Is aversive learning a marker of risk for anxiety disorders in children?

Abstract

Aversive conditioning and extinction were evaluated in children with anxiety disorders (n=23), at-risk for anxiety disorders (n=15), and controls (n=11). Participants underwent 16 trials of discriminative conditioning of two geometric figures, with (CS+) or without (CS-) an aversive tone (US), followed by 8 extinction trials (4 CS+, 4 CS-), and 8 extinction re-test trials averaging 2 weeks later. Skin conductance responses and verbal ratings of valence and arousal to the CS+/CS- stimuli were measured. Anxiety disordered children showed larger anticipatory and unconditional skin conductance responses across conditioning, and larger orienting and anticipatory skin conductance responses across extinction and extinction re-test, all to the CS+ and CS-, relative to controls. At-risk children showed larger unconditional responses during conditioning, larger orienting responses during the first block of extinction, and larger anticipatory responses during extinction re-test, all to the CS+ and CS-, relative to controls. Also, anxiety disordered children rated the CS+ as more unpleasant than the other groups. Elevated skin conductance responses to signals of threat (CS+) and signals of safety (CS-; CS+ during extinction) are discussed as features of manifestation of and risk for anxiety in children, compared to the specificity of valence judgments to the manifestation of anxiety.

Recruitment of orbitofrontal cortex during unpredictable threat among adults at risk for affective disorders

“…HR adults in our study did not exhibit elevated subjective anxiety and autonomic responses that have been previously reported among at-risk children and adolescents in response to threatening stimuli (Craske et al, 2008;Grillon et al, 1998). Furthermore, although AUT resulted in increased activity in bilateral BNST for all participants, we did not observe differences between groups.…”

“…Enhanced anticipatory anxiety as well as overall greater startle responses have been found in adolescent offspring of parents with anxiety disorders relative to low-risk controls (Grillon, Dierker, & Merikangas, 1998). Greater autonomic responses during conditioning, as well as while anticipating threat during extinction, have also been observed in at-risk children (Craske et al, 2008). Furthermore, neuroimaging studies with at-risk children have shown increased responses in the lateral OFC and insula to aversive stimuli (McCabe, Woffindale, Harmer, & Cowen, 2012), dorsal anterior cingulate cortex (ACC) to losses (Gotlib et al, 2010), pregenual ACC to negative words (Mannie et al, 2008), and ventrolateral prefrontal cortex (vlPFC) during negative mood induction (Joormann, Cooney, Henry, & Gotlib, 2012), as well as diminished responses in dorsolateral prefrontal cortex (dlPFC) to fearful faces (Mannie, Taylor, Harmer, Cowen, & Norbury, 2011).…”

Role of Inhibition in Exposure Therapy

“…In other words, anxiety disorders appear to be associated with difficulties learning to view specific cues as safe -cues that occur in the same context as danger cues but never actually signal danger themselves, and cues that used to signal danger and no longer do. Furthermore, these difficulties are present in children at risk for anxiety disorders, suggesting that they may serve as a pathway for the acquisition of anxiety disorders (Craske, Waters et al, 2008). Some potential mechanisms of this impaired inhibitory learning include an attentional bias toward threat (Bar-Haim, Lamy, Pergamin, Bakersman-Kranenburg, & van IJzendoorn, 2007), difficulty disengaging from threatening stimuli (Mogg, Holmes, Garner, & Bradley, 2008), interpretation of ambiguous stimuli as threatening (Mathews & MacLeod, 2005), elevated expectancies for threat (Chan & Lovibond, 1996), and overgeneralization of fear responding to stimuli that resemble the threat cue (Lissek & Grillon, 2010).…”

Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach

“…Since the meta-analysis, additional studies have confirmed either weakened extinction (i.e. elevated responding to the CS+ during extinction training), long term deficits in extinction (i.e., elevated responding to the CS+ at extinction retest), or elevated responding to the CS-, in anxiety disorders Craske et al, 2008b;Waters et al, 2009;Lissek et al, 2009;Michael et al, 2007;Milad et al, 2009].…”