Phasic heart period reactions to cued threat and nonthreat stimuli in generalized anxiety disorder

The hallmark of generalized anxiety disorder (GAD) is chronic uncontrollabl e worry. A preattentive bias toward threat cues and hypervigilance may supp ort this ongoing state of apprehension. A study was conducted to bridge the attentional and physiological underpinnings of GAD by examining phasic hea rt period (HP) responses to cued threat and nonthreat stimuli. Thirty-three GAD clients and 33 nonanxious control participants engaged in an S1-S2 pro cedure that employed cued threat and nonthreat word stimuli, during which p hasic HP reactions were recorded. As compared with the control group, the G AD group showed (1) smaller cardiac orienting responses and impaired habitu ation of cardiac orienting to neutral words, (2) KR acceleration in respons e to threat words, and (3) a conditioned anticipatory HR deceleration to th reat words over repeated trials. The cardiac-autonomic underpinnings of GAD appear to rigidly maintain precognitive defensive responses against threat . This portrayal is discussed in the context of an integrative model that d epicts diminished global adaptive variability in GAD.