University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 11, 20146, Hamburg, Germany.
Humboldt University of Berlin, Department of Clinical Psychology, Unter Den Linden 6, 10099, Berlin, Germany.
Behav Res Ther. 2022 Nov;158:104181. doi: 10.1016/j.brat.2022.104181. Epub 2022 Aug 12.
Avoidance behavior is a core symptom of anxiety disorders that may hinder adaptation. Anxiety disorders are heterogeneous and previous research suggests to decompose anxiety into two dimensions: anxious apprehension and anxious arousal. How these two dimensions are associated with avoidance of and exposure to threatening stimuli, as well as their accompanying neural processes, is barely understood. We examined threat processing using event-related potentials (N1, LPP) from 134 individuals considering the influence of anxiety dimensions. During a two-phase picture-viewing task the participants watched neutral and threatening pictures, which they were instructed to either avoid or attend to during repeated presentations. Results showed that threatening compared to neutral pictures were associated with increased attention allocation (N1) and in-depth processing (LPP), modulated by task-instructions (lower during avoidance). Further, increased anxious apprehension was associated with heightened automatic attention (increased N1), followed by reduced LPP amplitudes for threatening pictures suggesting reduced in-depth processing. During re-exposure, threatening pictures were associated with increased in-depth processing, with no difference between previously avoided and maintained pictures. Together, these results illustrate that avoidance and high anxious apprehension seem to lead to similar neural changes in the processing of aversive images that may conflict with long-term adaptation.
回避行为是焦虑障碍的核心症状之一，可能会妨碍适应。焦虑障碍具有异质性，先前的研究表明可以将焦虑分解为两个维度：焦虑预感和焦虑唤醒。这两个维度与对威胁性刺激的回避和暴露的关系，以及它们伴随的神经过程，几乎没有被理解。我们使用事件相关电位（N1、LPP）研究了威胁处理，考虑了焦虑维度的影响。在一个两阶段的图片观看任务中，参与者观看中性和威胁性图片，在重复呈现时，他们被指示回避或注意这些图片。结果表明，与中性图片相比，威胁性图片会引起注意力分配（N1）和深入处理（LPP）的增加，这受任务指令的调节（回避时较低）。此外，焦虑预感的增加与自动注意力的增加（N1 增加）有关，随后威胁性图片的 LPP 振幅降低，表明深入处理减少。在重新暴露时，威胁性图片与深入处理的增加有关，之前回避和维持的图片之间没有差异。总的来说，这些结果表明，回避和高度焦虑预感似乎会导致对厌恶图像的处理产生类似的神经变化，这可能与长期适应相冲突。
