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Study suggests prediction error signaling affects decision making, worry in anxiety

Recent findings indicated disrupted prediction error signaling during decision making among individuals with generalized anxiety disorder, suggesting prediction error may play a role in decision-making deficits and excessive worrying.

“Deficits in reinforcement-based decision making have been reported in generalized anxiety disorder. However, the pathophysiology of these deficits is largely unknown; published studies have mainly examined adolescents, and the integrity of core functional processes underpinning decision making remains undetermined. In particular, it is unclear whether the representation of reinforcement prediction error is disrupted in generalized anxiety disorder,” Stuart F. White, PhD, of the NIMH’s Section on Affective Cognitive Neuroscience, Section on Fear and Anxiety, and Unit on Learning and Decision Making, and colleagues wrote.

To explore these associations, researchers evaluated 46 individuals with generalized anxiety disorder not taking medication and 32 healthy comparison subjects matched for IQ, gender and age. Study participants completed a passive avoidance task while undergoing functional MRI.

Participants with anxiety exhibited impaired reinforcement-based decision making, compared with controls.

Imaging indicated a reduced correlation between prediction error and activity within the ventromedial prefrontal cortex, ventral striatum and other structures associated with decision making during feedback among participants with anxiety.

Further, participants with anxiety exhibited reduced correlation between punishment prediction errors — but not reward prediction errors — and activity within the left and right lentiform nucleus/putamen.

“The results suggest that the decision-making deficits observed in patients with the disorder are the result of a failure to appropriately represent [prediction error]. A notable feature of generalized anxiety disorder is worry over potential future consequences, such as illness or the loss of a job. Within the language of the present study, in day-to-day living, patients with generalized anxiety disorder engage in increased representation of events associated with negative expected value (these are their worries). The deficits in [prediction error] signaling seen in this study may contribute to the maintenance of these worries,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.