, 2004). A more direct human analog has been provided by Kerr et al. (2012). These investigators reasoned that the anxious anticipation of negative events is a key factor in psychiatric disorders, and that perhaps the perceived controllability of the anticipated event is a major factor that modulates the degree of anxiety experienced. Furthermore, based on the animal work reviewed above, they suspected that the vmPFC might be engaged by control and inhibit amygdala activity in top–down fashion. Their subjects were snake phobics and were exposed to both snake and neutral fish videos. Stimulus checks confirmed

that the snake videos were indeed highly aversive for these subjects, and Alectinib the fish videos were not. Each trial began

with an anticipation period of variable duration in which a cue signaled that a snake video or a fish video might follow in that trial. A second cue indicated that the participant would have control over whether the video (either snake or fish) would occur on that trial, or would not have control on that trial. Then, after a variable period of time, a response target occurred and the subject was instructed to press it as rapidly as possible. The video or a fixation point then appeared. On a controllable trial subjects were told that if they responded fast enough the fixation point rather than the video would appear, but if they were too slow they would see the video. MK-8776 On uncontrollable trials the subjects were told that regardless of how fast they pressed, the video and the fixation point would each occur half the time, but were asked to press as fast as

possible anyway. In actuality, the speed required also on controllable trials was adjusted so that the subjects succeeded about half the time in avoiding the video, and the actual frequencies on the uncontrollable trials was equated to this frequency. Thus, the controllable and uncontrollable trails were accurately yoked, as in animal studies. Importantly, questionnaire data indicated that the subjects perceived the controllable trials as controllable and the uncontrollable trials as uncontrollable. A variety of results were obtained, but most important here, there was one condition that selectively engaged fMRI vmPFC activity—snake controllable trials. Control did not increase vmPFC activity on neutral fish trials, even though the subjects pressed. vmPFC activity was higher on snake controllable trials than in any of the other conditions. Finally, there was a negative relationship between vmPFC and amygdala activity on snake trials. These findings provide strong support for generalizing the animal data reviewed above to humans. One of the more surprising results in our animal work was that the experience of control over a stressor is not just neutral with regard to later fear conditioning, but rather retards conditioning and facilitates extinction. Hartley et al. (2014) have very recently reported a direct human verification.