Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T00:49:14.494Z Has data issue: false hasContentIssue false
  • English
  • Français

Depressed mood enhances anxiety to unpredictable threat

Published online by Cambridge University Press:  17 November 2011

O. J. Robinson ,
C. Overstreet ,
A. Letkiewicz  and
C. Grillon
O. J. Robinson*
Affiliation:
Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, USA
C. Overstreet
Affiliation:
Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, USA
A. Letkiewicz
Affiliation:
Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, USA
C. Grillon
Affiliation:
Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, USA
*
*Address for correspondence: O. J. Robinson, Ph.D., NIMH, 15K North Drive, Bldg 15K, Room 203, MSC 2670, Bethesda, MD 20892-2670, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Depression and anxiety disorders (ADs) are highly co-morbid, but the reason for this co-morbidity is unclear. One possibility is that they predispose one another. An informative way to examine interactions between disorders without the confounds present in patient populations is to manipulate the psychological processes thought to underlie the pathological states in healthy individuals. In this study we therefore asked whether a model of the sad mood in depression can enhance psychophysiological responses (startle) to a model of the anxiety in ADs. We predicted that sad mood would increase anxious anxiety-potentiated startle responses.

Method

In a between-subjects design, participants (n=36) completed either a sad mood induction procedure (MIP; n=18) or a neutral MIP (n=18). Startle responses were assessed during short-duration predictable electric shock conditions (fear-potentiated startle) or long-duration unpredictable threat of shock conditions (anxiety-potentiated startle).

Results

Induced sadness enhanced anxiety- but not fear-potentiated startle.

Conclusions

This study provides support for the hypothesis that sadness can increase anxious responding measured by the affective startle response. This, taken together with prior evidence that ADs can contribute to depression, provides initial experimental support for the proposition that ADs and depression are frequently co-morbid because they may be mutually reinforcing.

