Norrholm Seth Davin, Glover Ebony M, Stevens Jennifer S, Fani Negar, Galatzer-Levy Isaac R, Bradley Bekh, Ressler Kerry J, Jovanovic Tanja
Atlanta Veterans Affairs Medical Center, Mental Health Service Line, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
Department of Psychology, Kennesaw State University, Kennesaw, GA, United States.
Int J Psychophysiol. 2015 Nov;98(2 Pt 2):270-275. doi: 10.1016/j.ijpsycho.2014.11.005. Epub 2014 Nov 18.
Psychophysiological measures of fear expression provide observable intermediate phenotypes of fear-related symptoms. Research Domain Criteria (RDoC) advocate using neurobiological intermediate phenotypes that provide dimensional correlates of psychopathology. Negative Valence Systems in the RDoC matrix include the construct of acute threat, which can be measured on a physiological level using potentiation of the acoustic startle reflex assessed via electromyography recordings of the orbicularis oculi muscle. Impairments in extinction of fear-potentiated startle due to high levels of fear (termed fear load) during the early phases of extinction have been observed in posttraumatic stress disorder (PTSD). The goals of the current work were to examine dimensional associations between fear-related symptoms of PTSD and fear load variables to test their validity as an intermediate phenotype. We examined extinction of fear-potentiated startle in a cohort (n=269) of individuals with a broad range of civilian trauma exposure (range 0-13 traumatic events per person, mean=3.5). Based on previously reported findings, we hypothesized that fear load would be significantly associated with intrusion and fear memories of an index traumatic event. The results indicated that early extinction was correlated with intrusive thoughts (p=0.0007) and intense physiological reactions to trauma reminders (p=0.036). Degree of adult or childhood trauma exposure, and depression severity were not associated with fear load. After controlling for age, sex, race, income, level of prior trauma, and level of fear conditioning, fear load during extinction was still significantly predictive of intrusive thoughts (p=0.004). The significance of these findings is that they support dimensional associations with symptom severity rather than diagnostic category and, as such, fear load may emerge as a transdiagnostic intermediate phenotype expressed across fear-related disorders (e.g., specific phobia, social phobia).
恐惧表达的心理生理测量提供了与恐惧相关症状的可观察中间表型。研究领域标准(RDoC)主张使用神经生物学中间表型,这些表型提供精神病理学的维度相关性。RDoC矩阵中的负性价态系统包括急性威胁这一结构,它可以在生理水平上通过对眼轮匝肌的肌电图记录评估听觉惊吓反射的增强来测量。在创伤后应激障碍(PTSD)中,已观察到在消退早期由于高水平恐惧(称为恐惧负荷)导致恐惧增强惊吓的消退受损。当前工作的目标是检查PTSD与恐惧负荷变量的恐惧相关症状之间的维度关联,以测试它们作为中间表型的有效性。我们在一组广泛经历平民创伤的个体(n = 269)中检查了恐惧增强惊吓的消退情况(每人创伤事件范围为0 - 13次,平均 = 3.5次)。基于先前报道的结果,我们假设恐惧负荷将与索引创伤事件的侵入性和恐惧记忆显著相关。结果表明,早期消退与侵入性思维(p = 0.0007)以及对创伤提示的强烈生理反应(p = 0.036)相关。成人或儿童时期的创伤暴露程度以及抑郁严重程度与恐惧负荷无关。在控制了年龄、性别、种族、收入、先前创伤水平和恐惧条件作用水平后,消退期间的恐惧负荷仍然是侵入性思维的显著预测指标(p = 0.004)。这些发现的意义在于它们支持与症状严重程度而非诊断类别之间的维度关联,因此,恐惧负荷可能成为在各种与恐惧相关的障碍(如特定恐惧症、社交恐惧症)中表现出的跨诊断中间表型。