Latent class growth analyses reveal overrepresentation of dysfunctional fear conditioning trajectories in patients with anxiety-related disorders compared to controls
Latent class growth analyses reveal overrepresentation of dysfunctional fear conditioning trajectories in patients with anxiety-related disorders compared to controls
复制标题
潜在类别增长分析揭示焦虑相关障碍患者与对照组相比功能障碍性恐惧条件反射轨迹的过度表达
DOI：
10.1016/j.janxdis.2021.102361
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发表时间：
2021-01-25
影响因子：
10.3
通讯作者：
Cath, Danielle C.
中科院分区：
文献类型：
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作者：
Duits, Puck;Baas, Johanna M. P.;Cath, Danielle C.
最近的荟萃分析表明，焦虑症患者和对照受试者在恐惧的获得和消退方面存在差异。然而，这些影响很小，可能只对一小部分患者有效。为了调查焦虑相关障碍患者(N=104；治疗前)和对照对象(N=93)在恐惧获得和消退方面的个体轨迹，使用数据驱动的潜在班级增长分析对先前研究(Duits等人，2017年)的数据进行了重新分析。在这项探索性研究中，主观恐惧等级、震惊预期等级和惊吓反应被用作结果衡量标准。恐惧和预期评级，但不是令人震惊的数据，在参与者中产生了明显的恐惧制约轨迹。与对照组相比，患者在两种不同的功能失调的恐惧条件反射轨迹中被过度代表：安全学习受损和对危险线索的恐惧消退不佳。对个体模式的描述可以确定，虽然一部分患者显示出功能失调的恐惧条件反射的轨迹，但相当大一部分患者(？50%)没有。轨迹分析相对于群体分析的优势在于，它允许识别患有功能失调的恐惧条件反射的个体。结果表明，功能障碍的恐惧学习也可能与不良的治疗结果有关，但需要在更大的样本中进行进一步的研究来解决这个问题。
Recent meta-analyses indicated differences in fear acquisition and extinction between patients with anxiety related disorders and comparison subjects. However, these effects are small and may hold for only a subsample of patients. To investigate individual trajectories in fear acquisition and extinction across patients with anxiety-related disorders (N = 104; before treatment) and comparison subjects (N = 93), data from a previous study (Duits et al., 2017) were re-analyzed using data-driven latent class growth analyses. In this explorative study, subjective fear ratings, shock expectancy ratings and startle responses were used as outcome measures. Fear and expectancy ratings, but not startle data, yielded distinct fear conditioning trajectories across participants. Patients were, compared to controls, overrepresented in two distinct dysfunctional fear conditioning trajectories: impaired safety learning and poor fear extinction to danger cues. The profiling of individual patterns allowed to determine that whereas a subset of patients showed trajectories of dysfunctional fear conditioning, a significant proportion of patients (?50 %) did not. The strength of trajectory analyses as opposed to group analyses is that it allows the identification of individuals with dysfunctional fear conditioning. Results suggested that dysfunctional fear learning may also be associated with poor treatment outcome, but further research in larger samples is needed to address this question.