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Lago TR, Brownstein MJ, Page E, Beydler E, Manbeck A, Beale A, Roberts C, Balderston N, Damiano E, Pineles SL, Simon N, Ernst M, Grillon C. The novel vasopressin receptor (V1aR) antagonist SRX246 reduces anxiety in an experimental model in humans: a randomized proof-of-concept study. Psychopharmacology (Berl) 2021; 238:2393-2403. [PMID: 33970290 PMCID: PMC8376758 DOI: 10.1007/s00213-021-05861-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
RATIONALE Arginine vasopressin (AVP) is a neuropeptide that modulates both physiological and emotional responses to threat. Until recently, drugs that target vasopressin receptors (V1a) in the human central nervous system were unavailable. The development of a novel V1a receptor antagonist, SRX246, permits the experimental validation of vasopressin's role in the regulation of anxiety and fear in humans. OBJECTIVES Here, we examined the effects of SRX246 in a proof-of-concept translational paradigm of fear (phasic response to imminent threat) and anxiety (prolonged response to potential threat). METHODS Healthy volunteers received both SRX246 and placebo in a randomized, double-blind, counter-balanced order separated by a 5-7-day wash-out period. Threat consisted of unpleasant electric shocks. The "NPU" threat test probed startle reactivity during predictable threat (i.e., fear-potentiated startle) and unpredictable threat (i.e., anxiety-potentiated startle). RESULTS As predicted, SRX246 decreased anxiety-potentiated startle independent of fear-potentiated startle. CONCLUSIONS As anxiety-potentiated startle is elevated in anxiety and trauma-associated disorders and decreased by traditional anxiolytics such as SSRIs and benzodiazepines, the V1a receptor is a promising novel treatment target.
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Affiliation(s)
- Tiffany R Lago
- National Institute of Mental Health, Bethesda, MD, USA.
- VA Boston Healthcare System, Boston, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | | | - Emily Page
- National Institute of Mental Health, Bethesda, MD, USA
| | - Emily Beydler
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Alexis Beale
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Nicholas Balderston
- National Institute of Mental Health, Bethesda, MD, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Eve Damiano
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
| | - Suzanne L Pineles
- Boston University School of Medicine, Boston, MA, USA
- National Center, PTSD At VA Boston Healthcare System, Boston, MA, USA
| | - Neal Simon
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
- Lehigh University, Bethelhem, PA, USA
| | - Monique Ernst
- National Institute of Mental Health, Bethesda, MD, USA
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Culot C, Corlazzoli G, Fantini-Hauwel C, Gevers W. The relation between task-relatedness of anxiety and metacognitive performance. Conscious Cogn 2021; 94:103191. [PMID: 34388407 DOI: 10.1016/j.concog.2021.103191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 11/19/2022]
Abstract
It is well established that anxiety influences a range of cognitive processes such as cognitive control or decision-making. What is less known is how anxiety influences the metacognitive evaluations individuals make about their own performance. The present study explored the importance of task-relatedness in the relation between anxiety and metacognitive awareness. More specifically, we hypothesized that induced anxiety would affect metacognitive performance in opposite directions depending solely on whether the threat is perceived as related or unrelated to the performance. We conducted two experiments to test this hypothesis. In both studies, electric shocks were administered randomly, regardless of participant's performance. In experiment 1, participants were informed that the shocks would be administered randomly, unrelated to performance. In experiment 2, participants were told that their metacognitive performance would influence the administration of the electric shocks (i.e. fewer electric shocks with better metacognitive performance). Our predictions were confirmed. Threat perceived as unrelated to metacognitive performance (Experiment 1) decreased metacognitive performance. Threat believed to be related to metacognitive performance resulted in improved performance (Experiment 2). These findings confirm that induced anxiety exerts a strong influence on metacognitive awareness while sparing first-order task performance. We furthermore demonstrate that the perceived relatedness of the anxiety determines whether metacognitive performance decreases or improves performance under threat.
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Affiliation(s)
- Catherine Culot
- Center for Research in Cognition and Neurosciences (CRCN) - Université Libre de Bruxelles (ULB), Brussels, Belgium; Neurosciences Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium.
