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Zhou X, Xiao Q, Liu Y, Chen S, Xu X, Zhang Z, Hong Y, Shao J, Chen Y, Chen Y, Wang L, Yang F, Tu J. Astrocyte-mediated regulation of BLA WFS1 neurons alleviates risk-assessment deficits in DISC1-N mice. Neuron 2024; 112:2197-2217.e7. [PMID: 38642554 DOI: 10.1016/j.neuron.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/10/2024] [Accepted: 03/27/2024] [Indexed: 04/22/2024]
Abstract
Assessing and responding to threats is vital in everyday life. Unfortunately, many mental illnesses involve impaired risk assessment, affecting patients, families, and society. The brain processes behind these behaviors are not well understood. We developed a transgenic mouse model (disrupted-in-schizophrenia 1 [DISC1]-N) with a disrupted avoidance response in risky settings. Our study utilized single-nucleus RNA sequencing and path-clamp coupling with real-time RT-PCR to uncover a previously undescribed group of glutamatergic neurons in the basolateral amygdala (BLA) marked by Wolfram syndrome 1 (WFS1) expression, whose activity is modulated by adjacent astrocytes. These neurons in DISC1-N mice exhibited diminished firing ability and impaired communication with the astrocytes. Remarkably, optogenetic activation of these astrocytes reinstated neuronal excitability via D-serine acting on BLAWFS1 neurons' NMDA receptors, leading to improved risk-assessment behavior in the DISC1-N mice. Our findings point to BLA astrocytes as a promising target for treating risk-assessment dysfunctions in mental disorders.
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Affiliation(s)
- Xinyi Zhou
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Department of Neurology, The Second Clinical Medical College, Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China; The First Affiliated Hospital, Jinan University, Guangzhou 510632, China
| | - Qian Xiao
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yaohui Liu
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shandong Provincial Key Laboratory of Animal Resistance Biology, College of Life Sciences, Shandong Normal University, No. 88 East Wenhua Road, Jinan 250014, China
| | - Shuai Chen
- University of Chinese of Academy of Sciences, Beijing 100049, China
| | - Xirong Xu
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China
| | - Zhigang Zhang
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yuchuan Hong
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China
| | - Jie Shao
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Department of Neurology, The Second Clinical Medical College, Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China; The First Affiliated Hospital, Jinan University, Guangzhou 510632, China
| | - Yuewen Chen
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yu Chen
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Liping Wang
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Fan Yang
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Jie Tu
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; University of Chinese of Academy of Sciences, Beijing 100049, China; Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
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Boschet-Lange JM, Scherbaum S, Pittig A. Temporal dynamics of costly avoidance in naturalistic fears: Evidence for sequential-sampling of fear and reward information. J Anxiety Disord 2024; 103:102844. [PMID: 38428276 DOI: 10.1016/j.janxdis.2024.102844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/24/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
Excessive avoidance is characteristic for anxiety disorders, even when approach would lead to positive outcomes. The process of how such approach-avoidance conflicts are resolved is not sufficiently understood. We examined the temporal dynamics of approach-avoidance in intense fear of spiders. Highly fearful and non-fearful participants chose repeatedly between a fixed no spider/low reward and a spider/high reward option with varying fear (probability of spider presentation) and reward information (reward magnitude). By sequentially presenting fear and reward information, we distinguished whether decisions are dynamically driven by both information (sequential-sampling) or whether the impact of fear information is inhibited (cognitive control). Mouse movements were recorded to assess temporal decision dynamics (i.e., how strongly which information impacts decision preference at which timepoint). Highly fearful participants showed stronger avoidance despite lower gains (i.e., costly avoidance). Time-continuous multiple regression of their mouse movements yielded a stronger impact of fear compared to reward information. Importantly, presenting either information first (fear or reward) enhanced its impact during the early decision process. These findings support sequential sampling of fear and reward information, but not inhibitory control. Hence, pathological avoidance may be characterized by biased evidence accumulation rather than altered cognitive control.
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Affiliation(s)
- Juliane M Boschet-Lange
- University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstraße 9-11, 97070 Würzburg, Germany
| | - Stefan Scherbaum
- Technische Universität Dresden, Department of Psychology, Dresden, Germany
| | - Andre Pittig
- University of Göttingen, Institute of Psychology, Translational Psychotherapy, Göttingen, Germany.
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Subhani M, Talat U, Knight H, Morling JR, Jones KA, Aithal GP, Ryder SD, Rennick-Egglestone S. Application and Extension of the Alcohol Recovery Narratives Conceptual Framework. QUALITATIVE HEALTH RESEARCH 2023; 33:1203-1217. [PMID: 37683106 PMCID: PMC10626984 DOI: 10.1177/10497323231197384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Recovery narratives are personal stories of health problems and recovery. A systematic review proposed a conceptual framework characterising alcohol misuse recovery narratives, consisting of eight principal dimensions, each with types and subtypes. The current study aims to apply and extend this preliminary conceptual framework. Semi-structured interviews were conducted to collect alcohol misuse recovery narratives from adult participants. A two-stage inductive and deductive thematic analysis approach was used to assess the relevance of the dimensions and types included in the preliminary conceptual framework and identify new components. The sample consisted of 11 participants from diverse socioeconomic backgrounds who had previously displayed varying degrees of alcohol misuse. All conceptual framework dimensions (genre, identity, recovery setting, drinking trajectories, drinking behaviours and traits, stages, spirituality and religion, and recovery experience) were present in the collected narratives. Three dimensions were extended by adding types and subtypes. Whilst the existing conceptual framework fitted the collected narratives, a new dimension describing the alcohol environment was required to fully characterise narratives. Types included in the alcohol environment dimension were policy and practice and social dynamics. The extended framework could guide the production of resources enabling clinicians to engage with narratives shared by their clients.
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Affiliation(s)
- Mohsan Subhani
- Nottingham Digestive Diseases Biomedical Research Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Usman Talat
- Alliance Manchester Business School, University of Manchester, Manchester, UK
| | - Holly Knight
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Joanne R. Morling
- Nottingham Digestive Diseases Biomedical Research Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Katy A. Jones
- School of Medicine, Applied Psychology, University of Nottingham, Nottingham, UK
| | - Guruprasad P. Aithal
- Nottingham Digestive Diseases Biomedical Research Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Stephen D. Ryder
- Nottingham Digestive Diseases Biomedical Research Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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Abend R. Understanding anxiety symptoms as aberrant defensive responding along the threat imminence continuum. Neurosci Biobehav Rev 2023; 152:105305. [PMID: 37414377 PMCID: PMC10528507 DOI: 10.1016/j.neubiorev.2023.105305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
Threat-anticipatory defensive responses have evolved to promote survival in a dynamic world. While inherently adaptive, aberrant expression of defensive responses to potential threat could manifest as pathological anxiety, which is prevalent, impairing, and associated with adverse outcomes. Extensive translational neuroscience research indicates that normative defensive responses are organized by threat imminence, such that distinct response patterns are observed in each phase of threat encounter and orchestrated by partially conserved neural circuitry. Anxiety symptoms, such as excessive and pervasive worry, physiological arousal, and avoidance behavior, may reflect aberrant expression of otherwise normative defensive responses, and therefore follow the same imminence-based organization. Here, empirical evidence linking aberrant expression of specific, imminence-dependent defensive responding to distinct anxiety symptoms is reviewed, and plausible contributing neural circuitry is highlighted. Drawing from translational and clinical research, the proposed framework informs our understanding of pathological anxiety by grounding anxiety symptoms in conserved psychobiological mechanisms. Potential implications for research and treatment are discussed.
