Startle response to unpredictable threat in comorbid panic disorder and alcohol dependence

Startle response to unpredictable threat in comorbid panic disorder and alcohol dependence
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DOI:
10.1016/j.drugalcdep.2013.02.003
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发表时间:
2013-09-01
影响因子:
4.2
通讯作者:
Shankman, Stewart A.
Shankman, Stewart A.
中科院分区:
医学2区
文献类型:
--
作者:
Gorka, Stephanie M.;Nelson, Brady D.;Shankman, Stewart A.

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背景:虽然惊恐障碍(PD)和酒精依赖(AD)共病的不良后果已被明确证实,但人们对它们同时发生的机制知之甚少。一些研究人员推测,酒精抑制对不可预测威胁的反应的能力可能是 PD 和 AD 共病的重要动机因素。迄今为止,还没有研究使用临床样本检查这些过程,并且尚不清楚患有 PD 和 AD 的个体与仅患有 PD 的个体相比,是否表现出对不可预测威胁的不同反应性。 方法:当前研究的目的是检查三组个体在可预测和不可预测的休克威胁期间厌恶反应的差异:(1)当前 PD 和缓解的 AD(PD 和 AD),(2)当前 PD 但没有终身症状 诊断为 AD(仅 PD),以及 (3) 终生未诊断为 PD 或 AD(对照)。使用完善的肌电图 (EMG) 惊吓范式评估厌恶反应。结果:结果表明,相对于对照组和仅 PD 个体(没有差异),PD 和 AD 个体在不可预测(但不可预测)威胁期间表现出更大的惊吓增强。结论:这些发现表明,对不可预测威胁的反应性增强可能是 PD 和 AD 合并症的一个重要过程,并且可能是一种潜在的潜在威胁。 参与饮酒的关键动机因素。 (C) 2013 Elsevier Ireland Ltd. 保留所有权利。
Background: Although the adverse consequences of comorbid panic disorder (PD) and alcohol dependence (AD) are well-established, relatively little is known about the mechanisms underlying their co-occurrence. Several researchers have postulated that alcohol's ability to dampen response to unpredictable threat may be an important motivational factor in comorbid PD and AD. To date, no research has examined these processes using a clinical sample and it is unclear whether individuals with PD and AD evidence different reactivity to unpredictable threat relative to individuals with PD-only.Methods: The aim of the current study was to examine differences in aversive responding during predictable and unpredictable threat-of-shock in three groups of individuals with: (1) current PD and remitted AD (PD and AD), (2) current PD but no lifetime diagnosis of AD (PD-only), and (3) no lifetime diagnoses of PD or AD (controls). Aversive responding was assessed using a well-established electromyography (EMG) startle paradigm.Results: Results indicated that PD and AD individuals evidenced greater startle potentiation during unpredictable (but not predictable) threat relative to controls and PD-only individuals (who did not differ).Conclusions: These findings suggest that heightened reactivity to unpredictable threat may be an important process in PD and AD comorbidity and a possible key motivational factor underlying engagement in alcohol use. (C) 2013 Elsevier Ireland Ltd. All rights reserved.