title: Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation.
abstract: Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits.
authors.affiliation: Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds UniversityJerusalem, State of Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers UniversityNewark, NJ, USA.
authors.forename: Hussain Y
authors.initials: HY
authors.lastname: Khdour
authors.affiliation: Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine.
authors.forename: Oday M
authors.initials: OM
authors.lastname: Abushalbaq
authors.affiliation: Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine.
authors.forename: Ibrahim T
authors.initials: IT
authors.lastname: Mughrabi
authors.affiliation: Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine.
authors.forename: Aya F
authors.initials: AF
authors.lastname: Imam
authors.affiliation: Center for Molecular and Behavioral Neuroscience, Rutgers University Newark, NJ, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gluck
authors.affiliation: Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds UniversityJerusalem, State of Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers UniversityNewark, NJ, USA.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Herzallah
authors.affiliation: Marcs Institute for Brain and Behavior and School of Social Sciences and Psychology, Western Sydney University Sydney, NSW, Australia.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Moustafa
keywords: dopamine; generalized anxiety disorder; learning; negative feedback; panic anxiety disorder; positive feedback; social anxiety disorder; striatum