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Geers AL, Seligman LD, Pituch KA, Colagiuri B, Marusak HA, Rabinak CA, Al-Ado SL, Turner N, Nedley M. A test of pre-exposure spacing and multiple context pre-exposure on the mechanisms of latent inhibition of dental fear: A study protocol. BMC Psychol 2024; 12:85. [PMID: 38383546 PMCID: PMC10882743 DOI: 10.1186/s40359-024-01580-5] [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: 01/25/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Latent inhibition occurs when exposure to a stimulus prior its direct associative conditioning impairs learning. Results from naturalistic studies suggest that latent inhibition disrupts the learning of dental fear from aversive associative conditioning and thereby reduces the development of dental phobia. Although theory suggests latent inhibition occurs because pre-exposure changes the expected relevance and attention directed to the pre-exposed stimulus, evidence supporting these mechanisms in humans is limited. The aim of this study is to determine if two variables, pre-exposure session spacing and multiple context pre-exposure, potentiate the hypothesized mechanisms of expected relevance and attention and, in turn, increase latent inhibition of dental fear. METHODS In a virtual reality simulation, child and adult community members (ages 6 to 35) will take part in pre-exposure and conditioning trials, followed by short- and long-term tests of learning. A 100ms puff of 60 psi air to a maxillary anterior tooth will serve as the unconditioned stimulus. Pre-exposure session spacing (no spacing vs. sessions spaced) and multiple context pre-exposure (single context vs. multiple contexts) will be between-subject factors. Stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial will serve as within-subject factors. Baseline pain sensitivity will also be measured as a potential moderator. DISCUSSION It is hypothesized that spaced pre-exposure and pre-exposure in multiple contexts will increase the engagement of the mechanisms of expected relevance and attention and increase the latent inhibition of dental fear. It is expected that the findings will add to theory on fear learning and provide information to aid the design of future interventions that leverage latent inhibition to reduce dental phobia.
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Affiliation(s)
- Andrew L Geers
- Department of Psychology, University of Toledo, 43606, Toledo, Ohio, USA.
| | - Laura D Seligman
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Keenan A Pituch
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Ben Colagiuri
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, Michigan, USA
| | - Sena L Al-Ado
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Natalie Turner
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Michael Nedley
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
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Geers AL, Seligman LD, Pituch KA, Colagiuri B, Marusak HA, Rabinak CA, Turner N, Al-Ado SL, Nedley M. A study protocol testing pre-exposure dose and compound pre-exposure on the mechanisms of latent inhibition of dental fear. BMC Psychol 2024; 12:36. [PMID: 38238866 PMCID: PMC10797709 DOI: 10.1186/s40359-024-01527-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Dental stimuli can evoke fear after being paired - or conditioned - with aversive outcomes (e.g., pain). Pre-exposing the stimuli before conditioning can impair dental fear learning via a phenomenon known as latent inhibition. Theory suggests changes in expected relevance and attention are two mechanisms responsible for latent inhibition. In the proposed research, we test whether pre-exposure dose and degree of pre-exposure novelty potentiate changes in expected relevance and attention to a pre-exposed stimulus. We also assess if the manipulations alter latent inhibition and explore the possible moderating role of individual differences in pain sensitivity. METHODS Participants will be healthy individuals across a wide range of ages (6 to 35 years), from two study sites. Participants will undergo pre-exposure and conditioning followed by both a short-term and long-term test of learning, all in a novel virtual reality environment. The unconditioned stimulus will be a brief pressurized puff of air to a maxillary anterior tooth. Pre-exposure dose (low vs. high) and pre-exposure novelty (element stimulus vs. compound stimuli) will be between-subject factors, with stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial as within-subject factors. Pain sensitivity will be measured through self-report and a cold pressor test. It is hypothesized that a larger dose of pre-exposure and compound pre-exposure will potentiate the engagement of the target mechanisms and thereby result in greater latent inhibition in the form of reduced fear learning. Further, it is hypothesized that larger effects will be observed in participants with greater baseline pain sensitivity. DISCUSSION The proposed study will test whether pre-exposure dose and compound stimulus presentation change expected relevance and attention to the pre-exposed stimulus, and thereby enhance latent inhibition of dental fear. If found, the results will add to our theoretical understanding of the latent inhibition of dental fear and inform future interventions for dental phobia prevention.
