Elevated decision uncertainty and reduced avoidance drives in depression, anxiety and substance use disorders during approach-avoidance conflict: a replication study.
Elevated decision uncertainty and reduced avoidance drives in depression, anxiety and substance use disorders during approach-avoidance conflict: a replication study.
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在接近-回避冲突期间，抑郁症、焦虑症和药物使用障碍中决策不确定性的增加和回避动力的减少：一项重复研究。
DOI：
10.1503/jpn.220226
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发表时间：
2023-05
影响因子：
4.3
通讯作者：
Aupperle, Robin
中科院分区：
文献类型：
--
作者：
Smith, Ryan;Lavalley, Claire A.;Taylor, Samuel;Stewart, Jennifer L.;Khalsa, Sahib S.;Berg, Hannah;Ironside, Maria;Paulus, Martin P.;Aupperle, Robin
趋避冲突下的决策（AAC；例如，牺牲生活质量以避免可怕的结果）可能在多种精神疾病中受到影响。最近，我们使用一种计算（主动推理）模型来描述患有抑郁症、焦虑症和/或物质使用障碍的个体在趋避冲突期间信息处理的差异。患有精神疾病的个体表现出决策不确定性（DU）增加以及对不愉快刺激的敏感性降低。这项预先注册的研究旨在确定这种加工功能障碍的可重复性。
一组新的参与者样本完成了趋避冲突任务。获得了反映决策不确定性以及对不愉快刺激的敏感性（“情绪冲突”；EC）的个体层面的计算参数估计值，并在各组之间进行了比较。随后结合先前和当前样本的分析能够对更窄的疾病类别进行评估。
本研究的样本包括480名参与者：97名健康对照者，175名物质使用障碍患者以及208名抑郁症和/或焦虑症患者。物质使用障碍患者比健康对照者表现出更高的决策不确定性和更低的情绪冲突值。患有抑郁症和/或焦虑症的女性（而非男性）的情绪冲突值比健康对照者低。然而，先前观察到的抑郁症和/或焦虑症患者与健康对照者之间在决策不确定性上的差异没有重现。对合并样本中特定疾病的分析表明，不同物质使用障碍和情感障碍之间的影响是常见的。
先前样本和当前样本在年龄和基线智力功能方面存在差异，尽管效应量较小，但这可能影响了抑郁症和/或焦虑症患者决策不确定性差异的重现。
这些临床群体差异的有力证据基础引发了未来研究应解决的具体问题：决策不确定性和情绪冲突能否成为行为治疗的目标，以及我们能否确定决策不确定性和情绪冲突的神经基础，以便用于衡量功能障碍的严重程度或作为神经调节治疗的目标？
Decision-making under approach–avoidance conflict (AAC; e.g., sacrificing quality of life to avoid feared outcomes) may be affected in multiple psychiatric disorders. Recently, we used a computational (active inference) model to characterize information processing differences during AAC in individuals with depression, anxiety and/or substance use disorders. Individuals with psychiatric disorders exhibited increased decision uncertainty (DU) and reduced sensitivity to unpleasant stimuli. This preregistered study aimed to determine the replicability of this processing dysfunction. A new sample of participants completed the AAC task. Individual-level computational parameter estimates, reflecting decision uncertainty and sensitivity to unpleasant stimuli (“emotion conflict”; EC), were obtained and compared between groups. Subsequent analyses combining the prior and current samples allowed assessment of narrower disorder categories. The sample in the present study included 480 participants: 97 healthy controls, 175 individuals with substance use disorders and 208 individuals with depression and/or anxiety disorders. Individuals with substance use disorders showed higher DU and lower EC values than healthy controls. The EC values were lower in females, but not males, with depression and/or anxiety disorders than in healthy controls. However, the previously observed difference in DU between participants with depression and/or anxiety disorders and healthy controls did not replicate. Analyses of specific disorders in the combined samples indicated that effects were common across different substance use disorders and affective disorders. There were differences, although with small effect size, in age and baseline intellectual functioning between the previous and current sample, which may have affected replication of DU differences in participants with depression and/or anxiety disorders. The now robust evidence base for these clinical group differences motivates specific questions that should be addressed in future research: can DU and EC become behavioural treatment targets, and can we identify neural substrates of DU and EC that could be used to measure severity of dysfunction or as neuromodulatory treatment targets?
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影响因子：
2.7
作者：
Aupperle, Robin L.;Sullivan, Sarah;Melrose, Andrew J.;Paulus, Martin P.;Stein, Murray B.
通讯作者：
Stein, Murray B.
影响因子：
6
作者：
Kubicka, L;Matejcek, Z;Roth, Z
通讯作者：
Roth, Z
影响因子：
5.2
作者：
Aupperle, Robin Leora;Paulus, Martin P.;Khalsa, Sahib S.
通讯作者：
Khalsa, Sahib S.
影响因子：
5.4
作者：
Bjelland, Ingvar;Krokstad, Steinar;Tambs, K.
通讯作者：
Tambs, K.
影响因子：
5.7
作者：
Friston, Karl J.;Mattout, Jeremie;Penny, Will
通讯作者：
Penny, Will