The LPP Indexes Baseline and Treatment-Related Changes in Anxiety Sensitivity

Development of neurophysiological treatment targets has been an important way to validate and advance treatment implementations. Anxiety Sensitivity (AS), described as a fear of fear, is one of the most well-researched transdiagnostic risk factors for psychopathology and has been demonstrated to be associated with a number of different INT symptoms and disorders, making it an ideal intervention target for treatment of anxiety and mood pathology. Currently, there exists a gap in terms of understanding underlying neural mechanisms of AS and treatment-related change in AS. The current study sought to examine the impact of 2 brief computerized interventions on AS in order to assess the P300 and late positive potential (LPP) event-related potential (ERP) components as an index of both baseline and treatment change in the transdiagnostic anxiety sensitivity construct. Participants received one of the following, with a 1-month follow-up: an anxiety reduction intervention of cognitive anxiety sensitivity treatment (CAST) alone, a mood intervention of cognitive bias modification interpretation (CBM-I), a combined CAST and CBM-I intervention, or a repeated contact control group. Baseline AS was significantly related to baseline P3/LPP, such that higher P3/LPP amplitude (heightened emotional reactivity) is associated with higher AS at intake. Further, treatment-related reductions in AS were associated with higher baseline reactivity: greater AS reductions at month one were associated with higher P3/LPP activity. Heightened emotional response was predictive of better treatment outcomes. Analyses also showed evidence for different mechanisms associated with CAST and CBM-I groups. Specifically, the CAST group evidenced predictions of treatment outcome in parietal areas, where the CBM-I group evidenced predictions in frontal areas. The Combined group evidenced both frontal and parietal activations, consistent with combining the effects from the CAST and CBM-I groups. These findings suggest that the P3/LPP is an index of cognitive-affective processes underlying AS at baseline and has predictive ability in assessing AS treatment outcome in that our observed treatment types engage different neural mechanisms.