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Affiliation(s)
- Rany Abend
- School of Psychology, Reichman University, P.O. Box 167, Herzliya 4610101, Israel; Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
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Spix M, Melles H, Jansen A. From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears. Behav Sci (Basel) 2023; 13:574. [PMID: 37504021 PMCID: PMC10376478 DOI: 10.3390/bs13070574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
When evaluating ambiguous situations, humans sometimes use their behavior as a source of information (behavior-as-information effect) and interpret safety behaviors as evidence for danger. Accordingly, we hypothesized that eating disorder safety behaviors (restrictive eating, body checking, etc.) might aggravate fear and anxiety in individuals with an eating disorder. The present study tested to what extent eating disorder safety behaviors increase threat perception in individuals with and without an eating disorder. For this, 108 individuals with a self-reported eating disorder diagnosis and 82 healthy controls rated the dangerousness of several short situations. The situations systematically varied in the presence of eating disorder safety behaviors and danger information. As expected, all participants perceived situations in which the protagonist executed an eating disorder safety behavior as more threatening than situations without a safety behavior. This 'behavior-as-information' effect was equally strong in individuals with and without an eating disorder. Additionally, safety behaviors strengthened threat perception more in safe situations than in dangerous situations. To conclude, the presence of eating disorder safety behavior can increase threat perception regardless of whether individuals have an eating disorder or not. This makes eating disorder safety behaviors a potential risk factor for the development and maintenance of eating disorder fears.
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Affiliation(s)
- Michelle Spix
- Department of Clinical Psychological Science, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Hanna Melles
- Department of Clinical Psychological Science, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Anita Jansen
- Department of Clinical Psychological Science, Maastricht University, 6229 ER Maastricht, The Netherlands
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Martínez-Rivera FJ, Pérez-Torres J, Velázquez-Díaz CD, Sánchez-Navarro MJ, Huertas-Pérez CI, Diehl MM, Phillips ML, Haber SN, Quirk GJ. A Novel Insular/Orbital-Prelimbic Circuit That Prevents Persistent Avoidance in a Rodent Model of Compulsive Behavior. Biol Psychiatry 2023; 93:1000-1009. [PMID: 35491274 DOI: 10.1016/j.biopsych.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/24/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND A common symptom of obsessive-compulsive disorder is the persistent avoidance of cues incorrectly associated with negative outcomes. This maladaptation becomes increasingly evident as subjects fail to respond to extinction-based treatments such as exposure-with-response prevention therapy. While previous studies have highlighted the role of the insular-orbital cortex in fine-tuning avoidance-based decisions, little is known about the projections from this area that might modulate compulsive-like avoidance. METHODS Here, we used anatomical tract-tracing, single-unit recording, and optogenetics to characterize the projections from the insular-orbital cortex. To model exposure-with-response prevention and persistent avoidance in rats, we used the platform-mediated avoidance task followed by extinction-with-response prevention training. RESULTS Using tract-tracing and unit recording, we found that projections from the agranular insular/lateral orbital (AI/LO) cortex to the prefrontal cortex predominantly target the rostral portion of the prelimbic (rPL) cortex and excite rPL neurons. Photoinhibiting this projection induced persistent avoidance after extinction-with-response prevention training, an effect that was still present 1 week later. Consistent with this, photoexcitation of this projection prevented persistent avoidance in overtrained rats. This projection to rPL appears to be key for AI/LO's effects, considering that there was no effect of photoinhibiting AI/LO projections to the ventral striatum or basolateral amygdala. CONCLUSIONS Our findings suggest that projections from the AI/LO to the rPL decreases the likelihood of avoidance behavior following extinction. In humans, this connectivity may share some homology of projections from lateral prefrontal cortices (i.e., ventrolateral prefrontal cortex, orbitofrontal cortex, and insula) to other prefrontal areas and the anterior cingulate cortex, suggesting that reduced activity in these pathways may contribute to obsessive-compulsive disorder.
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Affiliation(s)
- Freddyson J Martínez-Rivera
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - José Pérez-Torres
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Coraly D Velázquez-Díaz
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Marcos J Sánchez-Navarro
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Carlos I Huertas-Pérez
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Maria M Diehl
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Suzanne N Haber
- Department of Pharmacology and Physiology, University of Rochester School of Medicine, Rochester, New York; McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Gregory J Quirk
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
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Psychometric Properties of the Dutch Child Avoidance Measure. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01517-w. [PMID: 36913006 DOI: 10.1007/s10578-023-01517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
Avoidance is considered a hallmark feature of child anxiety, but convenient measures are scarce. This study examined the psychometric properties of the Child Avoidance Measure (CAM) in a Dutch population, focusing mainly on the child-version. We included children 8 to 13 years old from a community sample (n = 63, longitudinal design) and a sample of high-anxious children (n = 92, cross-sectional design). Regarding the child-version, the internal consistencies were acceptable to good with moderate test-retest reliability. The validity analyses showed encouraging results. High-anxious children had higher avoidance scores than children from a community sample. Regarding the parent-version, both the internal consistency and test-retest validity were excellent. Overall, this study confirmed the sound psychometric properties and usefulness of the CAM. Future studies should focus on the psychometric properties of the Dutch CAM in a clinical sample, assess its ecological validity more extensively, and examine more psychometric features of the parent-version.
