Kuhn Manuel, Mertens Gaetan, Lonsdorf Tina B
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ghent University, Ghent, Belgium.
Int J Psychophysiol. 2016 Dec;110:194-199. doi: 10.1016/j.ijpsycho.2016.08.001. Epub 2016 Aug 3.
Current treatments for anxiety disorders are effective but limited by the high frequency of clinical relapse. Processes underlying relapse are thought to be experimentally modeled in fear conditioning experiments with return fear (ROF) inductions. Thereby reinstatement-induced ROF might be considered a model to study mechanisms underlying adversity-induced relapse. Previous studies have reported differential ROF (i.e. specific for the danger stimulus) but also generalized ROF (i.e. for safe and danger stimuli), but reasons for these divergent findings are not clear yet. Hence, the response pattern (i.e. differential or generalized) following reinstatement may be of importance for the prediction of risk or resilience for ROF. The aim of this study was to investigate state anxiety as a potential individual difference factor contributing to differentiability or generalization of return of fear. Thirty-six participants underwent instructed fear expression, extinction and ROF induction through reinstatement while physiological (skin conductance response, fear potentiated startle) and subjective measures of fear and US expectancy were acquired. Our data show that, as expected, high state anxious individuals show deficits in SCR discrimination between dangerous and safe cues after reinstatement induced ROF (i.e. generalization) as compared to low state anxious individuals. The ability to maintain discrimination under aversive circumstances is negatively associated with pathological anxiety and predictive of resilient responding while excessive generalization is a hallmark of anxiety disorders. Therefore, we suggest that experimentally induced ROF might prove useful in predicting relapse risk in clinical settings and might have implications for possible interventions for relapse prevention.
目前针对焦虑症的治疗方法是有效的，但受临床高复发率的限制。复发背后的过程被认为可以在伴有恢复性恐惧（ROF）诱导的恐惧条件实验中进行实验建模。因此，恢复诱导的ROF可能被视为一种研究逆境诱导复发潜在机制的模型。先前的研究报告了差异性ROF（即特定于危险刺激）以及泛化性ROF（即针对安全和危险刺激），但这些不同发现的原因尚不清楚。因此，恢复后的反应模式（即差异性或泛化性）对于预测ROF的风险或恢复力可能很重要。本研究的目的是调查状态焦虑作为一个潜在的个体差异因素，对恐惧恢复的差异性或泛化性的影响。三十六名参与者在接受指导下进行恐惧表达、消退和通过恢复诱导ROF，同时获取生理指标（皮肤电反应、恐惧增强惊吓）以及恐惧和预期结果的主观测量指标。我们的数据表明，正如预期的那样，与低状态焦虑个体相比，高状态焦虑个体在恢复诱导ROF后（即泛化）对危险和安全线索的皮肤电反应辨别能力存在缺陷。在厌恶情境下维持辨别的能力与病理性焦虑呈负相关，并可预测恢复性反应，而过度泛化是焦虑症的一个特征。因此，我们认为实验诱导的ROF可能在临床环境中预测复发风险方面有用，并且可能对预防复发的可能干预措施有启示。
