Neural systems underlying approach and avoidance in anxiety disorders

Greater weekly physical activity linked to left resting frontal alpha asymmetry in women: A study on gender differences in highly active young adults

Physical activity, beneficial for physical and psychological health, may facilitate affective mechanisms of positive emotion and approach-motivation. Greater resting frontal alpha asymmetry (FAA), an index of greater relative left than right frontal cortical activity, is a neural correlate of affective mechanisms possibly associated with active lifestyles. This study sought to amplify limited literature on the relationship between physical (in)activity, FAA, and gender differences. College students (n = 70) self-reported physical activity (Total PA) and sedentary activity (Total Sitting) via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), followed by a resting electroencephalography session to record FAA. A Total PA × gender interaction (β = 0.462, t = 3.163, p = 0.002) identified a positive relationship between Total PA and FAA in women (β = 0.434, t = 2.221, p = 0.030) and a negative relationship for men (β = -0.338, t = -2.300, p = 0.025). Total Sitting was positively linked to FAA (β = 0.288, t = 2.228, p = 0.029; no gender effect). Results suggest affective mechanisms reflected by FAA (e.g., positive emotion, approach-motivation) are associated with physical activity for women, indicating a possible mechanism of the psychological benefits linked with physically active lifestyles. A positive relationship between sedentary behavior and greater left FAA may also reflect motivated mechanisms of behavior that aid in minimizing energy expenditure, particularly within the context of our highly active sample.

Social effort discounting reveals domain-general and social-specific motivation components

BACKGROUND

Social motivation is crucial for healthy interpersonal connections and is impaired in a subset of the general population and across many psychiatric disorders. However, compared to nonsocial (e.g., monetary) motivation, social motivation has been understudied in quantitative behavioral work, especially regarding willingness to exert social effort. We developed a novel social effort discounting task, paired with a monetary task to examine motivational specificity. We expected social task performance would relate to general motivation also show selective relationships with self-reported avoidance tendencies and with sociality.

METHODS

An analyzed sample of 397 participants performed the social and nonsocial effort discounting task online, along with self-report measures of various aspects of motivation and psychiatric symptomatology.

RESULTS

Social and nonsocial task motivation correlated strongly (rho=0.71 p<0.001). Both social and nonsocial task motivation related similarly to self-reported general motivation (social ß=0.16; nonsocial ß=0.13) and to self-reported approach motivation (social ß=0.14; nonsocial ß=0.11), with this common effect captured by a significant main effect across social and nonsocial conditions. Significant condition interaction effects supported a selective relationship of social task motivation with self-reported sociality and also with avoidance motivation.

CONCLUSIONS

Our novel social effort discounting task revealed both domain-general and social-specific components of motivation. In combination with other measures, this approach can facilitate further investigation of common and dissociable neurobehavioral mechanisms, in order to better characterize normative and pathological variation and develop personalized interventions targeting specific contributors to social impairment.

RECORD, a high-throughput, customizable system that unveils behavioral strategies leveraged by rodents during foraging-like decision-making

Translational studies benefit from experimental designs where laboratory organisms use human-relevant behaviors. One such behavior is decision-making, however studying complex decision-making in rodents is labor-intensive and typically restricted to two levels of cost/reward. We design a fully automated, inexpensive, high-throughput framework to study decision-making across multiple levels of rewards and costs: the REward-COst in Rodent Decision-making (RECORD) system. RECORD integrates three components: 1) 3D-printed arenas, 2) custom electronic hardware, and 3) software. We validated four behavioral protocols without employing any food or water restriction, highlighting the versatility of our system. RECORD data exposes heterogeneity in decision-making both within and across individuals that is quantifiably constrained. Using oxycodone self-administration and alcohol-consumption as test cases, we reveal how analytic approaches that incorporate behavioral heterogeneity are sensitive to detecting perturbations in decision-making. RECORD is a powerful approach to studying decision-making in rodents, with features that facilitate translational studies of decision-making in psychiatric disorders.

Mood and physiological effects of visual stimulation with images of the natural environment in individuals with depressive and anxiety disorders

BACKGROUND

Nature therapies are gaining attention as non-pharmacological treatments for depressive and anxiety disorders, but research on their effectiveness in patients is limited. This study investigates the mood-improving effects of visual stimulation with natural environmental images in patients with depressive and anxiety disorders.

METHODS

We conducted a randomized crossover comparison trial involving 60 right-handed adult participants with depressive or anxiety disorders and receiving outpatient treatment. Visual stimuli of natural environments consisted of green-themed nature images, while the control stimuli featured urban scenes dominated by buildings. The stimulation lasted for 3 min, during which orbital prefrontal brain activity was measured using a 2-channel Near-infrared Spectroscopy (NIRS) system, and heart rate variability was assessed using fingertip accelerated plethysmography.

RESULTS

Mood enhancement effects were observed in both the depressive and anxiety disorder groups following visual stimulation with nature images. In the depression group, orbital prefrontal oxygenated hemoglobin concentration significantly increased after visual stimulation with nature images, while there were no significant changes in the anxiety group. However, in the anxiety group, a correlation was found between reduced orbital prefrontal oxygenated hemoglobin in response to nature images and increased mood-enhancement. Furthermore, the severity of depressive symptoms did not significantly affect the intervention effects, whereas heightened anxiety symptoms was associated with a smaller mood enhancement effect.

DISCUSSION

Our study demonstrates the benefits of nature image stimulation for patients with depressive and anxiety disorders. Differential orbital prefrontal brain activity impacts notwithstanding, both conditions exhibited mood enhancement, affirming the value of nature image stimulation.

Responding to threat: Associations between neural reactivity to and behavioral avoidance of threat in pediatric anxiety

BACKGROUND

Despite broad recognition of the central role of avoidance in anxiety, a lack of specificity in its operationalization has hindered progress in understanding this clinically significant construct. The current study uses a multimodal approach to investigate how specific measures of avoidance relate to neural reactivity to threat in youth with anxiety disorders.

METHODS

Children with anxiety disorders (ages 6-12 years; n = 65 for primary analyses) completed laboratory task- and clinician-based measures of avoidance, as well as a functional magnetic resonance imaging task probing neural reactivity to threat. Primary analyses examined the ventral anterior insula (vAI), amygdala, and ventromedial prefrontal cortex (vmPFC).

RESULTS

Significant but distinct patterns of association with task- versus clinician-based measures of avoidance emerged. Clinician-rated avoidance was negatively associated with right and left vAI reactivity to threat, whereas laboratory-based avoidance was positively associated with right vAI reactivity to threat. Moreover, left vAI-right amygdala and bilateral vmPFC-right amygdala functional connectivity were negatively associated with clinician-rated avoidance but not laboratory-based avoidance.

LIMITATIONS

These results should be considered in the context of the restricted range of our treatment-seeking sample, which limits the ability to draw conclusions about these associations across children with a broader range of symptomatology. In addition, the limited racial and ethnic diversity of our sample may limit the generalizability of findings.

CONCLUSION

These findings mark an important step towards bridging neural findings and behavioral patterns using a multimodal approach. Advancing understanding of behavioral avoidance in pediatric anxiety may guide future treatment optimization by identifying individual-specific targets for treatment.

Temporal dynamics of costly avoidance in naturalistic fears: Evidence for sequential-sampling of fear and reward information

Excessive avoidance is characteristic for anxiety disorders, even when approach would lead to positive outcomes. The process of how such approach-avoidance conflicts are resolved is not sufficiently understood. We examined the temporal dynamics of approach-avoidance in intense fear of spiders. Highly fearful and non-fearful participants chose repeatedly between a fixed no spider/low reward and a spider/high reward option with varying fear (probability of spider presentation) and reward information (reward magnitude). By sequentially presenting fear and reward information, we distinguished whether decisions are dynamically driven by both information (sequential-sampling) or whether the impact of fear information is inhibited (cognitive control). Mouse movements were recorded to assess temporal decision dynamics (i.e., how strongly which information impacts decision preference at which timepoint). Highly fearful participants showed stronger avoidance despite lower gains (i.e., costly avoidance). Time-continuous multiple regression of their mouse movements yielded a stronger impact of fear compared to reward information. Importantly, presenting either information first (fear or reward) enhanced its impact during the early decision process. These findings support sequential sampling of fear and reward information, but not inhibitory control. Hence, pathological avoidance may be characterized by biased evidence accumulation rather than altered cognitive control.

