Threat-sensitivity in affective disorders: A case-control study.

Background: Anxiety disorders are highly comorbid with major depression but differ in their symptom profiles and pharmacological responses. Threat-sensitivity may explain such differences, yet research on its relationship to specific disorders is lacking.

Methods: One-hundred patients (71 women) and 35 healthy controls (23 women) were recruited. Thirty-five had Panic Disorder (PD), 32 had Generalized Anxiety Disorder (GAD) and 33 Major Depressive Disorder (MDD). Threat-sensitivity was measured via behaviour (Joystick Operated Runway Task; JORT) and self-report (Fear Survey Schedule; FSS).

Results: Behavioural sensitivity to simple threat was higher in females compared to males (p = .03). Self-reported sensitivity to simple threat (FSS Tissue Damage Fear) was higher in PD patients compared to other groups (p ≤ .007) and in GAD patients compared to controls (p = .02). Behavioural sensitivity to complex threat was higher in females than males (p = .03) and a group by sex interaction (p = .01) indicated that this difference was largest in PD patients. Self-reported sensitivity to complex threat (FSS Social Fear) was higher in all patients compared to controls (p ≤ .001). Females scored higher than males on FSS Tissue Damage Fear and FSS Social Fear).

Conclusions: Our findings oppose the simple/complex threat dichotomy, instead suggesting elevated sensitivity to physical threat differentiates anxiety disorders from MDD, whereas elevated sensitivity to social threat is associated with both anxiety disorders and MDD.