Fear Conditioning in Adolescents With Anxiety Disorders: Results From a Novel Experimental Paradigm

Mood and Anxiety Disorders Program, National Institute of Mental Health /National Institutes of Health, 15K North Drive, MSC 2670, Bethesda, MD 20892-2670, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 02/2008; 47(1):94-102. DOI: 10.1097/chi.0b01e31815a5f01
Source: PubMed


Considerable research examines fear conditioning in adult anxiety disorders but few studies examine youths. Adult data suggest that anxiety disorders involve elevated fear but intact differential conditioning. We used a novel paradigm to assess fear conditioning in pediatric anxiety patients.
Sixteen individuals with anxiety disorders and 38 healthy comparisons viewed two photographs of actresses displaying neutral expressions. One picture served as the conditioned stimulus (CS), paired with a fearful expression and a shrieking scream (CS+), whereas the other picture served as a CS unpaired with the aversive outcome (CS-). Conditioning was indexed by self-reported fear. Subjects participated in two visits involving conditioning and extinction trials.
Both groups developed greater fear of the CS+ relative to CS-. Higher fear levels collapsed across each CS characterized anxious relative to healthy subjects, but no significant interaction between group and stimulus type emerged. Fear levels at visit 1 predicted avoidance of visit 2. Fear levels to both CS types showed stability even after extinction.
Consistent with adult data, pediatric anxiety involves higher fear levels following conditioning but not greater differential conditioning. Extending these methods to neuroimaging studies may elucidate neural correlates of fear conditioning. Implications for exposure therapies are discussed.

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    • "Both Neumann et al. (2008) and Haddad et al.'s (2011) studies examined fear conditioning and extinction in healthy adolescents. In an earlier study conducted by Lau et al. (2008) using the Screaming Lady procedure described above, fear conditioning and extinction were compared in anxious versus healthy adolescents. Following conditioning, both anxious and healthy adolescents rated the CSþ as more fear provoking than the CSÀ and the size of this difference was comparable across the two groups. "
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    • "Also of considerable relevance is recent evidence demonstrating the modulating role that anxiety plays in attention and executive functioning (Pérez-Edgar and Fox, 2007; Roy et al., 2008; Bishop, 2009; Krug and Carter, 2010; Pérez-Edgar et al., 2011), which are key components of the schizophrenia endophenotype. Similarly, emotional content significantly impacts memory formation (LeDoux, 2000) and thus can further impact affective dysregulation as in the case of atypical fear extinction and generalization as is common in those with elevated levels of anxiety (Lau et al., 2008; Lissek et al., 2008). To our knowledge, no detailed study of fornix integrity has ever been reported in children with 22q11.2DS. "
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    • "tral male faces served as CS+ and CS− ( counterbalanced ) , the female was only presented during the practice phase . The aversive event ( US ) was a loud , male scream of 95 dB ( see for a similar stimulus , Hamm , Vaitl , & Lang , 1989 ) , presented binaurally through headphones for 2 s accompanied by an angry facial expression of the CS+ male ( Lau et al . , 2008 ) . Emotional facial expressions were used as they trigger amyg dala responses ( Sheline et al . , 2001 ; Shin & Liberzon , 2009 ; Stein et al . , 2007 ) . The experiment was programmed with E - prime software ( Version 2 . 08 , Psychology Software Tools , http : / / www . pstnet . com / ) ."
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