Involvement of cardiac,respiratory and gastrointestinal functions in neural responses to stressful events

In the stress concept, fight and flight situations as well as other CNS-controlled reaction patterns for alertness to danger have to be followed by or integrated with a restorative “build-up” process in order to maintain homeostasis. The “build-up” process can be studied physiologically for example after regular exercise or training. Under these conditions there is a decrease in resting sympathetic adrenergic activity and an increase in the parasympathetic vagal activity. A theoretical model for the “build-up” process in psychosomatic gastroenterology has previously been presented. The present paper deals with the “build-up” process in cardiovascular and respiratory tract diseases seen in athletes. Anorexia nervosa related to excess physical training is also discussed as well as the “build-up” process in severe obesity and psychosomatic gastroenterological disorders.     

The role of anxiety sensitivity in subjective and physiological responses to social and physical stressors

This study examined the specificity of the relationship between anxiety sensitivity (AS), a measure of catastrophizing about arousal-related sensations, and pain responses, by examining the effect of AS on responses to stressors of a physical and social nature. Healthy men and women (n = 129) between the ages of 18 and 25 years were recruited from the community to participate in a study examining subjective, cognitive and behavioural responses to different types of stressors. Participants were randomly assigned to one of 3 groups: (i) a neutral condition in which they sat quietly and read a popular magazine; (ii) a social stress condition in which they anticipated having to give a self-disclosing speech; and (iii) a physical stress condition in which they were presented with 3 countdown to shock trials where a mild electrical shock was administered on the non-dominant arm. Subjective ratings and physiological responses were recorded in anticipation of the stressor and immediately after stress exposure. Results indicated that AS was indirectly related to pain ratings via its effect on anticipatory anxiety ratings. AS was associated with anticipatory anxiety ratings, regardless of whether the stressor was of a physical or social nature. Furthermore, AS was not shown to be directly associated with exaggerated subjective or physiological reactions to the physical stressor. These results indicate that the role of AS in pain responses may be mediated through a global effect on anxiety, and limited to the anticipatory stage of the pain experience. If future studies yield similar findings in pain patients, then they would suggest that interventions for helping individuals high in AS should focus on catastrophic thinking in anticipation of stressors in general, rather than on pain-specific stressors.     

Time course of cardiac conditioned responses in restrained rats as a function of the trace CS-US interval

Two experiments aimed at understanding the temporal characteristics of trace-conditioned heart-rate responses to a 0.5-s tone (conditioned stimulus [CS]) in restrained rats. A CS paired with a tail-shock (unconditioned stimulus [US]) elicited lasting bradycardiac responses. The magnitude and extinction rate of conditioned responses (CR) were independent of the CS-US interval (interstimulus interval [ISI], 3 s to 20 s). Unreinforced test trials were analyzed for CR topography. Responding was delayed in groups with longer ISIs, but CR latencies, peak and decay times were not proportional to the ISI. Response peaks tended to cluster either about 6 s after CS onset, or about 10 s with a slow decay, depending on the ISI. The authors postulated 2 components of auditory stimulus traces involved in cardiac conditioning, maximally active 6 s and 10 s respectively after CS onset. The topography of the CR could be constrained to combinations of associative strength and instantaneous activity of these 2 components.     

The role of amygdala nuclei in the expression of auditory signaled two-way active avoidance in rats