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Affiliation(s)
- Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, OH, 43606, USA.
| | - Laura D Seligman
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Keenan A Pituch
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Ben Colagiuri
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | | | - Natalie Turner
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Sena L Al-Ado
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Michael Nedley
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
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Seligman LD, Geers AL, Kramer L, Clemens KS, Pituch KA, Colagiuri B, Marusak HA, Rabinak CA, Turner N, Nedley M. Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans. BMC Psychol 2023; 11:23. [PMID: 36698206 PMCID: PMC9875450 DOI: 10.1186/s40359-023-01054-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence suggests that dental anxiety and phobia are frequently the result of direct associative fear conditioning but that pre-exposure to dental stimuli prior to conditioning results in latent inhibition of fear learning. The mechanisms underlying the pre-exposure effect in humans, however, are poorly understood. Moreover, pain sensitivity has been linked to dental fear conditioning in correlational investigations and theory suggests it may moderate the latent inhibition effect, but this hypothesis has not been directly tested. These gaps in our understanding are a barrier to the development of evidence-based dental phobia prevention efforts. METHODS Healthy volunteers between the ages of 6 and 35 years will be enrolled across two sites. Participants will complete a conditioning task in a novel virtual reality environment, allowing for control over pre-exposure and the examination of behaviour. A dental startle (a brief, pressurized puff of air to a tooth) will serve as the unconditioned stimulus. Using a within-subjects experimental design, participants will experience a pre-exposed to-be conditioned stimulus, a non-pre-exposed to-be conditioned stimulus, and a neutral control stimulus. Two hypothesized mechanisms, changes in prediction errors and attention, are expected to mediate the association between stimulus condition and fear acquisition, recall, and retention. To ascertain the involvement of pain sensitivity, this construct will be measured through self-report and the cold pressor task. DISCUSSION Dental phobia negatively affects the dental health and overall health of individuals. This study aims to determine the mechanisms through which pre-exposure retards conditioned dental fear acquisition, recall, and retention. A randomized control trial will be used to identify these mechanisms so that they can be precisely targeted and maximally engaged in preventative efforts.
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Affiliation(s)
- Laura D. Seligman
- grid.449717.80000 0004 5374 269XDepartment of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX 78539 USA
| | - Andrew L. Geers
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Lauren Kramer
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Kelly S. Clemens
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Keenan A. Pituch
- grid.215654.10000 0001 2151 2636Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
| | - Ben Colagiuri
- grid.1013.30000 0004 1936 834XDepartment of Psychology, University of Sydney, Sydney, Australia
| | - Hilary A. Marusak
- grid.254444.70000 0001 1456 7807Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Wayne State University, Detroit, MI USA
| | - Christine A. Rabinak
- grid.254444.70000 0001 1456 7807Department of Pharmacy Practice, Wayne State University, Detroit, MI USA
| | - Natalie Turner
- grid.267337.40000 0001 2184 944XDepartment of Pediatric Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH USA
| | - Michael Nedley
- grid.267337.40000 0001 2184 944XDepartment of Pediatric Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH USA
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Marusak HA. The role of cannabinoids in shaping lifespan neurodevelopment. J Neurosci Res 2022; 100:709-712. [PMID: 35106825 DOI: 10.1002/jnr.25012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
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Alvand A, Kuruvilla-Mathew A, Kirk IJ, Roberts RP, Pedersen M, Purdy SC. Altered brain network topology in children with auditory processing disorder: A resting-state multi-echo fMRI study. NEUROIMAGE: CLINICAL 2022; 35:103139. [PMID: 36002970 PMCID: PMC9421544 DOI: 10.1016/j.nicl.2022.103139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022] Open
Abstract
A graph-theoretical approach was used to assess the functional topology in APD. Brain networks in APD are similarly integrated and segregated compared to HCs. Children with APD have different hub organization. Significant group differences were found in the PC measure in the bilateral STG. Regional differences observed within the DMN indicate multimodal roles in APD.
Children with auditory processing disorder (APD) experience hearing difficulties, particularly in the presence of competing sounds, despite having normal audiograms. There is considerable debate on whether APD symptoms originate from bottom-up (e.g., auditory sensory processing) and/or top-down processing (e.g., cognitive, language, memory). A related issue is that little is known about whether functional brain network topology is altered in APD. Therefore, we used resting-state functional magnetic resonance imaging data to investigate the functional brain network organization of 57 children from 8 to 14 years old, diagnosed with APD (n = 28) and without hearing difficulties (healthy control, HC; n = 29). We applied complex network analysis using graph theory to assess the whole-brain integration and segregation of functional networks and brain hub architecture. Our results showed children with APD and HC have similar global network properties –i.e., an average of all brain regions– and modular organization. Still, the APD group showed different hub architecture in default mode-ventral attention, somatomotor and frontoparietal-dorsal attention modules. At the nodal level –i.e., single-brain regions–, we observed decreased participation coefficient (PC – a measure quantifying the diversity of between-network connectivity) in auditory cortical regions in APD, including bilateral superior temporal gyrus and left middle temporal gyrus. Beyond auditory regions, PC was also decreased in APD in bilateral posterior temporo-occipital cortices, left intraparietal sulcus, and right posterior insular cortex. Correlation analysis suggested a positive association between PC in the left parahippocampal gyrus and the listening-in-spatialized-noise -sentences task where APD children were engaged in auditory perception. In conclusion, our findings provide evidence of altered brain network organization in children with APD, specific to auditory networks, and shed new light on the neural systems underlying children's listening difficulties.
