Time course of threat responding in panic disorder and depression
Time course of threat responding in panic disorder and depression
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DOI：
10.1016/j.ijpsycho.2015.07.005
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发表时间：
2015-10-01
影响因子：
3
通讯作者：
Shankman, Stewart A.
中科院分区：
文献类型：
--
作者：
Gorka, Stephanie M.;Liu, Huiting;Shankman, Stewart A.
对威胁的高度敏感性是惊恐障碍（PD）的特征。这也是一个被认为是PD的核心因素，但不是重度抑郁症（MDD）-一种通常与PD共同发生的相关疾病。然而，对威胁的敏感性是一个广泛的概念，目前尚不清楚PD患者是否表现出较高的初始威胁反应性，在调节其威胁反应的过程中是否存在障碍，或者两者兼而有之。目前还不清楚这些不同方面的威胁应对如何适用于可预测和/或不可预测的威胁。本研究的目的是检查186名成年人在可预测和不可预测的休克威胁期间的初始威胁反应性和威胁反应的时间过程是否存在差异，这些成年人具有：1）当前PD和无抑郁史（即，仅PD），2）当前MDD且无焦虑症病史（即，仅MDD），3）目前患有PD和MDD共病，或4）无精神病理学终身史（即，对照）。使用肌电图惊吓范例评估威胁反应。相对于对照组，三个精神病理组的个体对可预测和不可预测的威胁表现出高度的初始威胁反应，并且彼此没有差异。多层次混合模型分析表明，与PD证明随着时间的推移，在不可预测的威胁相对于那些没有PD惊吓反应下降。与未患有抑郁症的人相比，患有抑郁症的人在可预测的威胁期间惊吓反应的下降幅度更大。结果的模式表明，可能有概念上的差异之间的措施的初始威胁反应和时间过程中的威胁响应。此外，威胁响应的时间过程，而不是最初的威胁反应性，可以区分PD和MDD。(C)2015 Elsevier B. V.版权所有。
Heightened sensitivity to threat is a characteristic feature of panic disorder (PD). It is also a factor that is considered to be central to PD but not major depressive disorder (MDD) - a related disorder that commonly co-occurs with PD. However, sensitivity to threat is a broad construct and it is unclear whether individuals with PD exhibit heightened initial threat reactivity, impairments in modulating their threat responding overtime, or both. It is also unclear how these different facets of threat responding apply to predictable and/or unpredictable threat. The aim of the current study was to examine whether there are differences in initial threat reactivity and the time course of threat responding during predictable and unpredictable threat-of-shock in 186 adults with: 1) current PD and no history of depression (i.e., PD-only), 2) current MDD and no history of an anxiety disorder (i.e., MDD-only), 3) current co-morbid PD and MDD, or 4) no lifetime history of psychopathology (i.e., controls). Threat responding was assessed using an electromyography startle paradigm. Relative to controls, individuals in the three psychopathology groups exhibited heightened initial threat reactivity to predictable and unpredictable threat and did not differ from each other. Multilevel mixed model analyses indicated that those with PD evidenced less of a decline over time in startle responding during unpredictable threat relative to those without PD. Those with MDD displayed a greater slope of decline in startle responding during predictable threat compared with those without MDD. The pattern of results suggests that there may be conceptual differences between measures of initial threat reactivity and time course of threat responding. Moreover, time course of threat responding, not initial threat reactivity, may differentiate PD from MDD. (C) 2015 Elsevier B.V. All rights reserved.