Temporally massed CS presentations generate more fear extinction than spaced presentations.

Cain, Christopher K.; Blouin, Ashley M.; Barad, Mark

doi:10.1037/0097-7403.29.4.323

Cited by 125 publications

(143 citation statements)

References 57 publications

Supporting

Mentioning

130

Contrasting

Order By: Relevance

“…It is worth noting that during long extinction sessions, neither learning condition ( Figs 7A,B, 8A) showed a complete reduction in levels of CR. This is consistent with other studies using single-session extinction in rodents (Cain et al 2003) and humans (Tsao and Craske 2000). It is unclear whether the reduction of fear during extinction predicts fear expressed during subsequent tests (for review, see Craske et al 2014).…”

Section: Methodssupporting

confidence: 80%

Prediction error and trace dominance determine the fate of fear memories after post-training manipulations

et al. 2015

View full text Add to dashboard Cite

Different mnemonic outcomes have been observed when associative memories are reactivated by CS exposure and followed by amnestics. These outcomes include mere retrieval, destabilization-reconsolidation, a transitional period (which is insensitive to amnestics), and extinction learning. However, little is known about the interaction between initial learning conditions and these outcomes during a reinforced or nonreinforced reactivation. Here we systematically combined temporally specific memories with different reactivation parameters to observe whether these four outcomes are determined by the conditions established during training. First, we validated two training regimens with different temporal expectations about US arrival. Then, using Midazolam (MDZ) as an amnestic agent, fear memories in both learning conditions were submitted to retraining either under identical or different parameters to the original training. Destabilization (i.e., susceptibly to MDZ) occurred when reactivation was reinforced, provided the occurrence of a temporal prediction error about US arrival. In subsequent experiments, both treatments were systematically reactivated by nonreinforced context exposure of different lengths, which allowed to explore the interaction between training and reactivation lengths. These results suggest that temporal prediction error and trace dominance determine the extent to which reactivation produces the different outcomes.

show abstract

Section: Methodssupporting

confidence: 80%

Prediction error and trace dominance determine the fate of fear memories after post-training manipulations

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Additionally or alternatively, the improvement in this subgroup might not necessarily result from the added exposure but rather from the spacing of the additional exposure sessions during the booster phase. Animal studies (see Fitzgerald et al, 2014) showed that, once initiated in a massed way, extinction learning is boosted when subsequent trials are spaced (Cain et al, 2003). Third, the patients in this cluster may have needed exposure in a variety of contexts such as the home environment.…”

Section: Discussionmentioning

confidence: 99%

“…More theoretically, results from animal studies about fear extinction learning (i.e. the development of new associations with the stimulus that inhibits the manifestation of the original fear memory and the presumed mechanism of action of exposure therapy; see for an overview Fitzgerald, Seemann, & Maren, 2014) showed that once extinction learning is initiated in a massed way, further extinction learning is more effective when trials are spaced (Cain, Blouin, & Barad, 2003). …”

Section: Introductionmentioning

confidence: 99%

Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts

Hendriks

Kleine

Broekman³

et al. 2018

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background: Suboptimal response and high dropout rates leave room for improvement of trauma-focused treatment (TFT) effectiveness in ameliorating posttraumatic stress disorder (PTSD) symptoms. Objective: To explore the effectiveness and safety of intensive prolonged exposure (iPE) targeting chronic PTSD patients with a likely diagnosis of ICD-11 Complex PTSD following multiple interpersonal trauma and a history of multiple treatment attempts. Method: Participants (N = 73) received iPE in 12 × 90-minute sessions over four days (intensive phase) followed by four weekly 90-minute booster prolonged exposure (PE) sessions (booster phase). The primary outcomes, clinician-rated severity of PTSD symptoms, and diagnostic status (Clinician-Administered PTSD Scale; CAPS-IV) were assessed at baseline, post-treatment, and at three and six months. Treatment response trajectories were identified and predictors of these trajectories explored. Results: Mixed model repeated measures analysis of CAPS-IV scores showed a baseline-to-posttreatment decrease in PTSD symptom severity (p < .001) that persisted during the three- and six-month follow-ups with large effect sizes (Cohen’s d > 1.2); 71% of the participants responded. None of the participants dropped out during the intensive phase and only 5% during the booster phase. Adverse events were extremely low and only a minority showed symptom exacerbation. Cluster analysis demonstrated four treatment response trajectories: Fast responders (13%), Slow responders (26%), Partial responders (32%), and Non-responders (29%). Living condition and between-session fear habituation were found to predict outcome. Participants living alone were more likely to belong to the Partial responders than to the Non-responders cluster, and participants showing more between-session fear habituation were more likely to belong to the Fast responders than to the Non-responders cluster. Conclusions: The results of this open study suggest that iPE can be effective in PTSD patients with multiple interpersonal trauma and after multiple previous treatment attempts. In addition, in this chronic PTSD population iPE was safe.

show abstract

“…This study follows from a previous report from this group suggesting that extinction, unlike acquisition, proceeds more readily with massed trials (6 s interstimulus interval or ISI) than with spaced trials (600 s ISI), even when total CS exposure is held constant. 269 Massed extinction training produced a robust within-session decline in freezing that was maintained in a later retention test, whereas spaced extinction training maintained or even increased freezing during nonreinforced CS presentations and in a subsequent retention test, an effect that these authors attributed to 'incubation' of fear (cf. Berman et al 63 ).…”

Section: Neurotransmitter Systemsmentioning

confidence: 99%

Mechanisms of fear extinction

2006

View full text Add to dashboard Cite

Excessive fear and anxiety are hallmarks of a variety of disabling anxiety disorders that affect millions of people throughout the world. Hence, a greater understanding of the brain mechanisms involved in the inhibition of fear and anxiety is attracting increasing interest in the research community. In the laboratory, fear inhibition most often is studied through a procedure in which a previously fear conditioned organism is exposed to a fear-eliciting cue in the absence of any aversive event. This procedure results in a decline in conditioned fear responses that is attributed to a process called fear extinction. Extensive empirical work by behavioral psychologists has revealed basic behavioral characteristics of extinction, and theoretical accounts have emphasized extinction as a form of inhibitory learning as opposed to an erasure of acquired fear. Guided by this work, neuroscientists have begun to dissect the neural mechanisms involved, including the regions in which extinction-related plasticity occurs and the cellular and molecular processes that are engaged. The present paper will cover behavioral, theoretical and neurobiological work, and will conclude with a discussion of clinical implications. Molecular Psychiatry (2007) 12, 120-150.

show abstract

Temporally massed CS presentations generate more fear extinction than spaced presentations.

Cited by 125 publications

References 57 publications

Prediction error and trace dominance determine the fate of fear memories after post-training manipulations

Prediction error and trace dominance determine the fate of fear memories after post-training manipulations

Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts

Mechanisms of fear extinction

Contact Info

Product

Resources

About