Impact of state anxiety on the interaction between threat monitoring and cognition

How does threat processing impact cognitive performance? To investigate this question, in the present functional magnetic resonance imaging study, participants performed a response-conflict task (neutral, congruent, and incongruent trials) that followed a variable-length shock anticipation period or a corresponding delay during which they would not be shocked. The delay period was cued by a geometric-shaped stimulus indicating whether the subject was in the safe (no shock) or threat (potential shock) condition. Behaviorally, participants showed increased reaction time interference (incongruent-neutral) during threat trials, an effect that increased as a function of state anxiety level across participants. Brain imaging data were analyzed for the cue and the subsequent target phase of the task. At the target phase, the left anterior insula exhibited interaction-type responses (i.e., increased interference during threat trials) that were positively associated with state anxiety level - a relationship that paralleled the behavioral pattern. At the cue phase, greater responses to threat vs. safe were observed in a circuit of regions, including the medial PFC, anterior insula, thalamus, and bed nucleus of the stria terminalis/caudate, which we interpreted as engaged by shock monitoring/anticipation processes. In contrast, intriguingly, greater responses to safe vs. threat at the cue phase were observed in a broader set of regions that overlapped with the "resting-state" network. Finally, a standard statistical mediation analysis revealed that the relationship between state anxiety scores and interference-related responses in the left anterior insula during the target phase was partially mediated via cue responses in the medial PFC, consistent with the idea that more anxious individuals had difficulty in engaging the medial PFC during the threat condition. Taken together, our findings suggest that threat monitoring impairs the upcoming resolution of interference. Furthermore, a confluence of effects of cognitive task condition, threat, and individual differences in state anxiety was observed in the anterior insula, a structure that is suggested to be particularly important for the interaction between emotion and cognition.