Take my breath away: Neural activation at breath-hold differentiates individuals with panic disorder from healthy controls

•Brain activation at peak of an 18-s breath hold was compared as a function of PD.•Breath-holding elicits greater stimuli of fear and self-referential processing in PD.•Apnea enacts enhanced activation in structures involved in interoceptive sense in PD. There is neuroanatomical evidence of an "extended fear network" of brain structures involved in the etiology of panic disorder (PD). Although ventilatory distrubance is a primary symptom of PD these sensations may also trigger onset of a panic attack (PA). Here, a voluntary breath-holding paradigm was used to mimic the hypercapnia state in order to compare blood oxygen level-dependent (BOLD) response, at the peak of a series of 18 s breath-holds, of 21 individuals with PD to 21 low anxiety matched controls. Compared to the rest condition, BOLD activity at the peak (12 - 18 s) of the breath-hold was greater for PD versus controls within a number of structures implicated in the extended fear network, including hippocampus, thalamus, and brainstem. Activation was also observed in cortical structures that are shown to be involved in interoceptive and self-referential processing, such as right insula, middle frontal gyrus, and precuneus/posterior cingulate. In lieu of amygdala activation, our findings show elevated activity throughout an extended network of cortical and subcortical structures involved in contextual, interoceptive and self-referential processing when individuals with PD engage in voluntary breath-holding

Temporal and structural dynamics of anxiety sensitivity in predicting fearful responding to a 35% CO2 challenge

Contains fulltext : 90387.pdf (publisher's version ) (Closed access)The current study assessed the incremental prediction of anxiety sensitivity (AS) in both taxonic (categorical) and dimensional representations at various time points before and after a single vital capacity inhalation of a 35% CO2, 65% balanced O-2 gas mixture. Participants were 128 young adults screened for a history of panic attacks. By controlling for traitwise factors including state anxiety and testing both categorical and continuous conceptualizations of the AS construct at various timepoints, the present report was able to evaluate the temporal and structural dynamics of AS in relation to fearful responding to the challenge. Relevant variables were evaluated in a hierarchical linear regression framework, and it was found that a continuous conceptualization of AS provided incremental predictive validity above and beyond trait anxiety immediately post-challenge, while a categorical representation of AS was equivalent to a continuous model of AS at post-challenge but outperformed a continuous model at follow-up. These data provide basic but important evidence suggesting that AS is uniquely associated with anxious responding to a 35% CO2 challenge, and that categorical representations of AS should be considered in biological challenge studies

Body dysmorphic disorder symptoms and risk for suicide: The role of depression

•BDD symptoms were associated with perceived burdensomeness and low belongingness.•BDD symptoms were not associated with acquired capability for suicide.•Depression mediated the relation between BDD severity and suicidal desire. Body dysmorphic disorder (BDD) is associated with elevated suicidality. Little is known about why BDD patients are at increased risk. The interpersonal-psychological theory of suicide (IPTS) could clarify suicidality in BDD, and theorizes that perceived burdensomeness and thwarted belongingness lead to suicidal desire, while an acquired capability for suicide is necessary to attempt suicide. No study has investigated how BDD symptoms relate to IPTS constructs or mediators of the relationship between BDD and suicidality. Individuals (N=235) enrolled in Amazon.com’s Mechanical Turk (MTurk), who had appearance concerns, completed questionnaires about BDD, depression, eating pathology, and suicide risk. MTurk is an online data collection platform in which participants complete surveys for payment. BDD symptoms predicted suicidal desire, but not acquired capability for suicide. Depression mediated the relationship between BDD and suicidal desire. Research should examine how fluctuations in BDD affect suicide risk. Replication in a clinical sample may inform treatments for BDD

A neuroeconomic investigation of 5-HTT/5-HT1A gene variation, social anxiety, and risk-taking behavior

Background and objectives : Although approaches combining behavioral genetics and neuroeconomics have advanced models of addiction, no study has synthesized these methods to elucidate mechanisms of competing risk-approachand risk-avoidance in social anxiety (SA). Grounded in dual-mode models of serotonergic systems and self-regulation, this study investigated associations between SA, serotonin transporter 5-HTT (LPR; rs25531) and receptor 5-HT1A genes, and risk-taking on behavioral and self-report measures. Design and methods: Young adults (N = 309) completed a neuroeconomic task measuring gambling attractiveness (δ), reward probability discrimination (γ), and risk attitudes (α). Risk genotypes included 5-HTT (LPR; rs25531) low-expression variants (SS/SLG/LGLG), and 5-HT1A (rs6295) GG. Results: Path analysis revealed that SA related to increased gambling attractiveness, but only for 5-HT1A risk groups. Although the 5-HTT (LPR; rs25531) risk genotypes and self-reported SA predicted lower social risk-taking, high-SA individuals who exhibited more accurate reward probability discrimination (γ) reported taking increased social risks. Conclusion: In line with dual-mode models, results suggest that SA predicts behavioral risk-approach at the basic decision-making level, along with self-reported social risk-avoidance, modulated by serotonergic genotypes. High-SA individuals with more accurate assessments of reward probabilities may engage in greater social risk-taking, perhaps reflecting an adaptive tendency to approach feared situations