Anxiety not only increases,but also alters early error-monitoring functions

Anxiety has profound influences on a wide range of cognitive processes, including action monitoring. Eventrelated brain potential (ERP) studies have shown that anxiety can boost early error detection mechanisms, as reflected by an enhanced error-related negativity (ERN) following errors in high-anxious, as compared with low-anxious, participants. This observation is consistent with the assumption of a gain control mechanism exerted by anxiety onto error-related brain responses within the dorsal anterior cingulate cortex (ACC). However, whether anxiety simply enhances or, rather, alters early error detection mechanisms remains unsolved. In this study, we compared the performance of low-versus high-trait-anxious participants during a go/no-go task while high-density EEG was recorded. The two groups showed comparable behavioral performance, although levels of state anxiety increased following the task for high-anxious participants only. ERP results confirmed that the ERN/Ne to errors was enhanced for high-anxious, relative to low-anxious, participants. However, complementary topographic analyses revealed that the scalp map of the ERN/Ne was not identical between the two groups, suggesting that anxiety did not merely increase early error detection mechanisms, but also led to a qualitative change in the early appraisal of errors. Inverse solution results confirmed a shift within the ACC for the localization of neural generators underlying the ERN/Ne scalp map in high-anxious participants, corroborating the assumption of an early effect of anxiety on early error-monitoring functions. These results shed new light on the dynamic interplay between anxiety and error-monitoring functions in the human brain.     

Intolerance of uncertainty,causal uncertainty,causal importance,self-concept clarity and their relations to generalized anxiety disorder

Although numerous studies have provided support for the notion that intolerance of uncertainty plays a key role in pathological worry (the hallmark feature of generalized anxiety disorder (GAD)), other uncertainty-related constructs may also have relevance for the understanding of individuals who engage in pathological worry. Three constructs from the social cognition literature, causal uncertainty, causal importance, and self-concept clarity, were examined in the present study to assess the degree to which these explain unique variance in GAD, over and above intolerance of uncertainty. N = 235 participants completed self-report measures of trait worry, GAD symptoms, and uncertainty-relevant constructs. A subgroup was subsequently classified as low in GAD symptoms (n = 69) or high in GAD symptoms (n = 54) based on validated cut scores on measures of trait worry and GAD symptoms. In logistic regressions, only elevated intolerance of uncertainty and lower self-concept clarity emerged as unique correlates of high (vs. low) GAD symptoms. The possible role of self-concept uncertainty in GAD and the utility of integrating social cognition theories and constructs into clinical research on intolerance of uncertainty are discussed.     

Error detection and posterror behavior in depressed undergraduates

This study examined the influence of depression on error-monitoring and behavioral compensation after errors, two important aspects of cognitive control. Undergraduates differing in self-reported depression levels completed a modified Stroop task while error-related scalp potentials were recorded. Behaviorally, participants with higher depression scores were disproportionately slower and less accurate after errors in a task condition that included negative emotional words. Physiological results indicated that the amplitudes of the error-related negativity (ERN) and error positivity (Pe), two indices of error detection, were not correlated with depression score. ERN amplitudes predicted behavioral slowdown after errors, but only among more depressed participants in the negative-word condition. Together, the results imply that depression is associated not with an error detection deficit, but rather with alterations in subsequent performance changes, once errors have been identified.     

Clarifying the unique associations among intolerance of uncertainty,anxiety, and depression*

Increasing evidence suggests that intolerance of uncertainty (IU) may be a transdiagnostic factor across the anxiety disorders, and to a lesser extent, unipolar depression. Whereas anxiety inherently involves uncertainty regarding threat, depression has traditionally been associated with certainty (e.g. the hopelessness theory of depression). Some theorists posit that the observed relationship between depression and IU may be due to the relationship between depression and anxiety and the relationship between anxiety and IU. The present study sought to elucidate the unique relationships among trait anxiety, depression, and IU in undergraduate (N = 554) and clinical (generalized anxiety disorder; N = 43) samples. Findings suggest that IU may play a larger role in anxiety than depression, although some evidence indicates that inhibitory IU and depression may have a modest but independent relationship.     

