Anxiety
Conditions
Keywords
anxiety, selective serotonin reuptake inhibitor, emotion, functional magnetic resonance imaging
Brief summary
This study aims to increase the knowledge about psychological processes which may contribute to mental health problems such as depression and anxiety. This study aims to investigate if administering Escitalopram, an antidepressant which increases serotonin levels in parts of the brain, affects how the brain processes emotional information. It is hoped that measuring these changes will increase the understanding of processes involved in mental health problems.
Interventions
DRUGEscitalopram
Participants received 2-3 weeks of escitalopram.
DRUGPlacebo
Participants received 2-3 weeks of placebo, matched in colour and size to the escitalopram.
Sponsors
University College, London
UCLH/UCL Joint Research Office
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
Healthy Controls: * Fluency in English * Registration with a UK General Practitioner * Capacity for consent * No personal history of long-term medical conditions or psychiatric illness (including substance dependence, assessed with the Mini International Neuropsychiatric Interview) Anxious Individuals: * Fluency in English * Registration with a UK General Practitioner * Capacity for consent * Meeting criteria for generalised anxiety disorder, panic disorder and/or agoraphobia (also assessed with the Mini International Neuropsychiatric Interview); permitted comorbid conditions were: major depressive disorder, obsessive-compulsive disorder and/or post-traumatic stress disorder
Exclusion criteria
Healthy Controls and Anxious Individuals: * Having consumed alcohol within 12 hours prior to the study * having used illicit drugs within 3 months prior to the study * Having had any contraindications to MRI scanning * Being pregnant or breastfeeding * Having had impaired or uncorrected vision or hearing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 'Aversive amplification circuit' connectivity | Baseline and 2-3 weeks after baseline | The engagement of the neural circuit of the amygdala, cingulate cortex and prefrontal cortex will be measured via an fMRI analysis technique called a psychophysiological interactions (PPI) analysis. PPI analysis concerns behaviour-specific increases in the relationship across regional brain activity - this means that it can allow one to assess whether two regions (a priori selected ROIs) show increased connectivity during a specific context or behaviour, suggesting a behaviour-specific increase in transfer of information. The output of this analysis will take form of a continuous beta weight - an index of connectivity across two brain regions (amygdala and medial prefrontal cortex), which represents the primary outcome of the study. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive task performance: Go/no-go task | Baseline and 2-3 weeks after baseline | Measures approach/avoidance behaviours under threat of shock or safe conditions |
| Cognitive task performance: Facial emotional processing task | Baseline and 2-3 weeks after baseline | Measures brain responses to positive, negative and neutral emotions |
| Cognitive task performance: Emotional face recognition task | Baseline and 2-3 weeks after baseline | Measures brain responses during two distinct memory processes - the encoding (learning) and retrieval (remembering) of information |
| Cognitive task performance: Visual affective bias task | Baseline and 2-3 weeks after baseline | Measures biases in patients' cognition towards or away from rewarding stimuli |
| Regional activations during neuroimaging task: Facial emotional processing task | Baseline and 2-3 weeks after baseline | Measures brain responses to positive, negative and neutral emotions |
| Regional activations during neuroimaging task: Emotional face recognition task | Baseline and 2-3 weeks after baseline | Measures brain responses during two distinct memory processes - the encoding (learning) and retrieval (remembering) of information |
| Regional activations during neuroimaging task: Visual affective bias task | Baseline and 2-3 weeks after baseline | Measures biases in patients' cognition towards or away from rewarding stimuli |
| Cognitive task performance: Loss/risk aversion task | Baseline and 2-3 weeks after baseline | Measures how averse participants are to risk and loss in a mock gambling context |
| Clinical symptom measure: State Trait Anxiety Inventory (STAI) | Baseline and 2-3 weeks after baseline | Measures state and trait anxiety symptoms, scored between 20-80 with higher scores indicating more severe symptoms |
| Clinical symptom measures: Patient Health Questionnaire (PHQ-9) | Baseline and 2-3 weeks after baseline | Measures depressive symptoms, scored between 0-27 with higher scores indicating more severe symptoms |
| Clinical symptom measures: Beck's Depression Inventory (BDI) | Baseline and 2-3 weeks after baseline | Measures depressive symptoms, scored between 0-63 with higher scores indicating more severe symptoms |
| Clinical symptom measures: Catastrophizing questionnaire | Baseline and 2-3 weeks after baseline | Measures catastrophising, scored between 24-120 with higher scores indicating more severe symptoms |
| Clinical symptom measures: Daily Stress Inventory (DSI) | Baseline and 2-3 weeks after baseline | Measures frequency and impact of daily stresses. Frequency scored between 0-58 and impact scored between 0-6, with higher scores indicating more severe stress |
| Clinical symptom measures: Behavioural Inhibition/Behavioural Activation Scales (BIS/BAS) | Baseline and 2-3 weeks after baseline | Measures drive, fun-seeking, reward responsiveness and behavioural inhibition. Behavioural inhibition scored between 7-28, drive between 4-16, fun seeking between 4-16, and reward between 5-20, with higher scores indicating higher levels of those behaviours |
| Clinical symptom measures: Eysenck Impulsiveness Scale | Baseline and 2-3 weeks after baseline | Measures impulsiveness, venturesomeness and empathy. Impulsivity scored between 0-19, venturesomeness between 0-16, empathy between 0-18, with higher scores indicating higher levels of those traits |
| Clinical symptom measure: Generalised Anxiety Disorder Scale (GAD-7) | Baseline and 2-3 weeks after baseline | Measures symptoms of generalised anxiety, scored between 0-21 with higher scores indicating more severe symptoms |
Countries
United Kingdom
Outcome results
None listed