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

Autor: Kitt ER; Yale University, New Haven, CT, United States of America., Zacharek SJ; Yale University, New Haven, CT, United States of America., Odriozola P; Yale University, New Haven, CT, United States of America., Nardini C; Yale University, New Haven, CT, United States of America., Hommel G; Yale University, New Haven, CT, United States of America., Martino A; Yale University, New Haven, CT, United States of America., Anderson T; Yale University, New Haven, CT, United States of America., Spencer H; Yale University, New Haven, CT, United States of America., Broussard A; Yale University, New Haven, CT, United States of America., Dean J; Yale University, New Haven, CT, United States of America., Marin CE; Yale University, New Haven, CT, United States of America., Silverman WK; Yale University, New Haven, CT, United States of America., Lebowitz ER; Yale University, New Haven, CT, United States of America., Gee DG; Yale University, New Haven, CT, United States of America. Electronic address: dylan.gee@yale.edu.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Apr 15; Vol. 351, pp. 818-826. Date of Electronic Publication: 2024 Jan 28.
DOI: 10.1016/j.jad.2024.01.204
Abstrakt: Background: 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.
Methods: 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).
Results: 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.
Limitations: 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.
Conclusion: 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.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: