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What’s in a Face? Amygdalar Sensitivity to an Emotional Threatening Faces Task and Transdiagnostic Internalizing Disorder Symptoms in Participants Receiving Attention Bias Modification Training

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Abstract

Background

Altered amygdala activation in response to the emotional matching faces (EMF) task, a task thought to reflect implicit emotion detection and reactivity, has been found in some patients with internalizing disorders; mixed findings from the EMF suggest individual differences (within and/or across diagnoses) that may be important to consider. Attention Bias Modification (ABM), a mechanistic attention-targeting intervention, has demonstrated efficacy in treatment of internalizing disorders. Individual differences in neural activation to a relatively attention-independent task, such as the EMF, could reveal novel neural substrates relevant in ABM’s transdiagnostic effects, such as the brain’s generalized threat reactivity capacity.

Methods

In a sample of clinically anxious patients randomized to ABM (n = 43) or sham training (n = 18), we measured fMRI activation patterns during the EMF and related them to measures of transdiagnostic internalizing symptoms (i.e., anxious arousal, general distress, anhedonic depression, and general depressive symptoms).

Results

Lower baseline right amygdala activation to negative (fearful/angry) faces, relative to shapes, predicted greater pre-to-post reduction in general depression symptoms in ABM-randomized patients. Greater increases in bilateral amygdalae activation from pre-to-post ABM were associated with greater reductions in general distress, anhedonic depression, and general depression symptoms.

Conclusions

ABM may lead to greater improvement in depressive symptoms in individuals exhibiting blunted baseline amygdalar responses to the EMF task, potentially by enhancing neural-level discrimination between negative and unambiguously neutral stimuli. Convergently, longitudinal increases in amygdala reactivity from pre-to-post-ABM may be associated with greater improvement in depression, possibly secondary to improved neural discrimination of threat and/or decreased neurophysiological threat avoidance in these specific patients.

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Acknowledgements

This project was supported by National Institute of Mental Health Grant (NIMH MH100259). This research was also supported by funding from the Ruth L. Kirschstein National Research Service Award Institutional Research Training Grants sponsored by the National Institutes of Health (NIH T32 MH018951: Brent) and by NIMH Grant K23 MH119225. The NIH had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

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Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA

    Manivel Rengasamy, Mary Woody, Tessa Kovats, Greg Siegle & Rebecca B. Price

  2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA

    Greg Siegle & Rebecca B. Price

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  1. Manivel Rengasamy
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Correspondence to Manivel Rengasamy.

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Conflict of Interest

Manivel Rengasamy, Mary Woody, Tessa Kovats, Greg Siegle and Rebecca B. Price declare that they have no conflict of interest.

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The study was approved by the Institutional Review Board of the University of Pittsburgh and informed consent was obtained from all participants. This study was carried out in accordance with the Declaration of Helsinki.

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Rengasamy, M., Woody, M., Kovats, T. et al. What’s in a Face? Amygdalar Sensitivity to an Emotional Threatening Faces Task and Transdiagnostic Internalizing Disorder Symptoms in Participants Receiving Attention Bias Modification Training. Cogn Ther Res 45, 795–804 (2021). https://doi.org/10.1007/s10608-021-10205-9

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