Boschet-Lange Juliane M, Glück Valentina M, Pittig Roxana, Scherbaum Stefan, Pittig Andre
Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany.
Translational Psychotherapy, Institute of Psychology, University of Göttingen, Göttingen, Germany.
J Anxiety Disord. 2025 Apr;111:103005. doi: 10.1016/j.janxdis.2025.103005. Epub 2025 Mar 10.
In anxiety disorders, approach-avoidance behavior is typically biased towards excessive, maladaptive avoidance despite costs and impairments (i.e., costly avoidance). Yet, little is known about the underlying decision dynamics that may contribute to such imbalanced behavior. The current study tested for altered temporal decision dynamics in patients with anxiety disorders compared to matched healthy controls in a task where avoiding an aversive stimulus conflicted with obtaining rewards. Participants chose repeatedly between a fixed safe/low reward and a threat/high reward option with varying threat (probability of an aversive stimulus presentation) and reward information (reward magnitude). Structured computer mouse movements required for choosing between options were tracked to capture the temporal dynamics of the decision process (i.e., when and how strongly threat and reward information influenced decision preference). The current study replicated elevated costly threat avoidance in patients with anxiety disorders compared to matched controls. Importantly, time-continuous multiple regression of mouse movements revealed altered temporal dynamics: patients showed a faster (but not stronger) impact of threat and a weaker impact of competing rewards. These findings highlight that not only biases in threat processes but also competing rewards may guide excessive avoidance and could be important treatment targets in anxiety disorders. Future research may support the external validity of these findings in real-life decisions and try to identify therapeutic strategies that allow to specifically target the attenuated impact of rewards and the accelerated impact of threat in patients.
在焦虑症中，趋近-回避行为通常偏向于过度的、适应不良的回避，尽管会付出代价并造成功能损害（即代价高昂的回避）。然而，对于可能导致这种不平衡行为的潜在决策动态却知之甚少。本研究在一项任务中测试了焦虑症患者与匹配的健康对照相比，其时间决策动态是否发生改变，在该任务中，回避厌恶刺激与获得奖励相冲突。参与者在固定的安全/低奖励和威胁/高奖励选项之间反复进行选择，威胁（厌恶刺激呈现的概率）和奖励信息（奖励大小）各不相同。跟踪在选项之间进行选择所需的结构化计算机鼠标移动，以捕捉决策过程的时间动态（即威胁和奖励信息何时以及在多大程度上影响决策偏好）。与匹配的对照组相比，本研究再次证实焦虑症患者存在代价高昂的威胁回避增加的情况。重要的是，对鼠标移动的时间连续多元回归显示时间动态发生了改变：患者表现出威胁的影响更快（但不是更强），而竞争奖励的影响更弱。这些发现突出表明，不仅威胁过程中的偏差，而且竞争奖励都可能导致过度回避，并且可能是焦虑症的重要治疗靶点。未来的研究可能会支持这些发现在现实生活决策中的外部有效性，并试图确定能够专门针对患者奖励影响减弱和威胁影响加速的治疗策略。