Using a two-way signaled active avoidance (2-AA) learning procedure, where rats were trained in a shuttle box to avoid a footshock signaled by an auditory stimulus, we tested the contributions of the lateral (LA), basal (B), and central (CE) nuclei of the amygdala to the expression of instrumental active avoidance conditioned responses (CRs). Discrete or combined lesions of the LA and B, performed after the rats had reached an asymptotic level of avoidance performance, produced deficits in the CR, whereas CE lesions had minimal effect. Fiber-sparing excitotoxic lesions of the LA/B produced by infusions of N-methyl-d-aspartate (NMDA) also impaired avoidance performance, confirming that neurons in the LA/B are involved in mediating avoidance CRs. In a final series of experiments, bilateral electrolytic lesions of the CE were performed on a subgroup of animals that failed to acquire the avoidance CR after 3 d of training. CE lesions led to an immediate rescue of avoidance learning, suggesting that activity in CE was inhibiting the instrumental CR. Taken together, these results indicate that the LA and B are essential for the performance of a 2-AA response. The CE is not required, and may in fact constrain the instrumental avoidance response by mediating the generation of competing Pavlovian responses, such as freezing.Early studies of the neural basis of fear often employed avoidance conditioning procedures where fear was assessed by measuring instrumental responses that reduced exposure to aversive stimuli (e.g., Weiskrantz 1956; Goddard 1964; Sarter and Markowitsch 1985; Gabriel and Sparenborg 1986). Despite much research, studies of avoidance failed to yield a coherent view of the brain mechanisms of fear. In some studies, a region such as the amygdala would be found to be essential and in other studies would not. In contrast, rapid progress in understanding the neural basis of fear and fear learning was made when researchers turned to the use of Pavlovian fear conditioning (Kapp et al. 1984, 1992; LeDoux et al. 1984; Davis 1992; LeDoux 1992; Cain and Ledoux 2008a). It is now well established from such studies that specific nuclei and subnuclei of the amygdala are essential for the acquisition and storage of Pavlovian associative memories about threatening situations (LeDoux 2000; Fanselow and Gale 2003; Maren 2003; Maren and Quirk 2004; Schafe et al. 2005; Davis 2006).Several factors probably contributed to the fact that Pavlovian conditioning succeeded where avoidance conditioning struggled. First, avoidance conditioning has long been viewed as a two-stage learning process (Mowrer and Lamoreaux 1946; Miller 1948b; McAllister and McAllister 1971; Levis 1989; Cain and LeDoux 2008b). In avoidance learning, the subject initially undergoes Pavlovian conditioning and forms an association between the shock and cues in the apparatus. The shock is an unconditioned stimulus (US) and the cues are conditioned stimuli (CS). Subsequently, the subject learns the instrumental response to avoid the shock. Further, the “fear” aroused by the presence of the CS motivates learning of the instrumental response. Fear reduction associated with successful avoidance has even been proposed to be the event that reinforces avoidance learning (e.g., Miller 1948b; McAllister and McAllister 1971; Cain and LeDoux 2007). Given that Pavlovian conditioning is the initial stage of avoidance conditioning, as well as the source of the “fear” in this paradigm, it would be more constructive to study the brain mechanisms of fear through studies of Pavlovian conditioning rather than through paradigms where Pavlovian and instrumental conditioning are intermixed. Second, avoidance conditioning was studied in a variety of ways, but it was not as well appreciated at the time as it is today; that subtle differences in the way tasks are structured can have dramatic effects on the brain mechanisms required to perform the task. There was also less of an appreciation for the detailed organization of circuits in areas such as the amygdala. Thus, some avoidance studies examined the effects of removal of the entire amygdala or multiple subdivisions (for review, see Sarter and Markowitsch 1985). Finally, fear conditioning studies typically involved a discrete CS, usually a tone, which could be tracked from sensory processing areas of the auditory system to specific amygdala nuclei that process the CS, form the CS–US association, and control the expression of defense responses mediated by specific motor outputs. In contrast, studies of avoidance conditioning often involved diffuse cues, and the instrumental responses used to indirectly measure fear were complex and not easily mapped onto neural circuits.Despite the lack of progress in understanding the neural basis of avoidance responses, this behavioral paradigm has clinical relevance. For example, avoidance behaviors provide an effective means of dealing with fear in anticipation of a harmful event. When information is successfully used to avoid harm, not only is the harmful event prevented, but also the fear arousal, anxiety, and stress associated with such events; (Solomon and Wynne 1954; Kamin et al. 1963). Because avoidance is such a successful strategy to cope with danger, it is used extensively by patients with fear-related disorders to reduce their exposure to fear- or anxiety-provoking situations. Pathological avoidance is, in fact, a hallmark of anxiety disorders: In avoiding fear and anxiety, patients often fail to perform normal daily activities (Mineka and Zinbarg 2006).We are revisiting the circuits of avoidance conditioning from the perspective of having detailed knowledge of the circuit of the first stage of avoidance, Pavlovian conditioning. To most effectively take advantage of Pavlovian conditioning findings, we have designed an avoidance task that uses a tone and a shock. Rats were trained to shuttle back and forth in a runway in order to avoid shock under the direction of a tone. That is, the subjects could avoid a shock if they performed a shuttle response when the tone was on, but received a shock if they stayed in the same place (two-way signaled active avoidance, 2-AA). While the amygdala has been implicated in 2-AA (for review, see Sarter and Markowitsch 1985), the exact amygdala nuclei and their interrelation in a circuit are poorly understood.We focused on the role of amygdala areas that have been studied extensively in fear conditioning: the lateral (LA), basal (B), and central (CE) nuclei. The LA is widely thought to be the locus of plasticity and storage of the CS–US association, and is an essential part of the fear conditioning circuitry. The basal amygdala, which receives inputs from the LA (Pitkänen 2000), is not normally required for the acquisition and expression of fear conditioning (Amorapanth et al. 2000; Nader et al. 2001), although it may contribute under some circumstances (Goosens and Maren 2001; Anglada-Figueroa and Quirk 2005). The B is also required for the use of the CS in the motivation and reinforcement of responses in other aversive instrumental tasks (Killcross et al. 1997; Amorapanth et al. 2000). The CE, through connections to hypothalamic and brainstem areas (Pitkänen 2000), is required for the expression of Pavlovian fear responses (Kapp et al. 1979, 1992; LeDoux et al. 1988; Hitchcock and Davis 1991) but not for the motivation or reinforcement of aversive instrumental responses (Amorapanth et al. 2000; LeDoux et al. 2009). We thus hypothesized that damage to the LA or B, but not to the CE, would interfere with the performance of signaled active avoidance.     

