Fear, anxiety, and their disorders from the perspective of psychophysiology

Hamm, Alfons O.

doi:10.1111/psyp.13474

Cited by 93 publications

(109 citation statements)

References 90 publications

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“…The time frame or the imminence of the threat is also an important component. Building on earlier work by a number of authors, Hamm (2020) differentiates between anxiety and fear in terms of imminence with associated psychophysiological, neural and behavioural correlates. Anxiety in distal threat becomes fear as the threat approaches and becomes imminent.…”

Section: Threat Models Of Anxietymentioning

confidence: 99%

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Freeston

Tiplady²,

Mawn

et al. 2020

tCBT

159

126

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Abstract The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress as the subjective negative emotions experienced in response to the as yet unknown aspects of a given situation. In the first paper we drawn on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically, and empirically informed model for uncertainty distress and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (Covid-19), the model has broader applications to both mental and physical health care settings.

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Section: Threat Models Of Anxietymentioning

confidence: 99%

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Freeston

Tiplady²,

Mawn

et al. 2020

tCBT

159

126

View full text Add to dashboard Cite

show abstract

“…Thus, unlike what we and others 13 have observed for conditioned SCRs, the additional removal of the physical threat seems to moderate the effects of instructions on conditioned FPSs which some consider as indices for affective learning 21 . Affective learning results in the activation of the defensive system, i.e., the neural networks involved in threat processing and their communication with those circuits organizing defensive responding 26 , in response to a CS previously paired with an aversive event 21 . Thus, our findings implicate that the physical removal of the threat, i.e., the provision of an www.nature.com/scientificreports www.nature.com/scientificreports/ extremely potent safety signal, is associated with a slightly more effective inhibition of the defensive system than mere verbal instructions.…”

Section: Effects Of Instructions On Extinction Learningmentioning

confidence: 99%

Effects of verbal instructions and physical threat removal prior to extinction training on the return of conditioned fear

Wendt

Hufenbach

König

et al. 2020

Sci Rep

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Instructions given prior to extinction training facilitate the extinction of conditioned skin conductance (SCRs) and fear-potentiated startle responses (FPSs) and serve as laboratory models for cognitive interventions implemented in exposure-based treatments of pathological anxiety. Here, we investigated how instructions given prior to extinction training, with or without the additional removal of the electrode used to deliver the unconditioned stimulus (US), affect the return of fear assessed 24 hours later. We replicated previous instruction effects on extinction and added that the additional removal of the US electrode slightly enhanced facilitating effects on the extinction of conditioned FPSs. In contrast, extinction instructions hardly affected the return of conditioned fear responses. These findings suggest that instruction effects observed during extinction training do not extent to tests of return of fear 24 hours later which serve as laboratory models of relapse and improvement stability of exposure-based treatments.Exposure-based treatments of pathological anxiety, which involve confronting patients with their feared stimulus or situation until the fear response declines 1 , are considered as highly efficient 2 . However, about one third of patients undergoing exposure-based treatments may not experience a clinically relevant decline in their pathological anxiety 3 and another third may experience a relapse, i.e. a return of their pathological anxiety, within 10 years 4 . These findings highlight the relevance of determining factors that moderate both short-term and long-term outcomes of exposure-based treatments. Pavlovian fear conditioning paradigms allow for the investigation of the development, treatment and maintenance of fear under laboratory conditions and typically comprise several experimental phases 5 : During fear acquisition training, a previously unrelated stimulus (conditioned stimulus, CS) is presented together with an aversive event (unconditioned stimulus, US), acquires signal value for the US and eventually elicits a conditioned fear response (CR). During extinction training, the CS is presented without the US and the CR gradually declines which is why extinction procedures serve as a laboratory analogue for exposure-based treatments 6 . Subsequent retention tests which entail the re-exposure to the CS after experimental manipulations and/or a period of time are used to investigate the maintenance of the extinction memory trace. Thus, retention tests are used to model long-term stability of fear reduction and relapse after exposure-based treatments 7 .Verbal instructions about CS-US associations influence conditioned responding when given prior to acquisition training 8 as well as when given prior to extinction training 9 . Instructions given prior to extinction training serve as a laboratory analogue for cognitive interventions which often accompany exposure treatments, e.g., in form of guided threat reappraisal 10 . In general, instructions informing participants about the subsequen...

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“…Anticipation of threat engages conserved neural circuitry that has evolved to facilitate defensive behaviours; [1][2][3] perturbations in this circuitry could generate excessive anticipatory response, a core element of pathological anxiety. 4,5 Grounding research on mechanisms of perturbed threat anticipation in youth is important, because individual differences in threat anticipation and anxiety arise early. 6,7 However, ethical and practical issues limit such work.…”

Section: Introductionmentioning

confidence: 99%

Threat-anticipatory psychophysiological response is enhanced in youth with anxiety disorders and correlates with prefrontal cortex neuroanatomy

Abend

Bajaj

Harrewijn

et al. 2021

J Psychiatry Neurosci

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Background: Threat anticipation engages neural circuitry that has evolved to promote defensive behaviours; perturbations in this circuitry could generate excessive threat-anticipation response, a key characteristic of pathological anxiety. Research into such mechanisms in youth faces ethical and practical limitations. Here, we use thermal stimulation to elicit pain-anticipatory psychophysiological response and map its correlates to brain structure among youth with anxiety and healthy youth. Methods: Youth with anxiety (n = 25) and healthy youth (n = 25) completed an instructed threat-anticipation task in which cues predicted nonpainful or painful thermal stimulation; we indexed psychophysiological response during the anticipation and experience of pain using skin conductance response. High-resolution brain-structure imaging data collected in another visit were available for 41 participants. Analyses tested whether the 2 groups differed in their psychophysiological cue-based pain-anticipatory and pain-experience responses. Analyses then mapped psychophysiological response magnitude to brain structure. Results: Youth with anxiety showed enhanced psychophysiological response specifically during anticipation of painful stimulation (b = 0.52, p = 0.003). Across the sample, the magnitude of psychophysiological anticipatory response correlated negatively with the thickness of the dorsolateral prefrontal cortex (pFWE < 0.05); psychophysiological response to the thermal stimulation correlated positively with the thickness of the posterior insula (pFWE < 0.05). Limitations: Limitations included the modest sample size and the cross-sectional design. Conclusion: These findings show that threat-anticipatory psychophysiological response differentiates youth with anxiety from healthy youth, and they link brain structure to psychophysiological response during pain anticipation and experience. A focus on threat anticipation in research on anxiety could delineate relevant neural circuitry.

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Fear, anxiety, and their disorders from the perspective of psychophysiology

Cited by 93 publications

References 90 publications

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Effects of verbal instructions and physical threat removal prior to extinction training on the return of conditioned fear

Threat-anticipatory psychophysiological response is enhanced in youth with anxiety disorders and correlates with prefrontal cortex neuroanatomy

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