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Neural Mechanisms Underlying Biased Fear Perception in Youth With Anxiety

Abstract

Accurate recognition of facial affect can inform our understanding of others’ emotions and state of mind. Children and adults with anxiety are more likely to interpret ambiguous or neutral stimuli as threatening and are less able to regulate emotional responses to perceived threats which may contribute to the etiology and/or maintenance of anxiety. For instance, perceiving ambiguous social cues, like facial affect, as threatening may cause avoidance of social situations, limiting opportunities to reduce fears through habituation or reappraisal. Threat biases in anxiety may be subserved by elevated activation in arousal and salience-processing brain regions, aberrations in regulatory control brain regions, and impaired connections between these networks. However, less is known about perceptual sources of threat biases in anxiety because existing correlational studies cannot directionally test associations. Current research also suffers from additional limitations including homogenous samples of white, upper-middle-class, treatment-seeking youth, raising important questions about whether extant models of threat bias in anxiety are generalizable beyond the specific ecology of middle SES European American groups. To address these limitations, this dissertation probed the neurodevelopmental correlates of biases in threat perception in diverse samples of anxious youth. Chapter 1 probed the effects of trait anxiety and pre-scan anticipatory state anxiety on neural response to ambiguously fearful facial affect in preadolescent Latina girls. Results supported that trait anxiety is associated with increased insula sensitivity to fear and reduced activation in the inferior frontal gyrus. Further, pre-scan anticipatory state anxiety influenced perceptual networks and moderated the effect of trait anxiety on activation in executive control regions. In Chapter 2, structural brain analyses conducted in a subset of participants from Chapter 1 revealed that anxious girls displayed reduced integrity in the cingulum, a white matter tract that facilitates communication between limbic and regulatory prefrontal regions. Finally, in Chapter 3, anticipatory state anxiety was experimentally induced in socially-anxious young adults to probe subsequent threat biases in emotion perception. Results revealed that elevations in anticipatory anxiety predicted an increased tendency to label ambiguous facial affect as fearful but not angry. Together, these chapters suggest that threat biases may be subserved by reduced prefrontal regulation of hyperactive arousal networks coupled with aberrations in fear perception. Results also reveal that transient fluctuations in anticipatory state anxiety elicit threat biases in the perception of ambiguously fearful facial affect. Implications for research considerations and avenues for possible treatments are discussed.

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