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Garcia-Burgos D, Wilhelm P, Vögele C, Munsch S. Food Restriction in Anorexia Nervosa in the Light of Modern Learning Theory: A Narrative Review. Behav Sci (Basel) 2023; 13:bs13020096. [PMID: 36829325 PMCID: PMC9952578 DOI: 10.3390/bs13020096] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Improvements in the clinical management of anorexia nervosa (AN) are urgently needed. To do so, the search for innovative approaches continues at laboratory and clinical levels to translate new findings into more effective treatments. In this sense, modern learning theory provides a unifying framework that connects concepts, methodologies and data from preclinical and clinical research to inspire novel interventions in the field of psychopathology in general, and of disordered eating in particular. Indeed, learning is thought to be a crucial factor in the development/regulation of normal and pathological eating behaviour. Thus, the present review not only tries to provide a comprehensive overview of modern learning research in the field of AN, but also follows a transdiagnostic perspective to offer testable explanations for the origin and maintenance of pathological food rejection. This narrative review was informed by a systematic search of research papers in the electronic databases PsycInfo, Scopus and Web of Science following PRISMA methodology. By considering the number and type of associations (Pavlovian, goal-directed or habitual) and the affective nature of conditioning processes (appetitive versus aversive), this approach can explain many features of AN, including why some patients restrict food intake to the point of life-threatening starvation and others restrict calorie intake to lose weight and binge on a regular basis. Nonetheless, it is striking how little impact modern learning theory has had on the current AN research agenda and practice.
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Affiliation(s)
- David Garcia-Burgos
- Department of Psychology, University of Fribourg, 1700 Fribourg, Switzerland
- Department of Psychobiology, The “Federico Olóriz” Institute of Neurosciences, Biomedical Research Centre, University of Granada, 18071 Granada, Spain
- Correspondence:
| | - Peter Wilhelm
- Department of Psychology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
| | - Simone Munsch
- Department of Psychology, University of Fribourg, 1700 Fribourg, Switzerland
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Christian C, Levinson CA. An integrated review of fear and avoidance learning in anxiety disorders and application to eating disorders. NEW IDEAS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.newideapsych.2022.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Owen C, Crane J. Trauma-Informed Design of Supported Housing: A Scoping Review through the Lens of Neuroscience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14279. [PMID: 36361166 PMCID: PMC9658651 DOI: 10.3390/ijerph192114279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/17/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
There is growing recognition of the importance of the design of the built environment in supporting mental health. In this context, trauma-informed design has emerged as a new field of practice targeting the design of the built environment to support wellbeing and ameliorate the physical, psychological and emotional impacts of trauma and related pathologies such as Post Traumatic Stress Disorder (PTSD). With high levels of prevalence of PTSD among people escaping homelessness and domestic violence, a priority area is the identification and application of evidence-based design solutions for trauma-informed supported housing. This study sought to examine the scope of existing evidence on the relationship between trauma, housing and design and the correlation of this evidence with trauma-informed design principles, and to identify gaps and opportunities for future research. In response to the commonly articulated limitations of the evidence-base in built environment design research, we combined a scoping review of literature on trauma, housing and design with insights from neuroscience to focus and extend understanding of the opportunities of trauma-informed design. We found that while limited in scope, there is strong alignment between existing evidence and the principles of trauma-informed design. We also identify three areas of future research related to the key domains of safety and security; control; and enriched environments.
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Affiliation(s)
- Ceridwen Owen
- School of Architecture and Design, College of Sciences and Engineering, University of Tasmania, Launceston, TAS 7250, Australia
| | - James Crane
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia
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11
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More engagement in inefficient avoidance through partial reinforcement. J Behav Ther Exp Psychiatry 2022; 76:101751. [PMID: 35738697 DOI: 10.1016/j.jbtep.2022.101751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES In anxiety-related disorders, excessive avoidance often coexists with an impaired sense of control over external threats. In contrast, lab studies have shown that avoidance responding increase with higher objective controllability over threat, accompanied with more confidence in the effectiveness of the avoidance response. One reason for this divergence could be that those lab studies are overly simplistic with a single, avoidable threat. METHODS We conducted an experiment that additionally included a completely uncontrollable threat, and we manipulated the reinforcement rate of the avoidance response to the (semi-)controllable threat (75% versus 100%). RESULTS The 100% group showed increased avoidance to the controllable threat and decreased avoidance to the unavoidable threat over learning. Interestingly, compared to the 100% group, the 75% group displayed less confidence in their avoidance to the controllable threat and they avoided the uncontrollable threat more often. LIMITATIONS Only two reinforcement rates of effective avoidance were included, which may limit the generalizability of the current findings. Perceived control was not directly measured. CONCLUSIONS Lower reinforcement rates create ambiguity between effective and ineffective situations of avoidance, which engenders generalization of unpredictability from effective to ineffective situation, thereby driving up ineffective avoidance rates. Partially reinforced effective avoidance responses and elevated ineffective avoidance responses together lead to more exposure to uncontrollable threat, weakening the sense of control over the threat, which could further increase avoidance behaviors. Controllability is often overlooked in avoidance research but can be key to understanding the development of maladaptive avoidance behaviors.
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Sege CT, Taylor DL, Lopez JW, Fleischmann H, White EJ, McTeague LM. Coping in the Clinic: Effects of Clinically Elevated Anxiety on Dynamic Neurophysiological Mechanisms of Escape/Avoidance Preparation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022:S2451-9022(22)00183-5. [PMID: 35952971 PMCID: PMC9905342 DOI: 10.1016/j.bpsc.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/28/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Treatments for anxiety and related disorders target exaggerated escape/avoidance as a core feature, but current methods fail to improve escape/avoidance habits for many treatment-seeking individuals. To support developing tools that increase treatment efficacy by targeting mechanisms more directly, the current work examined potential distinctions in the neurophysiologies of escape and avoidance and tested how clinical anxiety affects these neurophysiologies. METHODS Twenty-five treatment-seeking individuals with varied principal diagnoses (e.g., generalized anxiety disorder, posttraumatic stress disorder) and 20 non-treatment-seeking control subjects participated. In the study task, approximately 5.25-second cues predicted aversive images that could be avoided (blocked by a button press before image onset), escaped (ended by a button press after image onset), or not controlled. To examine neural processing and defensive response modulation, anticipatory event-related potentials were derived, and startle reflexes were probed throughout each cue. RESULTS Multidimensional profiles were observed such that 1) anticipatory event-related potential enhancement was only reliable during avoidance preparation, and event-related potentials potentially reflected perceived/instrumental control; and 2) startle reflexes were inhibited during avoidance preparation, relatively enhanced during escape preparation, and further enhanced during uncontrollable anticipation, thus potentially reflecting fear-related activation. Treatment-seeking status, then, did not affect cortical processing, but it did moderate context-dependent fear (if individuals with severe depression were excluded) such that treatment-seeking individuals without depression showed exaggerated startle during escape, but not avoidance, preparation. CONCLUSIONS Data suggest a specific effect of anxiety on fear system activation during preparation to escape aversion. This effect warrants further investigation as a precision target for interventions that directly modulate the specific underlying neural circuitry.
