Latent class growth analyses reveal overrepresentation of dysfunctional fear conditioning trajectories in patients with anxiety-related disorders compared to controls.

Anxiety disorders Cognitive Behavioral Therapy (CBT) Fear conditioning Fear extinction Latent class growth analyses (LCGA) Latent trajectories Treatment outcome

Journal

Journal of anxiety disorders
ISSN: 1873-7897
Titre abrégé: J Anxiety Disord
Pays: Netherlands
ID NLM: 8710131

Informations de publication

Date de publication:
03 2021
Historique:
received: 18 03 2020
revised: 21 12 2020
accepted: 13 01 2021
pubmed: 29 1 2021
medline: 29 5 2021
entrez: 28 1 2021
Statut: ppublish

Résumé

Recent meta-analyses indicated differences in fear acquisition and extinction between patients with anxiety-related disorders and comparison subjects. However, these effects are small and may hold for only a subsample of patients. To investigate individual trajectories in fear acquisition and extinction across patients with anxiety-related disorders (N = 104; before treatment) and comparison subjects (N = 93), data from a previous study (Duits et al., 2017) were re-analyzed using data-driven latent class growth analyses. In this explorative study, subjective fear ratings, shock expectancy ratings and startle responses were used as outcome measures. Fear and expectancy ratings, but not startle data, yielded distinct fear conditioning trajectories across participants. Patients were, compared to controls, overrepresented in two distinct dysfunctional fear conditioning trajectories: impaired safety learning and poor fear extinction to danger cues. The profiling of individual patterns allowed to determine that whereas a subset of patients showed trajectories of dysfunctional fear conditioning, a significant proportion of patients (≥50 %) did not. The strength of trajectory analyses as opposed to group analyses is that it allows the identification of individuals with dysfunctional fear conditioning. Results suggested that dysfunctional fear learning may also be associated with poor treatment outcome, but further research in larger samples is needed to address this question.

Identifiants

pubmed: 33508747
pii: S0887-6185(21)00008-6
doi: 10.1016/j.janxdis.2021.102361
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102361

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

Puck Duits (P)

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Academic Anxiety Center, Utrecht, The Netherlands. Electronic address: p.duits@altrecht.nl.

Johanna M P Baas (JMP)

Department of Experimental Psychology and Helmholtz Institute, Utrecht University, Utrecht, The Netherlands. Electronic address: J.M.P.Baas@uu.nl.

Iris M Engelhard (IM)

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Academic Anxiety Center, Utrecht, The Netherlands. Electronic address: I.M.Engelhard@uu.nl.

Jan Richter (J)

Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany. Electronic address: jan.richter@uni-greifswald.de.

Hilde M Huisman-van Dijk (HM)

Altrecht Academic Anxiety Center, Utrecht, The Netherlands. Electronic address: ma.huisman@altrecht.nl.

Anke Limberg-Thiesen (A)

Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany. Electronic address: limberg@uni-greifswald.de.

Ivo Heitland (I)

Department of Experimental Psychology and Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.

Alfons O Hamm (AO)

Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany. Electronic address: hamm@uni-greifswald.de.

Danielle C Cath (DC)

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Academic Anxiety Center, Utrecht, The Netherlands; Department of Psychiatry, University Medical Center Groningen and University of Groningen, GGZ Drenthe, Department of Specialist Training, The Netherlands. Electronic address: d.c.cath@umcg.nl.

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