Citation

Fitzgerald JM, Klumpp H, Langenecker S, Phan KL. Depress. Anxiety 2019; 36(5): 453-464.

Affiliation

Department of Anatomy and Cell Biology and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, Illinois.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1002/da.22859

PMID

30408261

Abstract

BACKGROUND: Individuals who suffer from anxiety and/or depression face difficulty in adaptively managing emotional responses, while accumulating evidence suggests impaired emotion regulation is a transdiagnostic feature of psychopathology. Effectual regulation in the context of negative stimuli is characterized by engagement of the prefrontal cortex (PFC) coupled with reduced amygdala reactivity. In anxiety disorders and major depression, PFC underengagement and atypical PFC-amygdala connectivity has been observed, although patient findings based on case-control studies have been mixed with regard to magnitude, locality, and extent of dysfunction. As anxiety disorders and major depression are heterogeneous disorders and frequently comorbid with one another, delineating relationships between reappraise-related substrates and symptoms may advance our understanding of emotion dysregulation in these populations.

METHODS: We examined PFC activation and its functional connectivity (FC) to the amygdala using functional magnetic resonance imaging in a large sample of patients (N = 174) with primary generalized anxiety disorder (n = 47), social anxiety disorder (n = 78), or major depressive disorder (n = 49) during a reappraisal-based emotion regulation task. Comorbidity was permitted and the majority of participants had a concurrent psychiatric illnesses.

RESULTS: Across participants, whole-brain results showed that (1) greater anxiety and depression symptom severity was related to less engagement of the dorsal anterior cingulate cortex (ACC) and (2) less FC between the amygdala and ventrolateral PFC.

RESULTS were driven by anxiety, while depression symptoms were not significant.

CONCLUSION: These findings demonstrate that individual differences in anxiety and depression may help explain ACC and PFC dysfunction during emotion regulation observed across anxiety and depressive disorders.

© 2018 Wiley Periodicals, Inc.

Language: en

Keywords

anxiety/anxiety disorders; depression; functional MRI; generalized anxiety disorder; social anxiety disorder/social phobia