| | - Gaia Corlazzoli
- Center for Research in Cognition and Neurosciences (CRCN) - Université Libre de Bruxelles (ULB), Brussels, Belgium; Neurosciences Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Carole Fantini-Hauwel
- Research center for experiMEntAl & clinical cogNitive psychopatholoGy (MEANING), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Wim Gevers
- Center for Research in Cognition and Neurosciences (CRCN) - Université Libre de Bruxelles (ULB), Brussels, Belgium; Neurosciences Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
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Sambuco N, Costa VD, Lang PJ, Bradley MM. Aversive perception in a threat context: Separate and independent neural activation. Biol Psychol 2020; 154:107926. [PMID: 32621851 PMCID: PMC7490760 DOI: 10.1016/j.biopsycho.2020.107926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 11/19/2022]
Abstract
Unpleasant, compared to neutral, scenes reliably prompt enhanced functional brain activity in the amygdala and inferotemporal cortex. Considering data from psychophysiological studies in which defensive reactivity is further enhanced when viewing unpleasant scenes under threat of shock (compared to safety), the current study investigates functional activation in the amygdala-inferotemporal circuit when unpleasant (or neutral) scenes are viewed under threat of shock or safety. In this paradigm, a cue signaling threat or safety was presented in conjunction with either an unpleasant or neutral picture. Replicating previous studies, unpleasant, compared to neutral, scenes reliably enhanced activation in the amygdala and inferotemporal cortex. Functional activity in these regions, however, did not differ whether scenes were presented in a context threatening shock exposure, compared to safety, which instead activated regions of the anterior insula and cingulate cortex. Taken together, the data support a view in which neural regions activated in different defensive situations act independently.
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Affiliation(s)
- Nicola Sambuco
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States.
| | - Vincent D Costa
- Department of Behavioral Neuroscience, Oregon Health & Science University, United States
| | - Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
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Mkrtchian A, Aylward J, Dayan P, Roiser JP, Robinson OJ. Modeling Avoidance in Mood and Anxiety Disorders Using Reinforcement Learning. Biol Psychiatry 2017; 82:532-539. [PMID: 28343697 PMCID: PMC5598542 DOI: 10.1016/j.biopsych.2017.01.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/10/2017] [Accepted: 01/30/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Serious and debilitating symptoms of anxiety are the most common mental health problem worldwide, accounting for around 5% of all adult years lived with disability in the developed world. Avoidance behavior-avoiding social situations for fear of embarrassment, for instance-is a core feature of such anxiety. However, as for many other psychiatric symptoms the biological mechanisms underlying avoidance remain unclear. METHODS Reinforcement learning models provide formal and testable characterizations of the mechanisms of decision making; here, we examine avoidance in these terms. A total of 101 healthy participants and individuals with mood and anxiety disorders completed an approach-avoidance go/no-go task under stress induced by threat of unpredictable shock. RESULTS We show an increased reliance in the mood and anxiety group on a parameter of our reinforcement learning model that characterizes a prepotent (pavlovian) bias to withhold responding in the face of negative outcomes. This was particularly the case when the mood and anxiety group was under stress. CONCLUSIONS This formal description of avoidance within the reinforcement learning framework provides a new means of linking clinical symptoms with biophysically plausible models of neural circuitry and, as such, takes us closer to a mechanistic understanding of mood and anxiety disorders.
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Affiliation(s)
- Anahit Mkrtchian
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Jessica Aylward
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Peter Dayan
- Gatsby Computational Neuroscience Unit, University College London, London, United Kingdom
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Oliver J Robinson
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
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Vytal KE, Arkin NE, Overstreet C, Lieberman L, Grillon C. Induced-anxiety differentially disrupts working memory in generalized anxiety disorder. BMC Psychiatry 2016; 16:62. [PMID: 26976146 PMCID: PMC4791753 DOI: 10.1186/s12888-016-0748-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 02/12/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Anxiety is characterized by a bias towards threatening information, anxious apprehension, and disrupted concentration. Previous research in healthy subjects suggests that working memory (WM) is disrupted by induced anxiety, but that increased task-demand reduces anxiety and WM is preserved. However, it is unknown if patients with generalized anxiety disorder (GAD) can similarly normalize their performance on difficult WM tasks while reducing their anxiety. Increased threat-related bias and impoverished top-down control in trait anxiety suggests that patients may not reap the same cognitive and emotional benefits from demanding tasks that those low in anxiety. Here we examine this possibility using a WM task of varying difficulty. METHODS GAD patients (N = 30) and healthy controls (N = 30) performed an n-back task (no-load, 1-back, 2-back, and 3-back) while at risk for shock (threat) or safe from shock (safe). Anxiety was measured via startle reflex and self-report. RESULTS As predicted, healthy controls' performance was impaired under threat during low-load tasks and facilitated during high-load tasks. In contrast, GAD patients' performance was impaired under threat regardless of WM load. Anxiety was reduced as cognitive load increased in both groups. CONCLUSIONS The divergence of emotion regulation (reduction) and performance (persistent impairment) in the patient but not the control group, suggests that different top-down mechanisms may be operating to reduce anxiety. Continued WM disruption in patients indicates that attentional resources are allocated to emotion regulation instead of goal-directed behavior. Implications for our understanding of cognitive disruption in patients, and related therapeutic interventions are discussed.