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Affiliation(s)
- Christopher T Sege
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
| | - Danielle L Taylor
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Ralph H. Johnson VA Health Care System, Charleston, South Carolina
| | - James W Lopez
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Holly Fleischmann
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Evan J White
- Laureate Institute for Brain Research, The University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| | - Lisa M McTeague
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Ralph H. Johnson VA Health Care System, Charleston, South Carolina
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13
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The role of relief, perceived control, and prospective intolerance of uncertainty in excessive avoidance in uncertain-threat environments. Int J Psychophysiol 2022; 179:89-100. [PMID: 35820508 DOI: 10.1016/j.ijpsycho.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022]
Abstract
Excessive avoidance is a key feature of pathological anxiety. However, the precise mechanisms underlying the development of excessive avoidance are still unknown. In the present study, we tested the hypothesis that excessive avoidance, especially in individuals with high Intolerance of Uncertainty (IU) is aimed at distress reduction via the enhancement of subjective perceived control in uncertain-threat environments. In our experiment, participants learned to avoid an uncertain aversive sound through a discriminated free operant procedure. In a later test phase in extinction, we manipulated the amount of avoidance responses available per trial by creating a limited and an unrestricted response condition. Nonetheless, the aversive sound could be effectively avoided in both conditions. We measured response frequency, avoidance confidence ratings and anxiety-predisposing traits such as intolerance of uncertainty, trait anxiety and distress tolerance. The degree of distress suffered during trials was inferred from post-trial relief ratings that were requested after trials in which the aversive sound had been omitted. In the avoidance acquisition phase, we found a positive association between prospective intolerance of uncertainty (P-IU) and the decline rate of distress. This relationship was not significant, however, when inhibitory intolerance of uncertainty (I-IU) was controlled for. At test, we found that the increase in avoidance responses led to distress reduction through the enhancement of avoidance confidence. Finally, we found a significant modulating role of P-IU in the effect of response limit on distress reduction that lends further support to our hypothesis. Specifically, P-IU was positively associated with the effect of response limit on distress. However, such modulating role was not significant when controlling for trait anxiety or I-IU.
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14
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Kitt ER, Lewis KM, Galbraith J, Abend R, Smith AR, Lebowitz ER, Pine DS, Gee DG. Family accommodation in pediatric anxiety: Relations with avoidance and self-efficacy. Behav Res Ther 2022; 154:104107. [PMID: 35613517 PMCID: PMC9271364 DOI: 10.1016/j.brat.2022.104107] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 11/02/2022]
Abstract
Pediatric anxiety disorders are common, impairing, and chronic when not effectively treated. A growing body of research implicates family accommodation in the maintenance of pediatric anxiety. The present study aimed to quantify previously untested relations among family accommodation and two theoretically linked constructs: avoidance and self-efficacy. Eighty youths between ages 8 and 17 (53 with anxiety disorders, 27 non-anxious controls) completed measures of family accommodation and self-efficacy. In addition, avoidance was assessed using two distinct measures of avoidance: a clinician rating of real-world behaviors and a laboratory task-based index. As predicted, youths with anxiety disorders reported greater family accommodation than non-anxious controls. Across the sample, greater family accommodation was associated with greater avoidance, as measured using both clinician rating and the laboratory task, as well as with lower self-efficacy. In an exploratory mediation model, self-efficacy partially mediated the relation between family accommodation and clinician-rated avoidance; however, it did not mediate the relation between family accommodation and task-based avoidance. Considering the robust association between family accommodation and anxiety in youths, this addition to our understanding of related cognitive and behavioral factors provides important preliminary insight, which can guide future research on potential targets for early identification and intervention for pediatric anxiety.
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Affiliation(s)
| | | | | | - Rany Abend
- National Institute of Mental Health, Bethesda, MD, USA
| | | | | | - Daniel S Pine
- National Institute of Mental Health, Bethesda, MD, USA
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15
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Boschet JM, Scherbaum S, Pittig A. Costly avoidance of Pavlovian fear stimuli and the temporal dynamics of its decision process. Sci Rep 2022; 12:6576. [PMID: 35449167 PMCID: PMC9023480 DOI: 10.1038/s41598-022-09931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/24/2022] [Indexed: 11/09/2022] Open
Abstract
Conflicts between avoiding feared stimuli versus approaching them for competing rewards are essential for functional behavior and anxious psychopathology. Yet, little is known about the underlying decision process. We examined approach-avoidance decisions and their temporal dynamics when avoiding Pavlovian fear stimuli conflicted with gaining rewards. First, a formerly neutral stimulus (CS+) was repeatedly paired with an aversive stimulus (US) to establish Pavlovian fear. Another stimulus (CS−) was never paired with the US. A control group received neutral tones instead of aversive USs. Next, in each of 324 trials, participants chose between a CS−/low reward and a CS+/high reward option. For the latter, probability of CS+ presentation (Pavlovian fear information) and reward magnitude (reward information) varied. Computer mouse movements were tracked to capture the decision dynamics. Although no more USs occurred, pronounced and persistent costly avoidance of the Pavlovian fear CS+ was found. Time-continuous multiple regression of movement trajectories revealed a stronger and faster impact of Pavlovian fear compared to reward information during decision-making. The impact of fear information, but not reward information, modestly decreased across trials. These findings suggest a persistently stronger weighting of fear compared to reward information during approach-avoidance decisions, which may facilitate the development of pathological avoidance.
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Affiliation(s)
- Juliane M Boschet
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Stefan Scherbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Andre Pittig
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany. .,Translational Psychotherapy, Department of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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16
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Ball TM, Gunaydin LA. Measuring maladaptive avoidance: from animal models to clinical anxiety. Neuropsychopharmacology 2022; 47:978-986. [PMID: 35034097 PMCID: PMC8938494 DOI: 10.1038/s41386-021-01263-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/04/2021] [Accepted: 12/22/2021] [Indexed: 12/28/2022]
Abstract
Avoiding stimuli that predict danger is required for survival. However, avoidance can become maladaptive in individuals who overestimate threat and thus avoid safe situations as well as dangerous ones. Excessive avoidance is a core feature of anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). This avoidance prevents patients from confronting maladaptive threat beliefs, thereby maintaining disordered anxiety. Avoidance is associated with high levels of psychosocial impairment yet is poorly understood at a mechanistic level. Many objective laboratory assessments of avoidance measure adaptive avoidance, in which an individual learns to successfully avoid a truly noxious stimulus. However, anxiety disorders are characterized by maladaptive avoidance, for which there are fewer objective laboratory measures. We posit that maladaptive avoidance behavior depends on a combination of three altered neurobehavioral processes: (1) threat appraisal, (2) habitual avoidance, and (3) trait avoidance tendency. This heterogeneity in underlying processes presents challenges to the objective measurement of maladaptive avoidance behavior. Here we first review existing paradigms for measuring avoidance behavior and its underlying neural mechanisms in both human and animal models, and identify how existing paradigms relate to these neurobehavioral processes. We then propose a new framework to improve the translational understanding of maladaptive avoidance behavior by adapting paradigms to better differentiate underlying processes and mechanisms and applying these paradigms in clinical populations across diagnoses with the goal of developing novel interventions to engage specific identified neurobehavioral targets.
