DeVido J, Jones M, Geraci M, Hollon N, Blair R J R, Pine D S, Blair K
Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
Psychol Med. 2009 Jul;39(7):1153-61. doi: 10.1017/S003329170800487X. Epub 2008 Dec 22.
Generalized social phobia (GSP) involves the fear/avoidance of social situations whereas generalized anxiety disorder (GAD) involves an intrusive worry about everyday life circumstances. It remains unclear whether these, highly co-morbid, conditions represent distinct disorders or alternative presentations of a single underlying pathology. In this study, we examined stimulus-reinforcement-based decision making in GSP and GAD.
Twenty unmedicated patients with GSP, 16 unmedicated patients with GAD and 19 age-, IQ- and gender-matched healthy comparison (HC) individuals completed the Differential Reward/Punishment Learning Task (DRPLT). In this task, the subject chooses between two objects associated with different levels of reward or punishment. Thus, response choice indexes not only reward/punishment sensitivity but also sensitivity to reward/punishment level according to between-object reinforcement distance.
We found that patients with GAD committed a significantly greater number of errors than both the patients with GSP and the HC individuals. By contrast, the patients with GSP and the HC individuals did not differ in performance on this task.
These results link GAD with anomalous non-affective-based decision making. They also indicate that GSP and GAD are associated with distinct pathophysiologies.
广泛性社交恐惧症（GSP）涉及对社交情境的恐惧/回避，而广泛性焦虑症（GAD）涉及对日常生活情境的侵入性担忧。目前尚不清楚这些高度共病的情况是代表不同的疾病还是单一潜在病理的不同表现形式。在本研究中，我们研究了基于刺激强化的决策在GSP和GAD中的情况。
20名未服药的GSP患者、16名未服药的GAD患者以及19名年龄、智商和性别匹配的健康对照（HC）个体完成了差异奖励/惩罚学习任务（DRPLT）。在这个任务中，受试者在与不同奖励或惩罚水平相关的两个物体之间进行选择。因此，反应选择指标不仅反映奖励/惩罚敏感性，还反映根据物体间强化距离对奖励/惩罚水平的敏感性。
我们发现，GAD患者犯的错误数量明显多于GSP患者和HC个体。相比之下，GSP患者和HC个体在这项任务中的表现没有差异。
这些结果将GAD与异常的非情感性决策联系起来。它们还表明，GSP和GAD与不同的病理生理学相关。