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Affiliation(s)
- Katherine E Vytal
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, 15K North Drive, MSC 2670, Bethesda, MD, 20892-2670, USA.
| | - Nicole E Arkin
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, 15K North Drive, MSC 2670, Bethesda, MD, 20892-2670, USA
| | - Cassie Overstreet
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, 15K North Drive, MSC 2670, Bethesda, MD, 20892-2670, USA
| | - Lynne Lieberman
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, 15K North Drive, MSC 2670, Bethesda, MD, 20892-2670, USA
| | - Christian Grillon
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, 15K North Drive, MSC 2670, Bethesda, MD, 20892-2670, USA
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Abstract
Anxiety has wide-reaching and complex effects on cognitive performance. Although it can intrude on cognition and interfere with performance, it can also facilitate information processing and behavioural responses. In a previous study, we showed that anxiety induced by threat of shock facilitates performance on the Sustained Attention to Response Task, a vigilance test, which probes response inhibition to infrequent nogo stimuli. The present study sought to identify factors that may have contributed to such improved performance, including on- and off-task thinking (assessed with thought probes) and individual differences in attention control, as measured with the Attention Control Scale. Replicating our prior finding, we showed that shock threat significantly reduced errors of commission on the nogo trials. However, we extended this finding in demonstrating that this effect was driven by subjects with low attention control. We therefore confirm that anxiety increases inhibitory control of prepotent responses--a mechanism which is adaptive under threat--and show that this effect is greater in those who rely more upon such prepotent responding, i.e., those with low attentional control.
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Affiliation(s)
- Christian Grillon
- a Section on Neurobiology of Fear and Anxiety , National Institute of Mental Health, National Institutes of Health , Bethesda , MD , USA
| | - Oliver J Robinson
- a Section on Neurobiology of Fear and Anxiety , National Institute of Mental Health, National Institutes of Health , Bethesda , MD , USA
| | - Ambika Mathur
- a Section on Neurobiology of Fear and Anxiety , National Institute of Mental Health, National Institutes of Health , Bethesda , MD , USA
| | - Monique Ernst
- a Section on Neurobiology of Fear and Anxiety , National Institute of Mental Health, National Institutes of Health , Bethesda , MD , USA
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Costa VD, Bradley MM, Lang PJ. From threat to safety: instructed reversal of defensive reactions. Psychophysiology 2015; 52:325-32. [PMID: 25250656 DOI: 10.1111/psyp.12359] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 08/28/2014] [Indexed: 11/28/2022]
Abstract
Cues that signal the possibility of receiving an electric shock reliably induce defensive activation. To determine whether cues can also easily reverse defensive reactions, a threat reversal paradigm was developed in which a cue signaling threat of shock reversed its meaning across the course of the study. This allowed us to contrast defensive reactions to threat cues that became safe cues, with responses to cues that continued to signal threat or safety. Results showed that, when participants were instructed that a previously threatening cue now signaled safety, there was an immediate and complete attenuation of defensive reactions compared to threat cues that maintained their meaning. These findings highlight the role that language can play both in instantiating and attenuating defensive reactions, with implications for understanding emotion regulation, social communication, and clinical phenomena.
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Affiliation(s)
- Vincent D Costa
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, Florida, USA; National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Robinson OJ, Bond RL, Roiser JP. The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms. PeerJ 2015; 3:e770. [PMID: 25699215 PMCID: PMC4330902 DOI: 10.7717/peerj.770] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/26/2015] [Indexed: 01/01/2023] Open
Abstract
Stress can precipitate the onset of mood and anxiety disorders. This may occur, at least in part, via a modulatory effect of stress on decision-making. Some individuals are, however, more resilient to the effects of stress than others. The mechanisms underlying such vulnerability differences are nevertheless unknown. In this study we attempted to begin quantifying individual differences in vulnerability by exploring the effect of experimentally induced stress on decision-making. The threat of unpredictable shock was used to induce stress in healthy volunteers (N = 47) using a within-subjects, within-session design, and its impact on a financial decision-making task (the Iowa Gambling Task) was assessed alongside anxious and depressive symptomatology. As expected, participants learned to select advantageous decks and avoid disadvantageous decks. Importantly, we found that stress provoked a pattern of harm-avoidant behaviour (decreased selection of disadvantageous decks) in individuals with low levels of trait anxiety. By contrast, individuals with high trait anxiety demonstrated the opposite pattern: stress-induced risk-seeking (increased selection of disadvantageous decks). These contrasting influences of stress depending on mood and anxiety symptoms might provide insight into vulnerability to common mental illness. In particular, we speculate that those who adopt a more harm-avoidant strategy may be better able to regulate their exposure to further environmental stress, reducing their susceptibility to mood and anxiety disorders.
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Affiliation(s)
| | - Rebecca L Bond
- Institute of Cognitive Neuroscience, University College London , UK
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