Orbital frontal cortex functional connectivity during gain anticipation linking the rumination and non-suicidal self-injury in late adolescence

OBJECTIVE

Non-suicidal self-injury (NSSI) is prevalent and especially among the adolescence population. It has been argued that abnormal brain activations in reward processing could be regarded as objective biomarkers in NSSI, but the evidence is mixed. This study aims to explore the reward processing mechanism of NSSI from the perspective of functional brain circuitry and investigate the role of a cognitive factor (rumination).

METHOD

Seventy-one 17-21 years old participants performed a monetary incentive delay (MID) task during functional magnetic resonance imaging scanning. Psychophysiological interaction (PPI) analysis was used to test the inner-group differences of brain functional connectivity. In addition, a mediation model was established with the mediation effect of rumination on the relationship between functional brain circuitry and NSSI.

RESULTS

PPI analysis suggested that functional connectivity of the orbital frontal cortex (OFC) (with precuneus, SMA) was significantly enhanced in NSSI in the gain > loss contrast, but not in the loss > gain contrast. Mediation analysis revealed that rumination mediated the relationship between NSSI and the OFC- precuneus functional connectivity in the gain > loss contrast.

CONCLUSION

Our research revealed that the abnormal OFC functional connectivity in gain (not loss) anticipation can be served as the sensitive biomarkers of NSSI. And there was a chain path for NSSI, that was from functional brain circuitry to negative cognition and then to problem behavior.

Development and Validation of a Broad and Fear-Adaptable Measure of Fear Approach and Application to Common Eating Disorder Fears

Fear approach is a theorized mechanism of exposure treatment for anxiety-based disorders. However, there are no empirically established self-report instruments measuring the tendency to approach feared stimuli. Because clinical fears are heterogeneous, it is important to create a measure that is adaptable to person- or disorder-specific fears. The current study (N = 455) tests the development, factor structure, and psychometric properties of a self-report instrument of fear approach broadly and the adaptability of this measure to specific eating disorder fears (i.e., food, weight gain). Factor analyses identified a unidimensional, nine-item factor structure as the best fitting model. This measure had good convergent, divergent, and incremental validity and good internal consistency. The eating disorder adaptations retained good fit and strong psychometric properties. These results suggest that this measure is a valid, reliable, and adaptable measure of fear approach, which can be used in research and exposure therapy treatment for anxiety-based disorders.

Dual-process model of courage

Courage is one of the most significant psychological constructs for society, but not one of the most frequently studied. This paper presents a process model of courage consisting of decision-based pathways by which one comes to enact a courageous action. We argue the process of courage begins with a trigger involving an actor(s) and a situation(s). The actor(s) then engage(s) in four key assessments concerning (a) immediacy of the situation, (b) meaningfulness, value, and relevance to the actor, (c) adequacy of efficacy to act, and (d) decision to act with courage. The central component of this process entails an approach-avoidance conflict involving assessments of perceived risks and potential noble outcomes of acting with courage. The decision to act may result in courageous actions assuming it satisfies the four elements: intentionality, objective and substantial risk, a noble purpose, and meaning in time and place. Courageous actions have consequences. Finally, the consequences shape the actors' experience, which feeds into the trigger, closing the loop. Potential moderators of the courage process as well as potential tests of the model have been discussed.

A network approach to posttraumatic stress disorder: Comparing interview and self-report networks

OBJECTIVE

Trauma-related fear (e.g., reexperiencing), impaired reward (e.g., anhedonia), and interpersonal (e.g., detachment) processes may be functionally intertwined, giving rise to chronic psychopathology after a trauma. Network analyses can help pinpoint symptom drivers and treatment targets, but studies examining posttraumatic stress disorder (PTSD) treatment-seeking individuals are lacking.

METHOD

Treatment-seeking adults with primary PTSD (N = 350) completed interview and self-report measures of PTSD severity (PSS-I; PSS-SR). Self-report and interview-based networks were estimated and compared.

RESULTS

Both networks suggested distinct but interconnected communities of reexperiencing and dysphoric symptoms (e.g., interpersonal detachment, numbing). Centrality profiles were strongly associated across networks (rs = .71), with cued reexperiencing and interpersonal detachment showing strong centrality. Self-reported symptoms were more interconnected, suggesting lower specificity.

CONCLUSIONS

For those seeking treatment, interrelated fear and interpersonal processes may drive functional impairment in PTSD, and interview-based networks may help better delineate influential symptoms. Therapeutically, targeting cued reexperiencing and interpersonal detachment may facilitate broader symptom decreases. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Monoamine Oxidase: A Potential Link in Papez Circuit to Generalized Anxiety Disorders

Anxiety is a common mental illness that affects a large number of people around the world, and its treatment is often based on the use of pharmacological substances such as benzodiazepines, serotonin, and 5-hydroxytyrosine (MAO) neurotransmitters. MAO neurotransmitters levels are deciding factors in the biological effects. This review summarizes the current understanding of the MAO system and its role in the modulation of anxiety-related brain circuits and behavior. The MAO-A polymorphisms have been implicated in the susceptibility to generalized anxiety disorder (GAD) in several investigations. The 5-HT system is involved in a wide range of physiological and behavioral processes, involving anxiety, aggressiveness, stress reactions, and other elements of emotional intensity. Among these, 5-HT, NA, and DA are the traditional 5-HT neurons that govern a range of biological activities, including sleep, alertness, eating, thermoregulation, pains, emotion, and memory, as anticipated considering their broad projection distribution in distinct brain locations. The DNMTs (DNA methyltransferase) protein family, which increasingly leads a prominent role in epigenetics, is connected with lower transcriptional activity and activates DNA methylation. In this paper, we provide an overview of the current state of the art in the elucidation of the brain's complex functions in the regulation of anxiety.

Approach-avoidance reinforcement learning as a translational and computational model of anxiety-related avoidance

Although avoidance is a prevalent feature of anxiety-related psychopathology, differences in the measurement of avoidance between humans and non-human animals hinder our progress in its theoretical understanding and treatment. To address this, we developed a novel translational measure of anxiety-related avoidance in the form of an approach-avoidance reinforcement learning task, by adapting a paradigm from the non-human animal literature to study the same cognitive processes in human participants. We used computational modelling to probe the putative cognitive mechanisms underlying approach-avoidance behaviour in this task and investigated how they relate to subjective task-induced anxiety. In a large online study (n = 372), participants who experienced greater task-induced anxiety avoided choices associated with punishment, even when this resulted in lower overall reward. Computational modelling revealed that this effect was explained by greater individual sensitivities to punishment relative to rewards. We replicated these findings in an independent sample (n = 627) and we also found fair-to-excellent reliability of measures of task performance in a sub-sample retested 1 week later (n = 57). Our findings demonstrate the potential of approach-avoidance reinforcement learning tasks as translational and computational models of anxiety-related avoidance. Future studies should assess the predictive validity of this approach in clinical samples and experimental manipulations of anxiety.

Placing Approach-Avoidance Conflict Within the Framework of Multi-objective Reinforcement Learning

Many psychiatric disorders are marked by impaired decision-making during an approach-avoidance conflict. Current experiments elicit approach-avoidance conflicts in bandit tasks by pairing an individual's actions with consequences that are simultaneously desirable (reward) and undesirable (harm). We frame approach-avoidance conflict tasks as a multi-objective multi-armed bandit. By defining a general decision-maker as a limiting sequence of actions, we disentangle the decision process from learning. Each decision maker can then be identified as a multi-dimensional point representing its long-term average expected outcomes, while different decision making models can be associated by the geometry of their 'feasible region', the set of all possible long term performances on a fixed task. We introduce three example decision-makers based on popular reinforcement learning models and characterize their feasible regions, including whether they can be Pareto optimal. From this perspective, we find that existing tasks are unable to distinguish between the three examples of decision-makers. We show how to design new tasks whose geometric structure can be used to better distinguish between decision-makers. These findings are expected to guide the design of approach-avoidance conflict tasks and the modeling of resulting decision-making behavior.

