Predictable and Unpredictable Threat Reactivity Prospectively Predict Increases in Fear and Anxiety: An ERP and Startle Investigation

Abstract

Fear (e.g., arousal, fight/flight) and anxiety (e.g., general distress, worry) are distinct dimensions of psychopathology that may underlie clinically significant variation in the internalizing disorders. Animal work supports this distinction as cues that predictably signal an upcoming aversive stimulus elicit fear behavior in rodents while uncertain threat cues activate more sustained, anxiety-like states. Moreover, this distinction between phasic fear and sustained anxiety is reflected in the NIH’s Research Domain Criteria. The no-threat, predictable threat and unpredictable threat (NPU) task may probe core processes related to these dimensions. Prior work using this task has largely focused on categorical diagnoses. Knowing how predictable and unpredictable threat responding relate to transdiagnostic fear and anxiety may help identify and refine the underlying neurobiology. The purpose of this study is to assess associations between transdiagnostic fear and anxiety in the internalizing disorders and neurobiological response to predictable and unpredictable threat using the NPU-threat task. Furthermore, I will examine these associations prospectively to help inform prognostic trajectories for fear and anxiety, to facilitate potential early intervention or prevention efforts.