The role of defeat and entrapment in depression, anxiety, and suicide

Defeat and entrapment are psychological constructs that have played a central role in evolutionary accounts of depression. These concepts have since been implicated in theoretical accounts of anxiety disorders and suicidality. The current article reports on a systematic review of the existing research investigating the links among defeat, entrapment, and psychopathology in the domains of depression, suicidality, posttraumatic stress disorder (PTSD), and other anxiety syndromes. Fifty-one original research articles were identified and critically reviewed. There was strong convergent evidence for a link with depressive symptoms, across a variety of clinical and nonclinical samples. Preliminary support for an association with suicidality was also observed, with effects not readily explainable in terms of comorbid depression. There was strong evidence for an association between defeat and PTSD, although this may have been partly accounted for by comorbid depression. The findings for other anxiety disorders were less consistent. There was, however, evidence that social anxiety in individuals with psychosis may be related to perceptions of entrapment. Overall, there was evidence that perceptions of defeat and entrapment were closely associated with various forms of human psychopathology. These effects were often in the moderate to large range and superseded the impact of other environmental and psychological stressors on psychopathology. We provide a unified theoretical model of how defeat and entrapment may contribute to these different psychopathological conditions. Clinical implications and avenues for future research are discussed.     

The mediating role of state maladaptive emotion regulation in the relation between social anxiety symptoms and self-evaluation bias

Although social anxiety symptoms are robustly linked to biased self-evaluations across time, the mechanisms of this relation remain unclear. The present study tested three maladaptive emotion regulation strategies – state post-event processing, state experiential avoidance, and state expressive suppression – as potential mediators of this relation. Undergraduate participants (N?=?88; 61.4% Female) rated their social skill in an impromptu conversation task and then returned to the laboratory approximately two days later to evaluate their social skill in the conversation again. Consistent with expectations, state post-event processing and state experiential avoidance mediated the relation between social anxiety symptoms and worsening self-evaluations of social skill (controlling for research assistant evaluations), particularly for positive qualities (e.g. appeared confident, demonstrated social skill). State expressive suppression did not mediate the relation between social anxiety symptoms and changes in self-evaluation bias across time. These findings highlight the role that spontaneous, state experiential avoidance and state post-event processing may play in the relation between social anxiety symptoms and worsening self-evaluation biases of social skill across time.     

