Stimulus-reinforcement-based decision making and anxiety: impairment in generalized anxiety disorder (GAD) but not in generalized social phobia (GSP).
Stimulus-reinforcement-based decision making and anxiety: impairment in generalized anxiety disorder (GAD) but not in generalized social phobia (GSP).
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DOI：
10.1017/s003329170800487x
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发表时间：
2009-07
影响因子：
6.9
通讯作者：
Blair, K.
中科院分区：
文献类型：
--
作者：
DeVido, J.;Jones, M.;Geraci, M.;Hollon, N.;Blair, R. J. R.;Pine, D. S.;Blair, K.
广泛性社交恐惧症（GSP）涉及对社交场合的恐惧/回避，而广泛性焦虑症（GAD）涉及对日常生活环境的侵入性担忧。目前尚不清楚这些高度共病的病症是否代表不同的疾病或单一潜在病理的替代表现。在这项研究中，我们研究了 GSP 和 GAD 中基于刺激强化的决策。 20 名未接受治疗的 GSP 患者、16 名未接受治疗的 GAD 患者和 19 名年龄、智商和性别匹配的健康对照个体完成了差异奖励/惩罚学习任务 (DPLLT)。在此任务中，受试者在与不同级别的奖励或惩罚相关的两个对象之间进行选择。因此，反应选择不仅反映了奖励/惩罚的敏感性，而且还反映了根据对象间强化距离对奖励/惩罚水平的敏感性。我们发现，与 GSP 患者和健康对照个体相比，GAD 患者犯下的错误数量明显更多。相比之下，GSP 患者和健康对照个体在这项任务上的表现没有差异。这些结果将广泛性焦虑症与基于非情感的异常决策联系起来。此外，它们表明 GSP 和 GAD 与不同的病理生理学相关。
Generalized Social Phobia (GSP) involves the fear/avoidance of social situations while Generalized Anxiety Disorder (GAD) involves an intrusive worry about everyday life circumstances. It remains unclear whether these, highly comorbid, conditions represent distinct disorders or alternative presentations of a single underlying pathology. In this study, we examined stimulus-reinforcement based decision-making in GSP and GAD. Twenty unmedicated patients with GSP, sixteen unmedicated patients with GAD and nineteen age, IQ, and gender matched healthy comparison individuals completed the Differential Reward/ Punishment Learning Task (DRPLT). In this task, the subject chooses between two objects associated with different levels of reward or punishment. Thus, response choice indexes not only reward/ punishment sensitivity but also sensitivity to reward/ punishment level according to between-object reinforcement distance. We found that patients with GAD committed a significantly greater number of errors compared to both the patients with GSP and the healthy comparison individuals. In contrast, the patients with GSP and the healthy comparison individuals did not differ in performance on this task. These results link GAD with an anomalous non-affective based decision-making. Further, they are indicative that GSP and GAD are associated with distinct pathophysiologies.