Keywords

Anxietyco-morbiditydepressionmoodsadnessstartle reflex
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 7 , July 2012 , pp. 1397 - 1407
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, NB, Trinder, J, Brennan, C (1999). Affective startle modulation in clinical depression: preliminary findings. Biological Psychiatry 46, 542–550.CrossRefGoogle ScholarPubMed
Alvarez, RP, Chen, G, Bodurka, J, Kaplan, R, Grillon, C (2011). Phasic and sustained fear in humans elicits distinct patterns of brain activity. Neuroimage 55, 389–400.CrossRefGoogle ScholarPubMed
Angst, J, Angst, F, Stassen, HH (1999). Suicide risk in patients with major depressive disorder. Journal of Clinical Psychiatry 60, 57–62.Google ScholarPubMed
Beck, A (1967). Depression: Clinical, Experimental, and Theoretical Aspects. Harper & Row: New York.Google Scholar
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Beddington, J, Cooper, CL, Field, J, Goswami, U, Huppert, FA, Jenkins, R, Jones, HS, Kirkwood, TBL, Sahakian, BJ, Thomas, SM (2008). The mental wealth of nations. Nature 455, 1057–1060.CrossRefGoogle ScholarPubMed
Berna, C, Leknes, S, Holmes, EA, Edwards, RR, Goodwin, GM, Tracey, I (2010). Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biological Psychiatry 67, 1083–1090.CrossRefGoogle ScholarPubMed
Bierman, EJM, Comijs, HC, Jonker, C, Beekman, ATF (2005). Effects of anxiety versus depression on cognition in later life. American Journal of Geriatric Psychiatry 13, 686–693.CrossRefGoogle ScholarPubMed
Bifulco, A, Brown, GW, Moran, P, Ball, C, Campbell, C (1998). Predicting depression in women: the role of past and present vulnerability. Psychological Medicine 28, 39–50.CrossRefGoogle ScholarPubMed
Bittner, A, Goodwin, RD, Wittchen, HU, Beesdo, K, Hofler, M, Lieb, R (2004). What characteristics of primary anxiety disorders predict subsequent major depressive disorder. Journal of Clinical Psychiatry 65, 618–626.CrossRefGoogle ScholarPubMed
Brady, EU, Kendall, PC (1992). Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin 111, 244–255.CrossRefGoogle ScholarPubMed
Brown, C, Schulberg, H, Madonia, M, Shear, M, Houck, P (1996). Treatment outcomes for primary care patients with major depression and lifetime anxiety disorders. American Journal of Psychiatry 153, 1293–1300.Google ScholarPubMed
Brown, G, Bifulco, A, Harris, T (1987). Life events, vulnerability and onset of depression: some refinements. British Journal of Psychiatry 150, 30–42.CrossRefGoogle ScholarPubMed
Clark, L, Chamberlain, SR, Sahakian, BJ (2009). Neurocognitive mechanisms in depression: implications for treatment. Annual Review of Neuroscience 32, 57–74.CrossRefGoogle ScholarPubMed
Clark, LA, Watson, D (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology 100, 316–336.CrossRefGoogle ScholarPubMed
Cloninger, CR (1986). A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatric Developments 4, 167–226.Google ScholarPubMed
Cooney, R, Joormann, J, Eugène, F, Dennis, E, Gotlib, I (2010). Neural correlates of rumination in depression. Cognitive, Affective, and Behavioral Neuroscience 10, 470–478.CrossRefGoogle ScholarPubMed
Copeland, WE, Shanahan, L, Costello, EJ, Angold, A (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry 66, 764–772.CrossRefGoogle ScholarPubMed
Davis, M, Walker, DL, Miles, L, Grillon, C (2010). Phasic vs sustained fear in rats and humans: role of the extended amygdala in fear vs anxiety. Neuropsychopharmacology 35, 105–135.CrossRefGoogle Scholar
Deakin, JFW (1998). The role of serotonin in depression and anxiety. European Psychiatry 13, 57s–63s.CrossRefGoogle ScholarPubMed
Dichter, GS, Tomarken, AJ (2008). The chronometry of affective startle modulation in unipolar depression. Journal of Abnormal Psychology 117, 1–15.CrossRefGoogle ScholarPubMed
Dichter, GS, Tomarken, AJ, Shelton, RC, Sutton, SK (2004). Early- and late-onset startle modulation in unipolar depression. Psychophysiology 41, 433–440.CrossRefGoogle ScholarPubMed
Eley, TC (1999). Behavioral genetics as a tool for developmental psychology: anxiety and depression in children and adolescents. Clinical Child and Family Psychology Review 2, 21–36.CrossRefGoogle ScholarPubMed
Elliott, R, Zahn, R, Deakin, JFW, Anderson, IM (2011). Affective cognition and its disruption in mood disorders. Neuropsychopharmacology 36, 153–182.CrossRefGoogle ScholarPubMed
Eshel, N, Roiser, JP (2010). Reward and punishment processing in depression. Biological Psychiatry 68, 118–124.CrossRefGoogle ScholarPubMed
Etkin, A, Egner, T, Kalisch, R (2011). Emotional processing in anterior cingulate and medial prefrontal cortex. Trends in Cognitive Sciences 15, 85–93.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders – Patient Edition (SCID-I/P, 11/2002 Revision). New York State Psychiatric Institute: New York.Google Scholar
Forbes, EE, Miller, A, Cohn, JF, Fox, NA, Kovacs, M (2005). Affect-modulated startle in adults with childhood-onset depression: relations to bipolar course and number of lifetime depressive episodes. Psychiatry Research 134, 11–25.CrossRefGoogle ScholarPubMed
