorie foods as lower on craving predicted endorsement of restrictive eating, while rating low-calorie foods as lower on valence and arousal, and experiencing lower postauricular reactivity to high-calorie foods minus neutral images, predicted greater frequency of restrictive eating episodes. Decreased implicit and explicit appetitive motivation to high- and low-calorie food may relate to the presence and frequency of restrictive eating. Future longitudinal research should investigate whether decreased appetitive responding to food is a risk factor for, versus consequence of, restrictive eating.
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Affiliation(s)
- Sarah E Racine
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montréal, QC H3A 1G1, Canada.
| | - Léah Suissa-Rocheleau
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montréal, QC H3A 1G1, Canada
| | - Shelby J Martin
- Department of Psychology, Ohio University, Porter Hall, Athens, OH 45701, United States
| | - Stephen D Benning
- Department of Psychology, University of Nevada Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV 89154-5030, United States
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4
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Ferreira de Sá DS, Römer S, Brückner AH, Issler T, Hauck A, Michael T. Effects of intranasal insulin as an enhancer of fear extinction: a randomized, double-blind, placebo-controlled experimental study. Neuropsychopharmacology 2020; 45:753-760. [PMID: 31896118 PMCID: PMC7076012 DOI: 10.1038/s41386-019-0593-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/26/2019] [Accepted: 12/16/2019] [Indexed: 01/27/2023]
Abstract
Fear-extinction based psychotherapy (exposure) is the most effective method for treating anxiety disorders. Notwithstanding, since some patients show impairments in the unlearning of fear and insufficient fear remission, there is a growing interest in using cognitive enhancers as adjuvants to exposure. As insulin plays a critical role in stress processes and acts as a memory enhancer, this study aimed to assess the capacity of intranasal insulin to augment fear extinction. A double-blind, placebo-controlled differential fear-conditioning paradigm was conducted in 123 healthy participants (63 females). Pictures of faces with neutral expressions were used as conditioned stimuli and electric shocks as unconditioned stimuli. The paradigm consisted of four phases presented on three consecutive days: acquisition (day 1), extinction (day 2), reinstatement and re-extinction (day 3). A single intranasal dose of insulin (160 IU) or placebo was applied on day 2, 45 min before fear extinction. Skin conductance response (SCR), fear-potentiated startle (FPS) and expectancy ratings were assessed. During extinction, the insulin group (independent of sex) showed a significantly stronger decrease in differential FPS in comparison with the placebo group. Furthermore, a sex-specific effect was found for SCR, with women in the insulin group showing a greater decrease of differential SCR both at early extinction and at late re-extinction. Our results provide first evidence that intranasal insulin facilitates fear extinction processes and is therefore a promising adjuvant for extinction-based therapies in anxiety and related disorders. Sex-specific effects should be taken into consideration in future studies.
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Affiliation(s)
- Diana S. Ferreira de Sá
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sonja Römer
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Alexandra H. Brückner
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tobias Issler
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Alexander Hauck
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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Suissa-Rocheleau L, Benning SD, Racine SE. Associations between self-report and physiological measures of emotional reactions to food among women with disordered eating. Int J Psychophysiol 2019; 144:40-46. [DOI: 10.1016/j.ijpsycho.2019.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/12/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022]
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Ross M, Garland A, Harlander-Matauschek A, Kitchenham L, Mason G. Welfare-improving enrichments greatly reduce hens' startle responses, despite little change in judgment bias. Sci Rep 2019; 9:11881. [PMID: 31417122 PMCID: PMC6695442 DOI: 10.1038/s41598-019-48351-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/22/2019] [Indexed: 01/05/2023] Open
Abstract
Responses to ambiguous and aversive stimuli (e.g. via tests of judgment bias and measures of startle amplitude) can indicate mammals' affective states. We hypothesised that such findings generalize to birds, and that these two responses co-vary (since both involve stimulus evaluation). To validate startle reflexes (involuntary responses to sudden aversive stimuli) and responses in a judgment bias task as indicators of avian affective state, we differentially housed hens with or without preferred enrichments assumed to improve mood (in a crossover design). To control for personality, we first measured hens' baseline exploration levels. To infer judgment bias, control and enriched hens were trained to discriminate between white and dark grey cues (associated with reward and punishment, respectively), and then probed with intermediate shades of grey. For startle reflexes, forceplates assessed responses to a light flash. Judgment bias was only partially validated: Exploratory hens showed more 'optimism' when enriched, but Non-exploratory hens did not. Across all birds, however, startle amplitudes were dramatically reduced by enrichment (albeit more strongly in Exploratory subjects): the first evidence that avian startle is affectively modulated. Startle and judgment biases did not co-vary, suggesting different underlying mechanisms. Of the two measures, startle reflexes thus seem most sensitive to avian affective state.
