Behavioral and fMRI correlates of late-life generalized anxiety disorder

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): In clinically anxious individuals, selective attention to negative cues in the environment may perpetuate a vicious cycle of emotional dysfunction. Attention is captured by negative cues to an inordinate degree, triggering anxious mood states which, in turn, reinforce the salience of negative information. Very little is known regarding the role of attentional biases in anxious older adults, despite the acknowledged need for an increase in research on late-life anxiety. Furthermore, there is evidence that in older adults without clinical anxiety, the opposite bias (toward positive, and away from negative, emotional material) is present; yet how these age-related changes in emotional processing interact with anxiety is currently unknown. The emotional Stroop (eStroop) task, which requires rapid identification of the ink color of negative, neutral, and positive emotional words, has yet to be thoroughly tested as an index of attentional bias in older adults. The specific aims of this proposal are twofold: 1) to test whether eStroop response times differentiate anxious and non-anxious older adults; and 2) to identify neural correlates of the eStroop in late-life generalized anxiety disorder (GAD) patients and age-matched controls. In Study 1, 60 older adults in the community will complete the eStroop task. Response time data will be analyzed to test the prediction that high scorers on a self-report measure of worry, but not low scorers, will selectively attend to negative words, while low scorers, but not high scorers, will selectively attend to positive words. In study 2, fMRI data recently collected from 40 older adults (28 treatment-seeking GAD patients, 12 non-anxious controls) during the eStroop task will be analyzed. Analyses will focus on the neural circuits implicated in inhibitory control (prefrontal cortex regions) and emotional processing (amygdala) and will test the predictions of a theoretical model of attentional bias. This project will provide novel data on the utility of a widely-used task for research with older adult samples and will advance our understanding of the behavioral and neural correlates of normal and abnormal emotional processing in an understudied age group. Given that GAD is one of the most prevalent psychiatric conditions in late life, and response rates to current therapies are relatively poor, an improved understanding of the behavioral and neural mechanisms of late-life GAD is urgently needed. Generalized anxiety disorder is a prevalent, disabling condition in the older adult population. This study will explore whether biases in attention that have been shown to contribute to anxiety in younger adults are equally relevant in late-life anxiety, and what patterns of brain activity may underlie these biases.