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Affiliation(s)
- Tali M. Ball
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 USA
| | - Lisa A. Gunaydin
- grid.266102.10000 0001 2297 6811Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143 USA ,grid.266102.10000 0001 2297 6811Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA 94143 USA
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17
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Labrenz F, Woud ML, Elsenbruch S, Icenhour A. The Good, the Bad, and the Ugly-Chances, Challenges, and Clinical Implications of Avoidance Research in Psychosomatic Medicine. Front Psychiatry 2022; 13:841734. [PMID: 35250678 PMCID: PMC8894646 DOI: 10.3389/fpsyt.2022.841734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/28/2022] [Indexed: 12/12/2022] Open
Abstract
Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key factors in the etiology and pathophysiology of anxiety- and stress-related psychosomatic disorders. In these overlapping conditions, avoidance can increase the risk of mental comorbidities and interfere with the efficacy of cognitive behavioral treatment approaches built on fear extinction. Despite resurging interest in avoidance research also in the context of psychosomatic medicine, especially in conditions associated with pain, disturbed interoception, and disorders of the gut-brain axis, current study designs and their translation into the clinical context face significant challenges limiting both, the investigation of mechanisms involved in avoidance and the development of novel targeted treatment options. We herein selectively review the conceptual framework of learning and memory processes, emphasizing how classical and operant conditioning, fear extinction, and return of fear shape avoidance behaviors. We further discuss pathological avoidance and safety behaviors as hallmark features in psychosomatic diseases, with a focus on anxiety- and stress-related disorders. Aiming to emphasize chances of improved translational knowledge across clinical conditions, we further point out limitations in current experimental avoidance research. Based on these considerations, we propose means to improve existing avoidance paradigms to broaden our understanding of underlying mechanisms, moderators and mediators of avoidance, and to inspire tailored treatments for patients suffering from psychosomatic disorders.
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Affiliation(s)
- Franziska Labrenz
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany.,Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany
| | - Adriane Icenhour
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
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18
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Fernandez-Leon JA, Engelke DS, Aquino-Miranda G, Goodson A, Rasheed MN, Do Monte FH. Neural correlates and determinants of approach-avoidance conflict in the prelimbic prefrontal cortex. eLife 2021; 10:74950. [PMID: 34913438 PMCID: PMC8853658 DOI: 10.7554/elife.74950] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/13/2021] [Indexed: 12/04/2022] Open
Abstract
The recollection of environmental cues associated with threat or reward allows animals to select the most appropriate behavioral responses. Neurons in the prelimbic (PL) cortex respond to both threat- and reward-associated cues. However, it remains unknown whether PL regulates threat-avoidance vs. reward-approaching responses when an animals’ decision depends on previously associated memories. Using a conflict model in which male Long–Evans rats retrieve memories of shock- and food-paired cues, we observed two distinct phenotypes during conflict: (1) rats that continued to press a lever for food (Pressers) and (2) rats that exhibited a complete suppression in food seeking (Non-pressers). Single-unit recordings revealed that increased risk-taking behavior in Pressers is associated with persistent food-cue responses in PL, and reduced spontaneous activity in PL glutamatergic (PLGLUT) neurons during conflict. Activating PLGLUT neurons in Pressers attenuated food-seeking responses in a neutral context, whereas inhibiting PLGLUT neurons in Non-pressers reduced defensive responses and increased food approaching during conflict. Our results establish a causal role for PLGLUT neurons in mediating individual variability in memory-based risky decision-making by regulating threat-avoidance vs. reward-approach behaviors.
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Affiliation(s)
| | - Douglas S Engelke
- Department of Neurobiology and Anatomy, The University of Texas Health Science Center at Houston, Houston, United States
| | - Guillermo Aquino-Miranda
- Department of Neurobiology and Anatomy, The University of Texas Health Science Center at Houston, Houston, United States
| | | | - Maria N Rasheed
- Department of Neurobiology and Anatomy, The University of Texas Health Science Center at Houston, Houston, United States
| | - Fabricio H Do Monte
- Department of Neurobiology and Anatomy, The University of Texas Health Science Center at Houston, Houston, United States
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19
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Optimizing Long-term Outcomes of Exposure for Chronic Primary Pain from the Lens of Learning Theory. THE JOURNAL OF PAIN 2021; 22:1315-1327. [PMID: 34029684 DOI: 10.1016/j.jpain.2021.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 01/04/2023]
Abstract
Exposure in vivo is a theory-driven and widely used treatment to tackle functional disability in people with chronic primary pain. Exposure is quite effective; yet, in line with exposure outcomes for anxiety disorders, a number of patients may not profit from it, or relapse. In this focus article, we critically reflect on the current exposure protocols in chronic primary pain, and provide recommendations on how to optimize them. We propose several adaptations that are expected to strengthen inhibitory learning and/or retrieval of the extinction memory, thus likely decreasing relapse. We summarize the limited, but emerging experimental data in the pain domain, and draw parallels with experimental evidence in the anxiety literature. Our reflections and suggestions pertain to the use of the fear hierarchy, reassurance, positive psychology interventions, exposure with a range of stimuli and within different contexts, and the use of safety behaviors during treatment, as well as associating the fear-inducing stimuli with novel outcomes. In addition, we reflect on the importance of specifically tackling (the return of) pain-related avoidance behavior with techniques such as disentangling fear from avoidance and reinforcing approach behaviors. Finally, we discuss challenges in the clinical application of exposure to improve functioning in chronic primary pain and possible avenues for future research. Perspectives: Inspired by recent advances in learning theory and its applications on the treatment of anxiety disorders, we reflect on the delivery of exposure treatment for chronic primary pain and propose strategies to improve its long-term outcomes.
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20
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Hendrikx LJ, Krypotos AM, Engelhard IM. Enhancing extinction with response prevention via imagery-based counterconditioning: Results on conditioned avoidance and distress. J Behav Ther Exp Psychiatry 2021; 70:101601. [PMID: 32835958 DOI: 10.1016/j.jbtep.2020.101601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 07/13/2020] [Accepted: 08/01/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Maladaptive avoidance is a core characteristic of anxiety-related disorders. Its reduction is often promoted using extinction with response prevention (ExRP) procedures, but these effects are often short-lived. Research has shown that pairing a feared stimulus with a stimulus of an incompatible valence (i.e., counterconditioning) may be effective in reducing fear. This laboratory study tested whether positive imagery during ExRP (i.e., imagery counterconditioning protocol) can also reduce avoidance. METHODS In the counterconditioning procedure, participants imagined a positive sound. There were four phases. First, participants were presented with squares on a computer screen of which one (CS+) was paired with an aversive sound and another (CS-) was not. Second, they learned to avoid the negative sound in the presence of the CS+, via a key press. Third, they were assigned to either the Counterconditioning (that was asked to imagine a positive sound during ExRP) or No Counterconditioning group (standard ExRP). Finally, they performed a test phase that consisted of two parts: in the first part, avoidance responses were available for each CS and in the second part, these responses were prevented. RESULTS The Counterconditioning intervention resulted in a short-lived reduction of distress associated with the CS+. However, groups did not differ in avoidance or distress during the test phases. LIMITATIONS US-expectancy ratings were collected only at the end of the experiment. CONCLUSIONS The results indicate that positive imagery during ExRP may be effective in reducing distress during the intervention. Explanations for the persistence of avoidance and fear are discussed.