Understanding anxiety symptoms as aberrant defensive responding along the threat imminence continuum

Threat-anticipatory defensive responses have evolved to promote survival in a dynamic world. While inherently adaptive, aberrant expression of defensive responses to potential threat could manifest as pathological anxiety, which is prevalent, impairing, and associated with adverse outcomes. Extensive translational neuroscience research indicates that normative defensive responses are organized by threat imminence, such that distinct response patterns are observed in each phase of threat encounter and orchestrated by partially conserved neural circuitry. Anxiety symptoms, such as excessive and pervasive worry, physiological arousal, and avoidance behavior, may reflect aberrant expression of otherwise normative defensive responses, and therefore follow the same imminence-based organization. Here, empirical evidence linking aberrant expression of specific, imminence-dependent defensive responding to distinct anxiety symptoms is reviewed, and plausible contributing neural circuitry is highlighted. Drawing from translational and clinical research, the proposed framework informs our understanding of pathological anxiety by grounding anxiety symptoms in conserved psychobiological mechanisms. Potential implications for research and treatment are discussed.

The longitudinal role of family conflict and neural reward sensitivity in youth's internalizing symptoms

Adolescence is often associated with an increase in psychopathology. Although previous studies have examined how family environments and neural reward sensitivity separately play a role in youth's emotional development, it remains unknown how they interact with each other in predicting youth's internalizing symptoms. Therefore, the current research took a biopsychosocial approach to examine this question using two-wave longitudinal data of 9353 preadolescents (mean age = 9.93 years at T1; 51% boys) from the Adolescent Brain Cognitive Development study. Using mixed-effects models, results showed that higher family conflict predicted youth's increased internalizing symptoms 1 year later, whereas greater ventral striatum (VS) activity during reward receipt predicted reduced internalizing symptoms over time. Importantly, there was an interaction effect between family conflict and VS activity. For youth who showed greater VS activation during reward receipt, high family conflict was more likely to predict increased internalizing symptoms. In contrast, youth with low VS activation during reward receipt showed high levels of internalizing symptoms regardless of family conflict. The findings suggest that youth's neural reward sensitivity is a marker of susceptibility to adverse family environments and highlight the importance of cultivating supportive family environments where youth experience less general conflict within the family.

A Novel Insular/Orbital-Prelimbic Circuit That Prevents Persistent Avoidance in a Rodent Model of Compulsive Behavior

BACKGROUND

A common symptom of obsessive-compulsive disorder is the persistent avoidance of cues incorrectly associated with negative outcomes. This maladaptation becomes increasingly evident as subjects fail to respond to extinction-based treatments such as exposure-with-response prevention therapy. While previous studies have highlighted the role of the insular-orbital cortex in fine-tuning avoidance-based decisions, little is known about the projections from this area that might modulate compulsive-like avoidance.

METHODS

Here, we used anatomical tract-tracing, single-unit recording, and optogenetics to characterize the projections from the insular-orbital cortex. To model exposure-with-response prevention and persistent avoidance in rats, we used the platform-mediated avoidance task followed by extinction-with-response prevention training.

RESULTS

Using tract-tracing and unit recording, we found that projections from the agranular insular/lateral orbital (AI/LO) cortex to the prefrontal cortex predominantly target the rostral portion of the prelimbic (rPL) cortex and excite rPL neurons. Photoinhibiting this projection induced persistent avoidance after extinction-with-response prevention training, an effect that was still present 1 week later. Consistent with this, photoexcitation of this projection prevented persistent avoidance in overtrained rats. This projection to rPL appears to be key for AI/LO's effects, considering that there was no effect of photoinhibiting AI/LO projections to the ventral striatum or basolateral amygdala.

CONCLUSIONS

Our findings suggest that projections from the AI/LO to the rPL decreases the likelihood of avoidance behavior following extinction. In humans, this connectivity may share some homology of projections from lateral prefrontal cortices (i.e., ventrolateral prefrontal cortex, orbitofrontal cortex, and insula) to other prefrontal areas and the anterior cingulate cortex, suggesting that reduced activity in these pathways may contribute to obsessive-compulsive disorder.

Anxiety as a disorder of uncertainty: implications for understanding maladaptive anxiety, anxious avoidance, and exposure therapy

In cognitive-behavioral conceptualizations of anxiety, exaggerated threat expectancies underlie maladaptive anxiety. This view has led to successful treatments, notably exposure therapy, but is not consistent with the empirical literature on learning and choice alterations in anxiety. Empirically, anxiety is better described as a disorder of uncertainty learning. How disruptions in uncertainty lead to impairing avoidance and are treated with exposure-based methods, however, is unclear. Here, we integrate concepts from neurocomputational learning models with clinical literature on exposure therapy to propose a new framework for understanding maladaptive uncertainty functioning in anxiety. Specifically, we propose that anxiety disorders are fundamentally disorders of uncertainty learning and that successful treatments, particularly exposure therapy, work by remediating maladaptive avoidance from dysfunctional explore/exploit decisions in uncertain, potentially aversive situations. This framework reconciles several inconsistencies in the literature and provides a path forward to better understand and treat anxiety.

Elevated decision uncertainty and reduced avoidance drives in depression, anxiety and substance use disorders during approach-avoidance conflict: a replication study

BACKGROUND

Decision-making under approach-avoidance conflict (AAC; e.g., sacrificing quality of life to avoid feared outcomes) may be affected in multiple psychiatric disorders. Recently, we used a computational (active inference) model to characterize information processing differences during AAC in individuals with depression, anxiety and/or substance use disorders. Individuals with psychiatric disorders exhibited increased decision uncertainty (DU) and reduced sensitivity to unpleasant stimuli. This preregistered study aimed to determine the replicability of this processing dysfunction.

METHODS

A new sample of participants completed the AAC task. Individual-level computational parameter estimates, reflecting decision uncertainty and sensitivity to unpleasant stimuli ("emotion conflict"; EC), were obtained and compared between groups. Subsequent analyses combining the prior and current samples allowed assessment of narrower disorder categories.

RESULTS

The sample in the present study included 480 participants: 97 healthy controls, 175 individuals with substance use disorders and 208 individuals with depression and/or anxiety disorders. Individuals with substance use disorders showed higher DU and lower EC values than healthy controls. The EC values were lower in females, but not males, with depression and/or anxiety disorders than in healthy controls. However, the previously observed difference in DU between participants with depression and/or anxiety disorders and healthy controls did not replicate. Analyses of specific disorders in the combined samples indicated that effects were common across different substance use disorders and affective disorders.

LIMITATIONS

There were differences, although with small effect size, in age and baseline intellectual functioning between the previous and current sample, which may have affected replication of DU differences in participants with depression and/or anxiety disorders.

CONCLUSION

The now robust evidence base for these clinical group differences motivates specific questions that should be addressed in future research: can DU and EC become behavioural treatment targets, and can we identify neural substrates of DU and EC that could be used to measure severity of dysfunction or as neuromodulatory treatment targets?

Threat-induced anxiety and selfishness in resource sharing: Behavioral and neural evidence

In real life, it is not unusual that we face potential threats (i.e., physical stimuli and environments that may cause harm or danger) with other individuals together, yet it remains largely unknown how threat-induced anxious feelings influence prosocial behaviors such as resource sharing. In this study, we investigated this question by combining functional magnetic resonance imaging and a novel paradigm. Together with an anonymous partner, each participant faced the possibility of receiving a 10-s noise administration, which had a low or high probability to be a threat (i.e., the intensity of noise can induce a high level of unpleasantness). Each participant first reported her/his immediate feeling of anxiety about the current situation (being threatened by the unpleasant noise), then decided how to split a number of resources (which could relieve the noise) between her/him and the partner. Behavioral results revealed that the participants showed a selfish bias in the threat conditions than in the safe conditions, and that self-reported anxiety feeling significantly predicted this bias. Functional magnetic resonance imaging results revealed that: (1) the activation level of the anterior insula was correlated with self-reported anxiety and (2) the connectivity between the anterior insula and the temporoparietal junction was sensitive to the modulating effect of anxiety on the selfish bias. These findings indicate the neural correlates of the association between threat-induced anxiety and prosocial tendencies in social interactions.

