Effects of verbal instructions and physical threat removal prior to extinction training on the return of conditioned fear

Abstract

Instructions given prior to extinction training facilitate the extinction of conditioned skin conductance (SCRs) and fear-potentiated startle responses (FPSs) and serve as laboratory models for cognitive interventions implemented in exposure-based treatments of pathological anxiety. Here, we investigated how instructions given prior to extinction training, with or without the additional removal of the electrode used to deliver the unconditioned stimulus (US), affect the return of fear assessed 24 hours later. We replicated previous instruction effects on extinction and added that the additional removal of the US electrode slightly enhanced facilitating effects on the extinction of conditioned FPSs. In contrast, extinction instructions hardly affected the return of conditioned fear responses. These findings suggest that instruction effects observed during extinction training do not extent to tests of return of fear 24 hours later which serve as laboratory models of relapse and improvement stability of exposure-based treatments.Exposure-based treatments of pathological anxiety, which involve confronting patients with their feared stimulus or situation until the fear response declines 1 , are considered as highly efficient 2 . However, about one third of patients undergoing exposure-based treatments may not experience a clinically relevant decline in their pathological anxiety 3 and another third may experience a relapse, i.e. a return of their pathological anxiety, within 10 years 4 . These findings highlight the relevance of determining factors that moderate both short-term and long-term outcomes of exposure-based treatments. Pavlovian fear conditioning paradigms allow for the investigation of the development, treatment and maintenance of fear under laboratory conditions and typically comprise several experimental phases 5 : During fear acquisition training, a previously unrelated stimulus (conditioned stimulus, CS) is presented together with an aversive event (unconditioned stimulus, US), acquires signal value for the US and eventually elicits a conditioned fear response (CR). During extinction training, the CS is presented without the US and the CR gradually declines which is why extinction procedures serve as a laboratory analogue for exposure-based treatments 6 . Subsequent retention tests which entail the re-exposure to the CS after experimental manipulations and/or a period of time are used to investigate the maintenance of the extinction memory trace. Thus, retention tests are used to model long-term stability of fear reduction and relapse after exposure-based treatments 7 .Verbal instructions about CS-US associations influence conditioned responding when given prior to acquisition training 8 as well as when given prior to extinction training 9 . Instructions given prior to extinction training serve as a laboratory analogue for cognitive interventions which often accompany exposure treatments, e.g., in form of guided threat reappraisal 10 . In general, instructions informing participants about the subsequen...

The more, the better: Auditory threat conditioning using multiple conditioned and unconditioned stimuli over many trials

“…This suggests that the valence differences elicited during learning did not (or at least not fully) extinguish during extinction training. This observation supports previous studies (Luck & Lipp, 2015a, 2015bWendt et al, 2020) which suggested the presence of independent processing systems where valence may reflect an evaluative process that is more difficult to extinguish, even when explicit extinction-supporting instructions are provided. Specifically, online conditioned valence ratings show resistance to extinction at the beginning of extinction training regardless of instruction type and even following removal of physical threat (Luck & Lipp, 2015a, 2015b.…”

“…However, the conditioned SCR and UCS expectancy diminish immediately if participants are instructed that the UCS will no longer be presented even when the device AUDITORY THREAT CONDITIONING 35 delivering the UCS (i.e., an electrode) is not removed. In contrast, the startle response diminishes at a slower rate compared to other measures (Sevenster et al, 2012), but physical removal of the UCS electrode facilitates its extinction (Wendt et al, 2020). According to Sevenster et al (2012), these observations fit within the dual-process framework of fear learning and suggest the involvement of separate cognitive and affective systems.…”

“…Specifically, online conditioned valence ratings show resistance to extinction at the beginning of extinction training regardless of instruction type and even following removal of physical threat (Luck & Lipp, 2015a, 2015b. When ratings are obtained offline and regardless of instruction type, CS+ trials are still perceived as less pleasant, although there is some evidence to suggest that this resistance may be more prominent when no instructions are delivered (Wendt et al, 2020).…”

“…Along with online (neuro)physiological measures of conditioning, behavioural CR indices are also commonly employed. These are typically obtained offline following conditioning and after extinction and include, but are not limited to, subjective ratings of valence and arousal (Bröckelmann et al, 2011;Gawronski & Mitchell, 2014;Glotzbach et al, 2012;Junghöfer et al, 2015;Reinhardt et al, 2010;Sehlmeyer et al, 2011;Steinberg et al, 2013;Wendt et al, 2020) as well as self-reported fear/anxiety (Abend et al, 2020;Glotzbach et al, 2012;Morriss et al, 2015). Following conditioning, such studies typically (but see, e.g., Bröckelmann et al, 2011) report that CS+ trials are perceived as more unpleasant, arousing or fear-inducing than CS-trials (Gawronski & Mitchell, 2014; 1 Trial subdivisions into FIR and SIR have been motivated by early work suggesting that multiple CRs reflecting different underlying processes may be observable within a trial (Prokasy & Ebel, 1967).…”

Improvements for Therapeutic Intervention from the Use of Web Applications and Machine Learning Techniques in Different Affectations in Children Aged 0–6 Years

“…This area of activity can be transferred to the context of precision psychology [ 8 ], which seeks patients’ characteristics that facilitate diagnosis via prediction [ 9 ] as well as the most effective therapeutic approach depending on the profiles found. Machine learning techniques are being used in interventions for phobias [ 10 ] and in depressive disorders [ 11 ], applying self-instructional therapies and personalized cognitive therapies [ 11 , 12 ]. In addition, these tools are beginning to be implemented in the field of early care for children with a variety of conditions [ 13 ].…”