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Affiliation(s)
- Misha Ross
- Department of Animal Biosciences, University of Guelph, 50 Stone Road, Guelph, Ontario, N1G2W1, Canada
| | - Anna Garland
- Department of Animal Biosciences, University of Guelph, 50 Stone Road, Guelph, Ontario, N1G2W1, Canada
| | | | - Lindsey Kitchenham
- Department of Animal Biosciences, University of Guelph, 50 Stone Road, Guelph, Ontario, N1G2W1, Canada
| | - Georgia Mason
- Department of Animal Biosciences, University of Guelph, 50 Stone Road, Guelph, Ontario, N1G2W1, Canada.
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Boecker L, Pauli P. Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems. Neurosci Biobehav Rev 2019; 103:230-266. [PMID: 31129237 DOI: 10.1016/j.neubiorev.2019.05.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/12/2019] [Accepted: 05/18/2019] [Indexed: 02/06/2023]
Abstract
Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.
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Affiliation(s)
- Lea Boecker
- Department of Economic Psychology, Social Psychology & Experimental Methods, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Marcusstraße 9-11, 97070 Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany
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Hengesch X, Larra MF, Finke JB, Blumenthal TD, Schächinger H. Enhanced startle reflexivity during presentation of visual nurture cues in young adults who experienced parental divorce in early childhood. Int J Psychophysiol 2017; 120:78-85. [PMID: 28712816 DOI: 10.1016/j.ijpsycho.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/27/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
Abstract
Adverse childhood experiences (ACE) may influence stress and affective processing in adulthood. Animal and human studies show enhanced startle reflexivity in adult participants with ACE. This study examined the impact of one of the most common ACE, parental divorce, on startle reflexivity in adulthood. Affective modulation of acoustically-elicited startle eye blink was assessed in a group of 23 young adults with self-reported history of parental divorce, compared to an age- and sex-matched control group (n=18). Foreground pictures were either aversive (e.g. mutilation and injury), standard appetitive (e.g. erotic, recreational sport), or nurture pictures (e.g. related to early life, parental care), intermixed with neutral pictures (e.g. household objects), and organized in three valence blocks delivered in a balanced, pseudo-randomized sequence. During picture viewing startle eye blinks were elicited by binaural white noise bursts (50ms, 105 dB) via headphones and recorded at the left orbicularis oculi muscle via EMG. A significant interaction of group×picture valence (p=0.01) was observed. Contrast with controls revealed blunted startle responsiveness of the ACE group during presentation of aversive pictures, but enhanced startle during presentation of nurture-related pictures. No group differences were found during presentation of standard appetitive pictures. ACE participants rated nurture pictures as more arousing (p=0.02) than did control participants. Results suggest that divorce in childhood led to altered affective context information processing in early adulthood. When exposed to unpleasant (vs. neutral) pictures participants with ACE showed less startle potentiation than controls. Nurture context, however, potentiated startle in ACE participants, suggesting visual cuing to activate protective behavioral responses.
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Affiliation(s)
- Xenia Hengesch
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany.
| | - Mauro F Larra
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany
| | - Johannes B Finke
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany
| | - Terry D Blumenthal
- Department of Psychology, Wake Forest University, Winston-Salem, NC 27109, USA
| | - Hartmut Schächinger
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany.
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Schulz A, van Dyck Z, Lutz AP, Rost S, Vögele C. Gastric modulation of startle eye blink. Biol Psychol 2017; 127:25-33. [DOI: 10.1016/j.biopsycho.2017.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 01/04/2023]
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Horstick EJ, Mueller T, Burgess HA. Motivated state control in larval zebrafish: behavioral paradigms and anatomical substrates. J Neurogenet 2016; 30:122-32. [PMID: 27293113 DOI: 10.1080/01677063.2016.1177048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Over the course of each day, animals prioritize different objectives. Immediate goals may reflect fluctuating internal homeostatic demands, prompting individuals to seek out energy supplies or warmth. At other times, the environment may present temporary challenges or opportunities. Homeostatic demands and environmental signals often elicit persistent changes in an animal's behavior to meet needs and challenges over extended periods of time. These changes reflect the underlying motivational state of the animal. The larval zebrafish has been established as an effective genetically tractable vertebrate system to study neural circuits for sensory-motor reflexes. Fewer studies have exploited zebrafish to study brain circuits that control motivated behavior. In part this is because appropriate conceptual frameworks, anatomical knowledge, and behavioral paradigms are not yet well established. This review sketches a general conceptual framework for studying motivated state control in animal models, how this applies to larval zebrafish, and the current knowledge on neuroanatomical substrates for state control in this model.
