Startle Responses Differ in Those at Risk for Anxiety and Depression

One risk factor for the development of anxiety is the tendency for someone to respond anxiously to safe cues and dangerous cues similarly. Research has shown that some people exhibit elevated startle responses when presented with safe stimuli, but not when presented with overtly threatening stimuli. “These effects have been observed in individuals (across the age range) who have anxiety disorders, as well as in children and adolescents who are at risk for anxiety disorders,” said Michelle G. Craske of the Department of Psychology at the University of California, Los Angeles, and lead author of a recent study. Craske and her colleagues wanted to determine if this startle response (SR) could forecast anxiety in adolescents, and also wanted to ascertain if the degree of the startle response could disseminate between which young people were more likely to develop anxiety versus other mood problems, such as depression. “This is an important question given the high rate of comorbidity between anxiety and depression, and the continuing search for factors that are common to anxiety and depression as well as factors that are unique to each,” said Craske.

The researchers enlisted 132 adolescents from a larger study on youth emotional issues. They presented the teens with safe, followed by dangerous, scenarios and told them that they would receive a stimulus during the danger portion of the experiment, but administered the stimulus during the safe portion. Over the next four years, the team followed the teens to assess them for the development of mood problems or anxiety. “Elevated SRs during safe conditions, after delivery of an aversive stimulus, were predictive of the onset of anxiety disorders; no SR index was a statistically significant predictor of the onset of unipolar depressive disorders,” said the team. “These findings suggest that elevated responding in a safe condition of a threat paradigm is a marker of risk that is specific to first onset anxiety disorders.”

Craske, M. G., Wolitzky-Taylor, K. B., Mineka, S., Zinbarg, R., Waters, A. M., Vrshek-Schallhorn, S., Epstein, A., Naliboff, B., & Ornitz, E. (2011, October 10). Elevated Responding to Safe Conditions as a Specific Risk Factor for Anxiety Versus Depressive Disorders: Evidence From a Longitudinal Investigation. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0025738

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • jonah


    October 24th, 2011 at 4:28 PM

    This is quite curious that they respond like this to low level stress but those that you would think would indicate a higher level of a startle response did not produce as much anxiety.

  • Matt J

    Matt J

    October 25th, 2011 at 5:42 AM

    Startled response for a safe situation has ‘anxiety’ written all over it.The interesting thing to note here is how the reactions differed from the normal.

    While anxiety itself could be somewhat like the nature of a person,it could build upon someone through a past experience as well.

  • Roxanne


    October 25th, 2011 at 1:22 PM

    I hope that studies like this do pan out. There are too many children who have their young lives taken away from them because of habits that are formed early on in life. If we could get some kind of handle on what types of issues they may be facing later on in life then maybe they can get some help to ward off the worst of it.

  • Brad Cheney

    Brad Cheney

    October 26th, 2011 at 7:45 AM

    That’s interesting though not entirely unexpected. I would have imagined there would be a higher startle response in the subjects prone to anxiety anyway. People I know with anxiety issues are always on edge, even in what is to others a very ordinary and secure feeling environment.

  • G. Quinn

    G. Quinn

    October 26th, 2011 at 3:17 PM

    Of course the startle response was higher in the teens that would lean towards anxiety disorders in the safe stage! They weren’t expecting it to happen until the danger one so were unprepared, which of course was the plan from the start. I’d be startled too! Who ran that study, Captain Obvious?

  • Colin Welsh

    Colin Welsh

    October 26th, 2011 at 5:18 PM

    Is it just me or does it sound a little sadistic to be pulling a stunt like that on teens that have already been shown to have emotional issues like anxiety?

  • Grace Rowland

    Grace Rowland

    October 26th, 2011 at 6:17 PM

    @Colin Welsh: It’s a means to an end. Anything that can help predict what emotional issues teenagers will have going forward is a good thing in my opinion. You may not like the technique but in the end, the results did give us a genuine insight into how to handle these troubled children better and sooner in the best possible way.

    I would bet they volunteered too. I doubt any researcher had to hold a gun to their head to get them to participate.

  • dominique givens

    dominique givens

    October 28th, 2011 at 12:02 AM

    It’s not exactly a surprise that the depressed ones turned out to have no SR index. Speaking from my own experience I know when I’m depressed my thinking and reaction times appear to slow down. I wouldn’t have expected them to display the same reactions as an anxiety sufferer. Interesting study!

  • Alice


    September 14th, 2013 at 11:35 AM

    People have some misunderstandings of what this article says:

    @Colin Welsh, they were 132 kids from a study on youth emotional issues. That doesn’t mean they used kids with emotional issues. It only tells you what the study is about. If you look up the abstract, NONE of the kids had emotional issues. That is because it was a longitudinal study to observe a random group of healthy kids and see if anything would predict whether they went on to develop disorders later in life.

    @dominique givens, by “no SR index was a statistically significant predictor of the onset of unipolar depressive disorders,” they do not mean the kids who later went on to develop depression had no startle response at all. That would be a huge result. It would be the headline. They mean that high or low or medium, no particular type of startle response predicted depression. In other words, they could predict onset of anxiety, because those kids had a statistically “high” startle response. They couldn’t tell you anything about whether the kids will later get depression, because those kids’ startle responses were all over the map (which makes sense as some anxious people develop depression, as do some non-anxious people).

    That’s a helpful result, because as the researchers point out, they’re trying to figure out what is the same and different about depression and anxiety, to develop better treatment and prevention for both.

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