During vigilance to painful stimuli: slower response rate is related to high trait anxiety, whereas faster response rate is related to high state anxiety

A pathological increase in vigilance, or hypervigilance, may be related to pain intensity in some clinical pain syndromes and may result from attention bias to salient stimuli mediated by anxiety. During a continuous performance task where subjects discriminated painful target stimuli from painful nontargets, we measured detected targets (hits), nondetected targets (misses), nondetected nontargets (correct rejections), and detected nontargets (false alarms). Using signal detection theory, we calculated response bias, the tendency to endorse a stimulus as a target, and discriminability, the ability to discriminate a target from nontarget. Owing to the relatively slow rate of stimulus presentation, our primary hypothesis was that sustained performance would result in a more conservative response bias reflecting a lower response rate over time on task. We found a more conservative response bias with time on task and no change in discriminability. We predicted that greater state and trait anxiety would lead to a more liberal response bias. A multivariable model provided partial support for our prediction; high trait anxiety related to a more conservative response bias (lower response rate), whereas high state anxiety related to a more liberal bias. This inverse relationship of state and trait anxiety is consistent with reports of effects of state and trait anxiety on reaction times to threatening stimuli. In sum, we report that sustained attention to painful stimuli was associated with a decrease in the tendency of the subject to respond to any stimulus over time on task, whereas the ability to discriminate target from nontarget remains unchanged.NEW & NOTEWORTHY During a series of painful stimuli requiring subjects to respond to targets, we separated response willingness from ability to discriminate targets from nontargets. Response willingness declined during the task, with no change in subjects' ability to discriminate, consistent with previous vigilance studies. High trait anxious subjects were less willing to respond and showed slower reaction times to hits than low anxious subjects. This study reveals an important role of trait anxiety in pain vigilance.

The effects of warned loss magnitude and timeout duration on human avoidance behavior

This study experimentally investigated the determinants of avoidance behavior when participants are forewarned of aversive outcomes. The effects of 3 variables on avoidance behavior were examined: point-loss amount (5 levels, from 20 to 100 points), duration of timeout from positive reinforcement (5 levels, 20 to 100 s), and 3 predictive accuracy levels (100%, 50%, and 0%) of warning stimuli. Twelve participants completed 3 sessions, each comprising 25 discrete trials, that differed in predictive accuracy level. Throughout a session, a participant engaged in button press responses that were reinforced by points under a conjunctive fixed-ratio fixed-interval schedule. During each trial, a warning stimulus that indicated a loss amount and a timeout duration was presented. If the participant pressed the avoidance button, then the timeout started, otherwise the loss occurred. The trial ended with termination of timeout or an occurrence of the loss. Results showed that avoidance responses increased when the loss amount increased and decreased when the timeout duration increased. The frequency of avoidance responses was lowest when the predictive accuracy of warning stimuli was 0%. These findings demonstrated that this experimental procedure could be useful for investigating human avoidance behavior outside the laboratory.

Behavioral, Physiological and EEG Activities Associated with Conditioned Fear as Sensors for Fear and Anxiety

Anxiety disorders impose substantial costs upon public health and productivity in the USA and worldwide. At present, these conditions are quantified by self-report questionnaires that only apply to behaviors that are accessible to consciousness, or by the timing of responses to fear- and anxiety-related words that are indirect since they do not produce fear, e.g., Dot Probe Test and emotional Stroop. We now review the conditioned responses (CRs) to fear produced by a neutral stimulus (conditioned stimulus CS+) when it cues a painful laser unconditioned stimulus (US). These CRs include autonomic (Skin Conductance Response) and ratings of the CS+ unpleasantness, ability to command attention, and the recognition of the association of CS+ with US (expectancy). These CRs are directly related to fear, and some measure behaviors that are minimally accessible to consciousness e.g., economic scales. Fear-related CRs include non-phase-locked phase changes in oscillatory EEG power defined by frequency and time post-stimulus over baseline, and changes in phase-locked visual and laser evoked responses both of which include late potentials reflecting attention or expectancy, like the P300, or contingent negative variation. Increases (ERS) and decreases (ERD) in oscillatory power post-stimulus may be generalizable given their consistency across healthy subjects. ERS and ERD are related to the ratings above as well as to anxious personalities and clinical anxiety and can resolve activity over short time intervals like those for some moods and emotions. These results could be incorporated into an objective instrumented test that measures EEG and CRs of autonomic activity and psychological ratings related to conditioned fear, some of which are subliminal. As in the case of instrumented tests of vigilance, these results could be useful for the direct, objective measurement of multiple aspects of the risk, diagnosis, and monitoring of therapies for anxiety disorders and anxious personalities.

Relapse of anxiety-related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

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.

