Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands.
Laboratory of Biological Psychology, KU Leuven, Leuven, Belgium.
Behav Res Ther. 2018 Dec;111:99-105. doi: 10.1016/j.brat.2018.10.011. Epub 2018 Oct 30.
Excessive avoidance towards innocuous cues is a central diagnostic criterion across anxiety-related disorders. Relevant laboratory paradigms typically include instrumental learning procedures, where the presentation of an aversive cue (e.g., a shock) can be prevented by executing an experimenter-defined response (e.g., a button press) during the presentation of a warning cue (e.g., a square). Despite the popularity of these paradigms, there is no evaluation of how well the experimental findings of conditioned avoidance extend to maladaptive avoidance, or whether findings from animal studies could be informative for human studies. Here, we present a validation of the conditioned avoidance paradigm. We show that although this procedure meets the majority of the tested validity criteria (i.e. face, construct, predictive, and diagnostic validity), it also faces a number of challenges, including the non-consideration of individual differences in learning or the use of procedures that cannot be easily translated to clinical settings. For meeting these challenges, we suggest extensions of the paradigm including the test of individual differences by using ambiguous stimuli as well as the use of virtual reality procedures. Our main conclusion is that despite the significant knowledge provided in conditioned avoidance paradigms, their expansion will allow reaching more theoretical and clinical insights.
过度回避无害线索是各种焦虑相关障碍的一个核心诊断标准。相关的实验室范式通常包括工具性学习程序，其中在警告线索（例如，正方形）呈现期间执行实验者定义的反应（例如，按钮按压）可以防止呈现厌恶性线索（例如，电击）。尽管这些范式很流行，但并没有评估条件回避的实验结果在适应不良回避方面的有效性，或者动物研究的结果是否对人类研究有启发性。在这里，我们验证了条件回避范式。我们表明，尽管该程序符合大多数经过测试的有效性标准（即，表面、结构、预测和诊断有效性），但它也面临着许多挑战，包括不考虑学习中的个体差异或使用无法轻易转化为临床环境的程序。为了应对这些挑战，我们建议通过使用模糊刺激来测试个体差异，并使用虚拟现实程序来扩展该范式。我们的主要结论是，尽管条件回避范式提供了重要的知识，但它们的扩展将允许获得更多的理论和临床见解。
