Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

Taylor-Clift, April; Morris, Bethany H.; Rottenberg, Jonathan; Kovács, Mária

doi:10.1017/s003329171000036x

Cited by 46 publications

(54 citation statements)

References 68 publications

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“…However, in contrast to expectations, we observed attenuated rather than amplified SR during baseline and context conditions both before and after the explicit threat cue paradigm in the distress disorder group. Consistent with some prior research (e.g., Allen et al, 1999; Kaviani et al, 2004; Forbes et al, 2005; Lang et al, 2007; Taylor-Clift et al, 2011; Waters et al, in press), this result could be due to the inhibiting effect of depressive disorders upon SR magnitudes; 5 of the 9 adolescents in this group had a principal diagnosis of a depressive disorder. However, Grillon et al (2013) found enhanced rather than attenuated context-potentiated SR (i.e., placement of shock electrodes) in depression.…”

Section: Discussionsupporting

confidence: 89%

“…Moreover, SR modulation during emotional picture viewing in anxiety disorders is blunted by comorbid depression (Taylor-Clift et al, 2011). Depression has also been linked to diminished physiological reactivity during the anticipation of threat in conditioning experiments in offspring of mothers with a principal depressive disorder relative to offspring of mothers with a principal anxiety disorder and low risk offspring (Waters et al, 2014a).…”

Section: Introductionmentioning

confidence: 99%

“…Differences in findings may be due to variation in methodology. Blunting in depression has been obtained during viewing of pictures and films, or emotional imagery (Allen et al, 1999; Taylor-Clift et al, 2011; McTeague et al, 2012) or in anticipation of aversive tones (Waters et al, 2014a). Thus, threat is mild, imaginary, and/or may lack personal relevance (Grillon et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Context and explicit threat cue modulation of the startle reflex: Preliminary evidence of distinctions between adolescents with principal fear disorders versus distress disorders

Waters

Nazarian²,

Mineka

et al. 2014

Psychiatry Research

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Anxiety and depression are prevalent, impairing disorders. High comorbidity has raised questions about how to define and classify them. Structural models emphasise distinctions between “fear” and “distress” disorders while other initiatives propose they be defined by neurobiological indicators that cut across disorders. This study examined startle reflex (SR) modulation in adolescents with principal fear disorders (specific phobia; social phobia) (n = 20), distress disorders (unipolar depressive disorders, dysthymia, generalized anxiety disorder; post-traumatic stress disorder) (n = 9), and controls (n = 29) during (a) baseline conditions, (b) threat context conditions (presence of contraction pads over the biceps muscle), and (c) an explicit threat cue paradigm involving phases that signalled safety from aversive stimuli (early and late stages of safe phases; early stages of danger phases) and phases that signalled immediate danger of an aversive stimulus (late stages of danger phases). Adolescents with principal fear disorders showed larger SRs than other groups throughout safe phases and early stages of danger phases. SRs did not differ between groups during late danger phases. Adolescents with principal distress disorders showed attenuated SRs during baseline and context conditions compared to other groups. Preliminary findings support initiatives to redefine emotional disorders based on neurobiological functioning.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Context and explicit threat cue modulation of the startle reflex: Preliminary evidence of distinctions between adolescents with principal fear disorders versus distress disorders

Waters

Nazarian²,

Mineka

et al. 2014

Psychiatry Research

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“…As was previously mentioned, studies on the association between MDD and threat responding have been extremely mixed. Some findings suggest that MDD is associated with blunted threat responding (Taylor-Clift et al, 2011; Waters et al, 2014), whereas others suggest that MDD is associated with heightened threat responding (Grillon et al, 2013; Sheline et al, 2001; Siegle et al, 2007). Meanwhile, our original analyses (Shankman et al, 2013), indicated that MDD had no impact on predictable or unpredictable threat responding.…”

Section: Discussionmentioning

confidence: 99%

“…Using startle paradigms other than NPU, it has been shown that healthy controls and individuals with a current anxiety disorder both display elevated startle potentiation when viewing unpleasant pictures; however, individuals with an anxiety disorder and comorbid depression have blunted startle (Taylor-Clift et al, 2011). Additionally, in a sample of adolescents with principal fear disorders (i.e., specific and social phobia), distress disorders (i.e., MDD, dysthymia, generalized anxiety disorder, and PTSD), and controls, Waters et al (2014) found that those with a principal fear disorder, relative to the other two groups, exhibited greater startle during safety conditions and during early phases of explicit threat (i.e., an aversive event was possible but it would not occur for another 10-50s).…”