Quantifying aberrant approach-avoidance conflict in psychopathology: A review of computational approaches

Making effective decisions during approach-avoidance conflict is critical in daily life. Aberrant decision-making during approach-avoidance conflict is evident in a range of psychological disorders, including anxiety, depression, trauma-related disorders, substance use disorders, and alcohol use disorders. To help clarify etiological pathways and reveal novel intervention targets, clinical research into decision-making is increasingly adopting a computational psychopathology approach. This approach uses mathematical models that can identify specific decision-making related processes that are altered in mental health disorders. In our review, we highlight foundational approach-avoidance conflict research, followed by more in-depth discussion of computational approaches that have been used to model behavior in these tasks. Specifically, we describe the computational models that have been applied to approach-avoidance conflict (e.g., drift-diffusion, active inference, and reinforcement learning models), and provide resources to guide clinical researchers who may be interested in applying computational modeling. Finally, we identify notable gaps in the current literature and potential future directions for computational approaches aimed at identifying mechanisms of approach-avoidance conflict in psychopathology.

Social avoidance behavior modulates motivational responses to social reward-threat conflict signals: A preliminary fMRI study

Social avoidance behavior (SAB) produces impairment in multiple domains and contributes to the development and maintenance of several psychiatric disorders. Social behaviors such as SAB are influenced by approach-avoidance (AA) motivational responses to affective facial expressions. Notably, affective facial expressions communicate varying degrees of social reward signals (happiness), social threat signals (anger), or social reward-threat conflict signals (co-occurring happiness and anger). SAB is associated with dysregulated modulation of automatic approach-avoidance (AA) motivational responses exclusively to social reward-threat conflict signals. However, no neuroimaging research has characterized SAB-related modulation of automatic and subjective AA motivational responses to social reward-threat conflict signals. We recruited 30 adults reporting clinical, moderate, or minimal SAB based on questionnaire cutoff scores. SAB groups were matched on age range and gender. During fMRI scanning, participants completed implicit and subjective approach-avoidance tasks (AATs), which involved more incidental or more explicit evaluation of facial expressions that parametrically varied in social reward signals (e.g., 50%_Happy), social threat signals (e.g., 50%_Angry), or social reward-threat conflict signals (e.g., 50%_Happy + 50%_Angry). In the implicit AAT, SAB was associated with slower automatic avoidance actions and weaker amygdala-pgACC connectivity exclusively as a function of social reward-threat conflict signals. In the subjective AAT, SAB was associated with smaller increases in approach ratings, smaller decreases in avoidance ratings, and weaker dlPFC-pgACC connectivity exclusively in response to social reward-threat conflict signals. Thus, SAB is associated with dysregulated modulation of automatic and subjective AA motivational sensitivity to social reward-threat conflict signals, which may be facilitated by overlapping neural systems.

Association between reward-related functional connectivity and tri-level mood and anxiety symptoms

Depression and anxiety are associated with abnormalities in brain regions that process rewards including the medial orbitofrontal cortex (mOFC), the ventral striatum (VS), and the amygdala. However, there are inconsistencies in these findings. This may be due to past reliance on categorical diagnoses that, while valuable, provide less precision than may be required to understand subtle neural changes associated with symptoms of depression and anxiety. In contrast, the tri-level model defines symptom dimensions that are common (General Distress) or relatively specific (Anhedonia-Apprehension, Fears) to depression and anxiety related disorders, which provide increased precision. In the current study, eligibility was assessed by quasi-orthogonal screening questionnaires measuring reward and threat sensitivity (Behavioral Activation Scale; Eysenck Personality Questionnaire-Neuroticism). These participants were assessed on tri-level symptom severity and completed the Monetary Incentive Delay task during fMRI scanning. VS-mOFC and VS-amygdala connectivity were estimated during reward anticipation and reward outcome. Heightened General Distress was associated with lower VS-mOFC connectivity during reward anticipation (b = -0.064, p = 0.021) and reward outcome (b = -0.102, p = 0.014). Heightened Anhedonia-Apprehension was associated with greater VS-amygdala connectivity during reward anticipation (b = 0.065, p = 0.004). The present work has important implications for understanding the coupling between the mOFC and vS and the amygdala and the vS during reward processing in the pathophysiology of mood and anxiety symptoms and for developing targeted behavioral, pharmacological, and neuromodulatory interventions to help manage these symptoms.

Irrelevant Threats Linger and Affect Behavior in High Anxiety

Threat-related information attracts attention and disrupts ongoing behavior, and particularly so for more anxious individuals. Yet, it is unknown how and to what extent threat-related information leave lingering influences on behavior (e.g., by impeding ongoing learning processes). Here, human male and female participants (N = 47) performed probabilistic reinforcement learning tasks where irrelevant distracting faces (neutral, happy, or fearful) were presented together with relevant monetary feedback. Behavioral modeling was combined with fMRI data (N = 27) to explore the neurocomputational bases of learning relevant and irrelevant information. In two separate studies, individuals with high trait anxiety showed increased avoidance of objects previously paired with the combination of neutral monetary feedback and fearful faces (but not neutral or happy faces). Behavioral modeling revealed that high anxiety increased the integration of fearful faces during feedback learning, and fMRI results (regarded as provisional, because of a relatively small sample size) further showed that variance in the prediction error signal, uniquely accounted for by fearful faces, correlated more strongly with activity in the right DLPFC for more anxious individuals. Behavioral and neuronal dissociations indicated that the threat-related distractors did not simply disrupt learning processes. By showing that irrelevant threats exert long-lasting influences on behavior, our results extend previous research that separately showed that anxiety increases learning from aversive feedbacks and distractibility by threat-related information. Our behavioral results, combined with the proposed neurocomputational mechanism, may help explain how increased exposure to irrelevant affective information contributes to the acquisition of maladaptive behaviors in more anxious individuals.SIGNIFICANCE STATEMENT In modern-day society, people are increasingly exposed to various types of irrelevant information (e.g., intruding social media announcements). Yet, the neurocomputational mechanisms influenced by irrelevant information during learning, and their interactions with increasingly distracted personality types are largely unknown. Using a reinforcement learning task, where relevant feedback is presented together with irrelevant distractors (emotional faces), we reveal an interaction between irrelevant threat-related information (fearful faces) and interindividual anxiety levels. fMRI shows provisional evidence for an interaction between anxiety levels and the coupling between activity in the DLPFC and learning signals specifically elicited by fearful faces. Our study reveals how irrelevant threat-related information may become entrenched in the anxious psyche and contribute to long-lasting abnormal behaviors.

Prefrontal modulation of anxiety through a lens of noradrenergic signaling

Anxiety disorders are the most common class of mental illness in the U.S., affecting 40 million individuals annually. Anxiety is an adaptive response to a stressful or unpredictable life event. Though evolutionarily thought to aid in survival, excess intensity or duration of anxiogenic response can lead to a plethora of adverse symptoms and cognitive dysfunction. A wealth of data has implicated the medial prefrontal cortex (mPFC) in the regulation of anxiety. Norepinephrine (NE) is a crucial neuromodulator of arousal and vigilance believed to be responsible for many of the symptoms of anxiety disorders. NE is synthesized in the locus coeruleus (LC), which sends major noradrenergic inputs to the mPFC. Given the unique properties of LC-mPFC connections and the heterogeneous subpopulation of prefrontal neurons known to be involved in regulating anxiety-like behaviors, NE likely modulates PFC function in a cell-type and circuit-specific manner. In working memory and stress response, NE follows an inverted-U model, where an overly high or low release of NE is associated with sub-optimal neural functioning. In contrast, based on current literature review of the individual contributions of NE and the PFC in anxiety disorders, we propose a model of NE level- and adrenergic receptor-dependent, circuit-specific NE-PFC modulation of anxiety disorders. Further, the advent of new techniques to measure NE in the PFC with unprecedented spatial and temporal resolution will significantly help us understand how NE modulates PFC function in anxiety disorders.

Computational perspectives on human fear and anxiety

Fear and anxiety are adaptive emotions that serve important defensive functions, yet in excess, they can be debilitating and lead to poor mental health. Computational modelling of behaviour provides a mechanistic framework for understanding the cognitive and neurobiological bases of fear and anxiety, and has seen increasing interest in the field. In this brief review, we discuss recent developments in the computational modelling of human fear and anxiety. Firstly, we describe various reinforcement learning strategies that humans employ when learning to predict or avoid threat, and how these relate to symptoms of fear and anxiety. Secondly, we discuss initial efforts to explore, through a computational lens, approach-avoidance conflict paradigms that are popular in animal research to measure fear- and anxiety-relevant behaviours. Finally, we discuss negative biases in decision-making in the face of uncertainty in anxiety.

