Bauer Elizabeth A, MacNamara Annmarie
Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.
Depress Anxiety. 2021 Apr 28. doi: 10.1002/da.23160.
Anxiety and depression are highly comorbid and share clinical characteristics, such as high levels of negative emotion. Attention toward negative stimuli in anxiety and depression has been studied primarily using negative pictures. Yet, negative mental imagery-that is, mental representations of imagined negative events or stimuli-might more closely mirror patient experience.
The current study presents the first examination of neural response to negative imagery in 57 adults (39 female) who all shared a common "focal fear" diagnosis (i.e., specific phobia or performance-only social anxiety disorder), but varied in levels of comorbid anxiety and depression. After listening to standardized descriptions of negative and neutral scenes, participants imagined these scenes as vividly as possible. Associations between categorical and continuous measures of depression, generalized anxiety disorder (GAD), and social anxiety disorder with electrocortical and subjective responses to negative imagery were assessed.
Individuals who were more depressed showed reduced electrocortical processing of negative imagery, whereas those with GAD showed increased electrocortical processing of negative imagery-but only when controlling for depression. Furthermore, participants with higher levels of depression rated negative imagery as less negative and those with greater social anxiety symptoms rated negative imagery more negatively.
Depression and GAD are characterized by opposing electrocortical response to negative imagery; moreover, depression may suppress GAD-related increases in the electrocortical processing of negative imagery. Results highlight distinctions between different dimensions of distress-based psychopathology, and reveal the unique and complex contribution of comorbid depression to affective response in anxiety.
焦虑症和抑郁症高度共病且具有共同的临床特征,如高水平的负面情绪。焦虑症和抑郁症中对负面刺激的关注主要通过负面图片进行研究。然而,负面心理意象,即对想象中的负面事件或刺激的心理表征,可能更能反映患者的体验。
本研究首次对57名成年人(39名女性)对负面意象的神经反应进行了检查,这些成年人都有共同的“焦点恐惧”诊断(即特定恐惧症或仅表现为社交焦虑障碍),但共病焦虑和抑郁的程度各不相同。在听完负面和中性场景的标准化描述后,参与者尽可能生动地想象这些场景。评估了抑郁症、广泛性焦虑症(GAD)和社交焦虑症的分类及连续测量指标与对负面意象的脑电反应和主观反应之间的关联。
抑郁程度较高的个体对负面意象的脑电处理能力降低,而患有广泛性焦虑症的个体对负面意象的脑电处理能力增强——但这仅在控制抑郁因素时成立。此外,抑郁程度较高的参与者对负面意象的负面评价较低,而社交焦虑症状较重的参与者对负面意象的负面评价较高。
抑郁症和广泛性焦虑症的特征是对负面意象的脑电反应相反;此外,抑郁症可能会抑制广泛性焦虑症相关的对负面意象脑电处理的增加。研究结果突出了基于痛苦的精神病理学不同维度之间的差异,并揭示了共病抑郁症对焦虑症情感反应的独特而复杂的影响。