- Chicago, Illinois, United States
Stewart Shankman
University of Illinois at Chicago, Psychology, Faculty Member
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. Although panic disorder (PD) and post-traumatic stress disorder (PTSD) are characterized by heightened sensitivity to threat, no study to date has examined the effect of comorbid PD and PTSD on defensive responding. The present study... more
. Although panic disorder (PD) and post-traumatic stress disorder (PTSD) are characterized by heightened sensitivity to threat, no study to date has examined the effect of comorbid PD and PTSD on defensive responding. The present study probed startle eyeblink response to an acoustic probe in three groups of participants recruited from the community: (1) healthy individuals (n = 63), (2) individuals with PD without PTSD (n = 62), and (3) individuals with comorbid PD and PTSD (n = 24). Results indicated that PD individuals without PTSD exhibited greater sensitivity to threat relative to controls, and comorbid individuals displayed attenuated sensitivity to threat relative to PD individuals without PTSD (both ps < .05). The results are discussed in the context of the anxiety disorder spectrum, which postulates that anxiety disorders exist on a continuum spanning from specific/simple fear to broad distress, with defensive responding decreasing as distress increases.
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Research Interests: Psychology, Clinical Psychology, Cognitive Science, Psychometrics, Personality, and 15 morePersonality Assessment, Medicine, Anxiety, Humans, Major Depressive Disorder, Female, Male, Panic Disorder, Clinical Sciences, Middle Aged, Observer Variation, Adult, Anxiety Sensitivity, ANXIETY, and Negative affectivity
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Research Interests: Psychology, Abnormal Psychology, Clinical Psychology, Depression, Biomarkers, and 15 morePsychopathology, Electroencephalography, Medicine, Anxiety, Antisocial Personality Disorder, Humans, Major Depressive Disorder, Female, Male, Regression Analysis, Middle Aged, Adult, Biological markers, ANXIETY, and Case Control Studies
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In Section III of the DSM-5, the American Psychiatric Association (APA) proposes a pathological personality trait model of personality disorders. The recommended assessment instrument is the Personality Inventory for the DSM-5 (PID-5), an... more
In Section III of the DSM-5, the American Psychiatric Association (APA) proposes a pathological personality trait model of personality disorders. The recommended assessment instrument is the Personality Inventory for the DSM-5 (PID-5), an empirically derived scale that assesses personality pathology along five domains and 25 facets. Although the PID-5 demonstrates strong convergent validity with other personality measures, no study has examined whether it identifies traits that run in families, another important step toward validating the DSM-5's dimensional model. Using a family study method, we investigated familial associations of PID-5 domain and facet scores in 195 families, examining associations between parents and offspring and across siblings. The Psychoticism, Antagonism, and Detachment domains showed significant familial aggregation, as did facets of Negative Affect and Disinhibition. Results are discussed in the context of personality pathology and family study methodology. The results also help validate the PID-5, given the familial nature of personality traits.
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Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed... more
Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed patients with comorbid panic disorder were more likely to experience side effects than those without panic disorder. The study also examined whether greater burden of side effects predicted a poorer treatment course for patients with panic disorder than those without panic disorder. To examine the specificity of these effects, analyses also examined 2 other anxiety disorders-social phobia and generalized anxiety disorder (GAD). Between 2002 and 2006, a large sample (N = 808) of chronically depressed individuals (assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders [SCID-IV]) received antidepressants according to a predetermined algorithm for 12 weeks. Every 2 weeks, depressive symptoms (per the Hamilton Depression Rating Scale) and side effects (specific side effects as well as several indicators of side effect burden) were assessed. Lifetime diagnosis of panic disorder (assessed using the SCID-IV) at baseline was associated with higher likelihood of gastrointestinal (OR = 1.6 [95% CI, 1.0-2.6]), cardiac (OR = 1.8 [95% CI, 1.1-3.1]), neurologic (OR = 2.6 [95% CI, 1.6-4.2]), and genitourinary side effects (OR = 3.0 [95% CI, 1.7-5.3]) during treatment. Increases in side effect frequency, intensity, and impairment over time were more strongly associated with increases in depressive symptoms for patients with panic disorder compared to those without panic disorder. Neither social phobia nor GAD was associated with these effects. Potentially due to heightened interoceptive awareness of changes in their body, chronically depressed individuals with panic disorder may be at greater risk than those without panic disorder for antidepressant side effects and to experience a worsening of depressive symptoms as a result of these side effects over time. ClinicalTrials.gov identifier: NCT00057551.