Trait Versus Task-Induced Emotional Reactivity and Distress Intolerance in Hoarding Disorder: Transdiagnostic Implications

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individuals diagnosed with hoarding disorder (n = 24) in comparison to clinical controls (n = 21) and nonclinical community controls (n = 26) using a combination of self-report, physiological, and behavioral measures. We found that trait distress intolerance was significantly and independently associated with greater hoarding severity. The hoarding and clinical control groups reported more trait emotional reactivity and distress intolerance than the community control group, but did not differ from each other on these traits. The hoarding group reported more subjective distress before beginning a frustrating behavioral task, but did not evidence more physiological arousal. Moreover, the hoarding group experienced similar increases in distress during the task and did not differ from either group in regard to time persisting on this task. The clinical control group, however, terminated the frustrating task significantly faster than the community control group, who tended to persist until the task timed out. Lastly, trait distress intolerance evidenced a small-to-moderate but nonstatistically significant independent relationship with task persistence time. Given the desynchrony between subjective distress and physiological arousal, we encourage researchers to utilize multimodal assessment in the future. We also suggest that clinicians start to use behavioral experiments, as has been done with other psychological disorders, to improve distress intolerance among persons who experience hoarding disorder.     

Food hoarding behaviour in the golden hamster (Mesocricetus auratus): Effects of body weight loss and hoard-size discrimination

Two experiments investigated some of the factors that influence food hoarding behaviour in the golden hamster (Mesocricetus auratus). In Experiment 1, hamsters given limited access to food failed to increase the amount of food they consumed at each meal. Instead, they exhibited a significant increase in the amount of food taken to hoard during the limited access period, and this permitted hamsters who were allowed to retain their hoard to maintain body weight at levels comparable to free-feeding controls. Hamsters that were not allowed to retain hoarded food rapidly lost body weight. There was also an inverse correlation between body weight and amount of food taken to hoard in all hamsters given limited access to food, suggesting that body weight loss was one factor directly related to increased hoarding during periods of limited food accessibility. Experiment 2 investigated the effect of hoard-size discrimination on food hoarding in hamsters by artificially manipulating hoard size. The results suggested that hoarding behaviour could be influenced by artificially depleting and repleting the hoard, and this factor appears to influence hoarding in the absence of any significant changes in body weight. These results are discussed in relation to the kinds of adaptive feeding strategies that hamsters may utilize in their natural environment.     

Cognitive Beliefs Across the Symptom Dimensions of Pediatric Obsessive-Compulsive Disorder: Type of Symptom Matters

The cognitive model of obsessive-compulsive disorder (OCD) posits that dysfunctional cognitive beliefs are crucial to the onset and maintenance of OCD; however, the relationship between these cognitive beliefs and the heterogeneity of OCD symptoms in children and adolescents remains unknown. We examined how the major belief domains of the cognitive model (inflated responsibility/threat estimation, perfectionism/intolerance of uncertainty, importance/control of thoughts) and dysfunctional metacognitions were related to OCD symptoms across the following dimensions: doubting/checking, obsessing, hoarding, washing, ordering, and neutralization. Self-report ratings from 137 treatment-seeking youth with OCD were analyzed. When cognitive beliefs and symptom dimensions were analyzed in tandem, inflated responsibility/threat estimation and dysfunctional metacognitions were uniquely related to doubting/checking, obsessing, and hoarding and perfectionism/intolerance of uncertainty to ordering. Cognitive beliefs explained a large proportion of variation in doubting/checking (61%) and obsessing (46%), but much less so in ordering (15%), hoarding (14%), neutralization (8%), and washing (3%). Similar relations between cognitive beliefs and symptom dimensions were present in children and adolescents. Cognitive beliefs appear to be relevant for pediatric OCD related to harm, responsibility, and checking, but they do not map clearly onto contamination and symmetry-related symptoms. Implications for OCD etiology and treatment are discussed.     