Preclinical and clinical evidence on the approach-avoidance conflict evaluation as an integrative tool for psychopathology

The approach-avoidance conflict (AAC), i.e. the competing tendencies to undertake goal-directed actions or to withdraw from everyday life challenges, stands at the basis of humans' existence defining behavioural and personality domains. Gray's Reinforcement Sensitivity Theory posits that a stable bias toward approach or avoidance represents a psychopathological trait associated with excessive sensitivity to reward or punishment. Optogenetic studies in rodents and imaging studies in humans associated with cross-species AAC paradigms granted new emphasis to the hippocampus as a hub of behavioural inhibition. For instance, recent functional neuroimaging studies show that functional brain activity in the human hippocampus correlates with threat perception and seems to underlie passive avoidance. Therefore, our commentary aims to (i) discuss the inhibitory role of the hippocampus in approach-related behaviours and (ii) promote the integration of functional neuroimaging with cross-species AAC paradigms as a means of diagnostic, therapeutic, follow up and prognosis refinement in psychiatric populations.

Do expressions of sadness, anxiety and fear have different impacts on attracting donations? Evidence from a Chinese online charitable crowdfunding platform

Purpose

Extant research shows mixed results on the impact of expressed negative emotions on donations in online charitable crowdfunding. This study solves the puzzle by examining how different types of negative emotions (i.e. sadness, anxiety and fear) expressed in crowdfunding project descriptions affect donations.

Design/methodology/approach

Data on 15,653 projects across four categories (medical assistance, education assistance, disaster assistance and poverty assistance) from September 2013 to May 2019 come from a leading online crowdfunding platform in China. Text analysis and regression models serve to test the hypotheses.

Findings

In the medical assistance category, the expression of sadness has an inverted U-shaped effect on donations, while the expression of anxiety has a negative effect. An appropriate number of sadness words is helpful but should not exceed five times. In the education assistance and disaster assistance categories, the expression of sadness has a positive effect on donations, but disclosure of anxiety and fear has no influence on donations. Expressions of sadness, anxiety and fear have no impact on donations in the poverty assistance category.

Research limitations/implications

This work has important implications for fundraisers on how to regulate the fundraisers' expressions of negative emotions in a project's description to attract donations. These insights are also relevant for online crowdfunding platforms.

Originality/value

Online crowdfunding research often studies negative emotions as a whole and does not differentiate project types. The current work contributes by empirically testing the impact of three types of negative emotions on donations across four major online crowdfunding categories.

Changes in the Behavior and Body Weight of Mature, Adult Male Wistar Han Rats after Reduced Social Grouping and Social Isolation

Changes in housing density, including individual housing, are commonly necessary in animal research. Obtaining reproducibility and translational validity in biomedical research requires an understanding of how animals adapt to changes in housing density. Existing literature mainly addresses acclimatization after transportation. We used a within-subject design to examine changes in behavior and weight gain of 4-mo-old male Wistar Han rats after reduction of their social group (RSG; due to removal of one rat from a cage containing 3 rats) and social isolation (SI; the removed rat) for the subsequent 2 wk. Changes in weight gain and in exploratory and center-avoidance behavior in an inescapable open arena (OA) were measured before (D0) and on days 7 and 14 (D7 and D14, respectively) after social change. The motor response to d-amphetamine (1.5 mg/kg), which stimulates behavioral arousal in response to novelty, was assessed at D14. Within-subject design revealed that RSG rats in OA had less locomotion at D7 but not more center-avoidance behavior and had returned to the D0 activity level at D14; SI rats in OA had consistently less locomotion and more center-avoidance behavior. Rearing behavior during OA exposure did not change in either group. However, SI rats showed more center-avoidance behavior in OA, greater weight gain, and less amphetamine-induced rearing at D14 as compared with RSG rats. These data indicate that after RSG, mature adult male rats require 2 wk to return to their baseline level of OA-related behavior, while after SI they gain weight and acquire maladaptive exploratory and center-avoidance behavior. The finding that SI produces maladaptive behavioral and physiologic alterations in adult male rats deserves attention because these changes could have confounding effects on research findings.

Midfrontal Theta Activity Is Sensitive to Approach-Avoidance Conflict

Midfrontal theta (FMθ) in the human EEG is commonly viewed as a generic and homogeneous mechanism of cognitive control in general and conflict processing in particular. However, the role of FMθ in approach-avoidance conflicts and its cross-task relationship to simpler stimulus-response conflicts remain to be examined more closely. Therefore, we recorded EEG data while 59 healthy participants (49 female, 10 male) completed both an approach-avoidance task and a flanker task. Participants showed significant increases in FMθ power in response to conflicts in both tasks. To our knowledge, this is the first study to show a direct relationship between FMθ and approach-avoidance conflicts. Crucially, FMθ activity was task dependent and showed no cross-task correlation. To assess the possibility of multiple FMθ sources, we applied source separation [generalized eigendecomposition (GED)] to distinguish independent FMθ generators. The activity of the components showed a similar pattern and was again task specific. However, our results did not yield a clear differentiation between task-specific FMθ sources for each of the participants. Overall, our results show FMθ increases in approach-avoidance conflicts, as has been established only for more simple response conflict paradigms so far. The independence of task-specific FMθ increases suggests differential sensitivity of FMθ to different forms of behavioral conflict.SIGNIFICANCE STATEMENT FMθ is well established as an indicator for cognitive conflict in tasks involving simple stimulus-response conflicts. However, we do not yet know about its role in more complex forms of goal ambivalence, such as approach-avoidance conflicts. Thus, we implemented an approach-avoidance task and a flanker task to investigate FMθ in response to simple as well as more complex response conflicts. To our knowledge, this is the first study to show a direct relationship between FMθ and approach-avoidance conflicts. Although the transient FMθ increase is similar to that induced in a simple response conflict task, individual FMθ responsiveness to these two forms of conflict were independent of each other, suggesting intraindividual differences in the sensitivity of FMθ to different forms of behavioral conflict.

The influence of continuous prenatal exposure to valproic acid on physical, nociceptive, emotional and psychomotor responses during adolescence in mice: Dose-related effects within sexes

Clinical findings show that the use of valproic acid (VPA) during pregnancy increases the risk of birth defects and autism spectrum disorder in offspring. Although there is a consensus that monitoring of potential long-term outcomes of VPA exposure is needed, especially in undiagnosed individuals, preclinical studies addressing this issue are rare. The present study examined the effects of continuous intrauterine exposure to a wide dose range of VPA (50, 100, 200, and 400 mg/kg/day) on the physical and behavioral response in peripubertal mice as a rodent model of adolescence. Body weight and the hot plate test [on postnatal days (PND) 25 and 32], the elevated plus-maze test (on PND35), and the open field test (on PND40) served to examine physical growth, the supraspinal reflex response to a painful thermal stimulus and conditional learning, anxiety-like/risk-assessment behavior, as well as novelty-induced psychomotor activity, respectively. VPA exposure produced the following responses: (i) a negative effect on body weight, except for the dose of 100 mg/kg/day in both sexes; (ii) an increase in the percentage of animals that responded to the thermal stimulus above the defined cut-off time interval and the response latency in both sexes; (iii) dose-specific changes within sexes in behavior provoked by a novel anxiogenic environment, i.e., in females less anxiety-like/risk-assessment behavior in response to the lowest exposure dose, and in males more pronounced anxiety-like/risk-assessment behavior after exposure to the highest dose and 100 mg/kg/day; (iv) dose-specific changes within sexes in novelty-induced psychomotor activity, i.e., in females a decrease in stereotypy-like activity along with an increase in rearing, and in males a decrease in stereotypy-like activity only. These findings show that continuous intrauterine exposure to VPA produces maladaptive functioning in different behavioral domains in adolescence and that the consequences are delicate to assess as they are dose-related within sexes.

