Cognitive-behavioral therapy (CBT), a first-line treatment for pediatric anxiety disorders, is based on principles of threat learning and extinction. However, CBT does not work sufficiently for up to 40% of clinically anxious youth. The neural and behavioral correlates of conditioned inhibition might provide promising targets for attempts to improve CBT response. During conditioned inhibition, threat and safety cues appear together, forming a safety compound. Here, we test whether this safety compound elicits a reduced fear response compared to pairing the threat cue with a novel cue (novel compound). The current pilot study compares behavioral, physiological, and neural correlates of conditioned inhibition between children with (n = 17, M_age = 13.09, SD = 3.05) and without (n = 18, M_age = 14.49, SD = 2.38) anxiety disorders. Behavioral and physiological measures did not differ between children with and without anxiety disorders during fear acquisition. During testing, children with anxiety disorders showed overall higher skin conductance response and expected to hear the aversive sound following the novel compound more often than children without anxiety disorders. Children with anxiety disorders showed more activity in the right ventromedial prefrontal cortex (vmPFC) to the safety versus novel compound. Children without anxiety disorders showed the opposite pattern – more right vmPFC activity to the novel versus safety compound (F(1,31) = 5.40, p = 0.03). No group differences manifested within the amygdala, dorsal anterior cingulate cortex, or hippocampus. These pilot findings suggest a feasible approach for examining conditioned inhibition in pediatric anxiety disorders. If replicated in larger samples, findings may implicate perturbed conditioned inhibition in pediatric anxiety disorders and provide targets for CBT.

认知行为疗法 (CBT) 是儿科焦虑症的一线治疗方法，它基于威胁学习和消退的原则。然而，对于多达 40% 的临床焦虑青年来说，CBT 并不能充分发挥作用。条件抑制的神经和行为相关性可能为改善 CBT 反应的尝试提供有希望的目标。在条件抑制期间，威胁和安全提示一起出现，形成一种安全化合物。在这里，我们测试了与将威胁提示与新提示（新化合物）配对相比，这种安全化合物是否会引起减少的恐惧反应。目前的试点研究比较了（n = 17，M_年龄 = 13.09，SD ）儿童之间条件抑制的行为、生理和神经相关性 = 3.05）和没有（n = 18，M_年龄 = 14.49，SD  = 2.38）焦虑症。在恐惧获得过程中，有和没有焦虑症的儿童的行为和生理指标没有差异。在测试期间，与没有焦虑症的儿童相比，患有焦虑症的儿童表现出总体上更高的皮肤电导反应，并且预计会更频繁地听到新化合物后的厌恶声音。与新型化合物相比，患有焦虑症的儿童在右侧腹内侧前额叶皮层 (vmPFC) 中表现出更多的安全性。没有焦虑症的儿童表现出相反的模式——新化合物与安全化合物相比，vmPFC 活性更高 ( F (1,31) = 5.40, p = 0.03)。在杏仁核、背侧前扣带皮层或海马体中没有表现出组间差异。这些初步研究结果提出了一种可行的方法来检查小儿焦虑症的条件抑制。如果在更大的样本中重复，这些发现可能暗示儿科焦虑症中的条件抑制受到干扰，并为 CBT 提供了目标。