An Examination of Distress Intolerance in Undergraduate Students High in Symptoms of Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) engage in maladaptive coping strategies to reduce or avoid distress. Evidence suggests that uncertainty and negative emotions are triggers for distress in people with GAD; however, there may also be other triggers. Recent conceptualizations have highlighted six types of experiences that people report having difficulty withstanding: uncertainty, negative emotions, ambiguity, frustration, physical discomfort, and the perceived consequences of anxious arousal. The present study examined the extent to which individuals high in symptoms of GAD are intolerant of these distress triggers, compared to individuals high in depressive symptoms, and individuals who are low in GAD and depressive symptoms. Undergraduate students (N = 217) completed self-report measures of GAD symptoms, depressive symptoms, and distress intolerance. Individuals high in GAD symptoms reported greater intolerance of all of the distress triggers compared to people low in symptoms of GAD and depression. Individuals high in GAD symptoms reported greater intolerance of physical discomfort compared to those high in depressive symptoms. Furthermore, intolerance of physical discomfort was the best unique correlate of GAD status, suggesting that it may be specific to GAD (versus depression). These findings support continued investigation of the transdiagnosticity and specificity of distress intolerance.     

依恋焦虑对大学生囤积行为的影响:无法忍受不确定性与经验性回避的序列中介作用

为探讨依恋焦虑、无法忍受不确定性、经验性回避与大学生囤积行为的关系，本研究构建了一个序列中介模型。采用问卷法对黑龙江等地高校的610名大学生进行调查研究。结果发现：（1）无法忍受不确定性和经验性回避在依恋焦虑与大学生囤积行为之间均起部分中介作用；（2）无法忍受不确定性和经验性回避在依恋焦虑和大学生囤积行为之间构成序列中介，即依恋焦虑个体通过增强无法忍受不确定性，从而提高经验性回避倾向，进而增加大学生的囤积行为。研究进一步从认知和应对手段角度来考察依恋焦虑对大学生囤积行为的作用机制，对囤积行为的预防和干预具有启示意义。     

Performance monitoring in a confusing world: error-related brain activity, judgments of response accuracy, and types of errors

The error-related negativity (ERN) represents a neural response, recorded from scalp electrodes, that is associated with monitoring activities. It is most likely generated in the anterior cingulate cortex (ACC). Measures of the ERN, and of behavioral and perceived accuracy, were obtained from participants while they performed a visual 2-choice reaction time task under degraded stimulus conditions. Irrespective of behavioral accuracy, the amplitude of the ERN (measured at the time of the response) covaried with the perceived inaccuracy of the behavior (measured at the end of the trial). Errors due to premature responding (errors perceived as errors) were associated with large ERNs. Errors due to data limitations (errors about which there was uncertainty) were associated with smaller ERNs. These and other results are consistent with the proposal that performance monitoring, as manifested by the ERN, involves a comparison between representations of the appropriate response and the response actually made.     

Look before you leap: the role of negative urgency in appraisals of ambiguous and unambiguous scenarios in individuals high in generalized anxiety disorder symptoms

Negative interpretation bias, the propensity to make threatening interpretations of ambiguous information, is associated with symptoms of generalized anxiety disorder (GAD). Apart from its relationship with intolerance of uncertainty (IU), little is known about what explains the presence of this cognitive bias in GAD. One factor may be negative urgency (NU), the tendency to take rash action when distressed, which is related to GAD symptoms and to cognitive biases in nonclinical populations. The aim of the present study was to examine the relationship between NU and interpretation bias in individuals high in GAD symptoms (N = 111). IU, trait anxiety, and other forms of impulsivity were examined concurrently as competing correlates of interpretation bias. Greater NU and IU were found to be unique correlates of greater threatening interpretations of ambiguous scenarios. Greater NU was also a unique correlate of greater threatening interpretations of negative and positive scenarios. No other forms of impulsivity were uniquely related to interpretation bias. The findings suggest that greater NU may have a role in the tendency for individuals high in GAD symptoms to make threatening interpretations in response to ambiguous scenarios, overtly threatening situations, and situations without indication of threat or danger. Theoretical implications of these findings are discussed.     

Increased Error-Related Brain Activity in Six-Year-Old Children with Clinical Anxiety

Anxiety disorders are the most frequently diagnosed form of psychopathology in children and often result in chronic impairment that persists into adulthood. Identifying neurobehavioral correlates of anxiety that appear relatively early in life would inform etiological models of development and allow intervention and prevention strategies to be implemented more effectively. The error-related negativity (ERN), a negative deflection in the event-related potential at fronto-central sites approximately 50 ms following the commission of errors, has been consistently found to be larger among anxious adults. The current study sought to extend these findings to even younger individuals: the ERN was elicited by a Go/NoGo task in 48 six year-old children with a clinical anxiety disorder assessed by diagnostic interview and 48 age-matched controls. In addition to child anxiety disorder, the ERN was examined in relation to maternal history of anxiety disorder, which was previously related to a smaller ERN. Anxious children were characterized by a larger (i.e., more negative) ERN and maternal history of anxiety disorder was associated with a smaller ERN. Thus, the relationship between an increased ERN and clinical anxiety is evident by age 6, and this effect appears independent from an opposing influence of maternal anxiety history on the ERN. These findings support the ERN as a promising neurobehavioral marker of anxiety, and implications are discussed.     

