Related Experiment Video

Updated: Mar 15, 2026

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm

Published on: October 3, 2020

Prediction Error Representation in Individuals With Generalized Anxiety Disorder During Passive Avoidance

Stuart F White¹, Marilla Geraci¹, Elizabeth Lewis¹

¹From the Section on Affective Cognitive Neuroscience, the Section on Fear and Anxiety, and the Unit on Learning and Decision Making, NIMH, Bethesda; and the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Neb.

The American Journal of Psychiatry

|September 16, 2016

Abstract

Objective:

Deficits in reinforcement-based decision making have been reported in generalized anxiety disorder. However, the pathophysiology of these deficits is largely unknown; published studies have mainly examined adolescents, and the integrity of core functional processes underpinning decision making remains undetermined. In particular, it is unclear whether the representation of reinforcement prediction error (PE) (the difference between received and expected reinforcement) is disrupted in generalized anxiety disorder. This study addresses these issues in adults with the disorder.

Method:

Forty-six unmedicated individuals with generalized anxiety disorder and 32 healthy comparison subjects group-matched on IQ, gender, and age performed a passive avoidance task while undergoing functional MRI. Data analyses were performed using a computational modeling approach.

Results:

Behaviorally, individuals with generalized anxiety disorder showed impaired reinforcement-based decision making. Imaging results revealed that during feedback, individuals with generalized anxiety disorder relative to healthy subjects showed a reduced correlation between PE and activity within the ventromedial prefrontal cortex, ventral striatum, and other structures implicated in decision making. In addition, individuals with generalized anxiety disorder relative to healthy participants showed a reduced correlation between punishment PEs, but not reward PEs, and activity within the left and right lentiform nucleus/putamen.

Conclusions:

This is the first study to identify computational impairments during decision making in generalized anxiety disorder. PE signaling is significantly disrupted in individuals with the disorder and may lead to their decision-making deficits and excessive worry about everyday problems by disrupting the online updating ("reality check") of the current relationship between the expected values of current response options and the actual received rewards and punishments.

Keywords:

Decision-Making Generalized Anxiety Disorder Prediction Error Punishment Reward Striatum

More Related Videos

Using the Threat Probability Task to Assess Anxiety and Fear During Uncertain and Certain Threat

Using the Threat Probability Task to Assess Anxiety and Fear During Uncertain and Certain Threat

Published on: September 12, 2014

Reducing State Anxiety Using Working Memory Maintenance

Reducing State Anxiety Using Working Memory Maintenance

Published on: July 19, 2017

Related Concept Videos

Generalized Anxiety Disorder

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is a chronic condition characterized by excessive and uncontrollable worry that persists for at least six months, significantly interfering with daily functioning. Unlike situational anxiety, which arises in response to specific stressors, GAD often occurs without a clear cause. Individuals may experience disproportionate worry about work, health, or relationships. For instance, a person might continuously fear poor health despite normal medical evaluations or...

Avoidance Learning and Learned Helplessness

Avoidance Learning and Learned Helplessness

Avoidance learning and learned helplessness are critical concepts in understanding behavioral responses to negative stimuli.
Avoidance learning occurs when an organism learns that a specific behavior can prevent an unpleasant outcome. For example, a student who receives a bad grade may start studying harder to avoid future poor grades. This behavior persists even when the negative outcome is no longer present. Avoidance learning is powerful because it maintains behavior in the absence of the...

Social Anxiety Disorder

Social Anxiety Disorder

Social anxiety disorder, also known as social phobia, is characterized by an intense fear of social situations where one might face humiliation, rejection, embarrassment, or negative evaluation. This disorder leads individuals to avoid activities like casual conversations, public speaking, or seemingly simple tasks such as eating, signing documents, or swimming, in public settings. Its impact extends beyond discomfort, often significantly interfering with daily functioning and quality of life.

Behavior Therapy

Behavior Therapy

Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...

Preparedness and Phobias

Preparedness and Phobias

Human fear responses to certain stimuli, such as darkness, heights, deep water, and blood, can often arise despite the absence of direct negative experiences. This phenomenon is rooted in evolutionary psychology, which posits that humans have developed a predisposition to fear stimuli that historically posed significant survival threats. This predisposition, known as preparedness, suggests that early humans who developed a fear of potentially dangerous entities, such as venomous snakes and...

Anxiety: Overview

Anxiety: Overview

Anxiety is a common mental disorder featuring excessive worry, fear, and apprehension, significantly affecting daily life. People with anxiety disorders experience persistent and intense anxiety, interrupting their everyday functioning.
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.

Articles linked to this work by shared authors, journal, and citation graph.

Brain age prediction in generalized anxiety disorder using a convolutional neural network.

Translational psychiatry·2026

Intrinsic network static and dynamic functional connectivity associated with induced affect.

Social cognitive and affective neuroscience·2026

Discrete interneuron subsets participate in GluN1/GluN3A excitatory glycine receptor (eGlyR)-mediated regulation of hippocampal network activity throughout development and evolution.

Research square·2025

Loneliness exacerbates age differences in the -allostatic-interoceptive system during induced affect.

Social cognitive and affective neuroscience·2025

Deconvolution of DNA methylation data reveals cell type-specific epigenomic signatures in endometriosis and eutopic endometrium.

Molecular human reproduction·2025

Transactive Memory Systems and Hospital Trauma Team Performance: Shared Experience in Action Teams.

Organization science (Providence, R.I.)·2025

See all related articles