Modeling anxiety in healthy humans: a key intermediate bridge between basic and clinical sciences

• Published in: Neuropsychopharmacology Vol. 44; no. 12; pp. 1999 - 2010
• Main Authors: Grillon, C, Robinson, OJ, Cornwell, B, Ernst, M
• Format: Journal Article
• Language: English
• Published: England Springer Science and Business Media LLC 01.11.2019; Nature Publishing Group; Springer International Publishing
• Subjects: Animal cognition; Animal models; Animals; Anxiety; Anxiety - physiopathology; Anxiety Disorders; Anxiety Disorders - physiopathology; Cognitive ability; Cognitive control; Disease Models, Animal; Experimental models of disease; Humans; Hypotheses; Models, Biological; Prefrontal cortex; Psychopathology; Psychopathology - methods; Research Design; Review; Translational Research, Biomedical; Translational Research, Biomedical - methods
• ISSN: 0893-133X; 1740-634X; 1740-634X
• DOI: 10.1038/s41386-019-0445-1

Animal models of anxiety disorders are important for elucidating neurobiological defense mechanisms. However, animal models are limited when it comes to understanding the more complex processes of anxiety that are unique to humans (e.g., worry) and to screen new treatments. In this review, we outline how the Experimental Psychopathology approach, based on experimental models of anxiety in healthy subjects, can mitigate these limitations and complement research in animals. Experimental psychopathology can bridge basic research in animals and clinical studies, as well as guide and constrain hypotheses about the nature of psychopathology, treatment mechanisms, and treatment targets. This review begins with a brief review of the strengths and limitations of animal models before discussing the need for human models of anxiety, which are especially necessary to probe higher-order cognitive processes. This can be accomplished by combining anxiety-induction procedures with tasks that probe clinically relevant processes to identify neurocircuits that are potentially altered by anxiety. The review then discusses the validity of experimental psychopathology and introduces a methodological approach consisting of five steps: (1) select anxiety-relevant cognitive or behavioral operations and associated tasks, (2) identify the underlying neurocircuits supporting these operations in healthy controls, 3) examine the impact of experimental anxiety on the targeted operations in healthy controls, (4) utilize findings from step 3 to generate hypotheses about neurocircuit dysfunction in anxious patients, and 5) evaluate treatment mechanisms and screen novel treatments. This is followed by two concrete illustrations of this approach and suggestions for future studies.