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Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established treatment for the motor symptoms of Parkinson's disease (PD). While PD is primarily characterized by motor symptoms such as tremor, rigidity, and bradykinesia, it also involves a range of non-motor symptoms, and anxiety is one of the most common. The relationship between PD and anxiety is complex and can be a result of both pathological neural changes and the psychological and emotional impacts of living with a chronic progressive condition. Managing anxiety in PD is critical for improving the patients' quality of life. However, patients undergoing STN DBS can occasionally experience increased anxiety. Methods: This study investigates changes in risk-avoidant behavior following STN DBS in a pre-motor animal model of PD under chronic and acute unilateral high frequency stimulation. Results: No significant changes in risk-avoidant behaviors were observed in rats who underwent STN DBS compared with sham stimulation controls. Chronic stimulation prevented sensitization in the elevated zero maze. Conclusions: These results suggest that unilateral stimulation of the STN may have minimal effects on risk-avoidant behaviors in PD. However, additional research is required to fully understand the mechanisms responsible for changes in anxiety during STN DBS for PD. [ABSTRACT FROM AUTHOR]

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established treatment for the motor symptoms of Parkinson’s disease (PD). While PD is primarily characterized by motor symptoms such as tremor, rigidity, and bradykinesia, it also involves a range of non-motor symptoms, and anxiety is one of the most common. The relationship between PD and anxiety is complex and can be a result of both pathological neural changes and the psychological and emotional impacts of living with a chronic progressive condition. Managing anxiety in PD is critical for improving the patients’ quality of life. However, patients undergoing STN DBS can occasionally experience increased anxiety. Methods: This study investigates changes in risk-avoidant behavior following STN DBS in a pre-motor animal model of PD under chronic and acute unilateral high frequency stimulation. Results: No significant changes in risk-avoidant behaviors were observed in rats who underwent STN DBS compared with sham stimulation controls. Chronic stimulation prevented sensitization in the elevated zero maze. Conclusions: These results suggest that unilateral stimulation of the STN may have minimal effects on risk-avoidant behaviors in PD. However, additional research is required to fully understand the mechanisms responsible for changes in anxiety during STN DBS for PD.

A large body of work documents the utility of behavioral risk tasks for making inferences about adolescent risk-taking proclivities and related emotional and motivational correlates. Much less attention has been paid to risk-avoidance during adolescence. We provide validity data for a behavioral measure designed to assess avoidance, the Balloon Risk-Avoidance Task (BRAT). We examined avoidance in 127 youth, ages 10–17 (51% female, 68% Caucasian). Correlation analyses indicated significant positive associations between anxiety, fear, and BRAT avoidance behavior. Providing discriminant validity, avoidance on the BRAT was unrelated to depressive symptoms, depressed mood, or trait surgency (approach motivation). The BRAT was negatively associated with risk-taking behavior on the Balloon Analog Risk Task (BART). IQ and age were not associated with avoidance on the BRAT. We found that females showed significantly more avoidance behavior than males, but sex did not moderate the association between anxiety and avoidance. Cluster-based analyses revealed a subset of youth in mid-to-late adolescence showing significantly greater levels of avoidance behavior on the BRAT. These adolescents had higher levels of reported anxiety symptoms compared to individuals in mid-to-late who show lower levels of avoidance. Findings are discussed in terms of the clinical implications and the potential role that avoidance serves as both protective and risk factors in youth. [ABSTRACT FROM AUTHOR]

African elephants (Loxodonta africana) use many sensory modes to gather information about their environment, including the detection of seismic, or ground-based, vibrations. Seismic information is known to include elephant-generated signals, but also potentially encompasses biotic cues that are commonly referred to as 'noise'. To investigate seismic information transfer in elephants beyond communication, here we tested the hypothesis that wild elephants detect and discriminate between seismic vibrations that differ in their noise types, whether elephant- or human-generated. We played three types of seismic vibrations to elephants: seismic recordings of elephants (elephant-generated), white noise (human-generated) and a combined track (elephant- and human-generated). We found evidence of both detection of seismic noise and discrimination between the two treatments containing human-generated noise. In particular, we found evidence of retreat behaviour, where seismic tracks with human-generated noise caused elephants to move further away from the trial location. We conclude that seismic noise are cues that contain biologically relevant information for elephants that they can associate with risk. This expands our understanding of how elephants use seismic information, with implications for elephant sensory ecology and conservation management. [ABSTRACT FROM AUTHOR]

