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Physiological Correlates of Affective Decision-Making in Anxiety and Depression City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 9-2017 Physiological Correlates of Affective Decision-Making in Anxiety and Depression Louisa I. Thompson The Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/2254 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] PHYSIOLOGICAL CORRELATES OF AFFECTIVE DECISION-MAKING IN ANXIETY AND DEPRESSION by LOUISA I. THOMPSON A dissertation submitted to the Graduate Faculty in Psychology in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York. 2017 © 2017 LOUISA I. THOMPSON All Rights Reserved ii Physiological Correlates of Affective Decision-Making In Anxiety and Depression by Louisa I. Thompson This manuscript has been read and accepted for the Graduate Faculty in Psychology in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy. July 11, 2017 Sarit A. Golub, Ph.D., MPH Date Chair of Examining Committee July 11, 2017 Richard Bodnar, Ph.D. Date Executive Officer Supervisory Committee: Douglas Mennin, Ph.D. Justin Storbeck, Ph.D. Jennifer Stewart, Ph.D. Faith Gunning, Ph.D. THE CITY UNIVERSITY OF NEW YORK iii ABSTRACT Physiological Correlates of Affective Decision-Making in Anxiety and Depression by Louisa I. Thompson Advisor: Sarit A. Golub, Ph.D. Improving our understanding of cognitive and physiological profiles in anxiety and depression has the potential to reveal novel ways to target and improve treatments for these prevalent mental health conditions. The present study examined the impact of self-reported anxiety and depression symptoms on three established decision-making measures, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), Balloon Analogue Risk Task (BART; Lejuez et al., 2002), and Game of Dice Task (GDT; Brand et al., 2005), in a diverse sample of 100 college students (age 18 to 35). Physiological measures of tonic heart rate variability and galvanic skin response were obtained to better characterize autonomic flexibility and sympathetic reactivity, respectively, during decision-making performance. Interoceptive sensitivity, measured via a heart beat perception task (Schandry, 1981), was also examined as a potential moderator in the relationship between sympathetic reactivity and decision-making. Consistent with the literature, BART performance was negatively associated with IGT performance, while GDT performance was positively associated with IGT performance. Contrary to our hypotheses, physiological measures did not distinguish individuals who reported anxiety and/or depression from those who did not. Of the three tasks, only IGT performance was associated with sympathetic reactivity. Consistent with our hypotheses, anxiety and greater iv sympathetic reactivity to losses in the task predicted better scores. Interoceptive sensitivity moderated the association between sympathetic reactivity and IGT performance, but only among those with anxiety, with better performance associated with a combination of lower interoceptive sensitivity and higher sympathetic reactivity. Low tonic HRV predicted worse IGT performance in depressed participants and worse GDT performance in anxious participants. These findings, though preliminary, have implications for treatment advances involving HRV biofeedback and interoceptive exposure. Our findings also highlight substantial differences between the IGT, BART, and GDT in their associations with anxiety, depression, and physiological markers, for consideration in cross study comparisons and future research. v Table of Contents Introduction………………………………………………………………………………..1 Literature Review……..…………………………………………………………………...2 The somatic marker hypothesis (SMH)…………………………………………...2 The Iowa Gambling Task (IGT)……..………………….....……………………...3 Applying the SMH to Anxiety and Depression………..……………………..…...4 Affective Decision-Making Performance in Anxiety………………..........………5 Affective Decision-making Performance in Comorbid Anxiety and Depression...7 Skin Conductance and Affective Decision-Making Performance.............………10 The SMH and IGT: Limitations and Future Directions……….......……….…….11 Alternative Perspectives for Understanding Affective Decision-Making…….…13 The perseverative cognition hypothesis and autonomic flexibility…..….13 Interoceptive sensitivity……………………………………………...…..16 The Present Study…………...……….…………………………………………………..19 Aims………………………………………………………..…………………….19 Hypotheses…………………………………………..……...………………...….22 Method……………………………………...…………………..…………………..……24 Participants.………………………………………………………………………24 Procedure………...………………………………………………………………24 Neuropsychological Tasks………...