The Relationship between Traumatic Life Events and Hoarding Symptoms: A Multi-Method Approach

Hoarding Disorder is characterized by difficulties with discarding and frequently excessively acquiring possessions, resulting in substantial clutter. Previous research has implicated trauma in the development of hoarding, but no study to date has examined the relationship between trauma and hoarding using hypothetical hoarding paradigms. This study investigated the association between traumatic events and both self-report and hypothetical indices of hoarding symptoms. We predicted that frequency of trauma would be associated with greater hoarding symptoms (across self-report and hypothetical indices). Undergraduate students (N = 80) completed self-report measures of hoarding symptoms and trauma, and hypothetical measures of acquiring and saving tendencies. As expected, more frequent trauma, and physical/sexual trauma in particular, was associated with greater acquiring tendencies. However, frequency of trauma was not significantly correlated with saving tendencies or self-reported hoarding symptoms. Future research should replicate these findings using longitudinal designs to confirm whether trauma actually serves as a risk factor for hoarding. Replication in a clinical sample is needed to better understand the implications of these results for intervention.     

错误相关负波的神经起源及其影响因素

与个体做出错误反应相伴的错误相关ERP成分叫错误相关负波 (error-related negativity, ERN),当前冲突监控理论、表征失匹配理论和强化学习理论从不同的角度对ERN的神经机制进行解释,各理论间并非完全相互排斥。目前大部分研究认为ERN定位于扣带回,部分研究则出现其它脑区的激活,然而,扣带回与其它脑区存在复杂的神经功能联系,ERN 电位很可能是多个脑区电活动在头颅的综合表现,而非某一脑区的单独表现。ERN的神经机制受到实验任务、被试年龄及其意识水平等因素的影响。未来要推动实验室研究走向临床应用,发现与诊断脑电波异常的病人和毒品易复吸人群。     

Intolerance of uncertainty and decisions about delayed, probabilistic rewards

Worry is the inflated concern about potential future threats and is a hallmark feature of generalized anxiety disorder. Previous theoretical work has suggested that worry may be a consequence of intolerance of uncertainty (IU). The current study seeks to explore the behavioral consequences of IU. Specifically, we examine how IU might be associated with aspects of reward-based decision making. We utilized a simple laboratory gambling task in which participants chose between small, low-probability rewards available immediately at the beginning of each trial and large, high-probability rewards only available after some variable delay. Results demonstrate that higher levels of intolerance of uncertainty were associated with a tendency to select the immediately available, but less valuable and less probable rewards. IU also predicted decision-makers' sensitivity to outcomes. We discuss the cognitive and affective mechanisms that are likely to underlie the observed decision-making behavior and the implications for anxiety disorders.     

Preverbal error-monitoring in stutterers and fluent speakers

This study was designed to characterize the brain system that monitors speech in people who stutter and matched controls. We measured two electrophysiological peaks associated with action-monitoring: the error-related negativity (ERN) and the error positivity (Pe). Both the ERN and Pe were reliably observed after errors in a rhyming task and a nonverbal flanker task, replicating previous reports of a language-monitoring ERN and demonstrating that the Pe can also be elicited by phonological errors. In the rhyming task, stutterers showed a heightened ERN peak regardless of whether they actually committed an error. Similar results, though only marginally significant, were obtained from the flanker task. These results support the vicious cycle hypothesis, which posits that stuttering results from over-monitoring the speech plan. The elevation of the ERN in stutterers and the similarity of the results between the flanker and rhyming tasks implies that speech-monitoring may rely on the same neural substrate as action-monitoring.     

