Responding to threat: Associations between neural reactivity to and behavioral avoidance of threat in pediatric anxiety

焦虑 心理学 扁桃形结构 概化理论 背景(考古学) 前额叶腹内侧皮质 反应性(心理学) 意识的神经相关物 临床心理学 功能磁共振成像 操作化 避免伤害 发展心理学 精神科 前额叶皮质 认知 神经科学 医学 社会心理学 古生物学 哲学 替代医学 认识论 病理 生物 人格 五大性格特征
作者
Elizabeth R. Kitt,Sadie J. Zacharek,Paola Odriozola,Cristina Nardini,Erik C Nook,Alyssa Martino,Tess Anderson,Hannah Spencer,Alexis Broussard,Janice Dean,Carla E. Marin,Wendy K. Silverman,Eli R. Lebowitz,Dylan G. Gee
出处
期刊:Journal of Affective Disorders [Elsevier BV]
卷期号:351: 818-826
标识
DOI:10.1016/j.jad.2024.01.204
摘要

Despite broad recognition of the central role of avoidance in anxiety, a lack of specificity in its operationalization has hindered progress in understanding this clinically significant construct. The current study uses a multimodal approach to investigate how specific measures of avoidance relate to neural reactivity to threat in youth with anxiety disorders. Children with anxiety disorders (ages 6–12 years; n = 65 for primary analyses) completed laboratory task- and clinician-based measures of avoidance, as well as a functional magnetic resonance imaging task probing neural reactivity to threat. Primary analyses examined the ventral anterior insula (vAI), amygdala, and ventromedial prefrontal cortex (vmPFC). Significant but distinct patterns of association with task- versus clinician-based measures of avoidance emerged. Clinician-rated avoidance was negatively associated with right and left vAI reactivity to threat, whereas laboratory-based avoidance was positively associated with right vAI reactivity to threat. Moreover, left vAI-right amygdala and bilateral vmPFC-right amygdala functional connectivity were negatively associated with clinician-rated avoidance but not laboratory-based avoidance. These results should be considered in the context of the restricted range of our treatment-seeking sample, which limits the ability to draw conclusions about these associations across children with a broader range of symptomatology. In addition, the limited racial and ethnic diversity of our sample may limit the generalizability of findings. These findings mark an important step towards bridging neural findings and behavioral patterns using a multimodal approach. Advancing understanding of behavioral avoidance in pediatric anxiety may guide future treatment optimization by identifying individual-specific targets for treatment.
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