Transdiagnostic brain responses to disorder-related threat across four psychiatric disorders

Feldker, Katharina; Heitmann, Carina Yvonne; Neumeister, Paula; Tupak, Sara V.; Schrammen, Elisabeth; Moeck, Robert; Zwitserlood, Pienie; Bruchmann, Maximilian; Straube, Thomas

doi:10.1017/s0033291716002634

Cited by 34 publications

(38 citation statements)

References 82 publications

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“…Because of the insula's critical role in the prediction of unpleasant or aversive body states, it may have particular relevance to anxiety disorders, which are characterized by maladaptive attempts to predict and control future aversive events/body states (Paulus & Stein, ). The current findings are also in line with prior reports of increased insula activation in SAD (Feldker et al., ; Klumpp, Angstadt, & Phan, ) and GAD (Buff et al., ). By using a standardized paradigm across these multiple diagnostic groups, the current results confirm that increased insula activation cuts across diagnoses and indicate that insula involvement increases with anxiety symptom load.…”

Section: Discussionsupporting

confidence: 93%

“…Along with the insula, the anterior cingulate is part of the salience network implicated in the pathophysiology of anxiety (MacNamara et al., ). Prior works have found evidence of increased ACC activation in SAD, dental phobia, PD, PTSD, and GAD (Buff et al., ; Feldker et al., ); here, we extend these results by showing evidence of transdiagnostic correlations, including in MDD. Using event‐related potentials, researchers have similarly found evidence that anxiety is associated with increases in the error‐related negativity (ERN), which has been localized to the ACC (for a meta‐analysis, see Moser, Moran, Schroder, Donnellan, & Yeung, ).…”

Section: Discussionsupporting

confidence: 89%

“…We hypothesized that compared with controls, patients would show increased activation in the amygdala and insula for negative faces, and that continuous symptoms of anxiety and depression would be associated with heightened amygdala and insula activation for negative facial expressions (Blair et al., ; Gentili et al., ; Stuhrmann et al., ). We also hypothesized that symptoms of anxiety would be associated with greater activation in the ACC (Feldker et al., ; Graham & Milad, ) and increased dlPFC activation (Blair et al., ; Carré et al., ; Gentili et al., ) for negative faces; we expected reduced dlPFC activation for symptoms of depression (Stuhrmann et al., ). Prior findings using happy faces have been mixed (Stuhrmann et al., ); therefore, we did not have specific predictions in this regard.…”

Section: Introductionmentioning

confidence: 99%

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Transdiagnostic neural correlates of affective face processing in anxiety and depression

et al. 2017

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Background It is unknown whether there are neurobiological differences between various anxiety and depressive disorders, or whether they are characterized by shared neurobiological variation that cuts across diagnostic boundaries. For instance, multiple anxiety disorders and depression may be characterized by abnormalities in blood-oxygen-level dependent (BOLD) response during the processing of affective scenes and faces. To interrogate the shared or unique nature of these aberrations, research that examines the influence of transdiagnostic, dimensional predictors across multiple diagnoses is needed. Methods One-hundred and ninety-nine individuals, 142 with primary diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD) or major depressive disorder (MDD), and 57 who were free from psychiatric diagnoses (healthy controls, HCs) performed a face-matching task involving fearful, angry and happy faces (and geometric shapes) while undergoing functional magnetic resonance imaging. Results Across the three primary diagnoses, anxiety symptom scores were associated with increased Angry>Shapes activation in the bilateral insula, anterior/midcingulate and dorsolateral prefrontal cortex (dlPFC), while depressive symptoms were associated with reduced dlPFC activation for Angry>Shapes. Patient>HC differences were limited to non a priori regions, and no differences in BOLD activation were observed between diagnostic groups. Conclusions 1) Activation in paralimbic, cingulate and lateral prefrontal regions in response to angry faces is associated with transdiagnostic anxiety and depressive symptomatology. 2) Anxiety and depressive symptoms may exert opposing influences on lateral prefrontal activation. 3) Abnormal threat processing in GAD, SAD and MDD may reflect shared neural dysfunction that varies with symptom load.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Transdiagnostic neural correlates of affective face processing in anxiety and depression

et al. 2017

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“…The largest transdiagnostic study published to date leveraged an electronic case register to include 353 mental disorders clustered across ten spectra, representing all ICD‐10 mental disorders except organic mental disorders. About one third of the studies (35%) included at least one non‐clinical sample.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies (81%) were descriptive in nature. Mechanistic constructs were more infrequent (19%), and causal transdiagnostic constructs were hardly ever reported (7%) and only during the most recent years (2017‐2018).…”

Section: Resultsmentioning

confidence: 99%

Transdiagnostic psychiatry: a systematic review

et al. 2019

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The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.

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Brain Mechanisms of Pain and Anxiety of Dental Patients

2021

Dental Neuroimaging

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Transdiagnostic brain responses to disorder-related threat across four psychiatric disorders

Cited by 34 publications

References 82 publications

Transdiagnostic neural correlates of affective face processing in anxiety and depression

Transdiagnostic neural correlates of affective face processing in anxiety and depression

Transdiagnostic psychiatry: a systematic review

Brain Mechanisms of Pain and Anxiety of Dental Patients

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