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Affiliation(s)
- Eric J Horstick
- a Division of Developmental Biology , Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda , MD , USA
| | - Thomas Mueller
- b Division of Biology , Kansas State University , Manhattan , KS , USA
| | - Harold A Burgess
- a Division of Developmental Biology , Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda , MD , USA
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Racine SE, Forbush KT, Wildes JE, Hagan KE, Pollack LO, May C. Voluntary emotion regulation in anorexia nervosa: A preliminary emotion-modulated startle investigation. J Psychiatr Res 2016; 77:1-7. [PMID: 26945729 PMCID: PMC4826846 DOI: 10.1016/j.jpsychires.2016.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/25/2016] [Accepted: 02/19/2016] [Indexed: 11/17/2022]
Abstract
Emotion regulation difficulties are implicated in the development and maintenance of anorexia nervosa (AN). However, research has been limited by an almost exclusive reliance on self-report. This study is the first to use the emotion-modulated startle paradigm (EMSP) to investigate emotional reactivity and voluntary emotion regulation in individuals with AN. Twenty women with AN viewed negative, positive, neutral, and food images and were asked to enhance, suppress, or maintain their emotional responses mid-way through picture presentation. Startle eyeblink magnitudes in response to startle probes administered prior, and subsequent, to regulation instructions indexed emotional reactivity and regulation, respectively. On emotional reactivity trials, startle magnitudes were greater for negative, positive, and food images, compared to neutral images. Participants had difficulty suppressing startle responses to negative and food images, as indicated by non-significant suppress-maintain comparisons. In contrast, startle responses to enhance and suppress cues during presentation of pleasant images were comparable and significantly lower than maintain cues. Findings converge with self-report data to suggest that patients with AN have difficulties with voluntary emotion regulation. The EMSP may be a promising trans-diagnostic method for examining emotion regulation difficulties that underlie risk for eating disorders and other psychiatric conditions.
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Affiliation(s)
| | | | - Jennifer E. Wildes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelsey E. Hagan
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Lauren O. Pollack
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Casey May
- Department of Psychology, University of North Carolina-Greensboro, Greensboro, NC, USA
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Cortisol, but not intranasal insulin, affects the central processing of visual food cues. Psychoneuroendocrinology 2014; 50:311-20. [PMID: 25265284 DOI: 10.1016/j.psyneuen.2014.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 09/02/2014] [Accepted: 09/06/2014] [Indexed: 11/22/2022]
Abstract
Stress glucocorticoids and insulin are important endocrine regulators of energy homeostasis, but little is known about their central interaction on the reward-related processing of food cues. According to a balanced group design, healthy food deprived men received either 40IU intranasal insulin (n=13), 30mg oral cortisol (n=12), both (n=15), or placebo (n=14). Acoustic startle responsiveness was assessed during presentation of food and non-food pictures. Cortisol enhanced startle responsiveness during visual presentation of "high glycemic" food pictures, but not during presentation of neutral and pleasant non-food pictures. Insulin had no effect. Based on the "frustrative nonreward" model these results suggest that the reward value of high glycemic food items is specifically increased by cortisol.
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Schulz A, Ferreira de Sá DS, Dierolf AM, Lutz A, van Dyck Z, Vögele C, Schächinger H. Short-term food deprivation increases amplitudes of heartbeat-evoked potentials. Psychophysiology 2014; 52:695-703. [DOI: 10.1111/psyp.12388] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 10/29/2014] [Indexed: 12/19/2022]
Affiliation(s)
- André Schulz
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - Diana S. Ferreira de Sá
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - Angelika M. Dierolf
- Psychophysiological Laboratory; Department of Psychology; University of Trier; Trier Germany
| | - Annika Lutz
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Zoé van Dyck
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Claus Vögele
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Hartmut Schächinger
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
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Herbert C, Platte P, Wiemer J, Macht M, Blumenthal TD. Supertaster, super reactive: Oral sensitivity for bitter taste modulates emotional approach and avoidance behavior in the affective startle paradigm. Physiol Behav 2014; 135:198-207. [DOI: 10.1016/j.physbeh.2014.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 03/24/2014] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
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