Predictors of behavioral avoidance during respiratory symptom provocation

Transfer of exposure therapy effects to a threat context not considered during treatment in patients with panic disorder and agoraphobia: Implications for potential mechanisms of change

“…It has been suggested that avoidance behavior is initially motivated by the fear response but then becomes an inflexible autonomic habit-like behavior (Campese, et al, 2016;Gillan, et al, 2016;LeDoux, et al, 2017). Indeed, avoidance behavior was maintained without any detectable indices of fear supporting previous research both in animals (Kamin, Brimer, & Black, 1963;Mineka & Gino, 1980;Solomon, Kamin, & Wynne, 1953;Solomon & Wynne, 1954;Starr & Mineka, 1977) and humans (Benke, Krause, Hamm, & Pane-Farre, 2019;Delgado, Jou, Ledoux, & Phelps, 2009;Lovibond, Mitchell, Minard, Brady, & Menzies, 2009;Lovibond, Saunders, Weidemann, & Mitchell, 2008;Vervliet & Indekeu, 2015). Translating these basic research findings to our clinical sample we found a strong reduction of reported fear and physiological responding in those patients who showed active avoidance at both t1 and t2.…”

Promoting long-term inhibition of human fear responses by non-invasive transcutaneous vagus nerve stimulation during extinction training

“…Again, although a spontaneous recovery of fear after 28 days was not prevented by tVNS-paired extinction, these new finding suggest that tVNS may also facilitate the reduction of long-term risk assessments by consolidating the extinction memory that a cue is no longer associated with an aversive event. Since elevated expectations of aversive events in a certain context seem to be important for motivating avoidance behavior 43,44 transcutaneous vagus nerve stimulation might be an important adjunct to cognitive-behavioral exposure-based therapy, aimed to reduce persistent avoidance behavior in patients with anxiety disorders. group (d: right).…”

A Revised Framework for the Investigation of Expectation Update Versus Maintenance in the Context of Expectation Violations: The ViolEx 2.0 Model

“…Although approach and avoidance behaviors are not defined by expectation-related goals in ViolEx 2.0, they can play a central role in expectation update and maintenance. A prominent example is fearful avoidance ( Mowrer, 1956 ; Bouton et al, 2001 ; Vlaeyen and Linton, 2012 ; Benke et al, 2019 ). Here, individuals will avoid situations because of an anticipated situational outcome’s inherent aversiveness (e.g., pain) which prevents exposure to potential correcting expectation violations (i.e., no pain) and, as a consequence, leads to stable and invalid generalized expectations about threat.…”