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Affiliation(s)
- Laura J Hendrikx
- Department of Clinical Psychology, Utrecht University, the Netherlands
| | - Angelos-Miltiadis Krypotos
- Department of Clinical Psychology, Utrecht University, the Netherlands; Department of Healthy Psychology, KU Leuven, Belgium.
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, the Netherlands
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21
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Rodríguez-Valverde M, Luciano C, Barnes-Holmes D, Hernández-López M. Transfer of conditioned fear and avoidance: Concurrent measurement of arousal and operant responding. J Exp Anal Behav 2020; 115:204-223. [PMID: 33270247 DOI: 10.1002/jeab.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 11/07/2022]
Abstract
A reversal design was employed for the analysis of transfer of fear and avoidance through equivalence classes. Two 5-member equivalence classes (A1-B1-C1-D1-E1 and A2-B2-C2-D2-E2) were established. Then B1 and C1 were paired with shock (CS+) and served as SD s in avoidance training (B2 and C2 were trained as CS-/S∆ s for avoidance). Further avoidance training followed with D1 and E1 (as SD s) and D2 and E2 (as S∆ s), with the first presentation of each of these stimuli serving as the first transfer test. Afterwards, aversive conditioning contingencies were reversed: B2 and D2 were paired with shock and trained as SD s for avoidance, B1 and D1 were presented without shock (CS-/S∆ s). Transfer was tested again with C1, E1, C2 and E2. This reversal was implemented to allow for the within-subject replication of transfer effects upon changes in the function of only a subset of each class's elements. Avoidance (key presses) and conditioned fear (skin conductance and heart rate) were simultaneously measured. Results show a clear transfer effect for avoidance, with between- and within-subject replications. For physiological measures, transfer effects in the first test could only be imputed on the basis of group-based inferential statistical analysis. Evidence for between-subject replication was weaker, with only a limited proportion of participants meeting the individual criterion for transfer.
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Affiliation(s)
| | | | - Dermot Barnes-Holmes
- Ghent Universiteit, Belgium.,University of Ulster, Coleraine, Northern Ireland, UK
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22
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Abend R, Bajaj MA, Matsumoto C, Yetter M, Harrewijn A, Cardinale EM, Kircanski K, Lebowitz ER, Silverman WK, Bar-Haim Y, Lazarov A, Leibenluft E, Brotman M, Pine DS. Converging Multi-modal Evidence for Implicit Threat-Related Bias in Pediatric Anxiety Disorders. Res Child Adolesc Psychopathol 2020; 49:227-240. [PMID: 33095373 DOI: 10.1007/s10802-020-00712-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 01/08/2023]
Abstract
This report examines the relationship between pediatric anxiety disorders and implicit bias evoked by threats. To do so, the report uses two tasks that assess implicit bias to negative-valence faces, the first by eye-gaze and the second by measuring body-movement parameters. The report contrasts task performance in 51 treatment-seeking, medication-free pediatric patients with anxiety disorders and 36 healthy peers. Among these youth, 53 completed an eye-gaze task, 74 completed a body-movement task, and 40 completed both tasks. On the eye-gaze task, patients displayed longer gaze duration on negative relative to non-negative valence faces than healthy peers, F(1, 174) = 8.27, p = .005. In contrast, on the body-movement task, patients displayed a greater tendency to behaviorally avoid negative-valence faces than healthy peers, F(1, 72) = 4.68, p = .033. Finally, implicit bias measures on the two tasks were correlated, r(38) = .31, p = .049. In sum, we found an association between pediatric anxiety disorders and implicit threat bias on two tasks, one measuring eye-gaze and the other measuring whole-body movements. Converging evidence for implicit threat bias encourages future research using multiple tasks in anxiety.
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Affiliation(s)
- Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA.
| | - Mira A Bajaj
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Chika Matsumoto
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Marissa Yetter
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Elise M Cardinale
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | | | | | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Melissa Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bldg 15K, MSC-2670, Bethesda, MD, 20892, USA
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23
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Bennett MP, Roche B, Dymond S, Baeyens F, Vervliet B, Hermans D. Transitions from avoidance: Reinforcing competing behaviours reduces generalised avoidance in new contexts. Q J Exp Psychol (Hove) 2020; 73:2119-2131. [PMID: 32686989 PMCID: PMC7672781 DOI: 10.1177/1747021820943148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Generalised avoidance behaviours are a common diagnostic feature of anxiety-related disorders and a barrier to affecting changes in anxiety during therapy. However, strategies to mitigate generalised avoidance are under-investigated. Even less attention is given to reducing the category-based generalisation of avoidance. We therefore investigated the potential of an operant-based approach. Specifically, it was examined whether reinforcing competing (non-avoidance) behaviours to threat-predictive cues would interfere with the expression of generalised avoidance. Using a matching-to-sample task, artificial stimulus categories were established using physically dissimilar nonsense shapes. A member of one category (conditioned stimulus; CS1) was then associated with an aversive outcome in an Acquisition context, unless an avoidance response was made. Next, competing behaviours were reinforced in response to the CS1 in new contexts. Finally, we tested for the generalisation of avoidance to another member of the stimulus category (generalisation stimulus; GS1) in both a Novel context and the Acquisition context. The selective generalisation of avoidance to GS1 was observed, but only in the Acquisition context. In the Novel context, the generalisation of avoidance to GSs was significantly reduced. A comparison group (Experiment 2), which did not learn any competing behaviours, avoided GS1 in both contexts. These findings suggest that reinforcing competing behavioural responses to threat-predictive cues can lead to reductions in generalised avoidance. This study is among the first study to demonstrate sustained reductions in generalised avoidance resulting from operant-based protocols, and the clinical and research implications are discussed.
