The impact of anxiety upon cognition: perspectives from human threat of shock studies

Abstract

Anxiety disorders constitute a sizeable worldwide health burden with profound social and economic consequences. The symptoms are wide-ranging; from hyperarousal to difficulties with concentrating. This latter effect falls under the broad category of altered cognitive performance which is the focus of this review. Specifically, we examine the interaction between anxiety and cognition focusing on the translational threat of unpredictable shock paradigm; a method previously used to characterize emotional responses and defensive mechanisms that is now emerging as valuable tool for examining the interaction between anxiety and cognition. In particular, we compare the impact of threat of shock on cognition in humans to that of pathological anxiety disorders. We highlight that both threat of shock and anxiety disorders promote mechanisms associated with harm avoidance across multiple levels of cognition (from perception to attention to learning and executive function)—a “hot” cognitive function which can be both adaptive and maladaptive depending upon the circumstances. This mechanism comes at a cost to other functions such as working memory, but leaves some functions, such as planning, unperturbed. We also highlight a number of cognitive effects that differ across anxiety disorders and threat of shock. These discrepant effects are largely seen in “cold” cognitive functions involving control mechanisms and may reveal boundaries between adaptive (e.g., response to threat) and maladaptive (e.g., pathological) anxiety. We conclude by raising a number of unresolved questions regarding the role of anxiety in cognition that may provide fruitful avenues for future research.

The impact of threat of shock on the framing effect and temporal discounting: executive functions unperturbed by acute stress?

“…Moreover, we demonstrated a clear impact of threat 278 of shock on subjective mood and choice reaction times. However, contrary to our predictions, 279 stress did not alter the observed decision--making biases, perhaps because executive decision--280 making biases are traits that are impervious to, or are able to override, the lower--level state 281 affective biases induced by stress (Robinson et al, 2013b).…”

Symptoms and the body: Taking the inferential leap

“…It also gives stimuli their hedonic tone (i.e., whether, and to what extent, they are experienced as pleasant or unpleasant; Barrett and Bar, 2009). Stimuli that are characterized as potentially threatening or aversive at an early stage are afforded processing priority (e.g., Robinson et al, 2013) aimed at reducing the threat and thereby minimizing prediction error.…”

Reward Processing in Motivational and Affective Disorders

“…In animals threat of shock has been shown to engage neural circuitry distinct from that engaged during fear conditioning (Davis et al, 2010), another widely used but conceptually different aversive processing paradigm. More precisely, anxiety (or stress) is operationally defined as the prolonged apprehensive response to a context in which threats may occur, whereas fear is the acute response to a discrete, defined and predictable aversive stimulus or cue (Davis et al, 2010;Robinson et al, 2013c). Critically, stress induced by threat of shock has well documented psychological (Robinson et al, 2013c), psychophysiological (Grillon et al, 1991), and neural effects (Cornwell et al, 2007;Robinson et al, 2012Robinson et al, , 2013b.…”

“…More precisely, anxiety (or stress) is operationally defined as the prolonged apprehensive response to a context in which threats may occur, whereas fear is the acute response to a discrete, defined and predictable aversive stimulus or cue (Davis et al, 2010;Robinson et al, 2013c). Critically, stress induced by threat of shock has well documented psychological (Robinson et al, 2013c), psychophysiological (Grillon et al, 1991), and neural effects (Cornwell et al, 2007;Robinson et al, 2012Robinson et al, , 2013b. Perhaps more importantly there is also emerging evidence that threat of shock evokes mechanisms related to those that participate in pathological anxiety, for example Generalized Anxiety Disorder (Robinson et al, 2013c(Robinson et al, , 2014.…”

“…Critically, stress induced by threat of shock has well documented psychological (Robinson et al, 2013c), psychophysiological (Grillon et al, 1991), and neural effects (Cornwell et al, 2007;Robinson et al, 2012Robinson et al, , 2013b. Perhaps more importantly there is also emerging evidence that threat of shock evokes mechanisms related to those that participate in pathological anxiety, for example Generalized Anxiety Disorder (Robinson et al, 2013c(Robinson et al, , 2014. As such, it is hoped that exploring the impact of threat of shock on cognitive functions may also provide a window into the mechanisms which contribute to pathological stress-related disorders in healthy individuals, prior to disorder onset (Robinson et al, 2014).…”