Fear expression and return of fear following threat instruction with or without direct contingency experience

Persistent defensive reactivity during extensive avoidance training as a potential mechanism for the perpetuation of safety behaviors

Safety behaviors are core features of anxiety-related disorders, specifically involving behaviors that do not completely terminate aversive situations, but rather prevent the risk of the occurrence of the expected aversive outcome (US). This study aimed to examine the dynamics of defensive reactivity associated with safety behaviors, both before and after their execution, and to investigate changes in these reactions following extensive training. Twenty-four healthy participants underwent a US-avoidance task as an experimental analog to model safety behavior, requiring a button press to avoid the US without terminating the associated warning cue (CS). Two CS+ were used, with one being devalued during a devaluation procedure to assess the formation of avoidance habits. Defensive reactivity was assessed using fear-potentiated startle (FPS) and skin conductance responses (SCR). Participants showed pronounced defensive reactivity to both CS + vs. CS- before the avoidance action, which decreased upon the opportunity to avoid the US. Contrarily, after the avoidance action, a re-emergence of defensive responses was observed as indicated by FPS and increased SCR. Only one participant showed signs of avoidance habit formation. The findings reveal a re-emergence of defensive reactivity following safety behaviors challenging the prevailing belief that relief is the primary sustaining factor of safety behavior.

Suffering more in imagination than in reality? Mental imagery and fear generalization

Mental imagery may represent a weaker form of perception and, thus, mental images may be more ambiguous than visual percepts. If correct, the acquisition of fear would be less specific for imagined fears in comparison to perceptual fears, perhaps facilitating broader fear generalization. To test this idea, a two-day differential fear conditioning experiment (N = 98) was conducted. On day one, two groups of participants underwent differential fear conditioning such that a specific Gabor patch orientation (CS+) was paired with mild shocks (US) while a second Gabor patch of orthogonal orientation (CS-) was never paired with shock. Critically, one group imagined the Gabor patches and the other group was visually presented the Gabor patches. Next, both groups were presented visual Gabor patches of similar orientations (GCS) to the CS+. On day two, to assess the persistence of imagined fear, participants returned to the lab and were tested on the GCS devoid of shock. For day one, in contrast to our primary hypothesis, both self-report and skin conductance response measures did not show a significant interaction between the GCS and groups. On day two, both measures demonstrated a persistence of imagined fear, without US delivery. Taken together, rather than demonstrating an overgeneralization effect, the results from this study suggest that imagery-based fear conditioning generalizes to a similar extent as perceptually acquired fear conditioning. Further, the persistence of imagery-based fear may have unique extinction qualities in comparison to perceptual-based fear.

Biomarkers of Anxiety Acquisition and Generalization in Virtual Reality Experiments

Abstract. Anxiety disorders are characterized by exaggerated responses to a threatening situation and overgeneralization. Context conditioning has been used for the identification of risk factors. This systematic literature search identifies 16 articles published between 1990 and 2021 on differential anxiety conditioning and generalization in humans. Additionally, we provide example data for individuals suffering from panic attacks with and without depressive symptoms. Successful anxiety acquisition (discrimination between anxiety and safety context) was found on the subjective level of anxiety and US-expectancy, on the physiological level of electrodermal activity, and in the defensive behavior of startle response. Anxiety generalization (discrimination between generalization and safety context) was found on the verbal but not on the physiobehavioral level. In sum, we emphasize the impact of virtual reality on anxiety research. Verbal and physiobehavioral responses serve as reliable biomarkers for anxiety. Few studies found ratings to be the best predictor for anxiety generalization. Genetic predisposition or personality traits might foster overgeneralization.