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Affiliation(s)
- Marc P Bennett
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Bryan Roche
- National University of Ireland, Maynooth, Ireland
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24
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Meulders A. Fear in the context of pain: Lessons learned from 100 years of fear conditioning research. Behav Res Ther 2020; 131:103635. [DOI: 10.1016/j.brat.2020.103635] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
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25
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The effects of age and trait anxiety on avoidance learning and its generalization. Behav Res Ther 2020; 129:103611. [DOI: 10.1016/j.brat.2020.103611] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/03/2020] [Accepted: 03/23/2020] [Indexed: 02/05/2023]
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26
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Changes in Pain-Related Fear and Pain When Avoidance Behavior is no Longer Effective. THE JOURNAL OF PAIN 2020; 21:494-505. [DOI: 10.1016/j.jpain.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/28/2019] [Accepted: 09/01/2019] [Indexed: 12/28/2022]
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27
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Schlund MW, Ludlum M, Magee SK, Tone EB, Brewer A, Richman DM, Dymond S. Renewal of fear and avoidance in humans to escalating threat: Implications for translational research on anxiety disorders. J Exp Anal Behav 2020; 113:153-171. [PMID: 31803943 PMCID: PMC8168406 DOI: 10.1002/jeab.565] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/11/2019] [Accepted: 11/18/2019] [Indexed: 12/16/2022]
Abstract
Exposure-based treatment for threat avoidance in anxiety disorders often results in fear renewal. However, little is known about renewal of avoidance. This multimodal laboratory-based treatment study used an ABA renewal design and an approach-avoidance (AP-AV) task to examine renewal of fear/threat and avoidance in twenty adults. In Context A, 9 visual cues paired with increases in probabilistic money loss (escalating threats) produced increases in ratings of feeling threatened and loss expectancies and skin-conductance responses (SCR). During the AP-AV task, a monetary reinforcer was available concurrently with threats. Approach produced the reinforcer or probabilistic loss, while avoidance prevented loss and forfeited reinforcement. Escalating threat produced increasing avoidance and ratings. In Context B with Pavlovian extinction, threats signaled no money loss and SCR declined. During the AP-AV task, avoidance and ratings also declined. In a return to Context A with Pavlovian threat extinction in effect during the AP-AV task, renewal was observed. Escalating threat was associated with increasing ratings and avoidance in most participants. SCR did not show renewal. These are the first translational findings to highlight renewal of avoidance in humans. Further research should identify individual difference variables and altered neural mechanisms that may confer increased risk of avoidance renewal.
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Affiliation(s)
- Michael W Schlund
- Department of Psychology, Georgia State University
- Department of Psychiatry and Behavioral Sciences,
University of Pittsburgh
| | - Madonna Ludlum
- Department of Behavior Analysis, University of North
Texas
| | - Sandy K Magee
- Department of Behavior Analysis, University of North
Texas
| | - Erin B Tone
- Department of Psychology, Georgia State University
| | - Adam Brewer
- Department of Education, Western Connecticut State
University
| | - David M Richman
- Department of Educational Psychology and Leadership, Texas
Tech University
| | - Simon Dymond
- Department of Psychology, Swansea University
- Department of Psychology, Reykjavík University
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Smith BM, Smith GS, Dymond S. Relapse of anxiety-related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy. J Exp Anal Behav 2019; 113:87-104. [PMID: 31875982 DOI: 10.1002/jeab.573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/25/2022]
Abstract
Excessive fear and avoidance in relatively safe situations can lead to a narrowing of one's behavioral repertoire and less engagement with valued aspects of living. Ultimately, these processes can reach clinical levels, as seen in anxiety, trauma, and obsessive-compulsive disorders. Research on the basic behavioral processes underlying successful treatment with exposure therapy is growing, yet little is known about the mechanisms contributing to clinical relapse. Until recently, these mechanisms have largely been conceptualized in terms of Pavlovian return of fear, with relatively little research into operant processes. In the current paper, we briefly review translational research in anxiety disorders and the connections between fear and avoidance, focusing on recent work in the acquisition, extinction, and relapse of avoidance behavior and the generalization of this learning through arbitrary symbolic relations. We then introduce one possible treatment approach to mitigating clinical relapse, acceptance and commitment therapy (ACT), and provide a conceptual analysis for why ACT may be especially well-situated to address this issue. Finally, we end with potential directions for future research on treatment and relapse of anxiety disorders.
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Affiliation(s)
| | - Gregory S Smith
- Applied Behavior Analysis Department, The Chicago School of Professional Psychology
| | - Simon Dymond
- Department of Psychology, Swansea University.,Department of Psychology, Reykjavík University
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29
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Xia W, Eyolfson E, Lloyd K, Vervliet B, Dymond S. Living in fear: Low-cost avoidance maintains low-level threat. J Behav Ther Exp Psychiatry 2019; 62:57-64. [PMID: 30219564 DOI: 10.1016/j.jbtep.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Excessive avoidance of potential threat is a hallmark of anxiety and is thought to maintain fear by preserving the perceived high-threat value of avoided situations. Previous research has shown that the availability of avoidance maintains low-level threat. Here, we investigated whether an opportunity to engage in avoidance in the presence of a low-threat value safety cue would maintain its perceived threat value when avoidance was unavailable. METHODS In a threat conditioning procedure, one conditional danger stimulus (CS+; A+) was followed by an aversive unconditioned stimulus (US; electric shock), and two safety stimuli (CS-; B- and C-) were never followed by the US. Next, clicking a button present during A+ avoided the scheduled US. Avoidance was then made available during C- for participants in the Experimental group but not in the Control group. In the test, all stimuli were presented without the opportunity to avoid. Threat expectancy, eyeblink startle electromyography (EMG), and skin conductance responses (SCRs) were measured. RESULTS Findings showed an increase in threat expectancy for only C- in the Experimental group during the test phase following avoidance learning to similar levels as during threat conditioning. Compared to the Control group, threat expectancy for both B- and C- remained higher in Experimental group. SCR and startle EMG data did not corroborate these findings. LIMITATIONS Further research is needed to test the commonly held clinical assumption that avoidance can increase threat value. CONCLUSIONS Low-cost avoidance maintains low-threat value of safety cues.
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Affiliation(s)
- Weike Xia
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Park Campus, Swansea, SA2 8PP, United Kingdom
| | - Eric Eyolfson
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Park Campus, Swansea, SA2 8PP, United Kingdom
| | - Keith Lloyd
- Swansea University Medical School, Park Campus, Swansea SA2 8PP, United Kingdom
| | - Bram Vervliet
- Behavioral Neuroscience Program, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 149 13th St, Charlestown, MA 02129, USA; Center for Excellence on Generalization, Department of Psychology, KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Simon Dymond
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Park Campus, Swansea, SA2 8PP, United Kingdom; Department of Psychology, Reykjavík University, Menntavegur 1, Nauthólsvík, 101 Reykjavík, Iceland.
