Heightened reactivity to uncertain threat as a neurobehavioral marker of suicidal ideation in individuals with depression and anxiety

Lieberman, Lynne; Petrey, Kelsey; Shankman, Stewart A.; Phan, K. Luan; Gorka, Stephanie M.

doi:10.1016/j.ijpsycho.2020.06.003

Cited by 16 publications

(8 citation statements)

References 31 publications

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“…An association emerged between U‐threat hyperreactivity and higher levels of self‐reported anxiety and depressive symptoms. This finding is consistent with our prior work (Gorka et al., 2017; Lieberman et al., 2020; Radoman et al., 2019). Despite a body of literature supporting links between ELA exposure and both depression and anxiety in adulthood (Li et al., 2016; Nemeroff, 2004), ELA exposure was positively associated with depressive symptom severity but not anxiety symptom severity.…”

Section: Discussionsupporting

confidence: 94%

Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults

Hall

Phan

Gorka

2021

Journal of Traumatic Stress

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Early life adversity (ELA) increases the risk of problematic alcohol use and alcohol use disorder (AUD). However, it is unclear why some but not all ELA-exposed individuals develop problematic alcohol use. Research is needed to determine how this environmental risk factor interacts with underlying neurobehavioral vulnerabilities to problem alcohol use. Hypersensitivity to uncertain threats (U-threat) has been posited as an endophenotype for AUD that might aid in the refinement of mechanistic models of problematic alcohol use. Therefore, U-threat hypersensitivity requires examination as a possible individual difference factor that facilitates problematic alcohol use among ELA-exposed individuals. We examined the unique and interactive effects of ELA and U-threat reactivity on problem drinking and depressive and anxiety symptom severity. Participants (N = 131) completed a well-validated threat-of-shock task, and startle eyeblink potentiation was recorded to index aversive responding. Individuals also completed self-report measures of alcohol use, anxiety, and depressive symptoms. Results demonstrated a positive association between ELA and higher levels of problematic alcohol use at high levels of U-threat reactivity, β = .75, t = 3.93, p < .001. Conversely, at low levels of U-threat reactivity, ELA exposure was negatively associated with problematic alcohol use, β = −.49, t = −2.30, p = .023. There was no significant ELA x U-Threat reactivity interaction on anxiety or depression. U-threat response strongly interacts with ELA exposure, affecting the direction of the association between ELA and problem drinking. U-threat reactivity may be a promising target for the prevention and treatment of problematic drinking among ELA-exposed individuals.

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Section: Discussionsupporting

confidence: 94%

Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults

Hall

Phan

Gorka

2021

Journal of Traumatic Stress

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“…We suppose that this first lockdown in Austria may have led to high insecurity and anxiety with affective dynamics in patients with BD compared to controls. According to the literature, the ongoing COVID-19 pandemic is suggested to promote worries about health, personal and financial loss, uncertainties, anger, confusion, frustration, boredom, decrease in social contacts, isolation, loss in daily routine, stigma, emotional distress, and exacerbation of psychological symptoms in otherwise healthy individuals (Barzilay et al 2020 ; Brooks et al 2020 ; Fatke et al 2020 ; Lieberman et al 2020 ; Pérez-Fuentes et al 2020 ; Pfefferbaum and North 2020 ; Tull et al 2020 ). Certain aspects of the pandemic could affect patients with BD, especially concerning the risk of relapse or disruption in biological and social rhythm (Rajkumar 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Insecurity, confusion, emotional isolation, and stigma may affect mental health and well-being (Pfefferbaum and North 2020 ). Psychological stress symptoms (including depression, somatization, insomnia, and anxiety) can be consequences of such an extraordinary situation, including feelings of threat and uncertainty (Lieberman et al 2020 ; Pérez-Fuentes et al 2020 ). The effects may lead to severe emotional reactions, unhealthy behaviours, or noncompliance with public health directives (Pfefferbaum and North 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation

Dalkner

Wagner-Skacel

Ratzenhofer

et al. 2021

Int J Bipolar Disord

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Background The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group. Methods An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 ± 15.6 years) and 20 healthy controls (mean age = 32.7 ± 9.6 years). A 2 × 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2). Results At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients. Conclusions There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.

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“…Startle eyeblink is a useful research tool since it is highly sensitive to changes in emotional valence and arousal across species (Lang, 1995;Lang et al, 1990). Prior studies have demonstrated that greater startle eyeblink potentiation to U-threat is correlated with anxiety symptoms and substance use behaviors (Gorka et al, 2016;Lieberman et al, 2020), and that magnitude of startle eyeblink potentiation to U-threat differentiates several psychiatric groups from matched controls Grillon et al, 2008Grillon et al, , 2009.…”

Section: Introductionmentioning

confidence: 99%

Association between startle reactivity to uncertain threats and structural brain volume

et al. 2022

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Sensitivity to uncertain threat (U-threat) is a clinically important individual difference factor in multiple psychopathologies. Recent studies have implicated a specific frontolimbic circuit as a key network involved in the anticipation of aversive stimuli. In particular, the insula, thalamus, and dorsal anterior cingulate cortex (dACC) have recently been found to be robustly activated by anticipation of U-threat. However, no study to date has examined the association between U-threat reactivity and structural brain volume. In the present study, we utilized a pooled sample of 186 young adult volunteers who completed a structural MRI scan and the well-validated No-Predictable-Unpredictable (NPU) threat of electric shock task. Startle eyeblink potentiation was collected during the NPU task as an objective index of aversive reactivity. ROI-based analyses revealed that increased startle reactivity to U-threat was associated with reduced gray matter volume in the right insula and bilateral thalamus, but not the dACC. These results add to a growing literature implicating the insula and thalamus as core nodes involved in individual differences in U-threat reactivity.

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Heightened reactivity to uncertain threat as a neurobehavioral marker of suicidal ideation in individuals with depression and anxiety

Cited by 16 publications

References 31 publications

Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults

Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults

Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation

Association between startle reactivity to uncertain threats and structural brain volume

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