Anticipating reward & threat: A test of biobehavioral processes in MDD vs anxiety

描述（由申请人提供）：抑郁症和焦虑症都与严重的损害和残疾有关，当它们同时发生时（发生率高得惊人）特别有害且难以治疗。为了开发更有针对性的治疗方法，必须了解这两种疾病的核心疾病过程，因为这些过程可能是它们经常同时发生的原因。这项研究旨在评估两种倾向，已提出的基础抑郁症和焦虑症，分别-低敏感性的食欲刺激和高敏感性的厌恶刺激。抑郁症与接近或寻求奖励或其他积极刺激的倾向降低有关（即，对食欲的敏感性低）。焦虑症与对威胁性或厌恶性刺激的超敏感性有关。然而，一个重要的问题是，低接近动机是否是抑郁症特有的，或者对威胁/厌恶的过度敏感是否是焦虑症特有的。一个相关的问题是，这些情绪倾向是否与抑郁和焦虑共享，并与这两种情况之间的高共同发生率有关。目前的研究试图通过观察抑郁、焦虑或抑郁和焦虑并存的个体的这些过程的行为和生物学测量来研究这些问题。四组29人将参与--患有抑郁症和焦虑症的人、仅患有抑郁症的人、仅患有焦虑症的人以及非抑郁/非焦虑对照组。每名参与者将接受评估，包括临床访谈和评估个性和情绪/动机倾向的问卷调查。此外，我们还将研究低食欲动机（EEG活动的不对称性）和对威胁/厌恶的高敏感性（异常惊吓眨眼反应）的假定生物标志物。该项目有五个具体目标：1）通过比较控制组和抑郁个体在预期获得奖励（金钱）的可能性时的EEG不对称性，来检验抑郁与低接近动机之间的假设关联;（二）通过比较控制组和焦虑组的受试者在预期焦虑发生时的惊恐眨眼反应，检验焦虑和高厌恶敏感性之间的假设关联。3）测试低接近动机和高厌恶敏感性是否独立; 4）测试低接近动机和高厌恶敏感性是否分别特异于抑郁和焦虑; 5）测试抑郁和焦虑的共同发生是否是由于（或至少与）两种情况共同的过程。总之，这项研究有可能提供有关抑郁、焦虑及其共同发生的情绪和生物机制的重要信息。公共卫生相关性：抑郁症和焦虑症都与严重的损伤和残疾相关，当它们同时发生时（发生率高得惊人），特别有害且难以治疗。为了开发针对这些疾病的适当治疗方法，重要的是要了解导致它们的过程并检查可能导致它们同时发生的潜在异常。这项研究将检查与抑郁和焦虑有关的两种情绪异常/倾向-对快乐的敏感性降低和对厌恶或威胁的过度敏感。

DESCRIPTION (provided by applicant): Depressive and anxiety disorders are each associated with significant impairment and disability and when they co-occur (which happens at alarmingly high rates) are especially harmful and difficult to treat. In order to develop more targeted treatments, it is essential to understand the core disease processes that underlie these two conditions as these processes may be why they co-occur so often. This study seeks to evaluate two tendencies that have been proposed to underlie depression and anxiety, respectively - low sensitivity to appetitive stimuli and high sensitivity to aversive stimuli. Depression has been associated with a reduced tendency to approach or seek out rewards or other positive stimuli (i.e., low sensitivity to appetitive). Anxiety disorders have been associated with a hyper-sensitivity to threatening or aversive stimuli. An important question, though, is whether low approach motivation is specific to depression and/or whether hyper-sensitivity to threat/aversiveness is specific to anxiety. A related question is whether these emotional tendencies are shared by depression and anxiety and relate to the high co-occurrence rates between the two conditions. The current study seeks to examine these questions by looking at behavioral and biological measures of these processes in individuals with depression, anxiety, or co-occurring depression and anxiety. Four groups of 29 individuals will participate - those with depression and anxiety, those with depression only, those with anxiety only, and a non-depressed/non-anxious control group. Each participant will undergo an assessment consisting of a clinical interview and questionnaires assessing personality and emotional/motivational tendencies. Additionally, we will examine putative biological markers for low appetitive motivation (asymmetries in EEG activity) and high sensitivity to threat/aversiveness (abnormal startle eyeblink response). The project has five specific aims - 1) Test the hypothesized association between depression and low approach motivation by comparing the EEG asymmetries of controls and depressed individuals while they anticipate the possibility of receiving a reward (money); 2) Test the hypothesized association between anxiety and high aversiveness sensitivity by comparing the startle eyeblink responses of controls and anxious individuals while they anticipate the possibility of receiving an aversive/threatening stimulus (shock); 3) Test whether low approach motivation and high aversiveness sensitivity are independent; 4) Test whether low approach motivation and high aversiveness sensitivity are specific to depression and anxiety, respectively; and 5) Test whether the co-occurrence of depression and anxiety is due (or at least relates) to processes that are common to both conditions. In sum, the proposed study has the potential to provide important information regarding the emotional and biological mechanisms that underlie depression, anxiety and their co-occurrence. PUBLIC HEALTH RELEVANCE: Depressive and anxiety disorders are each associated with significant impairment and disability and when they co-occur (which happens at alarmingly high rates) are especially harmful and difficult to treat. In order to develop adequate treatments for these conditions, it is important to understand the processes that cause them and to examine potential abnormalities that may lead to their co-occurrence. This study will examine two emotional abnormalities/tendencies that have been related to depression and anxiety - a reduced sensitivity to pleasure and an over sensitivity to aversiveness or threat.