To cope with anxiety, use ‘safety signals’

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There could be a new way to combat anxiety: When life triggers excessive fear, use a safety signal, researchers say.

For as many as one in three people, life events or situations that pose no real danger can spark a disabling fear, a hallmark of anxiety and stress-related disorders. Cognitive behavioral therapy and antidepressants help about half the people suffering from anxiety, but millions of others do not find sufficient relief from existing therapies.

In humans and in mice, a symbol or a sound that is never associated with adverse events can relieve anxiety through an entirely different brain network than that activated by existing behavioral therapy, the researchers write in their study.

“A safety signal could be a musical piece, a person, or even an item like a stuffed animal that represents the absence of threat,” says co-first author Paola Odriozola, a PhD candidate in psychology at Yale University.

The approach differs from behavioral therapy, which slowly exposes patients to the source of their fear, such as spiders, until a patient learns that spiders do not represent a significant threat and anxiety is decreased. And for many people, exposure-based therapy does not truly help.

The new study may explain why.

In the new research, researchers conditioned subjects to associate one shape with a threatening outcome and a different shape with a non-threatening outcome. (In mice, researchers used tones in the conditioning instead of shapes.) The shape associated with threat alone was presented to subjects, and later subjects viewed both threatening and non-threatening shape together. Adding the second, non-threatening shape—the safety signal—suppressed the subjects’ fear compared to the response to the threat-related shape alone.

Brain imaging studies of both human and mice subjects presented with the signals showed this approach activated a different neural network than exposure therapy, suggesting safety signaling might be an effective way to augment current therapies.

“Exposure-based therapy relies on fear extinction, and although a safety memory is formed during therapy, it is always competing with the previous threat memory,” explains co-senior author Dylan Gee, assistant professor of psychology. “This competition makes current therapies subject to the relapse of fear—but there is never a threat memory associated with safety signals.”

Gee stressed that the need for alternatives for those suffering from anxiety-related disorders is great.

“Both cognitive behavioral therapy and antidepressants can be highly effective, but a substantial part of the population does not benefit sufficiently, or the benefits they experience don’t hold up in the longer term,” she says.

The study will appear in Proceedings of the National Academy of Sciences. Additional coauthors are from Weill Cornell Medicine.

Funding for the work came from the National Institutes of Health, the Brain & Behavior Research Foundation, the Jacobs Foundation, the Pritzker Neuropsychiatric Disorders Research Consortium, the New York-Presbyterian Youth Anxiety Center, the Dr. Mortimer D. Sackler family, the DeWitt-Wallace Fund of the New York Community Trust, and the National Science Foundation.

Source: Yale University