No abstract

The aim of the current study was twofold: (1) to systematically examine differences in fear conditioning between anxiety patients and healthy controls using meta-analytic methods, and (2) to examine the extent to which study characteristics may account for the variability in findings across studies. Forty-four studies (published between 1920 and 2013) with data on 963 anxiety disordered patients and 1,222 control subjects were obtained through PubMed and PsycINFO, as well as from a previous meta-analysis on fear conditioning (Lissek et al.). Results demonstrated robustly increased fear responses to conditioned safety cues (CS-) in anxiety patients compared to controls during acquisition. This effect may represent an impaired ability to inhibit fear in the presence of safety cues (CS-) and/or may signify an increased tendency in anxiety disordered patients to generalize fear responses to safe stimuli resembling the conditioned danger cue (CS+). In contrast, during extinction, patients show stronger fear responses to the CS+ and a trend toward increased discrimination learning (differentiation between the CS+ and CS-) compared to controls, indicating delayed and/or reduced extinction of fear in anxiety patients. Finally, none of the included study characteristics, such as the type of fear measure (subjective vs. psychophysiological index of fear), could account significantly for the variance in effect sizes across studies. Further research is needed to investigate the predictive value of fear extinction on treatment outcome, as extinction processes are thought to underlie the beneficial effects of exposure treatment in anxiety disorders.

The growing literature conceptualizing mental disorders like posttraumatic stress disorder (PTSD) as networks of interacting symptoms faces three key challenges. Prior studies predominantly used (a) small samples with low power for precise estimation, (b) nonclinical samples, and (c) single samples. This renders network structures in clinical data, and the extent to which networks replicate across data sets, unknown. To overcome these limitations, the present cross-cultural multisite study estimated regularized partial correlation networks of 16 PTSD symptoms across four data sets of traumatized patients receiving treatment for PTSD (total N = 2,782). Despite differences in culture, trauma type, and severity of the samples, considerable similarities emerged, with moderate to high correlations between symptom profiles (0.43–0.82), network structures (0.62–0.74), and centrality estimates (0.63–0.75). We discuss the importance of future replicability efforts to improve clinical psychological science and provide code, model output, and correlation matrices to make the results of this article fully reproducible.

Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus (COVID-19) pandemic, fear can become chronic and burdensome. To better understand predictors of fear of the coronavirus, we conducted an online survey (N = 439) between March 14 and 17, 2020, which started three days after the World Health Organization declared the coronavirus outbreak a pandemic. Fear of the coronavirus was assessed with eight questions pertaining to different dimensions of fear (e.g., subjective worry, avoidance, preferential attention) and an open-ended question. The predictors included measures of psychological vulnerability factors (i.e., intolerance of uncertainty, worry, health anxiety), media exposure, and personal relevance (i.e., personal health, risk for loved ones, and risk control). We found that respondents reported a wide range of concerns relating to the coronavirus outbreak, such as the health of their loved ones, collapse of health care systems, and economic consequences. Four predictors for fear of the coronavirus were retained after backward selection in a simultaneous regression analysis: health anxiety, intolerance of uncertainty, media use, and risks for loved ones (R2 = .37). We discuss the relevance of our findings for managing people’s fear of the coronavirus.