• Lack of epistemic trust is a key barrier in treatment of youth with enduring problems. • All participants experienced feelings of hopelessness due to the treatment process. • Crisis management in youth's high risk behavior leads to fragmented care. • Perceived accountability by practitioners increases pre-existing barriers. • Youth need to experience autonomy in treatment to regain trust despite their behavior. Youth with severe and enduring mental health problems (SEMHP) do not profit from regular child and adolescent psychiatric (CAP) treatment. Their changing and complex problems cause enormous suffering. To understand why these youth inadequately profit from CAP treatment, this qualitative study aimed to examine the experiences of youth with SEMHP, practitioners, and caregivers to identity barriers and facilitators in treatment. We conducted 31 semi-structured interviews with youth (n = 10), practitioners (n = 10), and caregivers of youth with SEMHP (n = 11). A thematic analysis was performed both deductively and inductively, and the perspectives of participants were compared. Results showed barriers and facilitators in five categories: before treatment, engagement and accountability, trust-based treatment, organization of care, and hopelessness. To restore epistemic trust, a shift from a risk-avoidance approach towards trust-based relationships in treatment is required. Additionally, organizing continuous and tailored care can prevent youth from slipping through the cracks of waiting lists and receiving inadequate treatment. [ABSTRACT FROM AUTHOR]

Loss aversion, a well-documented behavioral phenomenon, characterizes decisions under risk in adult populations. As such, loss aversion may provide a reliable measure of risky behavior. Surprisingly, little is known about loss aversion in adolescents, a group who manifests risk-taking behavior, or in anxiety disorders, which are associated with risk-avoidance. Finally, loss aversion is expected to be modulated by genotype, particularly the serotonin transporter (SERT) gene variant, based on its role in anxiety and impulsivity. This genetic modulation may also differ between anxious and healthy adolescents, given their distinct propensities for risk taking. The present work examines the modulation of loss aversion, an index of risk-taking, and reaction-time to decision, an index of impulsivity, by the serotonin-transporter-gene-linked polymorphisms (5HTTLPR) in healthy and clinically anxious adolescents. Findings show that loss aversion (1) does manifest in adolescents, (2) does not differ between healthy and clinically anxious participants, and (3), when stratified by SERT genotype, identifies a subset of anxious adolescents who are high SERT-expressers, and show excessively low loss-aversion and high impulsivity. This last finding may serve as preliminary evidence for 5HTTLPR as a risk factor for the development of comorbid disorders associated with risk-taking and impulsivity in clinically anxious adolescents.

Highlights: [•] Loss aversion is present in adolescents. [•] Levels of loss aversion are not modulated by clinical anxiety in adolescents. [•] The 5HTT gene modulates levels of loss aversion in clinically anxious patients. [•] A subset of anxious adolescents, high 5HTT-expressers, has low lambda and high impulsivity. [•] High 5HTT-expression may expose anxious patients to comorbid externalizing disorders. [Copyright &y& Elsevier]

Previous research on financial decision-making situations indicated that contextual aspects of financial information, such as framing, problem space and asset specificity influence the outcome. To assess the influence of these factors, an outsourcing task was used to survey the perceptions of accountants. The survey examined the effect of framing (positive/negative) with the inclusion of sunk and opportunity cost information across the decision task. The respondents were also presented with information regarding asset specificity - the extent to which assets are inexorably tied to the specific project or outsourcing agreement. In making the decision to outsource, the sunk cost effect, framing and asset specificity were found to be significant factors in influencing the decision outcome. The results however, were not fully consistent with the predictions of prospect theory in particular a reverse effect was found- in the negative frame, greater risk-avoidance was evident while in the positive frame, greater risk-taking was evident. [ABSTRACT FROM AUTHOR]

Abstract: It has been argued that individuals who are anxious are less likely and willing to take perceived risks across multiple behavioral domains (e.g., social, recreational, financial etc.), and that this bias is likely implicated in the etiology of pathological anxiety. While evidence is accumulating, there has been minimal research investigating the characteristics of risk-avoidance across anxiety disorders and across the specific risk-taking domains. The current study investigated risk-avoidance across domains in an anxious treatment-seeking sample. We hypothesized that: (i) individuals with anxiety would be more risk averse across domains relative to healthy controls; and, (ii) risk-avoidance would predict unique variance in anxiety symptoms, above and beyond other vulnerability factors (e.g., neuroticism). Individuals diagnosed with one or more anxiety disorders (n =67) completed measures of risk-taking, anxiety and depression symptoms, personality, and psychological distress. Healthy controls (n =58) completed measures of risk-taking and psychological distress. Results partially confirmed our hypotheses, demonstrating that anxious individuals were significantly more risk averse relative to controls across most domains, even after controlling for age and psychological distress. Furthermore, specific domains were found to account for unique variance in specific anxiety symptoms, as well as symptoms of depression. The results of this study provide novel evidence to suggest that risk-aversion is a possible transdiagnostic factor contributing to anxiety pathology. [Copyright &y& Elsevier]

Abstract: It has been proposed that a persistent and pervasive tendency to avoid risks is involved in the development and maintenance of clinically significant anxiety. Few studies, however, have examined the clinical implications of risk-aversion, and particularly the association between risk-aversion and treatment outcome. The current study investigated how risk-aversion in specific domains (Social and Recreational) related to treatment outcome in a clinical sample of patients with generalized anxiety disorder (GAD) undergoing internet-delivered cognitive-behavioral therapy (CBT). We hypothesized that: (i) risk-taking would increase as a result of treatment and (ii) risk-taking would mediate changes in symptom severity and impairment as a result of treatment. Individuals recruited online (N =44) meeting diagnostic criteria for GAD were randomized to the treatment (n =24) or control group (n =20). Participants completed measures of symptom severity, impairment and risk-taking before and after treatment. Results partially confirmed our hypotheses, demonstrating that participants in the treatment group significantly increased social and recreational risk-taking scores relative to the control group and risk-taking mediated treatment outcome for depression, but not for anxiety symptoms. The results of this study suggest that social and recreational risk-avoidance decreases following CBT treatment, and this change may mediate treatment outcome for depression. Clinical implications of these findings are discussed. [Copyright &y& Elsevier]