Striatal reactivity during emotion and reward relates to approach-avoidance conflict behaviour and is altered in adults with anxiety or depression

BACKGROUND

We have previously reported activation in reward, salience and executive control regions during functional MRI (fMRI) using an approach-avoidance conflict (AAC) decision-making task with healthy adults. Further investigations into how anxiety and depressive disorders relate to differences in neural responses during AAC can inform their understanding and treatment. We tested the hypothesis that people with anxiety or depression have altered neural activation during AAC.

METHODS

We compared 118 treatment-seeking adults with anxiety or depression and 58 healthy adults using linear mixed-effects models to examine group-level differences in neural activation (fMRI) during AAC decision-making. Correlational analyses examined relationships between behavioural and neural measures.

RESULTS

Adults with anxiety or depression had greater striatal engagement when reacting to affective stimuli (p = 0.008, d = 0.31) regardless of valence, and weaker striatal engagement during reward feedback (p = 0.046, d = -0.27) regardless of the presence of monetary reward. They also had blunted amygdala activity during decision-making (p = 0.023, d = -0.32) regardless of the presence of conflict. Across groups, approach behaviour during conflict decision-making was inversely correlated with striatal activation during affective stimuli (p < 0.001, r = -0.28) and positively related to striatal activation during reward feedback (p < 0.001, r = 0.27).

LIMITATIONS

Our transdiagnostic approach did not allow for comparisons between specific anxiety disorders, and our cross-sectional approach did not allow for causal inference.

CONCLUSION

Anxiety and depression were associated with altered neural responses to AAC. Findings were consistent with the role of the striatum in action selection and reward responsivity, and they point toward striatal reactivity as a future treatment target. Blunting of amygdala activity in anxiety or depression may indicate a compensatory response to inhibit affective salience and maintain approach.

An fMRI study of cognitive regulation of reward processing in generalized anxiety disorder (GAD)

BACKGROUND

Cognitive regulation can affect the process of decision making. Generalized anxiety disorder (GAD) patients seem to have an impairment in cognitive regulation of reward processing concerning food stimuli. This study aims to explore the impact of GAD in cognitive regulation of food-related rewards.

METHODS

GAD patients (n=11) and healthy controls (n=15) performed a cognitive regulation craving task with food images while undergoing a functional magnetic resonance imaging (fMRI) acquisition. Between-group differences in functional connectivity were measured using dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) seeds during cognitive regulation.

RESULTS

During cognitive regulation, there was a significant interaction for functional connectivity between the right dlPFC and bilateral vmPFC with the thalamus. GAD patients had lower functional connectivity for cognitive regulation conditions (distance and indulge) than for the non-regulated condition in these clusters, while control participants presented the opposite pattern. GAD group presented fixed food valuation scores after cognitive regulation.

CONCLUSIONS

GAD participants showed inflexibility while valuating food images, that could be produced by cognitive regulation deficits underpinned by functional connectivity alterations between prefrontal regions and the thalamus. These results show cognitive inflexibility and difficulty in the modulation of cognitive responses during decision making in GAD patients.

Reliance on distraction is associated with increased avoidance behavior under approach-avoidance conflict

The use of less effective emotional regulation strategies, such as distraction, may relate to greater reliance on avoidance behavior under conflict. Tulsa 1000 participants (n = 478) were recruited trans diagnostically and completed an approach avoidance conflict (AAC) task. Following the task, participants reported their use of distraction as an emotional regulation strategy. Quantile regression showed negative main effects of distraction and age on approach behavior under conflict. This suggests that individuals who use distraction as a regulation strategy are more likely to engage in avoidance behavior under conflict, which has treatment implications.

Cortico-Striatal Control over Adaptive Goal-Directed Responding Elicited by Cues Signaling Sucrose Reward or Punishment

The medial prefrontal cortex (mPFC) and nucleus accumbens (NAc) have been associated with the expression of adaptive and maladaptive behavior elicited by fear-related and drug-associated cues. However, reported effects of mPFC manipulations on cue-elicited natural reward-seeking and inhibition thereof have been varied, with few studies examining cortico-striatal contributions in tasks that require adaptive responding to cues signaling reward and punishment within the same session. The current study aimed to better elucidate the role of mPFC and NAc subdivisions, and their functional connectivity in cue-elicited adaptive responding using a novel discriminative cue responding task. Male Long-Evans rats learned to lever-press on a VR5 schedule for a discriminative cue signaling reward, and to avoid pressing the same lever in the presence of another cue signaling punishment. Postacquisition, prelimbic (PL) and infralimbic (IL) areas of the mPFC, NAc core, shell, PL-core, or IL-shell circuits were pharmacologically or chemogenetically inhibited while animals performed under (1) nonreinforced (extinction) conditions, where the appetitive and aversive cues were presented in alternating trials alone or as a compound stimulus; and (2) reinforced conditions, whereby cued responding was accompanied by associated outcomes. PL and IL inactivation attenuated nonreinforced and reinforced goal-directed cue responding, whereas NAc core and shell inactivation impaired nonreinforced responding for the appetitive, but not aversive cue. Furthermore, PL-core and IL-shell inhibition disinhibited nonreinforced but not reinforced cue responding. Our findings implicate the mPFC as a site of confluence of motivationally significant cues and outcomes, and in the regulation of nonreinforced cue responding via downstream NAc targets.SIGNIFICANCE STATEMENT The ability to discriminate and respond appropriately to environmental cues that signal availability of reward or punishment is essential for survival. The medial prefrontal cortex (mPFC) and nucleus accumbens (NAc) have been implicated in adaptive and maladaptive behavior elicited by fear-related and drug-associated cues. However, less is known about the role they play in orchestrating adaptive responses to natural reward and punishment cues within the same behavioral task. Here, using a novel discriminative cue responding task combined with pharmacological or chemogenetic inhibition of mPFC, NAc and mPFC-NAc circuits, we report that mPFC is critically involved in responding to changing cued response-outcomes, both when the responses are reinforced, and nonreinforced. Furthermore, the mPFC coordinates nonreinforced discriminative cue responding by suppressing inappropriate responding via downstream NAc targets.

Costly avoidance of Pavlovian fear stimuli and the temporal dynamics of its decision process

Conflicts between avoiding feared stimuli versus approaching them for competing rewards are essential for functional behavior and anxious psychopathology. Yet, little is known about the underlying decision process. We examined approach-avoidance decisions and their temporal dynamics when avoiding Pavlovian fear stimuli conflicted with gaining rewards. First, a formerly neutral stimulus (CS+) was repeatedly paired with an aversive stimulus (US) to establish Pavlovian fear. Another stimulus (CS−) was never paired with the US. A control group received neutral tones instead of aversive USs. Next, in each of 324 trials, participants chose between a CS−/low reward and a CS+/high reward option. For the latter, probability of CS+ presentation (Pavlovian fear information) and reward magnitude (reward information) varied. Computer mouse movements were tracked to capture the decision dynamics. Although no more USs occurred, pronounced and persistent costly avoidance of the Pavlovian fear CS+ was found. Time-continuous multiple regression of movement trajectories revealed a stronger and faster impact of Pavlovian fear compared to reward information during decision-making. The impact of fear information, but not reward information, modestly decreased across trials. These findings suggest a persistently stronger weighting of fear compared to reward information during approach-avoidance decisions, which may facilitate the development of pathological avoidance.

Emotional processing prospectively modulates the impact of anxiety on COVID-19 pandemic-related post-traumatic stress symptoms: an ERP study

BACKGROUND

Considering that the elevated distress caused by the COVID-19 pandemic, in some cases, led to post-traumatic stress symptoms (PTSS), it has been proposed as a specific traumatic event. The present longitudinal study investigated pre-pandemic motivated attention to emotional stimuli, as indexed by Late Positive Potential (LPP) amplitude, in relation with the potential differential role of anxiety and depressive symptoms in predicting PTSS severity related to the COVID-19 pandemic.

METHODS

A total of 79 university students initially completed self-report measures of depression and anxiety along with a passive viewing task of emotional (pleasant, unpleasant) and neutral pictures while electroencephaloghic activity was recorded. In December 2020, 57 participants completed a questionnaire assessing PTSS.

RESULTS

Significant interactions between anxiety and LPP emerged in predicting pandemic-related PTSS, where greater anxiety symptoms predicted PTSS only in individuals with greater LPP to unpleasant or with reduced LPP to pleasant stimuli.