Enhanced Instructed Fear Learning in Delusion-Proneness

Psychosis is associated with distorted perceptions and deficient bottom-up learning such as classical fear conditioning. This has been interpreted as reflecting imprecise priors in low-level predictive coding systems. Paradoxically, overly strong beliefs, such as overvalued beliefs and delusions, are also present in psychosis-associated states. In line with this, research has suggested that patients with psychosis and associated phenotypes rely more on high-order priors to interpret perceptual input. In this behavioural and fMRI study we studied two types of fear learning, i.e., instructed fear learning mediated by verbal suggestions about fear contingencies and classical fear conditioning mediated by low level associative learning, in delusion proneness-a trait in healthy individuals linked to psychotic disorders. Subjects were shown four faces out of which two were coupled with an aversive stimulation (CS+) while two were not (CS-) in a fear conditioning procedure. Before the conditioning, subjects were informed about the contingencies for two of the faces of each type, while no information was given for the two other faces. We could thereby study the effect of both classical fear conditioning and instructed fear learning. Our main outcome variable was evaluative rating of the faces. Simultaneously, fMRI-measurements were performed to study underlying mechanisms. We postulated that instructed fear learning, measured with evaluative ratings, is stronger in psychosis-related phenotypes, in contrast to classical fear conditioning that has repeatedly been shown to be weaker in these groups. In line with our hypothesis, we observed significantly larger instructed fear learning on a behavioural level in delusion-prone individuals (n = 20) compared to non-delusion-prone subjects (n = 23; n = 20 in fMRI study). Instructed fear learning was associated with a bilateral activation of lateral orbitofrontal cortex that did not differ significantly between groups. However, delusion-prone subjects showed a stronger functional connectivity between right lateral orbitofrontal cortex and regions processing fear and pain. Our results suggest that psychosis-related states are associated with a strong instructed fear learning in addition to previously reported weak classical fear conditioning. Given the similarity between nocebo paradigms and instructed fear learning, our results also have an impact on understanding why nocebo effects differ between individuals.

Learning via instructions about observations: exploring similarities and differences with learning via actual observations

Our behaviour toward stimuli can be influenced by observing how another person (a model) interacts with those stimuli. We investigated whether mere instructions about a model's interactions with stimuli (i.e. instructions about observations) are sufficient to alter evaluative and fear responses and whether these changes are similar in magnitude to those resulting from actually observing the interactions. In Experiments 1 (n = 268) and 2 (n = 260), participants either observed or read about a model reacting positively or negatively to stimuli. Evaluations of those stimuli were then assessed via ratings and a personalized implicit association test. In Experiments 3 (n = 60) and 4 (n = 190), we assessed participants' fear toward stimuli after observing or reading about a model displaying distress in the presence of those stimuli. While the results consistently indicated that instructions about observations induced behavioural changes, they were mixed with regard to whether instructions were as powerful in changing behaviour as observations. We discuss whether learning via observations and via instructions may be mediated by similar or different processes, how they might differ in their suitability for conveying certain types of information, and how their relative effectiveness may depend on the information to be transmitted.

Measuring fear: Association among different measures of fear learning

BACKGROUND AND OBJECTIVES

Fear conditioning paradigms use various measures to assess learned fear, including autonomic arousal responses like skin conductance, and self-reports of both associative (US-expectancies) and evaluative (affective ratings) learning. The present study uses a dimensional approach to examine associations among fear indices directly.

METHODS

Seventy-three participants completed a differential fear conditioning experiment, during which a neutral stimulus (CS+) was paired with an electric shock (US), while another stimulus (CS-) was never paired with the shock (partially instructed fear acquisition). Ten minutes later, both stimuli were presented without any shocks (fear extinction). Skin conductance responses and US-expectancy ratings were recorded during each phase, while self-reported negative affect was assessed for each CS at the end of extinction.

RESULTS

Results showed a positive association among US-expectancy ratings and skin conductance responses during acquisition and early extinction. US-expectancy ratings during overall extinction were positively associated with post-extinction negative affect.

LIMITATIONS

The lack of affective ratings post-acquisition may have obscured associations between associative and evaluative learning indices.

CONCLUSIONS

Results provide evidence for the expected correspondence among different indices of associative fear learning. Findings emphasize the need for incorporating both associative and evaluative learning measures in fear conditioning paradigms.

Human fear conditioning is moderated by stimulus contingency instructions

Recent research findings indicate that human fear conditioning is affected by instructions, particularly those concerning the contingency between the conditioned stimulus (CS) and the unconditioned stimulus (US). However, whether or not such instructions were provided to participants often remains unsaid in fear conditioning studies. In the current study (N = 102), we investigated whether conditioned fear acquisition depends on CS-US contingency instructions. Participants were randomly assigned to one of three groups. The first group was instructed about the precise CS-US contingency before conditioning. The second group was instructed to discover the CS-US contingency. The third group did not receive any contingency instructions. We found facilitated fear acquisition (using skin conductance and startle) and increased contingency awareness in the first and second group compared to the third group. Furthermore, contingency reversal instructions immediately reversed conditioned responses. Based on these results, we advise to systematically report the contingency instructions used in fear conditioning research.

