Fear conditioning in adolescents with anxiety disorders: results from a novel experimental paradigm.
OBJECTIVE
Considerable research examines fear conditioning in adult anxiety disorders but few studies examine youths. Adult data suggest that anxiety disorders involve elevated fear but intact differential conditioning. We used a novel paradigm to assess fear conditioning in pediatric anxiety patients.


METHODS
Sixteen individuals with anxiety disorders and 38 healthy comparisons viewed two photographs of actresses displaying neutral expressions. One picture served as the conditioned stimulus (CS), paired with a fearful expression and a shrieking scream (CS+), whereas the other picture served as a CS unpaired with the aversive outcome (CS-). Conditioning was indexed by self-reported fear. Subjects participated in two visits involving conditioning and extinction trials.


RESULTS
Both groups developed greater fear of the CS+ relative to CS-. Higher fear levels collapsed across each CS characterized anxious relative to healthy subjects, but no significant interaction between group and stimulus type emerged. Fear levels at visit 1 predicted avoidance of visit 2. Fear levels to both CS types showed stability even after extinction.


CONCLUSIONS
Consistent with adult data, pediatric anxiety involves higher fear levels following conditioning but not greater differential conditioning. Extending these methods to neuroimaging studies may elucidate neural correlates of fear conditioning. Implications for exposure therapies are discussed.
Lau
Jennifer Y F
JYF
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School. Electronic address: lauj@mail.nih.gov.
Lissek
Shmuel
S
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Nelson
Eric E
EE
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Lee
Yoon
Y
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Roberson-Nay
Roxann
R
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Poeth
Kaitlin
K
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Jenness
Jessica
J
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Ernst
Monique
M
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Grillon
Christian
C
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
Pine
Daniel S
DS
Drs. Lau, Lissek, Nelson, Ernst, Grillon, and Pine, Ms. Poeth, and Ms. Jenness are with the Mood and Anxiety Disorders Program, National Institute of Mental Health; Ms. Lee is with the Department of Comparative Human Development, University of Chicago; Dr. Roberson-Nay is with the Commonwealth Institute for Child and Family Studies, Virginia Treatment Center for Children, Virginia Commonwealth University Medical School.
D000161:Acoustic Stimulation; D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D001245:Association Learning; D003214:Conditioning, Classical; D003887:Desensitization, Psychologic; D005108:Extinction, Psychological; D005149:Facial Expression; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D010364:Pattern Recognition, Visual