Research Interests: Adolescent, Medicine, Comorbidity, Anxiety, Humans, and 15 moreAntidepressant, Female, Male, Panic Disorder, Aged, Middle Aged, Panic, Adult, Clinical Psychiatry, ANXIETY, Anxiety Disorder, Medical and Health Sciences, Antidepressive agents, Major Depressive Episode, and Outcome Assessment Health Care
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Numerous theoretical models suggest that inhibition difficulties—the inability to moderate automatic responses—contribute to the onset and/or maintenance of internalizing symptoms. Inhibition deficits and internalizing disorders run in... more
Numerous theoretical models suggest that inhibition difficulties—the inability to moderate automatic responses—contribute to the onset and/or maintenance of internalizing symptoms. Inhibition deficits and internalizing disorders run in families and share overlapping genetic risk factors, suggesting that inhibition deficits may be particularly prognostic of internalizing symptoms in those with high familial risk. This study tested this hypothesis in a longitudinal sample during the transition from adolescence to early adulthood. As hypothesized, prospective associations between inhibition and anxiety and depressive symptoms 8 years later were moderated by familial risk for depression. Specifically, poorer inhibition prospectively predicted greater anxiety and depressive symptoms in those at high (but not low) familial risk for major depressive disorder. These findings provide preliminary support for impaired inhibition as an indicator of risk for later internalizing symptoms in those...
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Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Twoprominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may... more
Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Twoprominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may lead to increased risk for suicide. Several laboratory studies examining the relationship between physiological habituation and suicide attempt history have yielded mixed results, potentially due to their use of broad measures of physiological arousal and/or focus on specific psychopathologies. However, no studies have examined the association between the time course (e.g., habituation, initial reactivity) of responding to aversiveness and NSSI, which may help to elucidate psychophysiological mechanisms of NSSI. Therefore, we examined habituation and initial reactivity to aversiveness (indexed by the time course of acoustic startle reflex, a well-validated measure of defensive responding) in three groups of young adult females – those with a history...
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BackgroundWhen sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals... more
BackgroundWhen sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals who exhibit heightened reactivity to U-threat at baseline are motivated to use alcohol as a means of avoidance-based coping, setting the stage for excessive drinking. To date, however, no study has attempted to characterize the dispositional nature of exaggerated reactivity to U-threat and test whether it is a vulnerability factor or exclusively a disease marker of problematic alcohol use.MethodThe current investigation utilized a family study design to address these gaps by examining whether (1) reactivity to U-threat is associated with risk for problematic alcohol use, defined by family history of alcohol use disorder (AUD) and (2) reactivity to U-threat is correlated amongst adult biological siblings. A total of 157 families, and 458 individuals...