Related to Anxiety: Arbitrarily Applicable Relational Responding and Experimental Psychopathology Research on Fear and Avoidance

Humans have an unparalleled ability to engage in arbitrarily applicable relational responding (AARR). One of the consequences of this ability to spontaneously combine and relate events from the past, present, and future may, in fact, be a propensity to suffer. For instance, maladaptive fear and avoidance of remote or derived threats may actually perpetuate anxiety. In this narrative review, we consider contemporary AARR research on fear and avoidance as it relates to anxiety. We first describe laboratory-based research on the emergent spread of fear- and avoidance-eliciting functions in humans. Next, we consider the validity of AARR research on fear and avoidance and address the therapeutic implications of the work. Finally, we outline challenges and opportunities for a greater synthesis between behavior analysis research on AARR and experimental psychopathology.

Human Thalamic Somatosensory Nucleus (Ventral Caudal, Vc) as a Locus for Stimulation by INPUTS from Tactile, Noxious and Thermal Sensors on an Active Prosthesis

The forebrain somatic sensory locus for input from sensors on the surface of an active prosthesis is an important component of the Brain Machine Interface. We now review the neuronal responses to controlled cutaneous stimuli and the sensations produced by Threshold Stimulation at Microampere current levels (TMIS) in such a locus, the human thalamic Ventral Caudal nucleus (Vc). The responses of these neurons to tactile stimuli mirror those for the corresponding class of tactile mechanoreceptor fiber in the peripheral nerve, and TMIS can evoke sensations like those produced by the stimuli that optimally activate each class. These neuronal responses show a somatotopic arrangement from lateral to medial in the sequence: leg, arm, face and intraoral structures. TMIS evoked sensations show a much more detailed organization into anterior posteriorly oriented rods, approximately 300 microns diameter, that represent smaller parts of the body, such as parts of individual digits. Neurons responding to painful and thermal stimuli are most dense around the posterior inferior border of Vc, and TMIS evoked pain sensations occur in one of two patterns: (i) pain evoked regardless of the frequency or number of spikes in a burst of TMIS; and (ii) the description and intensity of the sensation changes with increasing frequencies and numbers. In patients with major injuries leading to loss of somatic sensory input, TMIS often evokes sensations in the representation of parts of the body with loss of sensory input, e.g., the phantom after amputation. Some patients with these injuries have ongoing pain and pain evoked by TMIS of the representation in those parts of the body. Therefore, thalamic TMIS may produce useful patterned somatotopic feedback to the CNS from sensors on an active prosthesis that is sometimes complicated by TMIS evoked pain in the representation of those parts of the body.

Stop Preaching to the Choir, Publish Outside the Box: A Discussion

In this article, I comment on Normand's, Vyse's, Friman's, Schlinger's, and Reed's articles on publishing books, journal articles, letters to the editor, and columns outside of behavior analysis, that is, "outside the box," as well as communicating with editors, authors, and journalists. Among the topics I address are the prerequisite repertoires and these authors' guidance (e.g., task analyses), as well as technical terms and language and the many opportunities available to us, yet also caveats about how, whether, and when we should publish outside the box. In the process, I include lessons I have learned from submitting my own manuscripts outside the box and suggestions I have gleaned from my failures and successes. In conclusion, if the field values publishing outside the box, then, it should analyze the necessary repertoires and provide systematic instruction in them.

The Spread of Fear: Symbolic Generalization Mediates Graded Threat-Avoidance in Specific Phobia

Overgeneralization of fear and threat-avoidance represents a formidable barrier to successful clinical treatment of anxiety disorders. While stimulus generalization along quantifiable physical dimensions has been studied extensively, less consideration has been given to symbolic generalization, in which stimuli are indirectly and arbitrarily related. The present study examined whether the magnitude and extent of symbolic generalization of threat-avoidance and threat-beliefs differed between spider-phobic and nonphobic individuals. Initially, participants learned two sets of stimulus equivalence relations (A1 = B1 = C1; A2 = B2 = C2). Next, one cue (B1) was established as a conditioned stimulus (CS +; threat) that signalled onset of spider images and prompted avoidance, and another cue (B2) was established as a CS– (safety cue) that signalled the absence of such images. Subsequent testing showed that phobics compared to nonphobics exhibited greater symbolic generalization of threat-avoidance to threat cues A1 and C1 (indirect CS+ threat cues related via symmetry and equivalence, respectively), while all individuals showed nonavoidance to indirect safety cues A2 and C2. The enhanced symbolic generalization of threat-beliefs and avoidance behaviour observed in spider phobics warrants further investigation.

Maximization of reinforcement by two autistic students with accurate and inaccurate instructions

The present study examines maximization of reinforcement by two autistic individuals under conditions of no instructions, accurate instructions, and inaccurate instructions. Accuracy of instructions and magnitude of reinforcement for differential responding in a choice paradigm were systematically varied across phases. Subject one maximized reinforcement across all three conditions in seven experimental phases. Subject two maximized across these same seven phases, but also experienced three additional phases. In two of the additional phases, subject two maximized reinforcement. In a ninth phase, when reinforcement was intermittent rather than continuous, he failed to maximize reinforcement. Implications of the results for the controversies surrounding the concept of rule-governed behavior are discussed.