Revisiting potential associations between brain morphology, fear acquisition and extinction through new data and a literature review

Inter-individual differences in defensive responding are widely established but their morphological correlates in humans have not been investigated exhaustively. Previous studies reported associations with cortical thickness of the dorsal anterior cingulate cortex, insula and medial orbitofrontal cortex as well as amygdala volume in fear conditioning studies. However, these associations are partly inconsistent and often derived from small samples. The current study aimed to replicate previously reported associations between physiological and subjective measures of fear acquisition and extinction and brain morphology. Structural magnetic resonance imaging was performed on 107 healthy adults who completed a differential cued fear conditioning paradigm with 24 h delayed extinction while skin conductance response (SCR) and fear ratings were recorded. Cortical thickness and subcortical volume were obtained using the software Freesurfer. Results obtained by traditional null hypothesis significance testing and Bayesians statistics do not support structural brain-behavior relationships: Neither differential SCR nor fear ratings during fear acquisition or extinction training could be predicted by cortical thickness or subcortical volume in regions previously reported. In summary, the current pre-registered study does not corroborate associations between brain morphology and inter-individual differences in defensive responding but differences in experimental design and analyses approaches compared to previous work should be acknowledged.

Making translation work: Harmonizing cross-species methodology in the behavioural neuroscience of Pavlovian fear conditioning

Translational neuroscience bridges insights from specific mechanisms in rodents to complex functions in humans and is key to advance our general understanding of central nervous function. A prime example of translational research is the study of cross-species mechanisms that underlie responding to learned threats, by employing Pavlovian fear conditioning protocols in rodents and humans. Hitherto, evidence for (and critique of) these cross-species comparisons in fear conditioning research was based on theoretical viewpoints. Here, we provide a perspective to substantiate these theoretical concepts with empirical considerations of cross-species methodology. This meta-research perspective is expected to foster cross-species comparability and reproducibility to ultimately facilitate successful transfer of results from basic science into clinical applications.

Renewal of conditioned fear responses using a film clip as the aversive unconditioned stimulus

BACKGROUND AND OBJECTIVES

Pavlovian fear conditioning paradigms are valuable to investigate fear learning and the return of extinguished fear in the lab. However, their validity is limited, because the aversive stimuli (e.g., electric shocks) typically lack the modalities and complexity of real-world aversive experiences. To overcome this limitation, we examined fear acquisition, extinction and contextual renewal using an audiovisual unconditioned stimulus (US).

METHOD

On day 1, 50 healthy participants completed an acquisition phase in a specific context (i.e., desk or bookcase, 'context A'). Pictures of colored lamps served as conditioned stimuli and an aversive film clip was used as US. On day 2, extinction took place in the same context ('context A') or in a different context ('context B'). Afterwards, renewal was tested in the acquisition context (AAA vs. ABA design).

RESULTS

As hypothesized, fear acquisition and extinction, as measured by US expectancy ratings, fear potentiated startle (FPS), and skin conductance responses (SCRs), were successful. Most importantly, conditioned responding was renewed on all measures in the ABA condition, but not in the AAA condition. Differential renewal (i.e., larger renewal for CS + than for CS-) was only observed for US expectancy ratings.

LIMITATIONS

The return of conditioned responses was non-differential for FPS and SCR.

CONCLUSIONS

The current set-up enables investigation of fear renewal using an audiovisual US. Future studies can utilize this paradigm to investigate interventions that aim to reduce fear renewal by modifying the US memory, such as Eye Movement Desensitization and Reprocessing and imagery rescripting.

Preregistration of Analyses of Preexisting Data

The preregistration of a study's hypotheses, methods, and data-analyses steps is becoming a popular psychological research practice. To date, most of the discussion on study preregistration has focused on the preregistration of studies that include the collection of original data. However, much of the research in psychology relies on the (re-)analysis of preexisting data. Importantly, this type of studies is different from original studies as researchers cannot change major aspects of the study (e.g., experimental manipulations, sample size). Here, we provide arguments as to why it is useful to preregister analyses of preexisting data, discuss practical considerations, consider potential concerns, and introduce a preregistration template tailored for studies focused on the analyses of preexisting data. We argue that the preregistration of hypotheses and data-analyses for analyses of preexisting data is an important step towards more transparent psychological research.

