Intolerance of Uncertainty Mediates the Relationship between Panic and the Startle Reflex in Anticipation of Unpredictable Threat

Cogn Affect Behav Neurosci

Phan

et al. 2016

Self Cite

Individuals with high intolerance of uncertainty (IU) have been shown to exhibit abnormal threat responding, which may be mediated by hyperactive anterior insula (aINS) response to uncertainty. Research has indicated that individuals with high IU also exhibit abnormal positive valence responding, suggesting that IU may impact responding to uncertainty regardless of the valence of the potential outcome. To date, no study has investigated the neural processes associated with IU and response to uncertain positive stimuli, such as rewards. Therefore, this study was designed to examine the association between individual differences in IU and neural activation during uncertain reward using functional magnetic resonance imaging (fMRI). Thirty-seven adults completed a self-report measure of IU and a reward task during fMRI. Consistent with the threat literature, greater IU was associated with increased aINS activation during uncertain reward. This association was more robust for the prospective IU subscale, a dimension characterized by worry about future events. Together with prior studies, these findings provide evidence that IU is related to abnormal threat and reward responding, and that these deficits may be similarly linked to hyperactive aINS response to uncertainty.

Section: Discussionsupporting

confidence: 61%

Section: Fmri Processing and Analysesmentioning

confidence: 99%

Intolerance of uncertainty and insula activation during uncertain reward

Gorka

Cogn Affect Behav Neurosci

Phan

et al. 2016

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“…These results indicate the presence of mutual suppressor effects, when two correlated predictor variables have the opposite effect on a criterion variable, but the associations are obscured when examined separately (MacKinnon et al, 2000; Watson et al, 2013). The suppressor effect finding is not particularly surprising as other symptom dimensions have demonstrated similar effects in relation to psychophysiological measures of threat and reward sensitivity (Jackson, Nelson, & Hajcak, 2016; Nelson, Kessel, Jackson, & Hajcak, 2016; Nelson, Liu, Sarapas, & Shankman, in press). Together, these results highlight the importance of considering the multidimensional nature of anxiety and depression when examining potential underlying mechanisms.…”

Section: Discussionmentioning

confidence: 68%

Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14 Year-Old Girls

Hajcak

2016

J Abnorm Child Psychol

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There is growing evidence that heightened sensitivity to unpredictability is a core mechanism of anxiety disorders. In adults, multiple anxiety disorders have been associated with a heightened startle reflex in anticipation of unpredictable threat. Child and adolescent anxiety has been linked to an increased startle reflex across baseline, safety, and threat conditions. However, it is unclear whether anxiety in youth is related to the startle reflex as a function of threat predictability. In a sample of 90 8 to 14 year-old girls, the present study examined the association between anxiety symptom dimensions and startle potentiation during a no, predictable, and unpredictable threat task. Depression symptom dimensions were also examined given their high comorbidity with anxiety and mixed relationship with the startle reflex and sensitivity to unpredictability. To assess current symptoms, participants completed the self-report Screen for Child Anxiety Related Emotional Disorders and Children’s Depression Inventory. Results indicated that social phobia symptoms were associated with heightened startle potentiation in anticipation of unpredictable threat and attenuated startle potentiation in anticipation of predictable threat. Negative mood and negative self-esteem symptoms were associated with attenuated and heightened startle potentiation in anticipation of unpredictable threat, respectively. All results remained significant after controlling for the other symptom dimensions. The present study provides initial evidence that anxiety and depression symptom dimensions demonstrate unique associations with the startle reflex in anticipation of unpredictable threat in children and adolescents.

“…Prospective IU has been particularly associated with GAD , a condition characterized by increased positive and negative emotional reactivity and poor emotion regulation (Mennin, Turk, Heimberg, & Carmin, 2004). Indeed, in a separate investigation, greater prospective IU was associated with an increased startle reflex in anticipation of unpredictable threat (Nelson et al, 2015). These results suggest that, in contrast to inhibitory IU, high prospective IU is associated with increased psychophysiological reactivity to appetitive and aversive stimuli.…”

Section: Discussionmentioning

confidence: 74%

“…A number of studies have identified distinct relationships between inhibitory and prospective IU and psychobiological responding to uncertainty. For example, inhibitory IU has been associated with a decreased startle reflex while anticipating uncertain threat (Nelson & Shankman, 2011) and an attenuated ERN (Jackson, Nelson, & Hajcak, 2015b), whereas prospective IU has been associated with an increased startle reflex while anticipating uncertain threat (Nelson, Liu, Sarapas, & Shankman, 2015) and an enhanced ERN (Jackson et al, 2015b). Therefore, as an exploratory analysis, we examined whether there were specific relationships between the inhibitory and prospective IU subscales and the RewP.…”

mentioning

confidence: 99%

The impact of an unpredictable context and intolerance of uncertainty on the electrocortical response to monetary gains and losses

Cogn Affect Behav Neurosci

Kessel

Jackson

et al. 2015

Self Cite

There is growing evidence that unpredictability and uncertainty can alter reward system functioning. The present study examined the impact of (1) a task-irrelevant unpredictable relative to predictable context and (2) individual differences in intolerance of uncertainty (IU) on the reward-related positivity (RewP), an event-related potential (ERP) response to monetary gains relative to losses. Specifically, 64 participants listened to predictable and unpredictable tone sequences while electroencephalography was recorded during a monetary gambling task. Participants also completed the Intolerance of Uncertainty Scale, which measures both cognitive distress (prospective IU) and behavioral inhibition (inhibitory IU) elicited by uncertainty, in addition to the Depression Anxiety Stress Scale-21 and Penn State Worry Questionnaire. Results indicated that the RewP was reduced during the unpredictable relative to the predictable context. Greater selfreported anxiety elicited by the unpredictable context was associated with a decreased RewP, and a decreased RewP was associated with poorer lose-shift behavioral adjustment. Furthermore, the RewP mediated the relationship between selfreported anxiety elicited by the unpredictable context and lose-shift behavioral adjustment. The IU subscales demonstrated the opposite relationship with the RewP across both contexts-inhibitory IU was associated with an attenuated RewP and prospective IU was associated with an enhanced RewP. In contrast, anxiety, depression, stress, and worry symptomatology were not associated with the RewP. This is the first study to demonstrate that an unpredictable context and individual differences in the degree to which people cannot tolerate uncertainty impact an ERP measure of reward system functioning.