Gorman, JM, Kent, JM, Sullivan, GM, Coplan, JD (2000). Neuroanatomical hypothesis of panic disorder, revised. American Journal of Psychiatry 157, 493–505.CrossRefGoogle ScholarPubMed
Greenberg, PE, Kessler, RC, Birnbaum, HG, Leong, SA, Lowe, SW, Berglund, PA, Corey-Lisle, PK (2003). The economic burden of depression in the United States: how did it change between 1990 and 2000? Journal of Clinical Psychiatry 64, 1465–1475.CrossRefGoogle ScholarPubMed
Grillon, C (2008 a). Greater sustained anxiety but not phasic fear in women compared to men. Emotion 8, 410–413.CrossRefGoogle Scholar
Grillon, C (2008 b). Models and mechanisms of anxiety: evidence from startle studies. Psychopharmacology 199, 421–437.CrossRefGoogle ScholarPubMed
Grillon, C, Baas, J (2003). A review of the modulation of the startle reflex by affective states and its application in psychiatry. Clinical Neurophysiology 114, 1557–1579.CrossRefGoogle ScholarPubMed
Grillon, C, Baas, JP, Lissek, S, Smith, K, Milstein, J (2004). Anxious responses to predictable and unpredictable aversive events. Behavioral Neuroscience 118, 916–924.CrossRefGoogle ScholarPubMed
Grillon, C, Levenson, J, Pine, DS (2006). A single dose of the selective serotonin reuptake inhibitor citalopram exacerbates anxiety in humans: a fear-potentiated startle study. Neuropsychopharmacology 32, 225–231.CrossRefGoogle ScholarPubMed
Grillon, C, Lissek, S, Rabin, S, McDowell, D, Dvir, S, Pine, DS (2008). Increased anxiety during anticipation of unpredictable but not predictable aversive stimuli as a psychophysiologic marker of panic disorder. American Journal of Psychiatry 165, 898–904.CrossRefGoogle Scholar
Grillon, C, Pine, DS, Lissek, S, Rabin, S, Bonne, O, Vythilingam, M (2009). Increased anxiety during anticipation of unpredictable aversive stimuli in posttraumatic stress disorder but not in generalized anxiety disorder. Biological Psychiatry 66, 47–53.CrossRefGoogle ScholarPubMed
Grüsser, S, Wölfling, K, Mörsen, C, Kathmann, N, Flor, H (2007). The influence of current mood on affective startle modulation. Experimental Brain Research 177, 122–128.CrossRefGoogle ScholarPubMed
Harmer, CJ, Rogers, RD, Tunbridge, E, Cowen, PJ, Goodwin, GM (2003). Tryptophan depletion decreases the recognition of fear in female volunteers. Psychopharmacology 167, 411–417.CrossRefGoogle ScholarPubMed
Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, Sanislow, C, Wang, P (2010). Research Domain Criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry 167, 748–751.CrossRefGoogle Scholar
Jardine, R, Martin, NG, Henderson, AS, Rao, DC (1984). Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology 1, 89–107.CrossRefGoogle ScholarPubMed
Kaufman, J, Charney, D (2000). Comorbidity of mood and anxiety disorders. Depression and Anxiety 12, 69–76.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Kaviani, H, Gray, JA, Checkley, SA, Raven, PW, Wilson, GD, Kumari, V (2004). Affective modulation of the startle response in depression: influence of the severity of depression, anhedonia, and anxiety. Journal of Affective Disorders 83, 21–31.CrossRefGoogle ScholarPubMed
Kemp, AH, Gray, MA, Silberstein, RB, Armstrong, SM, Nathan, PJ (2004). Augmentation of serotonin enhances pleasant and suppresses unpleasant cortical electrophysiological responses to visual emotional stimuli in humans. NeuroImage 22, 1084–1096.CrossRefGoogle ScholarPubMed
Kendler, KS, Walters, EE, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1995). The structure of the genetic and environmental risk factors for six major psychiatric disorders in women: phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. Archives of General Psychiatry 52, 374–383.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Kessler, RC, Gruber, M, Hettema, JM, Hwang, I, Sampson, N, Yonkers, KA (2008). Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychological Medicine 38, 365–374.CrossRefGoogle ScholarPubMed
Kessler, RC, Stang, PE, Wittchen, H-U, Ustun, TB, Roy-Burne, PP, Walters, EE (1998). Lifetime panic-depression comorbidity in the National Comorbidity Survey. Archives of General Psychiatry 55, 801–808.CrossRefGoogle ScholarPubMed
Lissek, S, Orme, K, McDowell, DJ, Johnson, LL, Luckenbaugh, DA, Baas, JM, Cornwell, BR, Grillon, C (2007). Emotion regulation and potentiated startle across affective picture and threat-of-shock paradigms. Biological Psychology 76, 124–133.CrossRefGoogle ScholarPubMed
Mayberg, HS, Liotti, M, Brannan, SK, McGinnis, S, Mahurin, RK, Jerabek, PA, Silva, JA, Tekell, JL, Martin, CC, Lancaster, JL, Fox, PT (1999). Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. American Journal of Psychiatry 156, 675–682.CrossRefGoogle ScholarPubMed
McTeague, LM, Lang, PJ, Laplante, M-C, Cuthbert, BN, Strauss, CC, Bradley, MM (2009). Fearful imagery in social phobia: generalization, comorbidity, and physiological reactivity. Biological Psychiatry 65, 374–382.CrossRefGoogle ScholarPubMed
