A Functional Magnetic Resonance Imaging Investigation of Uncertainty in Adolescents with Anxiety Disorders

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Adolescence, anxiety, fMRI, uncertainty, decision- making


Psychology | Social and Behavioral Sciences


Background: Pediatric anxiety disorders, although highly prevalent, are understudied with little known about their pathophysiology. Intolerance of uncertainty (IU) is a trait associated with worry, a key characteristic of these disorders. Neural responses to uncertainty in healthy subjects involve the same frontal–limbic circuits that are hyper-responsive in pediatric anxiety. As such, the present study examines the relationship between IU and neural responses to uncertainty in anxious adolescents.

Methods: Sixteenadolescents(ages13–17)diagnosedwithgeneralizedanxietydisorderand/orsocialphobia(ANX)and13non-anxious control subjects completed a decision-making task while functional magnetic resonance imaging scans were acquired.

Results: TheANXgroupendorsedgreatertask-relatedanxietyandlesscertaintythancontrolsubjectsonapost-taskquestionnaire.Compared with control subjects, the ANX group did not demonstrate hyper-responsivity of brain regions as hypothesized. Across groups, IU was positively correlated with activity in several frontal and limbic regions. Further analyses identified subgroups within the ANX group: those with high IU activated frontal/limbic regions, whereas those with low IU and less anxiety during the task deactivated the same regions in response to uncertainty.

Conclusions: ResultssubstantiatethehypothesizedlinkbetweenIUandneuralresponsestouncertaintyinsomeadolescentswithanxiety disorders. Our findings, if replicated, suggest that trait measures, such as IU, can significantly improve our understanding of the neurobio- logical basis of pediatric anxiety disorders.

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