Sex differences in the effects of anxiety on behavioral and regional responses to negative emotions
Poster No:
740
Submission Type:
Abstract Submission
Authors:
Hak Kei Wong1, Shefali Chaudhary2, Yu Chen2, Sheng Zhang2, Chiang-Shan Li2
Institutions:
1University College London, London, London, 2Yale University School of Medicine, New Haven, CT
First Author:
Co-Author(s):
Introduction:
Men and women are known to show differences in the incidence and clinical manifestations of mood and anxiety disorders [1]. The lifetime and 12-months male to female prevalence ratios of anxiety disorder were 1:1.7 and 1:1.8, respectively, with women having higher rates of lifetime diagnosis of most anxiety disorders [2]. Further, women with a lifetime diagnosis of an anxiety disorder were more likely than men to be also diagnosed with another anxiety disorder and major depressive disorder [2]. Many imaging studies have investigated the neural correlates of sex differences in emotion processing. However, it remains unclear how anxiety might impact behavioral and neural responses during emotion processing differently in men and women.
Methods:
We recruited 119 healthy adults and assessed their levels of anxiety using State-Trait Anxiety Inventory (STAI) State score. With functional magnetic resonance imaging (fMRI), we examined regional responses to negative vs. neutral (Neg-Neu) picture matching in the Hariri task [3]. Clinical and behavioral data were analyzed using regression and repeated-measures analysis of covariance with age as a covariate, and fMRI data were analyzed using a full-factorial model with sex as a factor and age as a covariate and evaluated with a corrected threshold, according to current reporting standards. We performed the regression analyses on STAI score for men and women together as well as separately. For behavioral and neural outcomes identified in men or women alone, we performed slope tests in confirming sex differences. Finally, we performed mediation analyses to investigate the inter-relationship amongst anxiety, neural correlates of anxiety, and performance metrics from the Hariri task.
Results:
Men and women did not differ in STAI score (p = 0.137), or accuracy rate or reaction time (RT) (Neg-Neu) (both p's > 0.060). However, STAI scores correlated positively with RT (Neg-Neu) in women but not in men (r = 0.48, p<0.001 and r = -0.05, p = 0.699, respectively; Figure 1). Further, a slope test revealed significant sex differences in regression slope of RT (Neg-Neu) vs. STAI score (z = -3.21, p = 0.001). At voxel p<0.001 uncorrected and cluster p<0.05 FWE-corrected, men and women did not show significant differences in regional responses to Neg. vs. Neu trials. However, in regression analyses, STAI score correlated positively with lingual gyrus (LG) and negatively with medial prefrontal cortex (mPFC, Figure 2) and superior frontal gyrus (SFG) activity during Neg vs. Neu trials in women. The parameter estimates (β's) of mPFC also correlated with RT (Neg-Neu) in women but not in men. Generalized psychophysiological interaction (gPPI) analysis in women revealed mPFC connectivity with the right inferior frontal gyrus, right SFG, and left parahippocampal gyrus during Neg vs. Neu trials in positive correlation with both STAI score and RT (Neg-Neu). In a mediation analysis, mPFC gPPI but not mPFC activity mediated the association between STAI scores and RT (Neg-Neu).
Conclusions:
These findings are consistent with the most recent meta-analyses reporting no significant sex differences in regional responses to negative emotions. On the other hand, women and men demonstrated significant differences in the impact of individual anxiety on behavioral outcomes and neural correlates in identifying negative emotions. In women, those with higher levels of anxiety showed prolonged RT and diminished mPFC activation in matching negative vs. neutral images. With anxiety affecting the behavioral and neural responses to negative emotions in women but not in men and considering the known roles of the mPFC in emotion regulation [4], we discussed heightened sensitivity and regulatory demands during negative emotion processing as neurobehavioral markers of anxiety in women.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Emotion, Motivation and Social Neuroscience:
Emotional Perception 1
Modeling and Analysis Methods:
Activation (eg. BOLD task-fMRI)
Keywords:
ADULTS
Affective Disorders
Anxiety
Emotions
FUNCTIONAL MRI
Limbic Systems
NORMAL HUMAN
Perception
Psychiatric Disorders
Systems
1|2Indicates the priority used for review
Provide references using author date format
[2] McLean, C. P. et al. (2011) ‘Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness.’, Journal of psychiatric research, 45(8), pp. 1027–1035. doi: 10.1016/j.jpsychires.2011.03.006.
[3] Hariri AR, Tessitore A, Mattay VS, Fera F, Weinberger DR, 2002. The amygdala response to emotional stimuli: a comparison of faces and scenes. Neuroimage 17, 317–323. doi: 10.1006/nimg.2002.1179.
[4] Etkin, A. and Wager, T. D. (2007) ‘Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia.’, The American journal of psychiatry, 164(10), pp. 1476–1488. doi: 10.1176/appi.ajp.2007.07030504.