A review of boundary conditions and variables involved in the prevention of return of fear after post-retrieval extinction

Experimental evidence suggests that the return of fear may be prevented by post-retrieval extinction (PRE), a procedure consisting of extinction training after the presentation of a retrieval cue. However, attempts to replicate these findings have yielded mixed results, with some studies showing diminished fear responses after PRE, whereas others show no effect on the return of fear following this procedure. The discrepancies across studies have been interpreted as evidence that there might be conditions under which PRE is not effective (boundary conditions), but these variables have yet to be fully described. We aimed to provide an overview of PRE in humans. We briefly present the theory and research that originated post-retrieval procedures with a focus on the experimental setup used in human studies. We continue with a compilation of possible experimental boundary conditions along with some questions for future research.

Instructed fear stimuli bias visual attention

We investigated whether stimuli merely instructed to be fear-relevant can bias visual attention, even when the fear relation was never experienced before. Participants performed a dot-probe task with pictures of naturally fear-relevant (snake or spider) or -irrelevant (bird or butterfly) stimuli. Instructions indicated that two pictures (one naturally fear-relevant and one fear-irrelevant) could be followed by an electrical stimulation (i.e., instructed fear). In reality, no stimulation was administered. During the task, two pictures were presented on each side of the screen, after which participants had to determine as fast as possible on which side a black dot appeared. After a first phase, fear was reinstated by instructing participants that the device was not connected but now was (reinstatement phase). Participants were faster when the dot appeared on a location where an instructed fear picture was presented. This effect seemed independent of whether picture content was naturally fear-relevant, but was only found in the first half of each phase, suggesting rapid extinction due to the absence of stimulation, and rapid re-evaluation after reinstatement. A second experiment similarly showed that instructed fear biases attention, even when participants were explicitly instructed that no stimulation would be given during the dot-probe task. Together, these findings demonstrate that attention can be biased towards instructed fear stimuli, even when these fear relations were never experienced. Future studies should test whether this is specific to fear, or can be observed for all instructions that change the relevance of a given stimulus.

Subjective, physiological, and behavioural responses towards evaluatively conditioned stimuli

Evaluative Conditioning (EC) is commonly defined as the change in liking of a stimulus (conditioned stimulus, CS) due to its pairings with an affective unconditioned stimulus (US). In Experiment 1, we investigated effects of repeated stimulus pairings on affective responses, i.e. valence and arousal ratings, pupil size, and duration estimation. After repeatedly pairing the CSs with affective USs, a consistent pattern of affective responses emerged: The CS_negative was rated as being more negative and more arousing, resulted in larger pupils, and was temporally overestimated compared to the CS_neutral. In Experiment 2, the influence of a mere instruction about the contingency between a CS and US on affective responses was examined. After mere instruction about upcoming pairings between the CS and US, subjective ratings also changed, but there was neither evidence for differential pupillary responses nor for differential temporal processing. The results indicate that EC via pairings or instructions can change the affective responses towards formerly neutral stimuli and introduce pupil size as a physiological measure in EC research. However, Experiment 2 suggests that there might be moderating factors based on the type of EC procedure involved.

Pattern Analyses Reveal Separate Experience-Based Fear Memories in the Human Right Amygdala

Learning fear via the experience of contingencies between a conditioned stimulus (CS) and an aversive unconditioned stimulus (US) is often assumed to be fundamentally different from learning fear via instructions. An open question is whether fear-related brain areas respond differently to experienced CS-US contingencies than to merely instructed CS-US contingencies. Here, we contrasted two experimental conditions where subjects were instructed to expect the same CS-US contingencies while only one condition was characterized by prior experience with the CS-US contingency. Using multivoxel pattern analysis of fMRI data, we found CS-related neural activation patterns in the right amygdala (but not in other fear-related regions) that dissociated between whether a CS-US contingency had been instructed and experienced versus merely instructed. A second experiment further corroborated this finding by showing a category-independent neural response to instructed and experienced, but not merely instructed, CS presentations in the human right amygdala. Together, these findings are in line with previous studies showing that verbal fear instructions have a strong impact on both brain and behavior. However, even in the face of fear instructions, the human right amygdala still shows a separable neural pattern response to experience-based fear contingencies.SIGNIFICANCE STATEMENT In our study, we addressed a fundamental problem of the science of human fear learning and memory, namely whether fear learning via experience in humans relies on a neural pathway that can be separated from fear learning via verbal information. Using two new procedures and recent advances in the analysis of brain imaging data, we localized purely experience-based fear processing and memory in the right amygdala, thereby making a direct link between human and animal research.

