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Gepubliceerd in:

26-05-2016

Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14 Year-Old Girls

Auteurs: Brady D. Nelson, Greg Hajcak

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 2/2017

Abstract

There is growing evidence that heightened sensitivity to unpredictability is a core mechanism of anxiety disorders. In adults, multiple anxiety disorders have been associated with a heightened startle reflex in anticipation of unpredictable threat. Child and adolescent anxiety has been linked to an increased startle reflex across baseline, safety, and threat conditions. However, it is unclear whether anxiety in youth is related to the startle reflex as a function of threat predictability. In a sample of 90 8 to 14 year-old girls, the present study examined the association between anxiety symptom dimensions and startle potentiation during a no, predictable, and unpredictable threat task. Depression symptom dimensions were also examined given their high comorbidity with anxiety and mixed relationship with the startle reflex and sensitivity to unpredictability. To assess current symptoms, participants completed the self-report Screen for Child Anxiety Related Emotional Disorders and Children’s Depression Inventory. Results indicated that social phobia symptoms were associated with heightened startle potentiation in anticipation of unpredictable threat and attenuated startle potentiation in anticipation of predictable threat. Negative mood and negative self-esteem symptoms were associated with attenuated and heightened startle potentiation in anticipation of unpredictable threat, respectively. All results remained significant after controlling for the other symptom dimensions. The present study provides initial evidence that anxiety and depression symptom dimensions demonstrate unique associations with the startle reflex in anticipation of unpredictable threat in children and adolescents.

vorige artikel Neural Reactivity to Angry Faces Predicts Treatment Response in Pediatric Anxiety

To examine whether condition order (n = 48 predictable threat first; n = 42 unpredictable threat first) impacted the startle reflex, a Condition (no threat, predictable threat, unpredictable threat) X Cue (countdown vs. interstimulus interval) X Order (predictable threat first vs. unpredictable threat first) mixed-measures ANOVA was conducted with condition and cue entered as within-subjects factors and order entered as a between-subjects factor. Results indicated a Condition X Order interaction, F(2, 176) = 34.32, p < 0.001, η_p ² = 0.28. Follow-up analyses indicated that the startle reflex was greater during the unpredictable threat condition when it was presented first, F(1, 88) = 11.46, p < 0.001; however, order did not impact the startle reflex during the no threat or predictable threat conditions. Importantly, order did not moderate any relationship between anxiety or depression symptoms and the startle potentiation during the predictable or unpredictable threat condition.

Across the entire sample the startle reflex was not potentiated during the predictable threat countdown relative to the no threat countdown, but the difference between the countdown and interstimulus interval was greater during the predictable threat relative to no threat condition. Therefore, additional analyses were conducted to examine the association between anxiety and depression symptoms and startle potentiation during the countdown relative to interstimulus interval for the predictable threat and no threat conditions. Regression analyses indicated social phobia symptoms were associated with attenuated startle potentiation to the predictable threat countdown relative to interstimulus interval at a trend level, β = −0.20, p < 0.06. There were no other significant correlations between anxiety or depression symptom dimensions and startle potentiation to the no threat or predictable threat condition (ps > 0.37). Similarly, multiple regression analyses indicated that social phobia symptoms were associated with attenuated startle potentiation to the predictable threat countdown relative to interstimulus interval even after controlling for the other symptom dimensions, β = −0.30, p < 0.05. Together, these results suggest that the association between social phobia symptoms and startle potentiation to predictable threat was present regardless of the comparison condition.

Age and pubertal status, measured via the child-report Pubertal Development Scale (Petersen et al. 1988), were also examined as potential moderators of the relationship between anxiety and depression symptoms and startle potentiation to predictable or unpredictable threat. Results indicated neither developmental measure moderated the relationship between symptoms and startle potentiation (ps > 0.10).

The negative mood and negative self-esteem subscales were positively correlated with each other, but did not demonstrate bivariate relationships with startle potentiation to unpredictable threat. However, the subscales demonstrated opposing relationships with startle potentiation to unpredictable threat after controlling for the other symptom dimensions. This pattern of results is consistent with reciprocal suppressor effects, when two correlated predictor variables have the opposite relationship with a criterion variable, but these associations are obscured when each are only examined separately (MacKinnon et al. 2000; Watson et al. 2013). To verify this interpretation, additional linear regressions were conducted with just negative mood and negative self-esteem entered as simultaneous independent variables and startle potentiation to unpredictable threat entered as the dependent variable. Results indicated that greater negative self-esteem was associated with heightened startle potentiation to unpredictable threat, β = 0.31, p < 0.05, and greater negative mood was associated with attenuated startle potentiation to unpredictable threat at a trend level, β = −0.25, p < 07. Moreover, when social phobia was included as an independent variable, negative self-esteem, β = 0.27, p < 0.05, negative mood, β = −0.35, p < 0.05, and social phobia, β = 0.31, p < 0.01, were all significantly associated with startle potentiation to unpredictable threat. These results confirm that negative mood and negative self-esteem demonstrated reciprocal suppressor effects, and social phobia provided additional suppressor effects on negative mood.

As part of the overarching longitudinal study, participants and their parent were also administered the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kaufman et al. 1997). In the final sample of 90 participants, four participants met criteria for current social anxiety disorder. Similar to the continuous social phobia symptom measure, participants with current social anxiety disorder demonstrated greater startle potentiation in anticipation of unpredictable threat (M = 17.78, SD = 8.46) relative to those with no social anxiety disorder (M = 6.68, SD = 10.87), F(1, 88) = 4.04, p < 0.05, η_p ² = 0.04. However, there were no group differences in startle potentiation during the predictable threat condition, F(1, 88) = 0.58, ns. These results suggest that both categorical and continuous measures of social phobia were associated with heightened sensitivity to unpredictable threat.

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Titel: Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14 Year-Old Girls
Auteurs: Brady D. Nelson
Greg Hajcak
Publicatiedatum: 26-05-2016
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 2/2017
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-016-0169-1

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Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14 Year-Old Girls

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