ImportanceThe brain enters distinct activation states to support differential cognitive and emotional processes, but little is known about how brain activation states differ in youths with clinical anxiety.ObjectiveTo characterize brain activation states during socioemotional processing (movie stimuli) and assess associations between state characteristics and movie features and anxiety symptoms.Design, Setting, and ParticipantsThe Healthy Brain Network is an ongoing cross-sectional study of individuals aged 5 to 21 years experiencing difficulties in school, of whom approximately 45% met criteria for a lifetime anxiety disorder diagnosis. Data used in this study are from the first 9 releases (collected in a nonclinical research setting in the New York City metropolitan area from 2015 to 2020) and include 620 youths aged 5 to 15 years (53% of whom met criteria for a lifetime anxiety disorder diagnosis) who watched an emotional video during functional magnetic resonance imaging and completed questionnaires and clinical evaluation. Of those with functional magnetic resonance imaging data, 432 youths aged 7 to 15 years also self-reported on anxiety symptoms. Data were processed and analyzed between February 2020 and August 2024.Main Outcomes and MeasuresA hidden Markov model was trained to identify brain activation states across participants during video watching. Time spent in each state and the moment-to-moment probability of being in each state were extracted. Videos were annotated for emotion-specific and nonspecific information using the EmoCodes system. Self-reported anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Time spent in each state across the video and during and outside of peaks in negative content correlated with generalized and social anxiety scores.ResultsAmong the 620 youths in the overall analysis, 369 were male and the mean (SD) age was 10.4 (2.8) years. In the anxiety symptom analysis, 263 of 432 youths were male and the mean (SD) age was 11.5 (2.2) years. Three brain activation states were identified: a high somatomotor activation state (state 1), a high cingulo-opercular network activation state (state 2), and a high ventral attention and default mode state (state 3). The probability of being in state 3 was correlated with video content that was more negative, quieter, and with less visual motion (ρ < 0.08; P < .001). Increased generalized anxiety was associated with greater time in state 3 (B, 0.10; 95% CI, 0.01 to 0.20; false discovery rate [FDR]–corrected P = .048) and less time in state 2 (B, −0.11; 95% CI, −0.21 to −0.02; FDR-corrected P = .048) when negative social cues were present.Conclusions and RelevanceYouths entered 3 distinct brain activation states during movie watching, and youths with anxiety spent more time in a state with high ventral attention and default activation during negative socioemotional processing. Youths high in generalized anxiety may be more engaged in deeply processing negative emotional content, which may influence self-regulation. Interventions that focus on changing physiological and psychological state during negative social interactions in youths with anxiety should be considered.

中文翻译：

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青年在社会情感处理过程中的广泛性焦虑和大脑激活状态


重要性大脑进入不同的激活状态以支持不同的认知和情绪过程，但对于患有临床焦虑的青少年的大脑激活状态有何不同知之甚少。目的描述社会情感处理 （电影刺激） 过程中的大脑激活状态，并评估状态特征与电影特征和焦虑症状之间的关联。设计、设置和参与者健康大脑网络是一项正在进行的横断面研究，对象是 5 至 21 岁在学校遇到困难的个体，其中大约 45% 的人符合终生焦虑症诊断的标准。本研究中使用的数据来自前 9 个版本（从 2015 年到 2020 年在纽约市大都会区的非临床研究环境中收集），包括 620 名 5 至 15 岁的青少年（其中 53% 符合终生焦虑症诊断标准），他们在功能性磁共振成像期间观看了情感视频并完成了问卷调查和临床评估。在拥有功能性磁共振成像数据的人中，432 名 7 至 15 岁的青少年也自我报告了焦虑症状。在 2020 年 2 月至 2024 年 8 月期间对数据进行了处理和分析。主要结果和措施训练了一个隐藏的马尔可夫模型，以识别参与者在观看视频期间的大脑激活状态。提取了在每种状态下花费的时间以及处于每种状态的瞬间概率。使用 EmoCodes 系统对视频进行情感特定和非特定信息的注释。使用儿童焦虑相关障碍筛查评估自我报告的焦虑症状。 在整个视频中，以及负面内容高峰期间和之外，在每种状态下花费的时间与广义和社交焦虑分数相关。结果在总体分析的 620 名青少年中，男性 369 名，平均 （SD） 年龄为 10.4 （2.8） 岁。在焦虑症状分析中，432 名青年中有 263 名是男性，平均 （SD） 年龄为 11.5 （2.2） 岁。确定了三种大脑激活状态：高躯体运动激活状态（状态 1）、高扣带鳃盖网络激活状态（状态 2）和高腹侧注意力和默认模式状态（状态 3）。处于状态 3 的概率与更消极、更安静且视觉运动较少的视频内容相关 （ρ < 0.08;P < .001）。广泛性焦虑增加与状态 3 的时间较长相关 （B， 0.10;95% CI， 0.01 至 0.20;错误发现率 [FDR] – 校正后的 P = .048） 和状态 2 的时间较短 （B， -0.11;95% CI， -0.21 至 -0.02;FDR 校正的 P = .048）。结论和相关性青少年在看电影时进入 3 种不同的大脑激活状态，焦虑青少年在消极社会情绪处理过程中处于高度腹侧注意力和默认激活状态的时间更多。广泛性焦虑高度的青少年可能更深入地处理负面情绪内容，这可能会影响自我调节。应考虑关注在焦虑青少年消极社交互动期间改变生理和心理状态的干预措施。