In anxiety, maladaptive avoidance behavior provides for near-perfect controllability of potential threat. There has been little laboratory-based treatment research conducted on controllability as a contributing factor in the transition from adaptive to maladaptive avoidance. Here, we investigated for the first time whether partial reinforcement rate, or the reliability of avoidance at controlling or preventing contact with an aversive event, influences subsequent extinction of avoidance in humans. Five groups of participants were exposed to different partial reinforcement rates where avoidance cancelled upcoming shock on 100%, 75%, 50%, 25% or 0% of trials. During extinction, all shocks were withheld. Avoidance behavior, online shock expectancy ratings and skin conductance responses (SCRs) were measured throughout. We found that avoidance was a function of relative controllability: higher reinforcement rate groups engaged in significantly more extinction-resistant avoidance than lower reinforcement groups, and shock expectancy was inversely related with reinforcement rate during avoidance acquisition. Partial reinforcement effects were not evident in SCRs. Overall, the current study highlights the clinical relevance of laboratory-based treatment research on partial reinforcement or controllability effects on extinction of avoidance.

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Low-cost avoidance maintains low-threat value of safety cues.

Maladaptive avoidance of safe stimuli is a defining feature of anxiety and related disorders. Avoidance may involve physical effort or the completion of a fixed series of responses to prevent occurrence of, or cues associated with, the aversive event. Understanding the role of response effort in the acquisition and extinction of avoidance may facilitate the development of new clinical treatments for maladaptive avoidance. Despite this, little is known about the impact of response effort on extinction-resistant avoidance in humans. Here, we describe findings from two laboratory-based treatment studies designed to investigate the impact of high and low response effort on the extinction (Experiment 1) and return (Experiment 2) of avoidance. Response effort was operationalized as completion of fixed-ratio (FR) reinforcement schedules for both danger and safety cues in a multi-cue avoidance paradigm with behavioural, self-report, and physiology measures. Completion of the FR response requirements cancelled upcoming shock presentations following danger cues and had no impact on the consequences that followed safety cues. Both experiments found persistence of high response-effort avoidance across danger and safety cues and sustained (Experiment 1) and reinstated (Experiment 2) levels of fear and threat expectancy. Skin conductance responses evoked by all cues were similar across experiments. The present findings and paradigm have implications for translational research on maladaptive anxious coping and treatment development.