Ventrolateral Prefrontal Cortex Activation and Attentional Bias in Response to Angry Faces in Adolescents With Generalized Anxiety Disorder

Department of Psychology, University of Michigan, 2000 East Hall, 530 Church St., Ann Arbor, MI 48109, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 07/2006; 163(6):1091-7. DOI: 10.1176/appi.ajp.163.6.1091
Source: PubMed


While adolescent anxiety disorders represent prevalent, debilitating conditions, few studies have explored their brain physiology. Using event-related functional magnetic resonance imaging (fMRI) and a behavioral measure of attention to angry faces, the authors evaluated differences in response between healthy adolescents and adolescents with generalized anxiety disorder.
In the primary trials of interest, 18 adolescents with generalized anxiety disorder and 15 comparison subjects of equivalent age/gender/IQ viewed angry/neutral face pairs during fMRI acquisition. Following the presentation of each face pair, subjects pressed a button to indicate whether a subsequent asterisk appeared on the same (congruent) or opposite (incongruent) side as the angry face. Reaction time differences between congruent and incongruent face trials provided a measure of attention bias to angry faces.
Relative to the comparison subjects, patients with generalized anxiety disorder manifested greater right ventrolateral prefrontal cortex activation to trials containing angry faces. Patients with generalized anxiety disorder also showed greater attention bias away from angry faces. Ventrolateral prefrontal cortex activation differences remained evident when differences in attention bias were covaried. Finally, in an examination among patients of the association between degree of anxiety and brain activation, the authors found that as ventrolateral prefrontal cortex activation increased, severity of anxiety symptoms diminished.
Adolescents with generalized anxiety disorder show greater right ventrolateral prefrontal cortex activation and attentional bias away from angry faces than healthy adolescents. Among patients, increased ventrolateral prefrontal cortex activation is associated with less severe anxiety, suggesting that this activation may serve as a compensatory response.

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Available from: Eric E Nelson, Oct 09, 2015
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    • "In line with previous research (Monk et al., 2006; Pine et al., 2005; Stirling et al., 2006), our sample of older youth was characterized by attention bias away from threat. Similar results were also observed by Reinholdt-Dunne et al. (2012), with older youths displaying a bias away from threat-related pictorial stimuli. "
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    ABSTRACT: Cognitive models of anxiety suggest that threat-related attentional biases are associated with youth anxiety disorders. Although meta-analyses suggest that anxious youths display a bias toward threat, there is variability among studies, with youths displaying either an attention bias toward or away from threat. One possibility that may account for these discrepancies is the effect of youth age. Previous studies have found an effect of age on attentional biases in nonclinical samples. In this study, we examined the effects of age on attentional biases in youths diagnosed with an anxiety disorder. Clinically anxious youths (N = 33) completed the probe detection task using threat-related word stimuli. Our results revealed a significant effect of age, with older youths (11–17 years) displaying a significant bias away from threat and younger youths (8–10 years) displaying a nonsignificant bias toward threat. These findings suggest that anxious youth may have either an attentional bias toward or away from threat-related words depending on age.
    Journal of Cognitive Psychotherapy 08/2015; 29(3). DOI:10.1891/0889-8391.29.3.185
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    • "We adopted an event-related fMRI dot-probe task involving angry and neutral faces as used in prior studies (e.g. Hardee et al., 2013; Monk et al., 2006) to assist comparison and interpretation of findings. The incongruent-versus-congruent contrast isolates neural responses to probes that appeared in the opposite location of the threat. "
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    ABSTRACT: Children with behavioral inhibition (BI), a temperament characterized by biologically-based hyper-vigilance to novelty, display threat-related attention biases (AB) that shape developmental trajectories of risk for anxiety. Here we explore the relations between BI, neural function, and anxiety. Fifty-six 9-12-year-olds (23 behaviorally inhibited) performed the dot-probe task while undergoing fMRI. AB scores were not associated with BI group or parent-rated anxiety symptoms. Trials requiring attention orienting away from threat engaged an executive and threat-attention network (dlPFC, vlPFC, mPFC, and amygdala). Within that network, behaviorally inhibited children showed greater activation in the right dlPFC. Heightened dlPFC activation related to increased anxiety, and BI levels accounted for the direct relation between dlPFC activation and anxiety. Behaviorally inhibited children may engage the executive attention system during threat-related processing as a compensatory mechanism. We provide preliminary evidence that the link between PFC functioning and anxiety might be attributed to early-emerging temperamental vulnerabilities present before the emergence of clinical anxiety. Copyright © 2015. Published by Elsevier B.V.
    Biological psychology 08/2015; DOI:10.1016/j.biopsycho.2015.08.010 · 3.40 Impact Factor
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    • "For example, clinical research has traditionally investigated groups with versus without anxiety disorders. This line of research has demonstrated important differences in both brain and behavior between patient and healthy control groups (Monk et al., 2006; Phan et al., 2005; Thayer et al., 1996; Zhao et al., 2007). Even in relatively healthy samples, prior work has often separated participants into " high " and " low " anxiety groups. "
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    ABSTRACT: The ability to regulate the emotional response to threat is critical to healthy emotional function. However, the response to threat varies considerably from person-to-person. This variability may be partially explained by differences in emotional processes, such as locus of control and affective state, which vary across individuals. Although the basic neural circuitry that mediates the response to threat has been described, the impact individual differences in affective state and locus of control have on that response is not well characterized. Understanding how these factors influence the neural response to threat would provide new insight into processes that mediate emotional function. Therefore, the present study used a Pavlovian conditioning procedure to investigate the influence individual differences in locus of control, positive affect, and negative affect have on the brain and behavioral response to predictable and unpredictable threat. Thirty-two healthy volunteers participated in a fear conditioning study in which predictable and unpredictable threat (i.e., unconditioned stimulus) were presented during functional magnetic resonance imaging (fMRI). Locus of control showed a linear relationship with learning-related ventromedial prefrontal cortex (PFC) activity such that the more external an individual's locus of control, the greater their differential response to predictable versus unpredictable threat. In addition, positive and negative affectivity showed a curvilinear relationship with dorsolateral PFC, dorsomedial PFC, and insula activity, such that those with high or low affectivity showed reduced regional activity compared to those with an intermediate level of affectivity. Further, activity within the PFC, as well we other regions including the amygdala, were linked with the peripheral emotional response as indexed by skin conductance and electromyography. The current findings demonstrate that the neural response to threat within brain regions that mediate the peripheral emotional response are modulated by an individual's affective state as well as their perceptions of an event's causality. Copyright © 2015. Published by Elsevier Inc.
    NeuroImage 07/2015; DOI:10.1016/j.neuroimage.2015.07.034 · 6.36 Impact Factor
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