Don't fear 'fear conditioning': Methodological considerations for the design and analysis of studies on human fear acquisition, extinction, and return of fear

The so-called 'replicability crisis' has sparked methodological discussions in many areas of science in general, and in psychology in particular. This has led to recent endeavours to promote the transparency, rigour, and ultimately, replicability of research. Originating from this zeitgeist, the challenge to discuss critical issues on terminology, design, methods, and analysis considerations in fear conditioning research is taken up by this work, which involved representatives from fourteen of the major human fear conditioning laboratories in Europe. This compendium is intended to provide a basis for the development of a common procedural and terminology framework for the field of human fear conditioning. Whenever possible, we give general recommendations. When this is not feasible, we provide evidence-based guidance for methodological decisions on study design, outcome measures, and analyses. Importantly, this work is also intended to raise awareness and initiate discussions on crucial questions with respect to data collection, processing, statistical analyses, the impact of subtle procedural changes, and data reporting specifically tailored to the research on fear conditioning.

Rapid Top-Down Control of Behavior Due to Propositional Knowledge in Human Associative Learning

Propositional and associative processes have been proposed to explain human associative learning. Our main objective in this study was to evaluate whether propositional knowledge may gain control over behavior even under high time-pressure conditions, as suggested by propositional single-process models. In the experiment reported, different groups of participants had to learn a series of cue-outcome relationships on a trial-by-trial basis under different time pressure conditions. Later, a simple verbal instruction indicated that one of the cues had reversed its contingency (informed condition). The other cue had also changed its contingency, though in an unanticipated way (uninformed condition) whilst other contingencies did not change (no-change condition). The results showed that, in the absence of instructions, interference (i.e., uninformed vs. no-change effect) was greater in the high time than in the low time-pressure group. This result indicates that those responses which were previously relevant are more difficult to inhibit when there is little time to respond. However, time pressure had no detectable effect on the use of the verbal instruction, since an equivalent instruction advantage (i.e., uninformed vs. informed effect) was obtained in both time pressure groups. These results reveal that propositional knowledge can override those cue-outcome relationships that were learnt trial-by-trial even under conditions of high cognitive demand. This pattern of results is consistent with a propositional single-process model of associative learning.

Generalization of socially transmitted and instructed avoidance

Excessive avoidance behavior, in which an instrumental action prevents an upcoming aversive event, is a defining feature of anxiety disorders. Left unchecked, both fear and avoidance of potentially threatening stimuli may generalize to perceptually related stimuli and situations. The behavioral consequences of generalization mean that aversive learning experiences with specific threats may lead to the inference that classes of related stimuli are threatening, potentially dangerous, and need to be avoided, despite differences in physical form. Little is known however about avoidance generalization in humans and the learning pathways by which it may be transmitted. In the present study, we compared two pathways to avoidance—instructions and social observation—on subsequent generalization of avoidance behavior, fear expectancy and physiological arousal. Participants first learned that one cue was a danger cue (conditioned stimulus, CS+) and another was a safety cue (CS−). Groups were then either instructed that a simple avoidance response in the presence of the CS+ cancelled upcoming shock (instructed-learning group) or observed a short movie showing a demonstrator performing the avoidance response to prevent shock (observational-learning group). During generalization testing, danger and safety cues were presented along with generalization stimuli that parametrically varied in perceptual similarity to the CS+. Reinstatement of fear and avoidance was also tested. Findings demonstrate, for the first time, generalization of socially transmitted and instructed avoidance: both groups showed comparable generalization gradients in fear expectancy, avoidance behavior and arousal. Return of fear was evident, suggesting that generalized avoidance remains persistent following extinction testing. The utility of the present paradigm for research on avoidance generalization is discussed.