Individual Differences in Uncertainty Learning and Avoidance: Clinical, Behavioral, and Neural Markers of Fear-Based Anxiety

PI: Vanessa Brown

Supported by the National Institute of Mental Health


PUBLIC HEALTH RELEVANCE:

Anxiety disorders are characterized by problems learning about potentially dangerous situations, particularly when possible outcomes in a situation are uncertain. The present application proposes to use neural and computational approaches to understand why people high in anxiety have difficulties learning about uncertainty and why uncertain situations are avoided in and outside of the laboratory. The goal of this application is to determine what learning difficulties are present in anxiety in order to develop more effective treatments that target these learning difficulties.

PROJECT SUMMARY:

Anxiety disorders are highly prevalent and impairing. We have some treatments that work for some people, such as exposure therapy, but many people are not helped by existing treatments. We also cannot predict who will be helped and by what treatment. To improve this situation, we need a better understanding of how anxious people learn differently and how this leads to anxiety. We also need to understand how these learning differences lead to avoidance of anxiety-producing situations, as avoidance is one of the primary impairments in anxiety.

This project investigates the hypothesis that clinical anxiety is related to difficulties learning about uncertainty. In particular, we propose that people with anxiety show differences in learning whether unpredictable outcomes mean that outcomes are inherently difficult to predict (called ‘expected uncertainty’) versus that the environment has changed (‘unexpected uncertainty’). We further hypothesize that these differences in learning change how people with anxiety seek out uncertain options (explore) versus stick with safe, known options (exploit), and that these differences in choosing to explore versus exploit lead to unhelpful avoidance.

To test these hypotheses, we are enrolling adults with a range of anxiety symptoms. Participants complete a learning game to measure how people learn about different types of uncertainty and how this affects whether people seek out uncertainty versus avoid it. Most people complete this task during functional MRI scanning to look at differences in brain networks, such as the salience and frontoparietal networks, that may be involved in learning about uncertainty. Participants also complete an ecological momentary assessment where they report on avoidance behavior as they go about their daily lives. The goal of this study is to understand how people with anxiety learn and make decisions about uncertainty in order to develop and improve treatments to target these differences.