Phasic heart period reactions to cued threat and nonthreat stimuli in generalized anxiety disorder

Abstract

The hallmark of generalized anxiety disorder (GAD) is chronic uncontrollable worry. A preattentive bias toward threat cues and hypervigilance may support this ongoing state of apprehension. A study was conducted to bridge the attentional and physiological underpinnings of GAD by examining phasic heart period (HP) responses to cued threat and nonthreat stimuli. Thirty-three GAD clients and 33 nonanxious control participants engaged in an S1-S2 procedure that employed cued threat and nonthreat word stimuli, during which phasic HP reactions were recorded. As compared with the control group, the GAD group showed (1) smaller cardiac orienting responses and impaired habituation of cardiac orienting to neutral words, (2) HR acceleration in response to threat words, and (3) a conditioned anticipatory HR deceleration to threat words over repeated trials. The cardiac-autonomic underpinnings of GAD appear to rigidly maintain precognitive defensive responses against threat. This portrayal is discussed in the context of an integrative model that depicts diminished global adaptive variability in GAD.

Conditioned Fear Acquisition and Generalization in Generalized Anxiety Disorder

“…The study by Thayer et al (2000) mentioned in the introduction used a higher-order conditioning procedure. An earlier study by Pitman and Orr (1986) found no differences in differential conditioning during acquisition between GAD patients (as defined by DSM-III criteria) and controls, but comparison with this study is difficult given the changes in GAD criteria from DSM-III-R onwards.…”

“…These processes include acquisition, within-session extinction, extinction recall, conditioned inhibition and conditioned fear-generalization. For example, an enhanced fear acquisition may be characteristic of social phobia (Lissek et al, 2008a), generalized anxiety disorder (GAD; Thayer, Friedman, Borkovec, Johnsen, & Molina, 2000), or post-traumatic stress disorder (PTSD; Orr et al, 2000;Peri, Ben-Shakhar, Orr, & Shalev, 2000). Impaired within-session fear extinction has been shown for individuals with panic disorder (PD; Michael, Blechert, Vriends, Margraf, & Wilhelm, 2007;Otto et al, 2014) or GAD (Pitman & Orr, 1986), whereas impaired extinction recall could be present in PTSD (Milad et al, 2008) or obsessive-compulsive disorder (OCD; Milad et al, 2013).…”

Self-Esteem and Autonomic Physiology: Parallels Between Self-Esteem and Cardiac Vagal Tone as Buffers of Threat

“…For example, research has found that vagal influence as indexed with RSA tended to override sympathetic influence in predicting heart rate (e.g., Uytdehaage and Thayer, 1989). In another study, researchers measured orienting and defensive cardiac patterns in a conditioning paradigm (Thayer, Friedman, Borkovec, Johnsen, & Molina, 2000). The results showed that people with lower RSA (who were also diagnosed with general anxiety disorder) showed persistent defensive responses to threatening words that high RSA people responded to only with orienting.…”

The psychiatric view of the patient with palpitations

“…Çarpıntı yakınmasının en sık görüldüğü psikiyatrik hastalık panik bozukluktur (14 (19). Fobik bozukluk hastalarına korkulan nesne gösterildiğinde kalp atım hızında belirgin artış olduğu tespit edilmiştir (20).…”