Temporal dynamics of relief in avoidance conditioning and fear extinction: Experimental validation and clinical relevance

Abstract

The learning principles that guide the acquisition and extinction of avoidance are not fully understood. We developed a novel paradigm to study the temporal dynamics of relief, a putative reinforcer of avoidance, and the recovery of fear and avoidance following extinction. During conditioning, the avoidance action canceled the aversive unconditional stimulus (US), without terminating the predictive conditional stimulus (CS). Relief pleasantness was rated after fixed CS offsets, when US omission occured. Avoidance was effective to one CS, but not to another, to track stimulus-specific avoidance learning. Fear was extinguished under response prevention in a separate context. Recovery tests took place 24 h later, in both contexts and with a monetary cost added to the avoidance action. We found that avoidance gradually became stimulus-specific during conditioning, but hardly recovered during delayed testing. Across all phases, initial omissions of the aversive US triggered relief that gradually declined over consecutive omissions, in line with a theoretical prediction error signal. Participants that scored low on distress tolerance, however, displayed sustained levels of relief over continuous omissions. We propose that such forms of sustained relief may produce over-reinforcement of foregoing avoidance actions and promote the development of pathological avoidance. The current paradigm represents an efficacious tool to study the temporal dynamics of relief across avoidance learning and fear extinction and to characterize relief dysregulations in relation to psychopathology.

Renewal of fear and avoidance in humans to escalating threat: Implications for translational research on anxiety disorders

“…First, future studies should evaluate renewal using variants of Pavlovian and response-prevention extinction procedures aimed at augmenting exposure therapy (Vervliet & Indekeu, 2015;Vervliet et al, 2017). First, future studies should evaluate renewal using variants of Pavlovian and response-prevention extinction procedures aimed at augmenting exposure therapy (Vervliet & Indekeu, 2015;Vervliet et al, 2017).…”

“…Notwithstanding the above, the present study has several limitations which warrant further empirical attention. First, future studies should evaluate renewal using variants of Pavlovian and response-prevention extinction procedures aimed at augmenting exposure therapy (Vervliet & Indekeu, 2015;Vervliet et al, 2017). With such procedures, avoidance responding is either possible or prevented, the aversive event is withheld, and is then tested for renewal.…”

“…Related human studies have shown avoidance renewal following Pavlovian extinction with response prevention as well as instructions to not avoid (Vervliet & Indekeu, 2015). Renewal of avoidance can also be attenuated when a monetary cost is added to engage in avoidance (Vervliet, Lange, & Milad, 2017). Further, clinical studies with spider-fearful participants report a significant return of self-reported fear and behavioral avoidance (Rodriguez, Craske, Mineka & Hladek, 1999), but not elevated heart rate (Mineka, Mystkowski, Hladek, & Rodriguez, 1999;Mystkowski, Craske, & Echiverri, 2002), underscoring the complex relationship between fear and avoidance (Mineka, 1979).…”

Situational fears: Association with negative affect-related smoking cognition among treatment seeking smokers

“…Additionally, fears and avoidance exist on a continuum, ranging from mild to extreme (Harb, Eng, Zaider, & Heimberg, 2003). Although specific fears and avoidance frequently co-occur (Vervliet, Lange, & Milad, 2017), they are not perfectly coupled (Friedman, Stephens, & Thayer, 2014). For example, a person may have a fear of public situations, but may endure social situations while feeling anxious (Harb et al, 2003).…”

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

“…This reveals the implicit assumption that decreasing Pavlovian fear responses will naturally lead to decreased avoidance and enhanced life functioning, and relapse of fear will invariably lead to clinical relapse. Avoidance may persist even after fear has been extinguished, and the availability of an avoidance response following fear extinction has been shown to increase levels of fear (Vervliet & Indekeu, 2015;Vervliet, Lange, & Milad, 2017;Xia, Eyolfson, Lloyd, Vervliet, & Dymond, 2019). Decreases in Pavlovian fear responses do not consistently lead to decreases in avoidance (Treanor & Barry, 2017) or to more engagement in important areas of life (Gloster et al, 2017).…”