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The startle reflex is a robust measure of defense system activation. Startle probes also elicit ERP P300 and N100 responses that capture attentional engagement. The startle probe-elicited P300 and N100 have been primarily examined during... more
The startle reflex is a robust measure of defense system activation. Startle probes also elicit ERP P300 and N100 responses that capture attentional engagement. The startle probe-elicited P300 and N100 have been primarily examined during affective picture viewing paradigms, and no study has examined these measures in the context of a threat anticipation task or in relation to threat predictability. In the present study, 131 participants completed a no (N), predictable (P), and unpredictable (U) threat-of-shock task, and the startle eye blink reflex, P300, and N100 responses to the startle probe were measured. We also examined several psychometric properties of these psychophysiological measures. Results indicated probe P300 attenuation during the P and U relative to N condition. In contrast, probe N100 enhancement was present only for the U condition. The P300 and N100 decreased (i.e., habituated) at comparable rates across the different threat conditions. The startle reflex also decreased, but only startle during the U (and not P) condition continued to differ from the N condition by the end of the task. Internal consistency of the ERP measures was acceptable and comparable to the startle reflex. Finally, the startle reflex was correlated with the probe N100, but not P300, across threat conditions. This study is one of the first to use startle probe ERPs to demonstrate that a context of potential threat also elicits attentional engagement. Furthermore, this study provides novel evidence that the probe N100 may provide a measure that is uniquely sensitive to unpredictable threat.
Research Interests: Psychology, Psychophysiology, Audiology, Attention, Adolescent, and 15 moreMedicine, Biological Sciences, Predictability, Startle Reflex, Evoked Potentials, Uncertainty, Humans, Female, Male, Young Adult, Electromyography, N, Blinking, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Psychology, Clinical Psychology, Psychophysiology, Personality, Psychopathology, and 15 moreElectroencephalography, Medicine, Emotions, Biological Sciences, Humans, Major Depressive Disorder, Female, Male, Panic Disorder, Middle Aged, Adult, Personality Pathology, Negative affectivity, Psychology and Cognitive Sciences, and Medical and Health Sciences
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BackgroundProspective studies are needed to assess the influence of pre-pandemic risk factors on mental health outcomes following the COVID-19 pandemic. From direct interviews prior to (T1), and then in the same individuals after the... more
BackgroundProspective studies are needed to assess the influence of pre-pandemic risk factors on mental health outcomes following the COVID-19 pandemic. From direct interviews prior to (T1), and then in the same individuals after the pandemic onset (T2), we assessed the influence of personal psychiatric history on changes in symptoms and wellbeing.MethodsTwo hundred and four (19–69 years/117 female) individuals from a multigenerational family study were followed clinically up to T1. Psychiatric symptom changes (T1-to-T2), their association with lifetime psychiatric history (no, only-past, and recent psychiatric history), and pandemic-specific worries were investigated.ResultsAt T2 relative to T1, participants with recent psychopathology (in the last 2 years) had significantly fewer depressive (mean, M = 41.7 v. 47.6) and traumatic symptoms (M = 6.6 v. 8.1, p < 0.001), while those with no and only-past psychiatric history had decreased wellbeing (M = 22.6 v. 25.0, p < 0.01). Th...
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Previous studies have shown that peer dysfunction in adolescence predicts depression in adulthood, even when controlling for certain individual- and/or family-level characteristics. However, these studies have not controlled for numerous... more
Previous studies have shown that peer dysfunction in adolescence predicts depression in adulthood, even when controlling for certain individual- and/or family-level characteristics. However, these studies have not controlled for numerous potential familial confounders, precluding causal inferences. The present study therefore used a sibling comparison design (i.e., comparing siblings within families) to test whether peer dysfunction (e.g., lack of friendships, victimization) in adolescence continues to predict depression in adulthood after accounting for unmeasured familial confounds and individual characteristics in adolescence. Participants’ (N=85) dysfunction with peers was assessed in adolescence (mean age=13.21, SD=3.47) by self- and parent-report, and adult depressive symptoms was assessed up to five times, up to 38 years later. Multilevel modeling was used to examine the effect of adolescent peer dysfunction on adult depressive symptoms after adjusting for familial confounds ...
