Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers

Ottaviani, Cristina; Borlimi, Rosita; Brighetti, Gianni; Caselli, Gabriele; Favaretto, Ettore; Giardini, Irene; Marzocchi, C.; Nucifora, Valeria; Rebecchi, Daniela; Ruggiero, Giovanni Maria; Sassaroli, Sandra

doi:10.1016/j.ijpsycho.2014.05.010

Cited by 39 publications

(30 citation statements)

References 57 publications

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“…Thus, the induction had the effect to make the two groups more similar both at a behavioural and at a neural level. These findings extend to anxiety disorder previous observations from pathological worriers (Ottaviani et al, 2014) and patients with major depression (Ottaviani et al, 2015b).…”

Section: Discussionsupporting

confidence: 88%

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder.Biological Psychology http://dx.doi.org/10. 1016/j.biopsycho.2016.06.009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.  Trait worry was inversely related with prefrontal deactivation to target detection. HRV predicted neural activation changes produced by attentional focus switching. A worry induction increased pre-to post-target deactivation of default mode areas. The induction reduced behavioural and neurobiological differences between groups. AbstractGeneralized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within 'default mode' (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.

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Section: Discussionsupporting

confidence: 88%

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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“…Present results are in line with Ottaviani et al (2014), in which physiological responses to unpredictable bursts of loud white noise were characterized by lower vagally-mediated HRV in HW but not in LW. Indeed, reduced HRV has been proposed as a biomarker of worry, irrespective of the presence of a specific anxiety disorder (Chalmers et al, 2016).…”

Section: Discussionsupporting

confidence: 93%

“…Pathological worriers without GAD had higher levels of trait and state anxiety and depression (Ruscio, 2002; Hirsch and Mathews, 2012; Ottaviani et al, 2014). Interestingly, high-worriers were also characterized by higher levels of trait rumination, confirming the usefulness of merging rumination and worry under a unique transdiagnostic construct (e.g., perseverative cognition, repetitive negative thinking; McEvoy et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Association between Attention and Heart Rate Fluctuations in Pathological Worriers

Gazzellini

Dettori

Amadori

et al. 2016

Front. Hum. Neurosci.

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Recent data suggests that several psychopathological conditions are associated with alterations in the variability of behavioral and physiological responses. Pathological worry, defined as the cognitive representation of a potential threat, has been associated with reduced variability of heart beat oscillations (i.e., decreased heart rate variability; HRV) and lapses of attention indexed by reaction times (RTs). Clinical populations with attention deficit show RTs oscillation around 0.05 and 0.01 Hz when performing a sustained attention task. We tested the hypothesis that people who are prone to worry do it in a predictable oscillating pattern revealed through recurrent lapses in attention and concomitant oscillating HRV. Sixty healthy young adults (50% women) were recruited: 30 exceeded the clinical cut-off on the Penn State Worry Questionnaire (PSWQ; High-Worry, HW); the remaining 30 constituted the Low-Worry (LW) group. After a diagnostic assessment, participants performed two 15-min sustained attention tasks, interspersed by a standardized worry-induction procedure. RTs, HRV and moods were assessed. The analyses of the frequency spectrum showed that the HW group presents a significant higher and constant peak of RTs oscillation around 0.01 Hz (period 100 s) after the induction of worry, in comparison with their baseline and with the LW group that was not responsive to the induction procedure. Physiologically, the induction significantly reduced high-frequency HRV and such reduction was associated with levels of self-reported worry. Results are coherent with the oscillatory nature of the default mode network (DMN) and further confirm an association between cognitive rigidity and autonomic nervous system inflexibility.

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“…Importantly, symptoms of worry and rumination, encapsulated within the transdiagnostic concept of perseverative cognition (Brosschot et al , 2006) are associated with chronic (e.g., Brosschot et al , 2007; Pieper et al , 2010; Ottaviani et al , 2015a, b) and phasic (e.g. Ottaviani et al , 2009, 2014; Ottaviani and Shapiro, 2011) reductions in HRV in patients with GAD (Chalmers et al , 2014) and in healthy individuals (Ottaviani et al , 2016). To date, despite this intrinsic relationship between worry and autonomic dysregulation as core features of GAD, only one previous study tests for a common underlying neurobiology for these primary symptoms (Makovac et al , in press).…”

Section: Introductionmentioning

confidence: 99%

Amygdala functional connectivity as a longitudinal biomarker of symptom changes in generalized anxiety

Makovac

Watson

Meeten

et al. 2016

Social Cognitive and Affective Neuroscience

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Generalized anxiety disorder (GAD) is characterized by excessive worry, autonomic dysregulation and functional amygdala dysconnectivity, yet these illness markers have rarely been considered together, nor their interrelationship tested longitudinally. We hypothesized that an individual’s capacity for emotion regulation predicts longer-term changes in amygdala functional connectivity, supporting the modification of GAD core symptoms. Sixteen patients with GAD (14 women) and individually matched controls were studied at two time points separated by 1 year. Resting-state fMRI data and concurrent measurement of vagally mediated heart rate variability were obtained before and after the induction of perseverative cognition. A greater rise in levels of worry following the induction predicted a stronger reduction in connectivity between right amygdala and ventromedial prefrontal cortex, and enhanced coupling between left amygdala and ventral tegmental area at follow-up. Similarly, amplified physiological responses to the induction predicted increased connectivity between right amygdala and thalamus. Longitudinal shifts in a distinct set of functional connectivity scores were associated with concomitant changes in GAD symptomatology over the course of the year. Results highlight the prognostic value of indices of emotional dysregulation and emphasize the integral role of the amygdala as a critical hub in functional neural circuitry underlying the progression of GAD symptomatology.

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Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers

Cited by 39 publications

References 57 publications

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Association between Attention and Heart Rate Fluctuations in Pathological Worriers

Amygdala functional connectivity as a longitudinal biomarker of symptom changes in generalized anxiety

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