Competitive anxiety responses in the week leading up to competition: the role of intensity,direction and frequency dimensions

Objectives: To investigate the symptom responses associated with competitive anxiety through a fine-grained measurement approach. Incorporating dimensions of intensity, perceptions of direction, and frequency of intrusions, possible time-to-event changes were assessed with respect to the between-subjects variable of skill level.Method: Male athletes (N=82), separated into two skill classifications (club N=45 vs. national N=37), completed the competitive state anxiety inventory-2 (CSAI-2) modified to account for the dimensions of intensity, direction and frequency at five precompetition times (1 week, two days, one day, 2 h, 30 min).Results: Multivariate analysis of variance (skill level×time-to-competition) with follow-up analyses indicated main effects for skill level and time-to-competition with no interactions. For skill level differences, national athletes were more facilitative in their interpretation of the symptoms associated with cognitive and somatic anxiety. For change-over-time effects, intensities of cognitive and somatic anxiety increased and self-confidence decreased between 2 h and 30 min precompetition. Frequencies of cognitive anxiety increased from seven to two days, one day to 2 h and 2 h to 30 min precompetition; frequencies of somatic anxiety increased from seven days to two days and 2 h to 30 min pre-event; frequencies of self-confidence increased from seven to two days.Conclusions: Findings support the notion of measuring the separate dimensions of symptoms associated with competitive anxiety and emphasise the importance of assessing these constructs as processes that unfold over-time.     

The role of coping, anxiety, and stress in depression post-acute coronary syndrome

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.     

The role of anxiety and depression in the irritable bowel syndrome

Using a reliable and valid structured diagnostic interview scale (ADIS-R), and patients with careful medical characterization, we found significantly more diagnosable psychopathology, particularly anxiety disorders, among treatment seeking patients with irritable bowel syndrome than among comparable age and sex samples of treatment seeking patients with Inflammatory Bowel Disease. Significant differences were also found on the Hamilton Anxiety Rating Scale and Hamilton Rating Scale for Depression between IBS patients and the IBD patients and controls, who did not differ. Comparable levels of psychiatric disorder among parents of probands were found in all three groups. The results are consistent with Latimer's (1983) notion of IBS patients being a subclass of 'neurotics'.     

The moderating role of positive beliefs about worry in the relationship between stressful events and worry

Some theorists suggest that worry is elevated by positive beliefs when stressful events occur. Although several cross-sectional studies have revealed an association between positive beliefs and worry, few longitudinal studies have been conducted on this topic. Moreover, the effect of positive beliefs as a moderator on worry when stressful events occur has not been investigated. Against this background, the present study conducted a two-wave longitudinal survey to examine the moderating role of positive beliefs. One hundred and ninety-four college students voluntarily completed questionnaires. Hierarchical regression analysis showed a prospective relationship between the experience of stressful events and the subjective report of worry. Moreover, this relationship was moderated by an interaction with positive beliefs; stressful events were a stronger predictor of the extent of worry for individuals with a high level of positive beliefs than for those with a low level of positive beliefs. The moderating role of positive beliefs suggests that the level of positive beliefs amplifies the threat of worry caused by stressful events.     

The role of individual differences,response profiles,and treatment consonance in anxiety disorders

The importance of individual differences, response profiles, and treatment consonance in anxiety-disorders clinical research is reviewed. Anxiety-disorders assessment, synchrony, and concordance phenomena are examined within the framework of the tripartite model. Issues regarding response stereotypy, response specificity, and etiological vs. current response typologies are discussed. Interactions of varying response profiles with different treatment modalities are addressed, in terms of both previous and prospective studies. A preliminary classification schema is offered, for illustrative purposes, with empirical support for the differential outcome of anxiety patients receiving consonant vs. nonconsonant response profile × treatment type pairings. Hypotheses are presented regarding predicted effects of consonant vs. nonconsonant subject-treatment interactions. Recommendations for programmatic research are offered to accelerate scientific inquiry into the role of individual differences and response profiles in anxiety-disorders assessment, treatment, and research.Preparation of this paper was supported in part by National Institute of Mental Health Grant MH 36299.     

