Waters Allison M, Nazarian Maria, Mineka Susan, Zinbarg Richard E, Griffith James W, Naliboff Bruce, Ornitz Edward M, Craske Michelle G
School of Applied Psychology, Griffith University, Brisbane, Australia.
Department of Psychology, UCLA, Los Angeles, CA, USA.
Psychiatry Res. 2014 Jun 30;217(1-2):93-9. doi: 10.1016/j.psychres.2014.01.047. Epub 2014 Feb 5.
Anxiety and depression are prevalent, impairing disorders. High comorbidity has raised questions about how to define and classify them. Structural models emphasise distinctions between "fear" and "distress" disorders while other initiatives propose they be defined by neurobiological indicators that cut across disorders. This study examined startle reflex (SR) modulation in adolescents with principal fear disorders (specific phobia; social phobia) (n=20), distress disorders (unipolar depressive disorders, dysthymia, generalised anxiety disorder; post-traumatic stress disorder) (n=9), and controls (n=29) during (a) baseline conditions, (b) threat context conditions (presence of contraction pads over the biceps muscle), and (c) an explicit threat cue paradigm involving phases that signalled safety from aversive stimuli (early and late stages of safe phases; early stages of danger phases) and phases that signalled immediate danger of an aversive stimulus (late stages of danger phases). Adolescents with principal fear disorders showed larger SRs than other groups throughout safe phases and early stages of danger phases. SRs did not differ between groups during late danger phases. Adolescents with principal distress disorders showed attenuated SRs during baseline and context conditions compared to other groups. Preliminary findings support initiatives to redefine emotional disorders based on neurobiological functioning.
焦虑和抑郁是常见的、会造成损害的病症。高共病率引发了关于如何对它们进行定义和分类的问题。结构模型强调“恐惧”和“痛苦”病症之间的区别，而其他研究则提议根据贯穿不同病症的神经生物学指标来对它们进行定义。本研究考察了患有主要恐惧病症（特定恐惧症；社交恐惧症）（n = 20）、痛苦病症（单相抑郁症、心境恶劣障碍、广泛性焦虑症；创伤后应激障碍）（n = 9）的青少年以及对照组（n = 29）在以下情况下的惊吓反射（SR）调节：（a）基线条件下，（b）威胁情境条件下（肱二头肌上放置收缩垫），以及（c）一个明确的威胁提示范式，该范式包括表明免受厌恶刺激的安全阶段（安全阶段的早期和晚期；危险阶段的早期）以及表明厌恶刺激即将到来的危险阶段（危险阶段的晚期）。患有主要恐惧病症的青少年在整个安全阶段和危险阶段的早期比其他组表现出更大的惊吓反射。在危险阶段的晚期，各小组之间的惊吓反射没有差异。与其他组相比，患有主要痛苦病症的青少年在基线和情境条件下的惊吓反射减弱。初步研究结果支持基于神经生物学功能重新定义情绪障碍的研究。