Mechias, M-L, Etkin, A, Kalisch, R (2010). A meta-analysis of instructed fear studies: implications for conscious appraisal of threat. NeuroImage 49, 1760–1768.CrossRefGoogle ScholarPubMed
Melzig, CA, Weike, AI, Zimmermann, J, Hamm, AO (2007). Startle reflex modulation and autonomic responding during anxious apprehension in panic disorder patients. Psychophysiology 44, 846–854.CrossRefGoogle ScholarPubMed
Merikangas, KR, Zhang, H, Avenevoli, S, Acharyya, S, Neuenschwander, M, Angst, J (2003). Longitudinal trajectories of depression and anxiety in a prospective community study: the Zurich Cohort Study. Archives of General Psychiatry 60, 993–1000.CrossRefGoogle Scholar
Miles, L, Davis, M, Walker, D (2011). Phasic and sustained fear are pharmacologically dissociable in rats. Neuropsychopharmacology 36, 1563–1574.CrossRefGoogle ScholarPubMed
Millan, MJ (2008). State-of-Science Review: SR-E16. Stress-related Mood Disorder: Novel Concepts for Treatment and Prevention. UK Government's Foresight Project, Mental Capital and Wellbeing.Google Scholar
Mineka, S, Watson, D, Clark, LA (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology 49, 377–412.CrossRefGoogle ScholarPubMed
Mitchell, RLC, Phillips, LH (2007). The psychological, neurochemical and functional neuroanatomical mediators of the effects of positive and negative mood on executive functions. Neuropsychologia 45, 617–629.CrossRefGoogle ScholarPubMed
Mogg, K, Bradley, BP, Williams, R, Mathews, A (1993). Subliminal processing of emotional information in anxiety and depression. Journal of Abnormal Psychology 102, 304–311.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology 100, 569–582.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology 109, 504–511.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S, Morrow, J, Fredrickson, BL (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology 102, 20–28.CrossRefGoogle ScholarPubMed
Ochsner, KN, Gross, JJ (2005). The cognitive control of emotion. Trends in Cognitive Sciences 9, 242–249.CrossRefGoogle ScholarPubMed
Orne, MT (1969). Demand characteristics and the concept of quasi-controls. In Artifact in Behavioral Research (ed. Rosenthal, R. and Rosnow, R.), pp. 143–179. Academic Press: New York, 1969.Google Scholar
Pine, DS, Cohen, P, Gurley, D, Brook, J, Ma, Y (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry 55, 56–64.CrossRefGoogle ScholarPubMed
Robinson, O, Cools, R, Crockett, M, Sahakian, B (2010). Mood state moderates the role of serotonin in cognitive biases. Journal of Psychopharmacology 24, 573–583.CrossRefGoogle ScholarPubMed
Robinson, OJ, Letkiewicz, AM, Overstreet, C, Ernst, M, Grillon, C (2011). The effect of induced anxiety on cognition: threat of shock enhances aversive processing in healthy individuals. Cognitive, Affective & Behavioral Neuroscience 11, 217–227.CrossRefGoogle ScholarPubMed
Robinson, O, Sahakian, B (2008). Recurrence in major depressive disorder: a neurocognitive perspective. Psychological Medicine 38, 315–318.CrossRefGoogle ScholarPubMed
Robinson, O, Sahakian, B (2009 a). Acute tryptophan depletion evokes negative mood in healthy females who have previously experienced concurrent negative mood and tryptophan depletion. Psychopharmacology 205, 227–235.CrossRefGoogle ScholarPubMed
Robinson, OJ, Sahakian, BJ (2009 b). A double dissociation in the roles of serotonin and mood in healthy subjects. Biological Psychiatry 65, 89–92.CrossRefGoogle ScholarPubMed
Rosenberg, EL (1998). Levels of analysis and the organization of affect. Review of General Psychology 2, 247–270.CrossRefGoogle Scholar
Sanislow, CA, Pine, DS, Quinn, KJ, Kozak, MJ, Garvey, MA, Heinssen, RK, Wang, PS-E, Cuthbert, BN (2010). Developing constructs for psychopathology research: research domain criteria. Journal of Abnormal Psychology 119, 631–639.CrossRefGoogle ScholarPubMed
Schneider, F, Grodd, W, Weiss, U, Klose, U, Mayer, KR, Nägele, T, Gur, RC (1997). Functional MRI reveals left amygdala activation during emotion. Psychiatry Research: Neuroimaging 76, 75–82.CrossRefGoogle ScholarPubMed
Spielberger, CD (1983). State-Trait Anxiety Inventory (Form Y). Consulting Psychologists Press: Palo Alto, CA.Google Scholar
Tomarken, AJ, Shelton, RC, Hollon, SD (2007). Affective science as a framework for understanding the mechanisms and effects of antidepressant medication. In Emotion and Psychopathology: Bridging Affective and Clinical Science (ed. Rottenberg, J. and Johnson, S. L.), pp. 263–283. American Psychological Association: Washington, DC.CrossRefGoogle Scholar
van Eijndhoven, P, van Wingen, G, van Oijen, K, Rijpkema, M, Goraj, B, Verkes, RJ, Oude Voshaar, R, Fernández, G, Buitelaar, J, Tendolkar, I (2009). Amygdala volume marks the acute state in the early course of depression. Biological Psychiatry 65, 812–818.CrossRefGoogle Scholar
Weissman, MM, Leckman, JF, Merikangas, KR, Gammon, GD, Prusoff, BA (1984). Depression and anxiety disorders in parents and children: results from the Yale family study. Archives of General Psychiatry 41, 845–852.CrossRefGoogle ScholarPubMed