title: Fear conditioning in adolescents with anxiety disorders: results from a novel experimental paradigm.
abstract: 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.
authors.affiliation: 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.
authors.forename: Jennifer Y F
authors.initials: JYF
authors.lastname: Lau
authors.affiliation: 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.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Lissek
authors.affiliation: 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.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Nelson
authors.affiliation: 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.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Lee
authors.affiliation: 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.
authors.forename: Roxann
authors.initials: R
authors.lastname: Roberson-Nay
authors.affiliation: 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.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Poeth
authors.affiliation: 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.
authors.forename: Jessica
authors.initials: J
authors.lastname: Jenness
authors.affiliation: 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.
authors.forename: Monique
authors.initials: M
authors.lastname: Ernst
authors.affiliation: 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.
authors.forename: Christian
authors.initials: C
authors.lastname: Grillon
authors.affiliation: 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.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
mesh_terms: 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