LIMITATIONS

The prevalence of the female sex, the relatively young age of the participants, as well as the fact that they were all enrolled in a University course might not allow the generalization of the findings.

CONCLUSIONS

Taken together, the present longitudinal study provided novel evidence on EEG predictors of pandemic-related PTSS that might be useful for the prevention and treatment of PTSS. Indeed, assessing anxiety symptoms and pre-trauma LPP to emotional stimuli might be a useful target for identifying individuals that are more vulnerable to the development of PTSS during times of crisis.

Multiplexed action-outcome representation by striatal striosome-matrix compartments detected with a mouse cost-benefit foraging task

Learning about positive and negative outcomes of actions is crucial for survival and underpinned by conserved circuits including the striatum. How associations between actions and outcomes are formed is not fully understood, particularly when the outcomes have mixed positive and negative features. We developed a novel foraging (‘bandit’) task requiring mice to maximize rewards while minimizing punishments. By 2-photon Ca⁺⁺ imaging, we monitored activity of visually identified anterodorsal striatal striosomal and matrix neurons. We found that action-outcome associations for reward and punishment were encoded in parallel in partially overlapping populations. Single neurons could, for one action, encode outcomes of opposing valence. Striosome compartments consistently exhibited stronger representations of reinforcement outcomes than matrix, especially for high reward or punishment prediction errors. These findings demonstrate multiplexing of action-outcome contingencies by single identified striatal neurons and suggest that striosomal neurons are particularly important in action-outcome learning.

The role that the striatum plays in tracking the association between actions and combinations of rewarding and aversive outcomes remains unclear. Here, by using both calcium imaging in mice and reinforcement learning models, the authors find that individual striatal neurons can encode associations between actions and multiple, sometimes conflicting, outcomes.

The Good, the Bad, and the Ugly-Chances, Challenges, and Clinical Implications of Avoidance Research in Psychosomatic Medicine

Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key factors in the etiology and pathophysiology of anxiety- and stress-related psychosomatic disorders. In these overlapping conditions, avoidance can increase the risk of mental comorbidities and interfere with the efficacy of cognitive behavioral treatment approaches built on fear extinction. Despite resurging interest in avoidance research also in the context of psychosomatic medicine, especially in conditions associated with pain, disturbed interoception, and disorders of the gut-brain axis, current study designs and their translation into the clinical context face significant challenges limiting both, the investigation of mechanisms involved in avoidance and the development of novel targeted treatment options. We herein selectively review the conceptual framework of learning and memory processes, emphasizing how classical and operant conditioning, fear extinction, and return of fear shape avoidance behaviors. We further discuss pathological avoidance and safety behaviors as hallmark features in psychosomatic diseases, with a focus on anxiety- and stress-related disorders. Aiming to emphasize chances of improved translational knowledge across clinical conditions, we further point out limitations in current experimental avoidance research. Based on these considerations, we propose means to improve existing avoidance paradigms to broaden our understanding of underlying mechanisms, moderators and mediators of avoidance, and to inspire tailored treatments for patients suffering from psychosomatic disorders.

Neural correlates and determinants of approach-avoidance conflict in the prelimbic prefrontal cortex

The recollection of environmental cues associated with threat or reward allows animals to select the most appropriate behavioral responses. Neurons in the prelimbic (PL) cortex respond to both threat- and reward-associated cues. However, it remains unknown whether PL regulates threat-avoidance vs. reward-approaching responses when an animals’ decision depends on previously associated memories. Using a conflict model in which male Long–Evans rats retrieve memories of shock- and food-paired cues, we observed two distinct phenotypes during conflict: (1) rats that continued to press a lever for food (Pressers) and (2) rats that exhibited a complete suppression in food seeking (Non-pressers). Single-unit recordings revealed that increased risk-taking behavior in Pressers is associated with persistent food-cue responses in PL, and reduced spontaneous activity in PL glutamatergic (PL^GLUT) neurons during conflict. Activating PL^GLUT neurons in Pressers attenuated food-seeking responses in a neutral context, whereas inhibiting PL^GLUT neurons in Non-pressers reduced defensive responses and increased food approaching during conflict. Our results establish a causal role for PL^GLUT neurons in mediating individual variability in memory-based risky decision-making by regulating threat-avoidance vs. reward-approach behaviors.

Polygenic risk for neuroticism moderates response to gains and losses in amygdala and caudate: Evidence from a clinical cohort

BACKGROUND

Neuroticism is a heritable trait that contributes to the vulnerability to depression. We used polygenic risk scores (PRS) to examine genetic vulnerability to neuroticism and its associations with reward/punishment processing in a clinical sample with mood, anxiety, and substance use disorders. It was hypothesized that higher PRS for neuroticism is associated with attenuated neural responses to reward/punishment.

METHOD

Four hundred sixty-nine participants were genotyped and their PRSs for neuroticism were computed. Associations between PRS for neuroticism and anticipatory processing of monetary incentives were examined using functional magnetic resonance imaging.

RESULTS

Individuals with higher PRS for neuroticism showed less anticipatory activation in the left amygdala and caudate region to incentives regardless of incentive valence. Further, these individuals exhibited altered sensitivity to gain/loss processing in the right anterior insula. Higher PRSs for neuroticism were also associated with reduced processing of gains in the precuneus.

LIMITATIONS

The study population consisted of a transdiagnostic sample with dysfunctions in positive and negative valence processing. PRS for neuroticism may be correlated with current clinical symptoms due to the vulnerability to psychiatric disorders.

CONCLUSIONS

Greater genetic loading for neuroticism was associated with attenuated anticipatory responsiveness in reward/punishment processing with altered sensitivity to valences. Thus, a higher genetic risk for neuroticism may limit the degree to which positive and/or negative outcomes influence the current mood state, which may contribute to the development of positive and negative affective dysfunctions in individuals with mood, anxiety, and addictive disorders.

Neural Responsivity to Reward versus Punishment Shortly after Trauma Predicts Long-term Development of Post-Traumatic Stress Symptoms

BACKGROUND

Processing negative and positive valenced stimuli involve multiple brain regions including the amygdala and ventral striatum (VS). Post-Traumatic Stress Disorder (PTSD) is often associated with hyper-responsivity to negatively valenced, yet recent evidence also points to deficient positive valence functioning. It is yet unclear what is the relative contribution of such opposing valence processing shortly after trauma to the development of chronic PTSD.

METHODS

Neurobehavioral indicators of motivational positive vs. negative valence sensitivities were longitudinally assessed in 171 adults (87 females, age=34.19±11.47 years) at 1-, 6-, and 14-months following trauma exposure (TP1, TP2, TP3). Using a gambling fMRI paradigm, amygdala and VS functionality (activity and functional connectivity with the prefrontal cortex) in response to rewards vs. punishments were assessed with relation to PTSD severity at different time-points. The effect of valence processing was depicted behaviorally by the amount of risk taken to maximize reward.

RESULTS

PTSD severity at TP1 was associated with greater neural functionality in the amygdala (but not the VS) towards punishments vs. rewards, and fewer risky choices. PTSD severity at TP3 was associated with decreased neural functionality in both the VS and amygdala towards rewards vs. punishments at TP1 (but not with risky behavior). Explainable machine learning revealed the primacy of VS biased processing, over the amygdala, in predicting PTSD severity at TP3.

CONCLUSIONS

These results highlight the importance of biased neural responsivity to positive relative to negative motivational outcomes in PTSD development. Novel therapeutic strategies early after trauma may thus target both valence fronts.

The Role of the Dorsal-Lateral Prefrontal Cortex in Reward Sensitivity During Approach-Avoidance Conflict

Approach-Avoidance conflict (AAC) arises from decisions with embedded positive and negative outcomes, such that approaching leads to reward and punishment and avoiding to neither. Despite its importance, the field lacks a mechanistic understanding of which regions are driving avoidance behavior during conflict. In the current task, we utilized transcranial magnetic stimulation (TMS) and drift-diffusion modeling to investigate the role of one of the most prominent regions relevant to AAC-the dorsolateral prefrontal cortex (dlPFC). The first experiment uses in-task disruption to examine the right dlPFC's (r-dlPFC) causal role in avoidance behavior. The second uses single TMS pulses to probe the excitability of the r-dlPFC, and downstream cortical activations, during avoidance behavior. Disrupting r-dlPFC during conflict decision-making reduced reward sensitivity. Further, r-dlPFC was engaged with a network of regions within the lateral and medial prefrontal, cingulate, and temporal cortices that associate with behavior during conflict. Together, these studies use TMS to demonstrate a role for the dlPFC in reward sensitivity during conflict and elucidate the r-dlPFC's network of cortical regions associated with avoidance behavior. By identifying r-dlPFC's mechanistic role in AAC behavior, contextualized within its conflict-specific downstream neural connectivity, we advance dlPFC as a potential neural target for psychiatric therapeutics.