Career exploration in adolescents: The role of anxiety, attachment, and parenting style

The aim of the study was to examine the role of parent-adolescent attachment, adolescent anxiety and parenting style in the career exploration process and in career satisfaction. Three kinds of anxiety were considered: general trait anxiety, fear of failing in one’s career and fear of disappointing one’s parents. The participants were 283 French high school students on the threshold of one of the most important school transitions. The results varied by gender. For girls, general anxiety and neglectful style were negatively related to career exploration; secure attachment and fear of failing were positively related to it. For boys, fear of disappointing parents was positively related to career exploration. Attachment to parents, authoritative style, general anxiety, and fear of failing were related to some career exploration satisfaction scores, though differently for boys and girls. The differences between boys and girls in the roles played by anxiety, attachment and parenting style are discussed.     

The role of childhood abuse and neglect in the sensitization to stressful life events in adolescent depression

This study examined the role of childhood abuse and neglect in sensitizing adolescents to the effects of proximal stressful life events in a cross-sectional sample of 103 depressed and nondepressed adolescents. Consistent with hypotheses, adolescents with a history of childhood abuse and/or neglect reported a lower level of threat of stressful life events prior to episode onset than that reported by those without. This effect was specific to those on their 1st episode of depression and was specific to independent events (i.e., stressors outside of adolescents' control). Further, this effect was robust when controlling for level of chronic difficulties, which was higher in those with childhood abuse and/or neglect. The authors suggest that childhood abuse and/or neglect may be an important risk factor that sensitizes individuals to the effects of acute independent life events.     

The effect of monetary reward and punishment on the repetition of responses under open and closed task conditions

Subjects were given one study and two test trials on a list of paired associates. Critical responses on the first test were those which were rewarded or punished by gain or withdrawal of money. Between subjects variables were (a) whether the critical responses on test 1 were right or wrong, and (b) whether subjects were informed of the second test before or after test 1. On test 2, subjects were asked to repeat their test 1 responses to the appropriate stimuli. When subjects were unaware that they would receive a second test, rewarding a response on test 1 increased its probability of repetition on test 2; punishment had no significant effect. When subjects were aware that they would be tested again, the reward/ punishment treatment had no effect. An explanation based on the Law of Effect is rejected in favour of a cognitive explanation, utilizing the total time hypothesis.     

Alcohol and drug use in stressful times: The influence of the masculine role and sex-related personality attributes

In times of stress, men and women sometimes turn to the use of alcohol and drugs as an avenue for relieving their discomfort and distress. One explanation of this finding implicates traditional male tendencies as predisposing factors. The purpose of the present investigation was to study how the relationship between stress and substance use is moderated (1) by the masculine role, as measured by the Masculine Role Inventory; and (2) by socially desirable and undesirable masculine-instrumental and feminine-expressive personality attributes, as measured by the Extended Personal Attributes Questionnaire. The results indicated that during stressful episodes men characterized by socially undesirable instrumental personality attributes reported using tranquilizers and sedatives. By contrast, it was found that during stressful times, women characterized by success preoccupation reported less use of mind-altering drugs and more use of tranquilizers-sedatives. In addition, it was found that socially desirable expressive attributes served to buffer the impact of stressful experiences on women's use of alcohol.A preliminary report of these data were presented at the 1985 annual meeting of the Southwestern Psychological Association, Austin, Texas. Gratitude is extended to Toni Falbo for her assistance with this research.     

