Effect of Depressive Symptoms on Fear Extinction in Urban Youth

• In Event: Processes contributing to impaired regulatory responses after childhood trauma

Abstract

Background: Fear conditioning paradigms have shown that impaired regulation of fear-potentiated startle (FPS) in safety conditions is a common biomarker of trauma-related psychopathology. Given the high comorbidity between posttraumatic stress disorder (PTSD) and depression, and the increased prevalence of depression among traumatized youth, it is not clear which symptoms are most related to deficits in fear regulation. In addition, our previous work in youth with trauma exposure found that girls showed impaired discrimination between threat and safety signals compared to boys. The objective of this study was to examine the impact of depression symptoms and sex differences in fear extinction using a FPS study in children with trauma.

Methods: The study included N= 46 (24 girls) 9-year-old children (78% African American, 13% White) recruited from Detroit. FPS was assessed via electromyographic (EMG) recordings of the eyeblink muscle during differential fear conditioning and extinction. During fear conditioning, participants learned to distinguish cues based on the presence of an aversive air blast to the larynx paired with a conditioned stimulus (CS+), which was a shape presented on a computer monitor. A second CS- signaled the absence of the air blast. During extinction, the CS+ was no longer paired with the air blast. Trauma exposure was measured with the Violence Exposure Scale for Children-Revised (VEX-R). Depression symptoms were assessed using the Behavioral Assessment for Children – Second Edition (BASC-2), , and PTSD symptoms were assessed with the UCLA PTSD Reaction Index for DSM-5.

Results:
During acquisition, a repeated measures ANOVA showed a significant main effect of Block (F = 4.401, p = 0.042) and an interaction of Block*CS (F = 10.650, p = .002), demonstrating that the discrimination between threat and safety cues developed over time during the session. During fear extinction, a repeated measures ANOVA showed a significant main effect of Block (F = 8.581, p = 0.006), demonstrating that participants had significantly decreased FPS to both the CS+ and CS- from the start to end of extinction. The decrease in FPS from block 1 to block 4 of extinction was quantified as a percent extinction score to normalize for FPS levels at the start of extinction. Percent extinction was not associated with VEXR levels. An interaction was present between sex and depressive symptoms (F = 10.343, p = .003) when controlling for violence exposure and PTSD symptoms, demonstrating that a deficit in extinction was present in girls with high depressive symptoms, whereas the opposite pattern was found for boys.

Authors

• Mariam Reda, Wayne State Medicine
  Presenting Author

• Anais Fern Stenson, Wayne State University
  Non-Presenting Author

• Charis Wiltshire, Wayne State School of Medicine
  Non-Presenting Author

• Cassandra Wanna, Wayne State School of Medicine
  Non-Presenting Author

• Sean Minton, Emory University School of Medicine
  Non-Presenting Author

• Sterling Winters, Wayne State School of Medicine
  Non-Presenting Author

• John M France, Wayne State University
  Non-Presenting Author

• William M Davie, Wayne State School of Medicine
  Non-Presenting Author

• Tanja Jovanovic, Wayne State University
  Non-Presenting Author