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30
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Dymond S. Overcoming avoidance in anxiety disorders: The contributions of Pavlovian and operant avoidance extinction methods. Neurosci Biobehav Rev 2019; 98:61-70. [DOI: 10.1016/j.neubiorev.2019.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/13/2018] [Accepted: 01/06/2019] [Indexed: 01/29/2023]
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31
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Pittig A, Dehler J. Same fear responses, less avoidance: Rewards competing with aversive outcomes do not buffer fear acquisition, but attenuate avoidance to accelerate subsequent fear extinction. Behav Res Ther 2019; 112:1-11. [DOI: 10.1016/j.brat.2018.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/17/2018] [Accepted: 11/06/2018] [Indexed: 11/27/2022]
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32
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Krypotos AM, Vervliet B, Engelhard IM. The validity of human avoidance paradigms. Behav Res Ther 2018; 111:99-105. [DOI: 10.1016/j.brat.2018.10.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/11/2018] [Accepted: 10/26/2018] [Indexed: 01/10/2023]
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Krypotos AM, Engelhard IM. Testing a novelty-based extinction procedure for the reduction of conditioned avoidance. J Behav Ther Exp Psychiatry 2018; 60:22-28. [PMID: 29486371 DOI: 10.1016/j.jbtep.2018.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/27/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Excessive avoidance towards non-dangerous cues is a key diagnostic criterion across anxiety-related disorders. Despite current therapies being successful in reducing such avoidance, relapse rates remain high. Based on recent findings, according to which learned fear responses were reduced after the presentation of the fear stimulus with a novel-neutral event (novel-based extinction), we tested whether novel-based extinction could diminish conditioned avoidance. METHODS Forty-six participants completed a Pavlovian acquisition procedure during which two pictures of a spider were presented, one of which (CS+) was always followed by a shock (US), while the other (CS-) was never followed by a US. Next, participants learned that they could avoid the shock by pressing a computer button. An extinction and response procedure followed. During this phase, the control group was presented with both CSs that were not followed by the US. The experimental group encountered both CSs, but the CS+ was followed by a neutral event (i.e., presentation of a tone). Return of avoidance (i.e., button presses) and fear (i.e., US-expectancies and fear-ratings) towards both CSs was tested after three unexpected presentations of the US. RESULTS Similar levels of return of avoidance and explicit fear were found for both groups. LIMITATIONS We collected no physiological measures of fear and we assessed only the short-term effects of our manipulation. CONCLUSIONS Our results do not support the hypothesis that novelty-based extinction reduces avoidance responses. This study can serve as a first exploration of novelty-based extinction for reducing avoidance and explicit measures of fear.
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Affiliation(s)
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, The Netherlands
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34
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Pittig A, Treanor M, LeBeau RT, Craske MG. The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neurosci Biobehav Rev 2018; 88:117-140. [DOI: 10.1016/j.neubiorev.2018.03.015] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 12/25/2022]
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35
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Safety Behavior After Extinction Triggers a Return of Threat Expectancy. Behav Ther 2018; 49:450-458. [PMID: 29704972 DOI: 10.1016/j.beth.2017.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/27/2017] [Accepted: 08/09/2017] [Indexed: 11/22/2022]
Abstract
Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear extinction triggers a return of fear in healthy participants. Participants learned that two stimuli (A and C) were followed by an aversive loud noise ("threat"), and one stimulus (B) was not. Participants then learned to use safety behavior that prevented the loud noise. Next, A and C were no longer followed by the loud noise, which typically led to extinction of threat expectancy. Safety behavior then became available again for C, but not for A and B. All participants used safety behavior on these C trials. In a final test phase, A, B, and C were presented once without the availability to use safety behavior. At each stimulus presentation, participants rated threat expectancy by indicating to what extent they expected that the loud noise would follow. Compared with the last extinction trial, threat expectancy increased for C in the test phase, whereas it did not increase for A and B. Hence, safety behavior after the extinction of classically conditioned fear caused a partial return of fear. The findings suggest that safety behavior may be involved in relapse after exposure-based therapy for anxiety disorders.
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36
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Norbury A, Robbins TW, Seymour B. Value generalization in human avoidance learning. eLife 2018; 7:34779. [PMID: 29735014 PMCID: PMC5957527 DOI: 10.7554/elife.34779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/26/2018] [Indexed: 02/02/2023] Open
Abstract
Generalization during aversive decision-making allows us to avoid a broad range of potential threats following experience with a limited set of exemplars. However, over-generalization, resulting in excessive and inappropriate avoidance, has been implicated in a variety of psychological disorders. Here, we use reinforcement learning modelling to dissect out different contributions to the generalization of instrumental avoidance in two groups of human volunteers (N = 26, N = 482). We found that generalization of avoidance could be parsed into perceptual and value-based processes, and further, that value-based generalization could be subdivided into that relating to aversive and neutral feedback - with corresponding circuits including primary sensory cortex, anterior insula, amygdala and ventromedial prefrontal cortex. Further, generalization from aversive, but not neutral, feedback was associated with self-reported anxiety and intrusive thoughts. These results reveal a set of distinct mechanisms that mediate generalization in avoidance learning, and show how specific individual differences within them can yield anxiety.
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Affiliation(s)
- Agnes Norbury
- Computational and Biological Learning Laboratory, Department of EngineeringUniversity of CambridgeCambridgeUnited Kingdom
| | - Trevor W Robbins
- Department of PsychologyUniversity of CambridgeCambridgeUnited Kingdom,Behavioural and Clinical Neuroscience InstituteUniversity of CambridgeCambridgeUnited Kingdom
| | - Ben Seymour
- Computational and Biological Learning Laboratory, Department of EngineeringUniversity of CambridgeCambridgeUnited Kingdom,Center for Information and Neural NetworksNational Institute of Information and Communications TechnologySuita CityJapan
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37
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Vervliet B, Lange I, Milad MR. Temporal dynamics of relief in avoidance conditioning and fear extinction: Experimental validation and clinical relevance. Behav Res Ther 2017; 96:66-78. [DOI: 10.1016/j.brat.2017.04.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022]
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38
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Bauer MR, Wiley JF, Weihs KL, Stanton AL. Stuck in the spin cycle: Avoidance and intrusions following breast cancer diagnosis. Br J Health Psychol 2017. [DOI: 10.1111/bjhp.12252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Margaret R. Bauer
- Department of Psychology University of California, Los Angeles California USA
| | - Joshua F. Wiley
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Victoria Australia
| | - Karen L. Weihs
- Department of Psychiatry University of Arizona Tucson Arizona USA
- University of Arizona Cancer Center Tucson Arizona USA
| | - Annette L. Stanton
- Department of Psychology University of California, Los Angeles California USA
- Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles California USA
- Center for Cancer Prevention and Control Research Jonsson Comprehensive Cancer Center University of California, Los Angeles California USA
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