Elevated responding to safe conditions as a specific risk factor for anxiety versus depressive disorders

Evidence from a longitudinal investigation

Michelle G. Craske*, Kate B. Wolitzky-Taylor, Susan Mineka, Richard Zinbarg, Allison M. Waters, Suzanne Vrshek-Schallhorn, Alyssa Epstein, Bruce Naliboff, Edward Ornitz

*Corresponding author for this work

Research output: Contribution to journalArticle

62 Citations (Scopus)


The current study evaluated the degree to which startle reflexes (SRs) in safe conditions versus danger conditions were predictive of the onset of anxiety disorders. Specificity of these effects to anxiety disorders was evaluated in comparison to unipolar depressive disorders and with consideration of level of neuroticism. A startle paradigm was administered at baseline to 132 nondisordered adolescents as part of a longitudinal study examining risk factors for emotional disorders. Participants underwent a repetition of eight safe-danger sequences and were told that delivery of an aversive stimulus leading to a muscle contraction of the arm would occur only in the late part of danger conditions. One aversive stimulus occurred midway in the safe-danger sequences. Participants were assessed for the onset of anxiety and unipolar depressive disorders annually over the next 3 to 4 years. Larger SR magnitude during safe conditions following delivery of the aversive stimulus predicted the subsequent first onset of anxiety disorders. Moreover, prediction of the onset of anxiety disorders remained significant above and beyond the effects of comorbid unipolar depression, neuroticism, and subjective ratings of intensity of the aversive stimulus. In sum, elevated responding to safe conditions following an aversive stimulus appears to be a specific, prospective risk factor for the first onset of anxiety disorders.

Original languageEnglish
Pages (from-to)315-324
Number of pages10
JournalJournal of Abnormal Psychology
Issue number2
Publication statusPublished - 2012
Externally publishedYes


  • Anxiety disorders
  • Depressive disorders
  • Emotional disorders
  • Risk factors
  • Startle response

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