Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

Abstract

Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits.

Somatosensory amplification, health anxiety, and alexithymia in generalized anxiety disorder

“…However, the patients with GAD are shown to be having higher sensitivity for learning from negative feedback. [ 38 ] The presence of significant somatosensory amplification, health anxiety, and alexithymia may be the factors why individuals with GAD have higher sensitivity for learning from negative feedback that leads to excessive worry in more than one spheres of life. The development of specific psychotherapeutic interventions to address somatosensory amplification, health anxiety, and alexithymia may supplement, if not replace, the worry based CBTs and lead for better response rates of psychotherapeutic interventions in GAD.…”

The prevalence of impaired glucose regulation in anxiety disorder patients and the relationship with hypothalamic–pituitary–adrenal axis and hypothalamic–pituitary–thyroid axis activity

“…We recruited the patients with a first onset of anxiety disorders from the Psychiatric Inpatient Department of the West China Hospital of Sichuan University from September 2013 to May 2015 as the subjects of our study. The inclusion criteria were as follows: conform to the criteria for anxiety disorders, including panic disorder and generalized anxiety disorder, of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD‐10) ; first onset or never treated with anti‐anxiety medications; age > 18 years; and primary school or above education, so that one could understand the content of our study and be able to sign the informed consent form. The exclusion criteria included the following: severe lesions in vital organs, such as the heart, brain, and liver; diagnosed with other neurologic and psychiatric disorders; suicidal tendencies and severe cognitive impairment; medications affecting blood glucose; and pregnant and lactating women.…”

“…Anxiety disorder is a common disease amongst psychiatric patients with a prevalence about 30% . Impaired glucose regulation (IGR), as the early stage of diabetes, which includes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), is a transition state from normal glucose metabolism to diabetes.…”

Anxiety Disorders and PTSD in Palestine: Litreture review

“…[38] Anxiety disorders represent 32.9% of health problems that cause the most disability [39]. Furthermore, Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect [40]. According to the recent DSM-5 classi cation, anxiety disorders included generalized anxiety disorder, speci c phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.…”