Article

Harm Avoidance and Risk of Alzheimer's Disease

Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S Paulina, Suite 1038, Chicago, IL 60612, USA.
Psychosomatic Medicine (Impact Factor: 4.09). 09/2011; 73(8):690-6. DOI: 10.1097/PSY.0b013e3182302ale
Source: PubMed

ABSTRACT To test the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the risk of developing Alzheimer's disease (AD).
A total of 791 adults 55 years and older without dementia completed a standard self-report measure of harm avoidance. They then underwent annual evaluations that included detailed cognitive testing and clinical classification of mild cognitive impairment (MCI), dementia, and AD. In a uniform neuropathologic examination of those who died, counts of neuritic plaques, diffuse plaques, and neurofibrillary tangles were standardized and combined to yield a pathologic measure of disease. The relation of harm avoidance to incidence of AD and related outcomes was estimated in analyses adjusted for age, sex, and education.
During a mean of 3.5 years of annual observation, 98 people (12.4%) developed incident AD. A high level of harm avoidance (90th percentile) was associated with a more than two-fold increase in risk of AD compared with a low score (10th percentile). Higher harm avoidance was also associated with increased incidence of MCI and more rapid decline in episodic memory, working memory, and perceptual speed (but not semantic memory or visuospatial ability). In 116 participants who died and underwent brain autopsy, harm avoidance was not related to a composite measure of plaques and tangles.
A high level of the harm avoidance trait, indicating a tendency toward behavioral inhibition, is related to the risk of developing AD and its precursor, MCI.

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Available from: Patricia A Boyle, Aug 30, 2015
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    • "One personality dimension assessed by the TPQ, which the authors termed harm avoidance (HA), is defined as behavioral inhibition in response to novel or aversive situations (Cloninger, 1986, 1987). In line with our recent work (Sheynin et al., 2014a), and in agreement with reports from other groups (e.g., Mardaga and Hansenne, 2007; Baeken et al., 2009; Wilson et al., 2011; Bailer et al., 2013), we used this subscale to assess inhibited temperament in the current study. The other two dimensions assessed by the TPQ are reward dependence (RD), defined as marked response to rewarding stimuli, and novelty seeking (NS), defined as exploratory activity in response to novel stimulation. "
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    ABSTRACT: While avoidance behavior is often an adaptive strategy, exaggerated avoidance can be detrimental and result in the development of psychopathologies, such as anxiety disorders. A large animal literature shows that the acquisition and extinction of avoidance behavior in rodents depends on individual differences (e.g., sex, strain) and might be modulated by the presence of environmental cues. However, there is a dearth of such reports in human literature, mainly due to the lack of adequate experimental paradigms. In the current study, we employed a computer-based task, where participants control a spaceship and attempt to gain points by shooting an enemy spaceship that appears on the screen. Warning signals predict on-screen aversive events; the participants can learn a protective response to escape or avoid these events. This task has been recently used to reveal facilitated acquisition of avoidance behavior in individuals with anxiety vulnerability due to female sex or inhibited personality. Here, we extended the task to include an extinction phase, and tested the effect of signals that appeared during "safe" periods. Healthy young adults (n = 122) were randomly assigned to a testing condition with or without such signals. Results showed that the addition of safety signals during the acquisition phase impaired acquisition (in females) and facilitated extinction of the avoidance behavior. We also replicated our recent finding of an association between female sex and longer avoidance duration and further showed that females continued to demonstrate more avoidance behavior even on extinction trials when the aversive events no longer occurred. This study is the first to show sex differences on the acquisition and extinction of human avoidance behavior and to demonstrate the role of safety signals in such behavior, highlighting the potential relevance of safety signals for cognitive therapies that focus on extinction learning to treat anxiety symptoms.
    Frontiers in Behavioral Neuroscience 09/2014; 8:323. DOI:10.3389/fnbeh.2014.00323 · 4.16 Impact Factor
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    • "The basis of the association between harm avoidance and parkinsonism is likely to be complex. While, harm avoidance is related to other personality traits and psychosocial factors, [26] the association of harm avoidance and parkinsonism was unchanged when we adjusted for several of these factors in the current study (Table 3) [27]. Personality traits may affect for lifestyle choices i.e. physical and other late-life activities and could thus link harm avoidance with parkinsonism. "
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    ABSTRACT: We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults. At baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson's Disease Rating Scale (mUPDRS). Average follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions. A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.
    BMC Geriatrics 04/2014; 14(1):54. DOI:10.1186/1471-2318-14-54 · 2.00 Impact Factor
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    • "One personality dimension assessed by the TPQ, which the authors termed harm avoidance (HA), is defined as personality related to behavioural inhibition in response to novel or aversive situations (Cloninger, 1986, 1987). In agreement with work reported by other groups (e.g., Mardaga and Hansenne, 2007; Baeken et al., 2009; Wilson et al., 2011; Bailer et al., 2013), we used this subscale to assess inhibited temperament in the current study. We accordingly predicted that HA scores would be related to avoidance learning in the current task. "
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    ABSTRACT: Acquisition and maintenance of avoidance behaviour is a key feature of all human anxiety disorders. Animal models have been useful in understanding how anxiety vulnerability could translate into avoidance learning. For example, behaviourally-inhibited temperament and female sex, two vulnerability factors for clinical anxiety, are associated with faster acquisition of avoidance responses in rodents. However, to date, the translation of such empirical data to human populations has been limited since many features of animal avoidance paradigms are not typically captured in human research. Here, using a computer-based task that captures many features of rodent escape-avoidance learning paradigms, we investigated whether avoidance learning would be faster in humans with inhibited temperament and/or female sex and, if so, whether this facilitation would take the same form. Results showed that, as in rats, both vulnerability factors were associated with facilitated acquisition of avoidance behaviour in humans. Specifically, inhibited temperament was specifically associated with higher rate of avoidance responding, while female sex was associated with longer avoidance duration. These findings strengthen the direct link between animal avoidance work and human anxiety vulnerability, further motivating the study of animal models while also providing a simple testbed for a direct human testing.
    Behavioural processes 01/2014; 103. DOI:10.1016/j.beproc.2014.01.003 · 1.46 Impact Factor
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