……………………..………………….…...24 Physiological Measures………………………..………………….……………..28 Interoceptive Sensitivity Measure……………………………………….……….30 Anxiety and Depression Self-Report Measures…………………………….……31 vi Additional Self-Report Measures…………………………………………….….32 Data Analysis…………………………………………………………………….33 Results……………..…………………………………………………………………..…33 Sample Size………………………………………………………………………33 Affective Variable Adjustments……………...…………………………………..34 Descriptives and Bivariate Comparisons…………………………...……………34 Analysis of IGT Performance………...………………………….………………35 Analysis of Game of Dice Task (GDT) Performance…………..………..………42 Analysis of Balloon Analogue Risk Task (BART) Performance...………….…..44 Affective Group Analysis …………...………………………………………..…47 Task Comparison Analysis.……………..………………………………..….…..47 Discussion……………………………………..…………………………………………48 IGT Findings...………………………………………………..……………….....49 GDT Findings…………………………………….….……...…………………...54 BART Findings………………………………………………………………......57 Task Comparisons………………………………………………………………..60 Implications…………….……………………………………………...…………62 Limitations……………………………...…………………………………...…...66 Conclusions……………………………………………………………………....69 Appendix A: Tables and Figures…………………………………..……………………..71 References …………………………...…………………………………………………...97 vii List of Tables and Figures Table 1. Sample demographic and affective characteristics…………………………......71 Table 2. Decision-making task variables………………………………….…………......72 Table 3. Spearman correlations: DM task, digit span, and affective variables…………..73 Table 4. Physiological and interoceptive sensitivity variable descriptives………...….....74 Table 5. Spearman correlations: physiological, affective, and digit span variables……..75 Table 6. One-way ANOVA results for variables predicting physiological outcomes…...76 Iowa Gambling Task Analyses: Table 7. Independent regression: gender and affective variables…………………....…..77 Table 8. Independent regression: gender, depression, and LDSB variables………..…....78 Figure 1. Depression and working memory interaction……………………………….....79 Figure 2. Depression and working memory interaction using categorical LDSB…….....79 Table 9. Hierarchical regression: gender, depression, and dichotomized LDSB …….....80 Figure 3. Below average LDSB and depression predict worse performance……………80 Table 10. Hierarchical regression: tonic HRV interactions……………………………...81 Figures 4 and 5. Depression, tonic HRV, and working memory interactions……….......81 Table 11. Independent regression: Mean gain and loss event SCR amplitude…………..82 Table 12. Independent regression: mean SCR amplitude interactions………...………...82 Figure 6. Greater SCR response to losses associated with better performance……….....83 Table 13. Independent regression: mean frequency of non-specific SCRs per minute.....83 Table 14. Hierarchical regression: HBPT accuracy and anxiety interaction………….....84 Figure 7. HBPT accuracy predicts worse IGT performance in anxiety……………...….84 Table 15. Independent regression: HBPT accuracy, SCR amplitude, and anxiety….......85 viii Figure 8. HBPT accuracy, SCR amplitude, and anxiety interaction……………….…….85 Game of Dice Task Analyses: Table 16. Independent regression: race and affective variables..……………………..…86 Table 17. Hierarchical regression: race and worry interaction…………………………..86 Table 18. Independent regression: race and working memory variables……….………..87 Table 19. Hierarchical regression: anxiety and dichotomous LDSB interaction……...…87 Figure 9. Anxiety and working memory interaction………………………..………..…..88 Table 20. Hierarchical regression: worry and tonic HRV interaction……………….…...89 Figure 10. Worry and HRV interaction………………...………………………………...89 Table 21. Independent regression: average SCR amplitude for gain and loss events…....90 Balloon Analogue Risk Task Analyses: Table 22. Independent regression: gender and affective variables……………..………...90 Table 23. Independent regression: working memory variables……………………...…...91 Table 24. Hierarchical regression: anxiety and dichotomous LDSB interaction…………91 Figure 11. Dichotomous LDSB and anxiety interaction……………………………..…...92 Table 25. Hierarchical regression: worry and dichotomous LDSB interaction……...…...92 Figure 12. Dichotomous LDSB and anxiety interaction………………………………….93 Table 26. Independent regression: gender, worry, anxiety, and tonic HRV……………...93 Table 27. Independent regression: mean SCR amplitude for gain and loss events….…...94 Table 28. ANOVA: physiological variables by gender and affect category……..……....94 Table 29. Independent regression: BART performance predicting IGT performance…...95 Table
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