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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
Summary
Adults with generalized anxiety disorder exhibit impaired decision-making due to disrupted reinforcement prediction error (PE) signaling. This impacts their ability to update expected values, potentially contributing to worry.
Area of Science:
- Neuroscience
- Computational Psychiatry
- Clinical Psychology
Background:
- Generalized anxiety disorder (GAD) is associated with decision-making deficits.
- The underlying pathophysiology, particularly in adults, remains poorly understood.
- The role of reinforcement prediction error (PE) signaling in GAD decision-making is unclear.
Purpose of the Study:
- To investigate computational impairments in decision making in adults with GAD.
- To examine the representation of reinforcement prediction error (PE) in GAD.
- To explore the neural correlates of decision making in GAD using functional MRI.
Main Methods:
- Forty-six unmedicated adults with GAD and 32 healthy controls underwent functional MRI.
- Participants performed a passive avoidance task.
- Computational modeling was used to analyze functional MRI data.
Main Results:
- Individuals with GAD demonstrated impaired reinforcement-based decision making behaviorally.
- Reduced correlation between PE and brain activity was observed in the ventromedial prefrontal cortex and ventral striatum in GAD.
- GAD patients showed reduced correlation between punishment PEs and activity in the lentiform nucleus/putamen.
Conclusions:
- This study identifies computational decision-making impairments in GAD.
- Disrupted PE signaling is a key finding in GAD, affecting the updating of expected values.
- Impaired PE signaling may contribute to decision-making deficits and excessive worry in GAD.
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