Christiane A. Melzig

Individual differences in fear-potentiated startle as a function of resting heart rate variability: Implications for panic disorder

BACKGROUND Anticipatory anxiety, which can be indexed by the startle potentiation to a threat of shock, has been implicated in the development of panic disorder. Large individual differences exist in startle potentiation to threat of shock but few differences have been found between panic patients in general and non-anxious controls. The present studies explored resting heart rate variability (HRV) as a source of individual differences in startle potentiation in students at risk for panic disorder and in unmedicated panic patients. METHODS Participants in Study 1 were 22 students high and 21 students low in anxiety sensitivity (AS). Nine unmedicated panic patients and 15 matched non-anxious controls were included in Study 2. Startle potentiation to the threat of shock was examined as a function of AS (Study 1) and diagnostic category (Study 2) as well as resting HRV. RESULTS Whereas no differences in startle potentiation were found as a function of AS or panic disorder diagnosis in general, both studies revealed that low resting HRV was associated with exaggerated startle responses to the threat of shock. CONCLUSIONS The present results replicate and extend the sparse literature on fear-potentiated startle in panic disorder. Low HRV was associated with more pronounced startle potentiation to both explicit and contextual cues. Thus, low HRV may be a useful endophenotype for at least some anxiety disorders.

Brain dynamics in spider-phobic individuals exposed to phobia-relevant and other emotional stimuli.

Dense sensor event-related brain potentials were measured in participants with spider phobia and nonfearful controls during viewing of phobia-relevant spider and standard emotional (pleasant, unpleasant, neutral) pictures. Irrespective of the picture content, spider phobia participants responded with larger P1 amplitudes than controls, suggesting increased vigilance in this group. Furthermore, spider phobia participants showed a significantly enlarged early posterior negativity (EPN) and late positive potential (LPP) during the encoding of phobia-relevant pictures compared to nonfearful controls. No group differences were observed for standard emotional materials indicating that these effects were specific to phobia-relevant material. Within group comparisons of the spider phobia group, though, revealed comparable EPN and LPP evoked by spider pictures and emotional (unpleasant and pleasant) picture contents. These results demonstrate a temporal unfolding in perceptual processing from unspecific vigilance (P1) to preferential responding (EPN and LPP) to phobia-relevant materials in the spider phobia group. However, at the level of early stimulus processing, these effects of increased attention seem to be related to emotional relevance of the stimulus cues rather than reflecting a fear-specific response.

Enhanced long‐term recollection for emotional pictures: Evidence from high‐density ERPs

The present study used behavioral and electrophysiological measures to investigate the processes mediating long-term recognition memory for emotional and neutral pictures. The results show enhanced memory recollection for emotional arousing pictures compared to neutral low arousing pictures. In accordance with the behavioral data, we observed enhanced old/new effects in the ERPs for emotionally arousing pictures in the recollection-sensitive old/new component at centro-parietal sites (500-800 ms). Moreover, early old/new effects were present over frontal and parietal sites (300-500 ms) irrespective of picture contents. Analysis of the subjective awareness, indexed by the confidence ratings, showed that the late parietal old/new effect was increased for high confidence responses whereas the early component (300-500 ms) was mainly driven by low confidence responses, an indication for familiarity based recognition processes.

Anticipation of interoceptive threat in highly anxiety sensitive persons

Anticipatory anxiety plays a major role in the etiology of panic disorder. Although anticipatory anxiety elicited by expectation of interoceptive cues is specifically relevant for panic patients, it has rarely been studied. Using a population analogue in high fear of such interoceptive arousal sensations (highly anxiety sensitive persons) we evaluated a new experimental paradigm to assess anticipatory anxiety during anticipation of interoceptive (somatic sensations evoked by hyperventilation) and exteroceptive (electric shock) threat. Symptom reports, autonomic arousal, and defensive response mobilization (startle eyeblink response) were monitored during threat and matched safe conditions in 26 highly anxiety sensitive persons and 22 controls. The anticipation of exteroceptive threat led to a defensive and autonomic mobilization as indexed by a potentiation of the startle response and an increase in skin conductance level in both experimental groups. During interoceptive threat, however, only highly anxiety sensitive persons but not the controls exhibited a startle response potentiation as well as autonomic activation. The anticipation of a hyperventilation procedure thus seems a valid paradigm to investigate anticipatory anxiety elicited by interoceptive cues in the clinical context.

Interoceptive threat leads to defensive mobilization in highly anxiety sensitive persons.

To study defensive mobilization elicited by the exposure to interoceptive arousal sensations, we exposed highly anxiety sensitive students to a symptom provocation task. Symptom reports, autonomic arousal, and the startle eyeblink response were monitored during guided hyperventilation and a recovery period in 26 highly anxiety sensitive persons and 22 controls. Normoventilation was used as a non-provocative comparison condition. Hyperventilation led to autonomic arousal and a marked increase in somatic symptoms. While high and low anxiety sensitive persons did not differ in their defensive activation during hyperventilation, group differences were detected during early recovery. Highly anxiety sensitive students exhibited a potentiation of startle response magnitudes and increased autonomic arousal after hyper- as compared to after normoventilation, indicating defensive mobilization evoked by the prolonged presence of feared somatic sensations.

Wenn Furcht und Angst entgleisen

Zusammenfassung. Aus der Perspektive der Biologischen Psychologie sind Furcht und Angst durch die Aktivierung eines Defensivsystems gekennzeichnet, welches sowohl die Enkodierung bedrohlicher Reize reguliert als auch die Organisation automatisch ablaufender Reaktionsprogramme ubernimmt. Im Tiermodell wurde vor allem die Amygdala als zentrale Schaltstation dieses Defensivsystems herausgearbeitet, wobei diese Struktur sensorische Eingange aus dem Thalamus und Kortex erhalt und efferente Projektionen in verschiedene Strukturen des Kortex, Zwischen- und Mittelhirns sowie des Hirnstamms aussendet. Somit interagiert dieses affektive System mit einer ganzen Reihe kortikaler Regionen und kognitiver Funktionen. Pathologische Formen von Furcht und Angst unterscheiden sich nicht prinzipiell von normalen affektiven Reaktionen. Es liegt aber eine Sensibilisierung des Defensivsystems vor. Dies fuhrt dazu, dass das Defensivsystem bereits bei geringer raum-zeitlicher Nahe und Intensitat des bedrohlichen Reizes spezifisch...