Worry and anxiety account for unique variance in the relationship between intolerance of uncertainty and depression

The evidence supporting the relationship between intolerance of uncertainty (IU), a cognitive construct well established in the anxiety literature, and depression is mixed. Some research has demonstrated a direct association between IU and depression, whereas other studies suggest that IU is either unrelated or indirectly related to depression through other pathways, including anxiety. The present study aimed to further elucidate the relationship between IU and depression in an undergraduate sample (N = 221). We posited a model in which worry and anxiety account for unique variance in the association between IU and depression. Results supported this hypothesis. Worry and trait anxiety significantly accounted for unique variance in the relationship between IU and depression. Furthermore, the model that best fit the data included two additional direct paths, from IU to anxiety and from worry to depression, and excluded the direct path from IU to depression. Our findings support the notion that IU and depression are indirectly related through worry and anxiety. Limitations and future directions are discussed.     

What’s in a name? Intolerance of uncertainty,other uncertainty-relevant constructs,and their differential relations to worry and generalized anxiety disorder*

A number of studies have examined the association of intolerance of uncertainty (IU) to trait worry and generalized anxiety disorder (GAD). However, few studies have examined the extent of overlap between IU and other psychological constructs that bear conceptual resemblance to IU, despite the fact that IU-type constructs have been discussed and examined extensively within psychology and other disciplines. The present study investigated (1) the associations of IU, trait worry, and GAD status to a negative risk orientation, trait curiosity, indecisiveness, perceived constraints, self-oriented and socially prescribed perfectionism, intolerance of ambiguity, the need for predictability, and the need for order and structure and (2) whether IU is a unique correlate of trait worry and of the presence versus absence of Probable GAD, when overlap with other uncertainty-relevant constructs is accounted for. N = 255 adults completed self-report measures of the aforementioned constructs. Each of the constructs was significantly associated with IU. Only IU, and a subset of the other uncertainty-relevant constructs were correlated with trait worry or distinguished the Probable GAD group from the Non-GAD group. IU was the strongest unique correlate of trait worry and of the presence versus absence of Probable GAD. Indecisiveness, self-oriented perfectionism and the need for predictability were also unique correlates of trait worry or GAD status. Implications of the findings are discussed, in particular as they pertain to the definition, conceptualization, and cognitive-behavioral treatment of IU in GAD.     

The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder

Distress tolerance (DT) and intolerance of uncertainty (IU) have been identified as transdiagnostic processes that predict symptom severity across a range of distinct anxiety disorders. However, the joint effect of these two variables on therapeutic outcome has not yet been examined. It is possible that DT and IU may both impact on treatment response to cognitive-behavioural therapy (CBT) in clients with anxiety, as clients with weak DT and strong IU may be less likely to engage in exposure and cognitive restructuring tasks across treatment due to their associated distress. The purpose of this study was to examine the interaction of DT and IU as predictors of post-treatment symptom severity and treatment response to group CBT in participants with primary DSM-IV-TR diagnosed social anxiety disorder (SAD). Participants (N = 95) with SAD completed 12 weeks of manualized group CBT. Results of multilevel longitudinal analysis demonstrated an interaction effect, such that lower DT and higher IU predicted higher SAD symptom severity across the course of therapy. The findings are discussed in terms of clinical implications for the disorder-specific and transdiagnostic treatment of anxiety disorders.     

I don’t know where to look: the impact of intolerance of uncertainty on saccades towards non-predictive emotional face distractors

Attentional bias to uncertain threat is associated with anxiety disorders. Here we examine the extent to which emotional face distractors (happy, angry and neutral) and individual differences in intolerance of uncertainty (IU), impact saccades in two versions of the “follow a cross” task. In both versions of the follow the cross task, the probability of receiving an emotional face distractor was 66.7%. To increase perceived uncertainty regarding the location of the face distractors, in one of the tasks additional non-predictive cues were presented before the onset of the face distractors and target. We did not find IU to impact saccades towards non-cued face distractors. However, we found IU, over Trait Anxiety, to impact saccades towards non-predictive cueing of face distractors. Under these conditions, IU individuals’ eyes were pulled towards angry face distractors and away from happy face distractors overall, and the speed of this deviation of the eyes was determined by the combination of the cue and emotion of the face. Overall, these results suggest a specific role of IU on attentional bias to threat during uncertainty. These findings highlight the potential of intolerance of uncertainty-based mechanisms to help understand anxiety disorder pathology and inform potential treatment targets.