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Prefrontal dysfunction during emotion regulation in generalized anxiety and panic disorders
T Manber Ball1, H J Ramsawh, L Campbell-Sills
1Department of Psychiatry, University of California San Diego, La Jolla, CA 92037, USA. tmball@ucsd.edu
Psychological Medicine
|November 1, 2012
Summary
Emotion dysregulation in generalized anxiety disorder (GAD) and panic disorder (PD) may stem from reduced prefrontal cortex (PFC) activation during emotion regulation, indicating insufficient top-down control.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Emotion dysregulation mechanisms in anxiety disorders remain unclear.
- Generalized anxiety disorder (GAD) and panic disorder (PD) were investigated.
- Hypotheses explored prefrontal cortex (PFC) activation patterns during emotion regulation.
Purpose of the Study:
- To test if GAD and PD are characterized by hypo-activation in the PFC during emotion regulation.
- To evaluate the competing hypothesis of PFC hyper-activation in GAD.
- To understand the neural basis of emotion dysregulation in anxiety.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used.
- Participants included healthy controls (HC), GAD, and PD groups.
- Participants performed an emotion regulation task involving reappraisal or maintenance of emotional responses.
Main Results:
- Healthy controls showed greater PFC activation than GAD and PD participants.
- GAD participants reported less daily reappraisal use, linked to anxiety severity.
- Reduced PFC activation during reappraisal correlated with higher anxiety and impairment.
Conclusions:
- Hypo-activation in the PFC during emotion regulation may underlie emotion dysregulation in GAD and PD.
- This hypo-activation suggests insufficient top-down control.
- Failure to engage the PFC in emotion regulation might be a key factor in developing anxiety disorders.
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