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Translating Big Data To Clinical Outcomes In Anxiety: Potential For Multimodal Integration, Parmis Khosravi, André Zugman, Paia Amelio, Anderson M. Winkler, Daniel S. Pine

School of Medicine Publications and Presentations

Purpose of the Review

This review describes approaches to research on anxiety that attempt to link neural correlates to treatment response and novel therapies. The review emphasizes pediatric anxiety disorders since most anxiety disorders begin before adulthood.

Recent Findings

Recent literature illustrates how current treatments for anxiety manifest diverse relations with a range of neural markers. While some studies demonstrate post-treatment normalization of markers in anxious individuals, others find persistence of group differences. For other markers, which show no pretreatment association with anxiety, the markers nevertheless distinguish treatment-responders from non-responders. Heightened error related negativity represents the risk marker discussed in …

Homicidal Ideation And Psychiatric Comorbidities In The Inpatient Adolescents Aged 12–17, Ching-Fang Sun, Zeeshan Mansuri, Chintan Trivedi, Ramu Vadukapuram, Abhishek Reddy

School of Medicine Publications and Presentations

Objectives: Adolescents with a homicidal tendency is a growing concern in the United States. Studies in the past have showcased the relationship between homicidal ideation (HI) and psychiatric illnesses, but very limited information is available on the adolescent and inpatient population. We aim to evaluate the prevalence of demographic characteristics and psychiatric disorders in adolescents with and without HI.

Materials and methods: Adolescent (age 12–17) population admitted to the hospital with the diagnosis of homicidal ideation was identified from the 2016–2018 National Inpatient Sample Dataset (NISD). Patients without HI were defined as the control group. The prevalence of psychiatric comorbidities …

Risk Of Suicide In Patients With Major Depressive Disorder And Comorbid Chronic Pain Disorder: An Insight From National Inpatient Sample Data, Taranjeet Jolly, Ramu Vadukapuram, Chintan Trivedi, Zeeshan Mansuri, Mahwish Adnan, Steven P. Cohen, To-Nho Vu

School of Medicine Publications and Presentations

Background: Approximately 17.3 million adults in the United States have had a minimum of one major depressive episode. Comorbidity of depression and pain can affect individuals of any age, but is more prevalent in the elderly affecting up to 13% of people in the elderly population. Given that depression and suicidal ideation (SI) pose a considerable burden resulting in enormous suffering, there is a need to understand the factors of the relationship between chronic pain (CP), depression, and SI.

Objectives: Our primary objective in this study was to compare suicidality (SI/attempt [SA]) between patients with major depressive disorder (MDD) and …

Computational Modeling Of Threat Learning Reveals Links With Anxiety And Neuroanatomy In Humans, Rany Abend, Diana Burk, Sonia G. Ruiz, Andrea L. Gold, Julia L. Napoli, Jennifer C. Britton, Kalina J. Michalska, Tomer Shechner, Anderson M. Winkler, Ellen Leibenluft

School of Medicine Publications and Presentations

Influential theories implicate variations in the mechanisms supporting threat learning in the severity of anxiety symptoms. We use computational models of associative learning in conjunction with structural imaging to explicate links among the mechanisms underlying threat learning, their neuroanatomical substrates, and anxiety severity in humans. We recorded skin-conductance data during a threat-learning task from individuals with and without anxiety disorders (N=251; 8-50 years; 116 females). Reinforcement-learning model variants quantified processes hypothesized to relate to anxiety: threat conditioning, threat generalization, safety learning, and threat extinction. We identified the best-fitting models for these processes and tested associations among latent learning parameters, whole-brain …

Threat Imminence Reveals Links Among Unfolding Of Anticipatory Physiological Response, Cortical-Subcortical Intrinsic Functional Connectivity, And Anxiety, Rany Abend, Sonia G. Ruiz, Mira A. Bajaj, Anita Harrewijn, Julia O. Linke, Lauren Y. Atlas, Anderson M. Winkler, Daniel S. Pine

School of Medicine Publications and Presentations

Excessive expression of fear responses in anticipation of threat occurs in anxiety, but understanding of underlying pathophysiological mechanisms is limited. Animal research indicates that threat-anticipatory defensive responses are dynamically organized by threat imminence and rely on conserved circuitry. Insight from basic neuroscience research in animals on threat imminence could guide mechanistic research in humans mapping abnormal function in this circuitry to aberrant defensive responses in pathological anxiety.

50 pediatric anxiety patients and healthy-comparisons (33 females) completed an instructed threat-anticipation task whereby cues signaled delivery of painful (threat) or non-painful (safety) thermal stimulation. Temporal changes in skin-conductance indexed anxiety effects on …