{
  "abstract": "Background: As a key mechanism of disorder, clinical anxiety changes how a defensive motivation system functions in active threat coping contexts. Building on initial evidence that a lab-based escape/avoid preparation task is sensitive to disruptions in underlying defensive activation, current research moved toward implementation as a clinical assessment by testing if task responding predicts symptoms in anxiety treatment seekers. Methods: In our escape/avoid task, unpleasant images are shown after 5.5-second cues that indicate if the upcoming image can be prevented (avoid context), terminated after onset (escape context), or not controlled (no-control comparator). To assess defensive activation during response preparation/threat anticipation, a startle reflex indicator of such activation is probed during each cue. Guided by prior data, 125 individuals were classified into groups based on whether startle was enhanced 1) in a no-control, relative to avoid, context, and 2) in an escape, relative to avoid, context. To test clinical correlates, anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory), and worry (Penn State Worry Questionnaire) were then compared across response groups. Results: Anxiety and worry were higher in participants with enhanced no-control and escape startle than in participants with enhanced no-control but not escape startle. Further, depression was higher in participants with under-enhancement of no-control startle than other groups. Finally, when comparing startle-based profiles to canonical questionnaire cut-off score-based groups, ~54-63% convergence emerged. Conclusions: Defensive profiling in escape/avoid contexts shows promise as a prognostic indicator, but a need to continue improving is also indicated. Possibilities to improve predictiveness and reliability are discussed.",
  "abstract_shown": true,
  "affiliations": [
    "Medical University of South Carolina"
  ],
  "article_type": "New results",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "J. H. Gertler"
    },
    {
      "name": "C. Marsicano"
    },
    {
      "name": "M. S. George"
    },
    {
      "name": "L. M. McTeague"
    },
    {
      "affs": [
        0
      ],
      "name": "C. T. Sege"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aam97899x3a6k.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.16.751525",
  "fulltext_url": "https://www.biorxiv.org/content/10.64898/2026.09.16.751525v1.full",
  "id": "aam97899x3a6k",
  "issns": [],
  "landing_url": "https://www.biorxiv.org/content/10.64898/2026.09.16.751525v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "biorxiv",
      "neuroscience"
    ],
    [
      "openalex",
      "3205|Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes"
    ]
  ],
  "openalex": "W7214086173",
  "pdf_url": "https://www.biorxiv.org/content/10.64898/2026.09.16.751525v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-16",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/aam97899x3a6k.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:23:59Z",
      "native_id": "10.64898/2026.09.16.751525",
      "source": "biorxiv",
      "url": "https://www.biorxiv.org/content/10.64898/2026.09.16.751525v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "biorxiv:neuroscience",
      "subfield": "neuroscience"
    }
  ],
  "title": "Toward an Objective Assessment of Fight-or-Flight System Function in Anxiety Disorders: Startle Reflex Modulation in Threat Coping Contexts as a Candidate Neurophysiological Marker of Disrupted Defense System Operation",
  "title_text": "Toward an Objective Assessment of Fight-or-Flight System Function in Anxiety Disorders: Startle Reflex Modulation in Threat Coping Contexts as a Candidate Neurophysiological Marker of Disrupted Defense System Operation",
  "type": "preprint",
  "updated_at": "2026-10-30T12:23:59Z",
  "url": "https://research.draconitic.com/paper/aam97899x3a6k",
  "venue": "bioRxiv",
  "versions": []
}