The effects of schedules of reinforcement on instruction-following in human subjects with verbal and nonverbal stimuli

The experiment reported here represents a partial replication of an experiment by Newman, Buffington, and Hemmes (in press) and analyzes responding in college students as a function of three different schedules of reinforcement (FR 1, FR 2, FR 3) and either verbal discriminative stimuli (instructions) or nonverbal discriminative stimuli (different colored cards). All consequences (tokens) were based on behavior consistent either with the verbal discriminative stimulus (S(D)) or with the nonverbal S(D). The schedule of reinforcement varied across subjects, and accuracy of the verbal and nonverbal S(D)s varied across phases from. Results showed that the behavior of all continuous reinforcement (FR 1) subjects was sensitive to the accuracy of the verbal S(D)s, but the behavior of subjects in the nonverbal S(D) conditions showed more sensitivity than the behavior of subjects in verbal conditions under intermittent schedules (FR 2 and FR 3). These finding suggest that the behavior of subjects in experiments where instructions are sometimes pitted against actual contingencies of reinforcement is a function not only of the instruction, but also of the type of reinforcement schedule used.

Avoidance of pain of unpredictable intensity

Unpredictability of the intensity of an aversive event might be an important factor in producing negative effects of the event, especially if the UCS becomes stronger than could have been expected. The present experiment tested the hypothesis that unpredictability of intensity of a painful stimulus contributes to avoidance behaviour. The experiment was concealed in a shock working-up procedure, which was done to assess the pain level subjects were willing to tolerate in a subsequent experiment. The experimental subjects, who received an unannounced sudden increase of the pain stimulus during the working-up procedure, tolerated less pain on a subjective as well as on an objective level (avoidance of high levels of pain) than the control subjects, who received the stimuli in a predictable pattern. The results support the hypothesis that unpredictability of intensity of an aversive event contributes to avoidance behaviour.

The relationship between underpredicted pain and escape

Escape and avoidance that are disproportional to the danger of the pertinent stimulus are important clinical problems that are often related to inaccurate (catastrophic) expectations. One possible source of such expectations is a prior, underestimated aversive experience. In the present experiment the hypotheses that underestimated pain leads to escape and that it leads to avoidance were tested. In order to control for the effect of the intensity of the pain stimulus, a control group that received 20 pain stimuli of high intensity was formed. Subjects in the experimental condition received 17 pain stimuli of low intensity and 3 of (unexpectedly) high intensity (experimentally induced underprediction). Underprediction of the high intensity stimulus was significantly related to escape, but not to avoidance. The results suggest that the way in which avoidance was operationalized accounts for this. The strong support of the hypothesized relationship between underpredicted pain and escape is an important finding, however.

Effects of atropine on the repeated acquisition and performance of response sequences in humans

The present study assessed a 24-hr time course for the acute effects of intramuscular injections of atropine sulfate (0, 1.5, 3.0, and 6.0 mg/70 kg) in healthy adult humans responding under a two-component multiple schedule of repeated acquisition and performance of response sequences. Subjects resided in an inpatient research ward for the duration of the study. In each component of the multiple schedule, subjects completed a different sequence of 10 responses in a predetermined order using three keys of a numeric keypad. In the acquisition component, the subjects' task was to acquire a new sequence each session. Eight sessions were conducted daily: one immediately before administration of the drug and then 0.5, 1.5, 3.0, 5.0, 7.0, 9.0, and 24.0 hr after administration. In the performance component, the response sequence always remained the same. Overall percentage of errors increased and overall response rates decreased in the acquisition and performance components as an orderly function of drug dose. However, these effects were selective in that behavior in the acquisition component generally was affected at lower doses than in the performance component. When behavior was affected in both the acquisition and performance components, the time courses of effects were similar. Drug effects began at 0.5 or 1.5 hr, reached peak effects between 3.0 and 5.0 hr, and returned to placebo levels between 7.0 and 9.0 hr postdrug in both schedule components. None of the drug doses produced reliable effects the day after drug administration (24-hr postdrug) in either schedule component. The present study provides the first within-subject assessment of the magnitude and duration of the effects of an anticholinergic on repeated acquisition and performance baselines and extends to atropine the selective effects on these two baselines demonstrated previously with other compounds in humans and nonhumans.

Effects of provocation and alcohol on human aggressive behavior

Effects of provoking stimuli on human aggressive behavior and on the relationship between alcohol and aggressive behavior were measured. Four adult males manipulated pushbuttons that produced points on their own counters (redeemable for money) or ostensibly subtracted points (money) from the counters of fictitious persons described as participating in the same study at other locations. During five 10-min components, frequency and intensity of point subtractions, ostensibly controlled by another person, were manipulated. Each subject was repeatedly exposed to alcohol doses (0.25, 0.5 and 0.75 g/kg of 95% ethanol) over time using a repeated measures design. Aggressive responding was affected by provocation intensity and frequency. The highest dose of alcohol produced selective increases in aggressive responding; however, no interactions between alcohol effects and provocation conditions were observed.