Section: Introductionmentioning

confidence: 99%

Time course of threat responding in panic disorder and depression

Gorka

Liu

Sarapas

et al. 2015

International Journal of Psychophysiology

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Heightened sensitivity to threat is a characteristic feature of panic disorder (PD). It is also a factor that is considered to be central to PD but not major depressive disorder (MDD) – a related disorder that commonly co-occurs with PD. However, sensitivity to threat is a broad construct and it is unclear whether individuals with PD exhibit heightened initial threat reactivity, impairments in modulating their threat responding over time, or both. It is also unclear how these different facets of threat responding apply to predictable and/or unpredictable threat. The aim of the current study was to examine whether there are differences in initial threat reactivity and the time course of threat responding during predictable and unpredictable threat-of-shock in 186 adults with: 1) current PD and no history of depression (i.e., PD-only), 2) current MDD and no history of an anxiety disorder (i.e., MDD-only), 3) current comorbid PD and MDD, or 4) no lifetime history of psychopathology (i.e., controls). Threat responding was assessed using an electromyography startle paradigm. Relative to controls, individuals in the three psychopathology groups exhibited heightened initial threat reactivity to predictable and unpredictable threat and did not differ from each other. Multilevel mixed model analyses indicated that those with PD evidenced less of a decline over time in startle responding during unpredictable threat relative to those without PD. Those with MDD displayed a greater slope of decline in startle responding during predictable threat compared with those without MDD. The pattern of results suggests that there may be conceptual differences between measures of initial threat reactivity and time course of threat responding. Moreover, time course of threat responding, not initial threat reactivity, may differentiate PD from MDD.

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The Anxiety Spectrum and the Reflex Physiology of Defense: From Circumscribed Fear to Broad Distress

McTeague

Lang²

2012

Depress Anxiety

204

186

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Guided by the diagnostic nosology, anxiety patients are expected to show defensive hyperarousal during affective challenge, irrespective of the principal phenotype. In the current study, patients representing the whole spectrum of anxiety disorders (i.e., specific phobia, social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder(PTSD)), and healthy community control participants, completed an imagery-based fear elicitation paradigm paralleling conventional intervention techniques. Participants imagined threatening and neutral narratives as physiological responses were recorded. Clear evidence emerged for exaggerated reactivity to clinically relevant imagery—most pronounced in startle reflex responding. However, defensive propensity varied across principal anxiety disorders. Disorders characterized by focal fear and impairment (e.g., specific phobia) showed robust fear potentiation. Conversely, for disorders of long-enduring, pervasive apprehension and avoidance with broad anxiety and depression comorbidity (e.g., PTSD secondary to cumulative trauma, GAD), startle responses were paradoxically diminished to all aversive contents. Patients whose expressed symptom profiles were intermediate between focal fearfulness and broad anxious-misery in both severity and chronicity exhibited a still heightened but more generalized physiological propensity to respond defensively. Importantly, this defensive physiological gradient—the inverse of self-reported distress—was evident not only between but also within disorders. These results highlight that fear circuitry could be dysregulated in chronic, pervasive anxiety, and preliminary functional neuroimaging findings suggest that deficient amygdala recruitment could underlie attenuated reflex responding. In summary, adaptive defensive engagement during imagery may be compromised by long-term dysphoria and stress—a phenomenon with implications for prognosis and treatment planning. Depression and Anxiety 29:264–281, 2012.

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Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

Abstract: An anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).

Cited by 46 publications

References 68 publications

Context and explicit threat cue modulation of the startle reflex: Preliminary evidence of distinctions between adolescents with principal fear disorders versus distress disorders

Context and explicit threat cue modulation of the startle reflex: Preliminary evidence of distinctions between adolescents with principal fear disorders versus distress disorders

Time course of threat responding in panic disorder and depression

The Anxiety Spectrum and the Reflex Physiology of Defense: From Circumscribed Fear to Broad Distress

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