1. Sensitivity to Punishment and Reward Predict Anxiety and Fear Outcomes
Nicholas W. Talisman, Sage K. Hess, Kara N. Meadows, Kelvin A. Adom, & Cynthia Rohrbeck, PhD
Introduction
Results
Models
Anxiety disorders are an extremely prevalent category of mental illness, particularly in college settings (21.8%), where these disorders have surpassed depression as the most prevalent mental health concern (American College Health Association, 2014). The Reinforcement Sensitivity Theory of Personality (RST; Gray, 1970) provides one framework for understanding mechanisms underlying the development of anxiety symptoms (Bijttebier et al., 2009). In RST, an individual’s responses to potentially rewarding stimuli are facilitated by the Behavioral Activation System (BAS), and individuals’ responses to immediately threatening or aversive stimuli are facilitated by the Fight-Flight-Freeze System (FFFS). Prior research has established associations between BIS, BAS, and FFFS sensitivity and the development of anxiety disorders (Izadpaneh et al., 2016). However, less research has separated anxiety into its constituent components of panic and worry and investigated specific associations with RST systems. This study aimed to explore these specific associations in a sample of college students. Undergraduates (N=336) attending a private urban university completed the self-report measures through a secure online survey platform.
Because the revised model of RST suggests FFFS activation is subjectively experienced as panic, it was hypothesized that FFFS sensitivity would be positively associated with panic. Similarly, since the revised model of RST suggests BIS activation is subjectively experienced as worry, it was hypothesized that BIS sensitivity would be positively associated with worry. In revised RST, the BIS is responsible for the resolution of conflicts that arise due to activation between or within the other two systems. Consequently, it was hypothesized that BAS and FFFS sensitivity would be positively associated with worry.
Table 1 Descriptive Statistics and Bivariate Correlations
Variable
(Mean, SD)
FFFS
(28.71, 4.69)
BAS
(22.53, 2.95)
BIS
(30.28, 4.71)
Panic
(18.66, 11.40)
Worry
(55.58, 13.54) --
-.36**
.53**
-.18**
.28**
-.07
.33**
.42**
-.25**
.55**
.57**
Note: N=336; *p-value less than .05; **p-value less than .001.
Hypothesis 1: Supported
FFFS sensitivity was significantly associated with panic (F=28.82, p<.001) and worry (F=70.92, p<.001).
Hypothesis 2: Supported
The BIS was significantly associated with panic (F=40.02, p<.001) and worry (F=144.73, p<.001).
Hypothesis 3: Not Supported
The BAS was not significantly associated with panic, but was significantly inversely related to worry (F=22.36, p<.001).
The results of these simple linear regressions are displayed in the graphs below.
Discussion
The findings of this study bolster existing literature suggesting RST system sensitivities (Izadpaneh et al., 2016) are associated with anxiety outcomes. Specifically, the results indicate that higher FFFS sensitivity and BIS sensitivity have positive relationships with both physiological and cognitive aspects of anxiety. The finding that FFFS sensitivity was directly associated with worry scores among college students supports the revised model of RST (Gray & McNaughton, 2000). This pattern of findings reinforces the central role of an individual’s responsivity to punishment in the development of anxiety disorders. However, in contrast to the expected hypothesis, BAS sensitivity was negatively associated with worry. This finding is not consistent with the relationship between the BAS and BIS in the revised model of RST and warrants further investigation. However, this negative association raises the possibility that BAS sensitivity may serve as a protective factor against the development of anxiety disorders.
As anxiety disorders are extremely prevalent, particularly among the college-age population represented in this study, the identification of potential factors that can be targeted in prevention and intervention is critical. Future stages of this project will explore RST system associations with panic and worry over time. In addition, future analyses will investigate the role of the interplay between RST systems and exposure to stressful life events in the development and progression of anxiety symptoms.
Methods
Predictors
Revised Reinforcement Sensitivity Theory Questionnaire (rRST-Q; Reuter et al., 2015) The rRST-Q is a 31-item self-report measure of reinforcement sensitivity with a 5-point Likert scale. There are three subscales, presented below.
Fight Flight Freeze System Subscale (FFFS)
The FFFS contains 12 items assessing individual responses to immediately threatening stimuli.
Example of flight response item: “When faced with danger, I tend to flee.”
Example of fight response item: “Attack is the best form of defense.”
Example of freeze response item: “I often feel paralyzed when in a dangerous situation.”
Behavioral Activation System Subscale (BAS)
The BAS contains 8 items assessing individual propensity to seek out reward.
Example item: “Most of the time I have a thirst for action.”
Behavioral Inhibition System Subscale (BIS)
The BIS contains 11 items assessing individual propensity to avoid potentially threatening stimuli.
Example item: “I’m often glad if someone makes decisions for me.”
Outcomes:
Beck Anxiety Inventory (BAI; Beck et al., 1988)
The BAI contains 21 items assessing symptoms of panic experienced over the past month on a 4-point Likert scale.
Example items: “numbness or tingling,” “hands trembling”
Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990)
The PSWQ contains 16 items assessing symptoms of worry.
Example item: “Many situations make me worry.”
References
American College Health Association. (2014). Spring 2014 Reference group executive summary. National College Health Assessment.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893.
Bijttebier, P., Beck, I., Claes, L., & Vandereycken, W. (2009). Gray's reinforcement sensitivity theory as a framework for research on personality–psychopathology associations. Clinical Psychology Review, 29(5),
Corr, P. J. (Ed.). (2008). The reinforcement sensitivity theory of personality. Cambridge University Press.
Gray, J. A. (1970). The psychophysiological basis of introversion-extraversion. Behaviour Research and Therapy, 8(3),
Gray, J. A., & McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the function of the septo-hippocampal system. Oxford University Press.
Izadpanah, S., Schumacher, M., Bähr, A., Stopsack, M., Grabe, H. J., & Barnow, S. (2016). A 5-year longitudinal study of the adolescent reinforcement sensitivity as a risk factor for anxiety symptoms in adulthood: Investigating the indirect effect of cognitive emotion regulation. Personality and Individual Differences, 95,
Meyer T.J., Miller M.L., Metzger R.L., Borkovec T.D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28,
Shankman, S. A., Nelson, B. D., Sarapas, C., Robison-Andrew, E. J., Campbell, M. L., Altman, S. E., … Gorka, S. M. (2013). A psychophysiological investigation of threat and reward sensitivity in individuals with Panic Disorder and/or Major Depressive Disorder. Journal of Abnormal Psychology, 122(2), 322–338.