Uncontrollable and unpredictable stress interacts with subclinical depression and anxiety scores in determining anxiety response

Abstract

According to learned helplessness theory, uncontrollable stress is assumed to be a critical etiological factor in the pathogenesis of depression. In contrast, unpredictability of stressors is assumed to facilitate the development of sustained anxiety. Despite the frequent co-morbidity of depression and anxiety disorders, these two factors have rarely been studied simultaneously in humans. Therefore, we investigated whether there are interaction effects of uncontrollability and unpredictability on anxiety response in healthy participants. 79 healthy participants performed a visual dot probe task with emotional faces while receiving mild electrical shocks in four different conditions (2x2 factorial design).In (un)controllable conditions, participants were (not) able to attenuate shock intensity. In (un)predictable conditions, participants were (not) able to anticipate shock occurrence. Before the experiment, participants' subclinical depression and anxiety scores were measured using the Beck Depression and Anxiety Inventories (BDI/BAI). During the experiment, continuous skin conductance and self-reported state anxiety were assessed and attentional biases towards angry faces were calculated. As expected, participants showed greater anxiety in uncontrollable compared to controllable and in unpredictable compared to predictable conditions. Additionally, anxiety decreased within the test sessions in participants with low BDI/BAI scores but not in participants with higher BDI/BAI scores. Most importantly, controllability and predictability interacted with each other and with BDI/BAI scores with regard to anxiety. Our results provide evidence that uncontrollability and unpredictability of stressors not only have separate but also interaction effects on several anxiety measures in susceptible individuals and may provide insights into the psychological mechanisms underlying a depressive/anxiety comorbidity.3

A Translational Paradigm to Study the Effects of Uncontrollable Stress in Humans

“…Fifty years of research more thoroughly investigating this finding revealed that animals showed symptoms of greater passivity, reduced social interaction, neophobia, and decreased food intake in response to inescapable stress [2]-behaviours mirrored in the symptoms of anxiety and depression in humans [3]. Indeed, studies in humans linked the lack of control over a stressor with increased subjective stress [7], anxiety [8], pain intensity perception [9], deficits in selective attention [10], and impaired fear extinction learning [11].…”

“…Whereas animal research can boast established, well-standardised paradigms [5], human studies are largely heterogeneous concerning their experimental setup and the outcome variables they investigate. To illustrate this, stressors ranged from physical stimuli, i.e., electric shocks [8,9,11], thermal stimulation [20], and loud sounds [7,10] to video clips of snakes [19] and unsolvable reasoning tasks [21]. Probably for reasons of feasibility, many studies opted for a within-subject design, rather than comparing three groups according to the triadic design.…”

Suicidal ideation in patients with coronary heart disease and hypertension: Baseline results from the DEPSCREEN‐INFO clinical trial

“…The model also suggests that current life stress interacts with dispositional vulnerabilities and can further aggravate suicidal ideation. We included these interactions in our adaptation of the model and treat somatic symptom severity and anxiety as the main stress‐relevant indicators of cardiac patients (Edmondson, Newman, Whang, & Davidson, ; Havranek et al, ; Niérat, Laviolette, Hudson, Similowski, & Sévoz‐Couche, ). Moreover, we hypothesize that a history of myocardial infarction, together with severe somatic symptoms, may trigger suicidal ideation.…”

Are carriers ofCYP21A2mutations less vulnerable to psychological stress? A population-based national cohort study

“…Our results point rather to a tendency towards a lower probability of receiving a diagnosis of anxiety in obligate carriers of a severe CYP21A2 mutation. Unpredictable psychological stressors are more likely to result in depressive symptoms than predictable stressors . Is it possible that the exaggerated increase in the ACTH response is of greater importance than a smaller increase in CRH over time.…”

“…Unpredictable psychological stressors are more likely to result in depressive symptoms than predictable stressors. 26 Is it possible that the exaggerated increase in the ACTH response is of greater importance than a smaller increase in CRH over time.…”