Abstract: Previous research suggests that the pervasive tendency to avoid perceived risks (i.e., the safety bias) may be implicated in the maintenance of pathological anxiety. These studies have not explored, however, the potential clinical implications of such a bias, such as the influence of risk aversion on treatment seeking. The aim of this study was to investigate how risk-avoidance is related to willingness to seek treatment in an online sample of clinically anxious individuals with social phobia (SP), obsessive–compulsive disorder (OCD) and generalized anxiety disorder (GAD). Healthy control participants (n =117) and those endorsing criteria for one or more anxiety disorder(s) (n =92; SP, n =33; OCD, n =19; GAD, n =40) were recruited from various online sources. Respondents completed an online survey comprised of a validated diagnostic interview, self-report measures assessing for symptom severity, risk-taking across various domains, a generalized index of risk-taking and treatment utilization. Consistent with hypotheses, SP and GAD individuals reported significantly more risk-avoidance when compared to non-clinical controls. Furthermore, willingness to seek treatment was found to be positively associated with social risk-taking and generalized risk-taking orientation in clinically anxious individuals who had never sought treatment. These results suggest that certain individual cognitive factors may contribute to the decision to seek treatment and may provide an interesting avenue of future investigation for increasing service utilization and treatment seeking in anxious populations. [Copyright &y& Elsevier]

Background: The pervasive tendency to avoid perceived risks has been recently implicated in the maintenance of anxiety pathology, and more specifically, social phobia. Social anxiety symptoms are thus hypothesised to be associated with a global risk-avoidant decision-making bias. Aim: This study investigated: (1) the relationship between risk-avoidance and social anxiety symptoms using both self-report and behavioural measures of risk-taking; and (2) whether risk-avoidance mediates the relationship between a dispositional vulnerability to anxiety (Behavioural Inhibition System [BIS] sensitivity) and social anxiety symptoms. Method: Fifty-five undergraduate students completed self-report measures assessing for social anxiety symptoms, risk-taking across various domains, and BIS sensitivity. Risk-avoidance was also assessed using a behavioural computer task. Results: As hypothesised, risk-avoidance correlated significantly with both social anxiety and BIS. Multiple regression analyses revealed that risk-avoidance served as a partial mediator between BIS and social anxiety. Conclusion: These results confirm the hypothesised relationship between BIS, risk-avoidance, and social anxiety symptoms. Risk-avoidance is one possible mechanism by which personality characteristics may be linked to anxiety pathology. [ABSTRACT FROM AUTHOR]

• Orexin/hypocretin neurons are activated by stress, and project brain-wide. • In the lateral hypothalamus, the orexin neurons activate GAD65 neurons that drive locomotion. • In the nucleus accumbens shell, the orexin neurons activate D2 neurons that drive risk avoidance. • Orexin neuron activation may be translated into different "mixes" of behaviours via downstream inhibitory gating. Survival-maximizing, well-timed actions are a key responsibility of the brain. Hypothalamic neurons containing neurotransmitters orexins/hypocretins are important players in this process. Individuals without orexin neurons display inappropriately-timed transitions between arousal states, and other behavioural abnormalities including increased risk-taking. Deciphering neural circuits through which orexin neurons control brain states and behavior thus illuminates brain mechanisms of context-appropriate actions. This review outlines and puts into broader context recent examples of orexin circuit analyses in the lateral hypothalamus (LH) and the nucleus accumbens (NAc), two brain regions clasically implicated in context-appropriate actions. In the LH, orexin neurons excite GAD65-expressing neurons. The LH(GAD65) neuron excitation induces elevated locomotor activity, while inhibition of LH(GAD65) neuron natural activity depresses voluntary locomotion. The orexin → LH(GAD65) circuit may therefore assist in creating the drive to run. In the NAc shell region, orexin axons excite D2 neurons (dopamine-inhibited neurons expressing dopamine type-2 receptor). NAc(D2) cell activation increases risk-avoidance behaviors, while NAc(D2) cell inhibition reduces risk-avoidance. The excitatory orexin → NAc(D2) circuit may thus assist in reducing risk-taking, and oppose the inhibitory VTA(dopamine) → NAc(D2) circuit during computation of risk appetite. Neural computation in these local and long-range orexin circuits may thus assist in generating risk-avoiding locomotor responses to stressors known to activate orexin neurons, such as body energy depletion or potential external threats. A model is proposed where orexin-opposing, inhibitory inputs acting on the orexin target neurons may context-specifically channel orexin-induced brain excitation towards particular sets of actions. [ABSTRACT FROM AUTHOR]