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Affiliation(s)
- Ashkan Alvand
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand; Eisdell Moore Centre, Auckland, New Zealand.
| | - Abin Kuruvilla-Mathew
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand; Eisdell Moore Centre, Auckland, New Zealand.
| | - Ian J Kirk
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand; Eisdell Moore Centre, Auckland, New Zealand; Centre for Brain Research, The University of Auckland, Auckland, New Zealand.
| | - Reece P Roberts
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand; Centre for Brain Research, The University of Auckland, Auckland, New Zealand.
| | - Mangor Pedersen
- School of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand.
| | - Suzanne C Purdy
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand; Eisdell Moore Centre, Auckland, New Zealand; Centre for Brain Research, The University of Auckland, Auckland, New Zealand.
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Andreatta M, Pauli P. Contextual modulation of conditioned responses in humans: A review on virtual reality studies. Clin Psychol Rev 2021; 90:102095. [PMID: 34763127 DOI: 10.1016/j.cpr.2021.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
Conditioned response (CRs) triggered by stimuli predicting aversive consequences have been confirmed across various species including humans, and were found to be exaggerated in anxious individuals and anxiety disorder patients. Importantly, contextual information may strongly modulate such conditioned responses (CR), however, there are several methodological boundaries in the translation of animal findings to humans, and from healthy individuals to patients. Virtual Reality (VR) is a useful technological tool for overcoming such boundaries. In this review, we summarize and evaluate human VR conditioning studies exploring the role of the context as conditioned stimulus or occasion setter for CRs. We observe that VR allows successful acquisition of conditioned anxiety and conditioned fear in response to virtual contexts and virtual cues, respectively. VR studies also revealed that spatial or temporal contextual information determine whether conditioned anxiety and conditioned fear become extinguished and/or return. Novel contexts resembling the threatening context foster conditioned fear but not conditioned anxiety, suggesting distinct context-related generalization processes. We conclude VR contexts are able to strongly modulate CRs and therefore allow a comprehensive investigation of the modulatory role of the context over CR in humans leading to conclusions relevant for non-VR and clinical studies.
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Affiliation(s)
- Marta Andreatta
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany; Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, the Netherlands.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany; Center of Mental Health, University of Würzburg, Würzburg, Germany.
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Marusak HA, Hehr A, Bhogal A, Peters C, Iadipaolo A, Rabinak CA. Alterations in fear extinction neural circuitry and fear-related behavior linked to trauma exposure in children. Behav Brain Res 2020; 398:112958. [PMID: 33069739 DOI: 10.1016/j.bbr.2020.112958] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 10/05/2020] [Indexed: 01/12/2023]
Abstract
Exposure to childhood trauma is extremely common (>60 %) and is a leading risk factor for fear-based disorders, including anxiety and posttraumatic stress disorder. These disorders are characterized by deficits in fear extinction and dysfunction in underlying neural circuitry. Given the strong and pervasive link between childhood trauma and the development of psychopathology, fear extinction may be a key mechanism. The present study tests the impact of childhood trauma exposure on fear extinction and underlying neural circuitry. Children (N = 44, 45 % trauma-exposed; 6-11 yrs) completed a novel two-day virtual reality fear extinction experiment. On day one, participants underwent fear conditioning and extinction. Twenty-four hours later, participants completed a test of extinction recall during fMRI. Conditioned fear was measured throughout the experiment using skin conductance and fear-related behavior, and activation in fear-related brain regions was estimated during recall. There were no group differences in conditioned fear during fear conditioning or extinction learning. During extinction recall, however, trauma-exposed children kept more distance from both the previously extinguished and the safety cue, suggesting poor differentiation between threat and safety cues. Trauma-exposed youth also failed to approach the previously extinguished cue over the course of extinction recall. The effects on fear-related behavior during extinction recall were accompanied by higher activation to the previously extinguished cue in fear-relevant brain regions, including the dorsal anterior cingulate cortex and anterior insula, in trauma-exposed relative to control children. Alterations in fear-related brain regions and fear-related behavior may be a core mechanism through which childhood trauma confers heightened vulnerability to psychopathology.
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Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States.
| | - Aneesh Hehr
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Amanpreet Bhogal
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Craig Peters
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States
| | - Allesandra Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States
| | - Christine A Rabinak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Translational Neuroscience Program, School of Medicine, Wayne State University, Detroit, MI, United States
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