Temporal dynamics of emotional processing in anxiety

描述(申请人提供)：尽管广泛性焦虑症(GAD)的发病率很高，但与其他焦虑症相比，研究相对较少。广泛性焦虑症患者过度担心不确定的未来，他们认为这将是令人厌恶的。随着对神经反应性的日益复杂的评估的出现，现在必须探索GAD的预期性质以及对情感刺激的反应。为了为广泛性AD中慢性的、难以控制的厌恶体验的神经生物学基础提供证据，有必要对厌恶刺激呈现(恢复)后的生理反应进行测量。该范式将采用一种创新的方法来检查情绪反应，包括对厌恶的视觉刺激的预期、反应和恢复。GAD和对照受试者之间将进行比较，这些受试者目前或过去没有精神障碍。与非焦虑对照组相比，GAD患者在预期情绪刺激时，预计会表现出更大的杏仁核活动以及脑岛和几个关键区域的活动，这些区域与预期厌恶有关。在恢复方面，GAD患者在接受厌恶刺激后的目标脑区表现出持续的神经反应，这一点预计与MDD患者相似。公共卫生相关性：通过更好地了解焦虑和抑郁人群的预期、反应和康复过程，新的治疗策略可能使个人受益，并减轻其症状的社会负担。这些数据还可能表明，在具有焦虑和抑郁特征遗传易感性的个人中，情感障碍的敏感先兆，目的是最终防止这些人出现临床综合征。

DESCRIPTION (provided by applicant): Despite its high prevalence, generalized anxiety disorder (GAD) has been relatively under studied compared with other anxiety disorders. Patients with GAD worry excessively about an uncertain future that they believe will be aversive. Despite evidence that worry concerns the future, most experimental paradigms studying GAD focus only on direct responses to evocative material. With the advent of increasingly sophisticated assessments of neural responsivity, it is now essential to probe the anticipatory nature of GAD alongside responses to affective stimuli. Another important factor in this form of psychopathology is the chronic nature of anxiety and difficulty controlling negative thoughts once they are initiated. Difficulty controlling worry is one of the diagnostic criteria for GAD well supported by self-report data in these patients. To provide evidence for the neurobiological substrate of chronic, difficult to control aversive experiences in GAD, the measurement of physiological responses in the aftermath of aversive stimulus presentations (recovery) is warranted. The work planned will focus on the neural signature of processing negative emotional information in GAD using functional magnetic resonance brain imaging (fMRI). The paradigm will take an innovative approach in examining emotional reactivity including anticipation of, response to, and recovery from aversive visual stimuli in a single study. Comparisons will be made between GAD and control subjects with no current or past psychiatric disorder. Contrasts will also be made between GAD patients and major depressive disorder (MDD) patients as well as patients with both conditions. GAD patients are expected to show greater amygdala activity as well as activity in the insula and several key areas implicated in the anticipation of aversion during anticipation of emotional stimuli than non-anxious controls. In response to aversive stimuli, GAD patients are expected to show less reactivity in these regions than non-anxious controls. For recovery, GAD patients are expected to be similar to MDD patients in showing sustained neural responding in the targeted brain regions following aversive stimuli. PUBLIC HEALTH RELEVANCE: By better understanding the processes of anticipation, response, and recovery in anxious and depressive populations, new strategies for treatment may benefit individuals and reduce the societal burden of their symptoms. These data will allow clinicians to know which stage of emotional processing for a particular group of patients might most benefit from interventions targeting that stage. These data may also suggest sensitive precursors of affective disorders in individuals with genetic susceptibility to anxious and depressive traits with the goal to ultimately prevent the clinical syndrome from developing in these individuals.