Reduced neural differentiation of rewards and punishment during passive avoidance learning in adolescents with generalized anxiety disorder

BACKGROUND

It has been proposed that individuals with generalized anxiety disorder (GAD) show dysfunctional computations related to approach-avoidance decision-making. However, few studies have examined the neural basis of this impairment, particularly in adolescents with GAD. The goal of the current study was to address this gap in the literature.

METHOD

The study involved 51 adolescents with GAD and 51 typically developing (TD) comparison individuals matched on age (16.10 and 15.75 respective means), gender (30 F/21 M and 24 F/27 M), and IQ (103.20 and 103.18 respective means). Participants underwent functional magnetic resonance imaging during a passive avoidance task.

RESULTS

We found a significant Group-by-Reinforcement interaction within reward-related brain regions including the caudate, putamen, mid cingulate/paracentral lobule, and superior and middle frontal gyrus. TD adolescents showed a greater differential response to reward versus punishment feedback within these regions relative to adolescents with GAD. In particular, this reflected reduced responses to rewards in the adolescents with GAD. There were no group differences in neural responses when making approach/avoidance responses.

CONCLUSION

The results of this study suggest reduced differential responsiveness to reinforcement as a component of the pathophysiology seen in adolescents with GAD. This dysfunction likely underpins decision-making impairments that may exacerbate the participants' worry.

A 7-Tesla MRI Study of the Periaqueductal Grey: Resting State and Task Activation Under Threat

The periaqueductal grey (PAG) is a region of the midbrain implicated in a variety of behaviors including defensive responses to threat. Despite the wealth of knowledge pertaining to the differential functional roles of the PAG columns in nonhuman and human research, the basic functional connectivity of the PAG at rest has not been well characterized. Therefore, the current study utilized 7-Tesla MRI to characterize PAG functional connectivity at rest and task activation under uncertain threat. A sample of 53 neurologically healthy undergraduate participants (Mage=22.2, SDage=3.62) underwent structural and resting state functional MRI scans. Supporting previous work, voxel-wise analyses showed the PAG is functionally connected to emotion regulation and fear networks. Comparison of functional connectivity of PAG columns did not reveal any significant differences. Thirty-five participants from the same sample also completed an uncertain threat task with blocks of 3 conditions-No shock, Predictable shock, and Unpredictable shock. There were no robust activity differences within the PAG columns or the whole PAG across conditions, though there was differential activity at the voxel level in the PAG and in other regions theoretically relevant to uncertain threat. Results of this study elucidate PAG connectivity at rest and activation in response to uncertain threat.

Impaired probabilistic reversal learning in anxiety: Evidence from behavioral and ERP findings

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High and low anxious participants finish a probabilistic reversal learning task.

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High anxious participants showed a worse performance and less likely to lose-shift.

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Feedback-related negativity (FRN) was correlated with the frequency of lose-shift.

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High anxious participants showed a smaller FRN in response to lose-shift.

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Anxious people’s reversal learning is affected by impaired sensitivity to losses.

Background

Reversal learning reflects an individual’s capacity to adapt to a dynamic environment with changing stimulus–reward contingencies. This study focuses on the potential influence of anxiety on reversal learning skills.

Methods

We asked 40 participants with a high level of trait anxiety (HTA) and 40 counterparts with a low anxiety level (LTA) to finish a probabilistic reversal learning task with event-related potential (ERP) recording, during which stimulus–reward contingencies are reversed after players have learned the optimal choice.

Results

We found that compared to their LTA counterparts, the HTA participants showed worse learning performance and were less likely to make lose-shift choices. The FRN amplitude might help interpret these behavioral results, which is suggested to be associated with punishment sensitivity and was positively correlated with the number of lose-shift in this study. Seeing that anxiety level predicted the FRN amplitude for lose-shift, we explain that anxious individuals’ inflexible behavioral responses to losses are due to their impaired sensitivity to negative feedback.

Conclusions

A higher level of anxiety is associated with weaker reversal learning performance, possibly because of abnormal sensitivity to negative outcomes. These findings have implications for the understanding of behavioral symptoms in anxiety.

Causal Evidence for Induction of Pessimistic Decision-Making in Primates by the Network of Frontal Cortex and Striosomes

Clinical studies have shown that patients with anxiety disorders exhibited coactivation of limbic cortices and basal ganglia, which together form a large-scale brain network. The mechanisms by which such a large-scale network could induce or modulate anxiety-like states are largely unknown. This article reviews our experimental program in macaques demonstrating a causal involvement of local striatal and frontal cortical sites in inducing pessimistic decision-making that underlies anxiety. Where relevant, we related these findings to the wider literature. To identify such sites, we have made a series of methodologic advances, including the combination of causal evidence for behavioral modification of pessimistic decisions with viral tracing methods. Critically, we introduced a version of the classic approach-avoidance (Ap-Av) conflict task, modified for use in non-human primates. We performed microstimulation of limbic-related cortical regions and the striatum, focusing on the pregenual anterior cingulate cortex (pACC), the caudal orbitofrontal cortex (cOFC), and the caudate nucleus (CN). Microstimulation of localized sites within these regions induced pessimistic decision-making by the monkeys, supporting the idea that the focal activation of these regions could induce an anxiety-like state, which subsequently influences decision-making. We further performed combined microstimulation and tract-tracing experiments by injecting anterograde viral tracers into focal regions, at which microstimulation induced increased avoidance. We found that effective stimulation sites in both pACC and cOFC zones projected preferentially to striosomes in the anterior striatum. Experiments in rodents have shown that the striosomes in the anterior striatum project directly to the dopamine-containing cells in the substantia nigra, and we have found evidence for a functional connection between striosomes and the lateral habenular region in which responses to reward are inhibitory. We present here further evidence for network interactions: we show that the pACC and cOFC project to common structures, including not only the anterior parts of the striosome compartment but also the tail of the CN, the subgenual ACC, the amygdala, and the thalamus. Together, our findings suggest that networks having pACC and cOFC as nodes share similar features in their connectivity patterns. We here hypothesize, based on these results, that the brain sites related to pessimistic judgment are mediated by a large-scale brain network that regulates dopaminergic functions and includes striosomes and striosome-projecting cortical regions.

Long-term stability of computational parameters during approach-avoidance conflict in a transdiagnostic psychiatric patient sample

Maladaptive behavior during approach-avoidance conflict (AAC) is common to multiple psychiatric disorders. Using computational modeling, we previously reported that individuals with depression, anxiety, and substance use disorders (DEP/ANX; SUDs) exhibited differences in decision uncertainty and sensitivity to negative outcomes versus reward (emotional conflict) relative to healthy controls (HCs). However, it remains unknown whether these computational parameters and group differences are stable over time. We analyzed 1-year follow-up data from a subset of the same participants (N = 325) to assess parameter stability and relationships to other clinical and task measures. We assessed group differences in the entire sample as well as a subset matched for age and IQ across HCs (N = 48), SUDs (N = 29), and DEP/ANX (N = 121). We also assessed 2-3 week reliability in a separate sample of 30 HCs. Emotional conflict and decision uncertainty parameters showed moderate 1-year intra-class correlations (.52 and .46, respectively) and moderate to excellent correlations over the shorter period (.84 and .54, respectively). Similar to previous baseline findings, parameters correlated with multiple response time measures (ps < .001) and self-reported anxiety (r = .30, p < .001) and decision difficulty (r = .44, p < .001). Linear mixed effects analyses revealed that patients remained higher in decision uncertainty (SUDs, p = .009) and lower in emotional conflict (SUDs, p = .004, DEP/ANX, p = .02) relative to HCs. This computational modelling approach may therefore offer relatively stable markers of transdiagnostic psychopathology.