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Background. Identifying risk markers for major depressive disorder (MDD) that persist into remission is key to address the high rates of recurrence in MDD. Central to MDD recurrence is the negative information processing bias, such as... more
Background. Identifying risk markers for major depressive disorder (MDD) that persist into remission is key to address the high rates of recurrence in MDD. Central to MDD recurrence is the negative information processing bias, such as heightened responses to errors, which may subsequently impair one’s ability to monitor performance and adjust behaviors based on environmental demands. However, little is known regarding the neurophysiological correlates of post-error adaptation in depression. Method. The current study comprehensively investigated event-related potentials (ERPs), theta power, and behavioral performance following errors from a flanker task in 103 participants with remitted MDD (rMDD) and 118 healthy controls (HC). Specifically, using trial-level data, we tested: (a) the immediate impact of errors on stimulus processing (N2 and theta power) and response (error-related negativity [ERN], correct response negativity, and theta power) of the following trial, and (b) longer-t...
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Repetitive negative thinking (RNT) is a transdiagnostic risk factor for internalizing psychopathology, and theoretical models suggest that RNT may maintain symptoms by interfering with psychophysiological habituation. The present study... more
Repetitive negative thinking (RNT) is a transdiagnostic risk factor for internalizing psychopathology, and theoretical models suggest that RNT may maintain symptoms by interfering with psychophysiological habituation. The present study therefore examined associations between RNT and habituation within and between study sessions. Community members (N=86) completed a habituation task involving exposure to acoustic probes at up to five sessions spaced seven days apart on average. Eyeblink startle response was measured using the electromyography startle magnitude. Self-reported anxiety was assessed before and after the habituation task at each session. Multilevel growth curve modeling indicated that RNT was associated with a higher ‘floor’ (i.e., asymptote) of startle responding as evidenced by reduced within-session startle habituation at later sessions. Results suggest that RNT may disrupt startle habituation and are consistent with theoretical models proposing that RNT sustains physi...
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Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies... more
Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies have been mixed. Predictability of threat, an important feature of threat processing, may have contributed to these mixed findings. Additionally, anxiety sensitivity, a dimensional trait associated with PD, may yield stronger associations with cognitive processes than categorical diagnoses of PD. In this study, 171 participants with PD and/or depression and healthy controls completed a task that differentiated anticipation of predictable vs. unpredictable shocks, while startle eyeblink and event-related potentials (ERPs [N100, P300]) were recorded. In all participants, relative to the control condition, probe N100 was enhanced to both predictable and unpredictable threat, whereas P300 suppression was unique to predictable threat. Probe N100, but not...
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Emotion-modulated startle is a frequently used method in affective science. Although there is a growing literature on the reliability of this measure, it is presently unclear how many startle responses are necessary to obtain a reliable... more
Emotion-modulated startle is a frequently used method in affective science. Although there is a growing literature on the reliability of this measure, it is presently unclear how many startle responses are necessary to obtain a reliable signal. The present study therefore evaluated the reliability of startle responding as a function of number of startle responses (NoS) during a widely used threat-of-shock paradigm, the NPU-threat task, in a clinical (N=205) and non-clinical (N=92) sample. In the clinical sample, internal consistency was also examined independently for healthy controls vs. those with panic disorder and/or major depression and retest reliability was assessed as a function of NoS. Although results varied somewhat by diagnosis and for retest reliability, the overall pattern of results suggested that six startle responses per condition were necessary to obtain acceptable reliability in clinical and non-clinical samples during this threat-of-shock paradigm in the present ...
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The popularity of network analysis in psychopathology research has increased exponentially in recent years. Yet, little research has examined the replicability of cross-sectional psychopathology network models, and those that have used... more
The popularity of network analysis in psychopathology research has increased exponentially in recent years. Yet, little research has examined the replicability of cross-sectional psychopathology network models, and those that have used single items for symptoms rather than multi-item scales. The present study therefore examined the replicability and generalizability of regularized partial correlation networks of internalizing symptoms within and across five samples (total N = 2,573) using the Inventory for Depression and Anxiety Symptoms, a factor analytically-derived measure of individual internalizing symptoms. As different metrics may yield different conclusions about the replicability of network parameters, we examined both global and specific metrics of similarity between networks. Correlations between network structures (.36-.84) and between centrality indices suggested moderate to strong similarities within and across networks. Furthermore, global strength (i.e., connectivity...