The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning

Anxiety about pain is increasingly recognized as one factor contributing to increased pain perception and pain behavior [McCracken, L. M., Faber S. D., & Janeck A. S. (1998) Pain-related anxiety predicts nonspecific physical complaints in persons with chronic pain. Behavior Research and Therapy, 36, 621-630; McCracken L., & Gross R. (1995). The pain anxiety symptoms scale (PASS) and the assessment of emotional responses to pain. Innovations in clinical practice: a source book, 14, 309-321]. To assess this emotional reaction to pain in chronic pain patients, McCracken, Zayfert and Gross [McCracken, L., Zayfert, C., & Gross, R. (1992). The Pain Anxiety Symptom Scale: development and validation of a scale to measure fear of pain. Pain, 50, 67-73] developed the Pain Anxiety Symptom Scale (PASS) composed of four subscales: Cognitive Anxiety, Fearful Appraisal, Escape Avoidance and Physiological Anxiety. The present study extended previous work by examining the relationship among pain anxiety dimensions, use of active and passive coping strategies and arthritis self-efficacy as predictors of functional status in 154 rheumatoid arthritis (RA) patients. Functional status was assessed using the Five-Factor Model of the Arthritis Impact Scale, 2nd ed., (AIMS2): Physical Functioning, Affective Experience, Symptoms, Social Interaction and Role Function. Hierarchical multiple regression analysis on each of the AIMS2 criterion variables showed that pain anxiety, pain and symptom self-efficacy, health status and coping strategies were able to explain between 9 and 38% of the variance in the five AIMS2 variables. The present results support the hypothesized role of pain anxiety along with previously established contributions of self-efficacy and coping strategies, in affecting physical, social, emotional and role functioning in chronic RA patients.     

Individual differences in the selective processing of threatening information, and emotional responses to a stressful life event.

Previous research has established that high levels of trait anxiety commonly are associated with an automatic pattern of encoding selectivity, operating to favour the processing of emotionally threatening information. It has been suggested that this processing bias may play a functional role in mediating emotional vulnerability by moderating affective responses to stressful real life events. The current experiment employs a longitudinal design, capable of addressing the central predictions arising from this theoretical position. Thirty-one women awaiting colposcopy investigation were screened on both traditional questionnaire measures of emotional vulnerability, and on a modified emotional Stroop task that provided objective indices of their automatic and strategic patterns of processing selectivity. Subsequently, those 15 women who later received a diagnosis of cervical pathology reported the degree to which this diagnosis had impaired their level of emotional functioning. The results confirm that, at the initial test time, trait anxiety was indeed associated with an apparently automatic tendency to selectively process threat related distractor information. Furthermore, an index of this initial pattern of automatic processing selectivity was consistently the best predictor of the intensity of emotional distress elicited by the subsequent diagnosis of cervical pathology. None of our conventional questionnaire measures were capable of significantly predicting this later emotional response. We suggest that these findings offer empirical support for the hypotheses that patterns of automatic processing selectivity may moderate individuals' emotional responses to stressful life events.     

BIS, BAS, and bias: The role of personality and cognitive bias in social anxiety

The goal of the present research was to test the hypothesis that cognitive biases for negative and threatening social information mediate the effects of behavioral inhibition system (BIS) and behavioral approach system (BAS) sensitivity on social anxiety. Participants completed self-report measures of BIS and BAS and then underwent a social-threat induction procedure in which they were told they would have to perform a speech. A battery of cognitive bias measures was then administered, followed by a battery of state anxiety measures. Audience members also rated participants’ anxiety during the speech. Structural equation modeling was used to test the hypothesized model. As predicted, the fully-mediated model showed the best fit to the data, and higher BIS and lower BAS were found to have significant indirect effects on social anxiety via cognitive bias.     

Self-evaluation and self-perception: The role of attention in the experience of anxiety

Abstract

Self-awareness promotes the experience of anxiety in two ways. It does so directly, by enhancing awareness of the emotional state itself, and by initiating the self-evaluation process that is necessary for anxiety to occur. It also does so indirectly, by constraining some behaviors and inhibiting others. In particular, it increases accuracy of self-perception, and, in so doing, retards the process of self-delusion. This is important, because the latter process has been shown to have a salutary effect on mental health, acting as a buffer against dysphoric states such as depression and anxiety.