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When neutral is not neutral: Neurophysiological evidence for reduced discrimination between aversive and non-aversive information in generalized anxiety disorder

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Abstract

Generalized anxiety disorder (GAD) is characterized by a range of cognitive and affective disruptions, such as pathological worry. There is debate, however, about whether such disruptions are specifically linked to heightened responses to aversive stimuli, or due to overgeneralized threat monitoring leading to deficits in the ability to discriminate between aversive and non-aversive affective information. The present study capitalized on the temporal and functional specificity of scalp-recorded event-related potentials (ERPs) to examine this question by exploring two targeted neurocognitive responses in a group of adults diagnosed with GAD: (1) visual processing of angry (aversive) versus neutral (non-aversive) faces; and (2) response monitoring of incorrect (aversive) versus correct (non-aversive) responses. Electroencephalography was recorded while 15 adults with GAD and 15 age-matched controls viewed angry and neutral faces prior to individual trials of a flanker task. ERPs to faces were the P1, reflecting attention allocation, the early posterior negativity (EPN), reflecting early affective discrimination, and the N170, reflecting face-sensitive visual discrimination. The error-related negativity (ERN) and positivity (Pe) were generated to incorrect and correct responses. Results showed reduced discrimination between aversive and non-aversive faces and responses in the GAD relative to the control group during visual discrimination (N170) and later-emerging error monitoring (Pe). These effects were driven by exaggerated processing of non-aversive faces and responses, suggesting over-generalized threat monitoring. Implications for cognitive-affective models of GAD are discussed.

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Notes

  1. The SCID is a semi-structured interview that assesses the presence and severity of DSM-IV defined mental disorders.

  2. All interviewers were trained over a 6-month period in diagnostic interviewing with the SCID. Reliability was determined via the clinician severity rating (CSR) from the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV; DiNardo et al. 1994). The CSR is a 0–8 rating of the severity of symptoms and impairment associated with each diagnosis that was evaluated between the interviewer and an expert diagnostician (Ph.D.), who provided ratings following a dispositional case presentation. Reliability was examined in 60% (9/15) of participants. There was 100% agreement (k = 1.00, p < .001) such that CSR ratings were at or above the clinical level of severity (4). Clinical participants had a primary diagnosis of GAD according to the SCID and the highest CSR rating when comorbidity was present.

  3. When possible, analyses were conducted with these additional participants and results remained the same.

  4. Actor numbers used: 5,7,8,10,11,12,13,14,20,21,23,33,38,39,41,43.

  5. Electrodes and time windows were selected based on topographical maps generated from the combined sample (GAD and Control).

  6. Multiple comparisons were corrected for using the Benjamini–Hochberg procedure (Benjamini and Hochberg 1995) that ranks p values and accounts for the number of comparisons made. Corrections were applied separately for each family of ERPs (stimulus-locked and response-locked) with anxiety questionnaires. The raw p value is reported and was significant using a false discovery rate criterion of 0.25.

  7. ERN was also examined as ERN-CRN difference scores (∆ERN) and at peak amplitudes. For peak amplitudes the same main effects of Correctness and Condition were replicated.

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Acknowledgements

This research was made possible by grant R56MH111700 and SC1MH104907 awarded to TDT from the National Institute of Mental Health and the National Institute of General Medical Sciences, respectively, and by grant TR000457 of the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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  1. Hunter College, The City University of New York, New York, NY, USA

    Samantha Denefrio, Sarah Myruski & Tracy A. Dennis-Tiwary

  2. The Graduate Center, The City University of New York, New York, NY, USA

    Samantha Denefrio & Tracy A. Dennis-Tiwary

  3. Teachers College, Columbia University, New York, NY, USA

    Douglas Mennin

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Denefrio, S., Myruski, S., Mennin, D. et al. When neutral is not neutral: Neurophysiological evidence for reduced discrimination between aversive and non-aversive information in generalized anxiety disorder. Motiv Emot 43, 325–338 (2019). https://doi.org/10.1007/s11031-018-9732-0

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