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21. Neural representations for top-down facilitation of threat perception in anxiety
Anxiety is characterized by the anticipation of future threats. However, our understanding of threat-related perceptual biases in anxiety, and the underlying neurobiology, is largely based on neural processing of acute or present threat. Consistent with the predictive coding framework, the current study examined how individuals with clinical anxiety (Generalized Anxiety Disorder, Social Anxiety Disorder, or Panic Disorder diagnoses; N=26) use prior knowledge of threat in a “top-down” manner to detect threatening targets compared to individuals without anxiety (N=25). Participants completed a perceptual decision-making task in which threatening or neutral cues were used to identify subsequently presented fearful and neutral faces. Threatening cues led to faster (p<.001) and more precise (p<.01) perceptual decisions compared to neutral cues. Functional magnetic resonance imaging results showed that for the clinically anxious group, threatening (vs neutral) cues led to differential neural activity while processing threatening (vs neutral) faces in the superior temporal sulcus (involved in processing emotional expressions) and ventromedial prefrontal cortex (involved in maintaining prestimulus representations; small volume corrected for multiple comparisons). Present results evidence neural mechanisms by which prior knowledge regarding threat influences perception in anxiety, allowing for more comprehensive and ecologically valid models that emphasize top-down factors in perceptual decision-making.