A multi-modal assessment of fear conditioning in adolescent anorexia nervosa.
A multi-modal assessment of fear conditioning in adolescent anorexia nervosa.
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青少年神经性厌食症恐惧调节的多模式评估。
DOI：
10.1002/eat.24180
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Zbozinek,TomislavD
中科院分区：
文献类型：
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作者：
Murray,StuartB;Strober,Michael;LeGrange,Daniel;Schauer,Rebecca;Craske,MichelleG;Zbozinek,TomislavD
目的神经性厌食症（AN）是一种恶性精神疾病，其主要特征是害怕体重增加。尽管恐惧在神经性神经病的精神病理学中占据中心地位，但仍缺乏对负价系统的受控评估。在此，我们评估患有 AN 的青少年女性的恐惧条件反射。 方法 被 DSM-5 诊断为 AN (N= 25) 的青春期女孩 (Mage= 14.6 岁，±1.57) 和没有 DSM-5 诊断 (N= 25) 的年龄匹配对照女孩 (Mage= 14.8 岁，±1.46) 完成结构化临床访谈并参加经典三相巴甫洛夫恐惧调节范式。患有共病焦虑症的参与者被排除在外。测量皮肤电导反应（SCR），以及自我报告的恐惧、效价和恐惧预期评级。结果两组在所有四项测量中都表现出显着的习得差异。关于组间比较，在获得过程中自我报告的恐惧、效价和恐惧预期评级没有出现差异，尽管对于 SCR，患有 AN 的人相对于对照组表现出较低的生理唤醒。两组在无条件刺激（US）预期、自我报告恐惧和自我报告效价方面都表现出显着的差异消退。在条件刺激（CS）+消退期间，在任何结果测量中均未发现明显的统计学显着组间差异。然而，对照组报告的 CS− 的正价比 AN 的对照组更高。结论与我们的假设相反，我们的初步评估没有发现 AN 青春期女孩在恐惧获得或消退方面的恐惧反应升高的支持。这些数据表明，青春期女孩的 AN 可能与获得恐惧的倾向增强无关，但相反，可能表明 AN 的暴露治疗可能有所帮助，因为消退学习在 AN 中是完整的。公共意义 AN 的特点是与恐惧相关的症状，包括与食物和体重相关的恐惧，以及行为回避，但评估恐惧学习的对照研究有限。我们对青少年 AN 的初步评估表明，AN 青少年的恐惧学习没有异常。这些发现可能为 AN 精神病理学的现有机制模型以及基于暴露的 AN 治疗方法的开发提供信息。
ObjectiveAnorexia nervosa (AN) is a pernicious psychiatric disorder which is principally characterized by a fear of weight gain. Notwithstanding the centrality of fear in the psychopathology of AN, controlled assessments of negative valence systems are lacking. Herein we assess fear conditioning in adolescent females with AN.MethodAdolescent girls (Mage= 14.6 years, ±1.57) with DSM‐5 diagnoses of AN (N= 25) and age‐matched control girls (Mage= 14.8 years, ±1.46) with no DSM‐5 diagnoses (N= 25) completed structured clinical interviews and participated in a classical three‐phase Pavlovian fear conditioning paradigm. Participants with comorbid anxiety disorders were excluded. Skin conductance response (SCR) was measured, alongside self‐reported fear, valence, and fear expectancy ratings.ResultsBoth groups demonstrated significant differential acquisition across all four measures. Regarding group comparisons, no differences emerged for self‐reported fear, valence, and fear expectancy ratings during acquisition, although for SCR, those with AN demonstrated reduced physiological arousal relative to controls. Both groups demonstrated significant differential extinction for unconditioned stimuli (US) expectancy, self‐report fear, and self‐report valence. No statistically significant group differences were evident during extinction to the conditioned stimuli (CS)+, on any outcome measure. However, controls reported more positive valence to the CS− than those with AN.ConclusionsContrary to our hypotheses, our preliminary assessment did not find support for elevated fear responding among adolescent girls with AN with regards to fear acquisition or extinction. These data suggest that AN in adolescent girls may not be associated with a heightened propensity to acquire fear, but conversely, may suggest that exposure treatments for AN may be helpful, since extinction learning is intact in AN.Public significanceAN is characterized by fear‐related symptoms, including food and weight‐related fear, and behavioral avoidance, yet controlled studies assessing fear learning are limited. Our preliminary assessment of adolescent AN indicates no abnormalities in fear learning among adolescents with AN. These findings may inform existing mechanistic models of AN psychopathology, and the development of exposure‐based treatments for AN.