Lack of optimism and sweating the small stuff: Rostral anterior cingulate cortex dysfunction in Generalized Anxiety Disorder, but not Generalized Social Phobia, during the contemplation of future events

Authors

• JC Leshin
• KS Blair

Abstract

Generalized Anxiety Disorder (GAD) and Generalized Social Phobia (GSP) are highly comorbid and show similar neural disruptions during emotion regulation. In contrast, perturbations in optimism and its associated neural correlates may occur specifically in GAD and could prove an important biomarker for this disorder. We compared the neural correlates of optimism bias, elicited during the contemplation of future events, in patients with GAD (n=18), GSP (n=18), and healthy comparison individuals (n=18) using functional magnetic resonance imaging. Individuals contemplated the likelihood of future high and low impact positive (e.g., winning the lottery) and negative (e.g., having a heart attack) events occurring to themselves relative to other comparable individuals. In line with previous work, healthy subjects showed significant optimistic bias (OB); they considered themselves significantly more likely to experience future positive and significantly less likely to experience future negative events relative to others. This was also seen in patients with GSP. However, GAD subjects showed no OB for positive events. At the neural level, positive OB was associated with significantly greater modulation of rostral medial prefrontal cortex (rMPFC) in healthy individuals and patients with GSP relative to patients with GAD. Patients with GAD further differed from both the healthy comparison and the GSP comparison group by showing decreased neural responses to high impact future events, and increased neural responses to low impact future events. These findings may represent the neural substrate that underlies the reduced optimism and increased worry about everyday events in this population.

Scientific Focus Area: Neuroscience

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