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Attentional bias to threat is a fundamental transdiagnostic component and potential vulnerability factor for internalizing psychopathologies. However, the measurement of attentional bias, such as traditional scores from the dot-probe... more
Attentional bias to threat is a fundamental transdiagnostic component and potential vulnerability factor for internalizing psychopathologies. However, the measurement of attentional bias, such as traditional scores from the dot-probe paradigm, evidence poor reliability and do not measure intra-individual variation in attentional bias. The present study examined, in three independent samples, the psychometric properties of a novel attentional bias (AB) scoring method of the dot-probe task based on responses to individual trials. For six AB scores derived using the response-based approach, we assessed the internal consistency, test–retest reliability, familial associations, and external validity (using Social Anxiety Disorder, a disorder strongly associated with attentional bias to threatening faces). Compared to traditional AB scores, response-based scores had generally better internal consistency (range of Cronbach’s alphas: 0.68–0.92 vs. 0.41–0.71), higher test–retest reliabilities (range of Pearson’s correlations: 0.26–0.77 vs. − 0.05 to 0.35), and were more strongly related in family members (range of ICCs: 0.11–0.27 vs. 0–0.05). Furthermore, three response-based scores added incremental validity beyond traditional scores and gender in the external validators of current and lifetime Social Anxiety Disorder. Findings indicate that response-based AB scores from the dot-probe task have better psychometric properties than traditional scores.
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The National Institutes of Mental Health’s Research Domain Criteria (RDoC) is a promising research initiative that emphasizes the use of biomarkers to advance assessment of internalizing psychopathology. However, despite exciting research... more
The National Institutes of Mental Health’s Research Domain Criteria (RDoC) is a promising research initiative that emphasizes the use of biomarkers to advance assessment of internalizing psychopathology. However, despite exciting research results, important ethical issues need to be taken into account for future research and policy endeavors involving biomarkers. The goal of this paper is to briefly draw awareness to several of these issues. Specifically, we discuss (1) potential implications of changing mental health classification in regards to the ongoing debate about diagnostic labels in mental health; (2) the general lack of standardization, normative data, and psychometrics (reliability and validity) of biomarker data; (3) the importance of demographic factors – in terms of moderating factors of the relationship between brain and behavior, and representation in biomarker research; and (4) the importance of increasing understanding of the temporal and contextual factors that af...
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Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed... more
Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed individuals, the present study tested in 68 non-depressed young adults whether three well-established risk factors for major depressive disorder (MDD) – (a) past episodes of MDD, (b) family history of MDD, and (c) reduced neurophysiological responses to reward – predicted mean levels, instability, or inertia (i.e., inflexibility) of positive affect (PA) and/or negative affect (NA). Momentary PA and NA were assessed up to 6 times per day for 14 days (mean number of surveys completed=45.89). MDD history and family history of MDD were assessed via semi-structured interview, and neurophysiological responses to reward were indexed using the Reward Positivity, an event-related potential related to depression. After adjusting for current depressive symptoms, resul...
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Asian Americans are one of the fastest growing minority groups in the United States; however, mental health within this population segment, particularly anxiety disorders, remains significantly understudied. Both the heterogeneity within... more
Asian Americans are one of the fastest growing minority groups in the United States; however, mental health within this population segment, particularly anxiety disorders, remains significantly understudied. Both the heterogeneity within the Asian American population and the multidimensional nature of anxiety contribute to difficulties in understanding anxiety in this population. The present paper reviewed two sources of heterogeneity within anxiety in Asian Americans: (1) cultural variables and (2) mechanisms or components of anxiety. Specifically, we examined four cultural variables most commonly found in research related to anxiety in Asian Americans: acculturation, loss of face, affect valuation, and individualism-collectivism. We also discussed ways to parse anxiety through a Research Domain Criteria (RDoC) framework, specifically focusing on sensitivity to acute and potential threat, constructs within the Negative Valence System. Previously unpublished preliminary data were pr...