a Department of Clinical Psychology, Utrecht University , Utrecht , the Netherlands.
Cogn Emot. 2019 Nov;33(7):1523-1530. doi: 10.1080/02699931.2019.1573718. Epub 2019 Mar 5.
Avoidance towards innocuous cues is a key diagnostic criterion across anxiety-related disorders. Importantly, the most effective intervention for anxiety-related disorders, exposure therapy with response prevention, sometimes does not prevent the relapse of anxiety's symptomatology. We tested whether extinction effects, the experimental proxy of exposure, are enhanced by increasing the discrepancy between the prediction of an unpleasant event happening (shock presentation), and the actual event (shock omission). Forty-eight individuals first saw pictures of three stimuli. Two pictures (CSA, CSB) were followed by a shock (US) and one (CS-) was not. Next, participants learned to avoid the US by pressing a computer key. An extinction and response prevention procedure followed. In the first part of it, participants saw unreinforced presentations of all CSs. In the second part, the group saw unreinforced presentations of the CSA and CS-. The group encountered compound unreinforced presentations of the CSA and CSB, and separate presentations of the CS-. Return of avoidance and fear was tested after unsignalled presentations of the US. Compound extinction resulted in comparable reduction of fear and avoidance compared to standard extinction. We discuss how future research could enhance extinction effects by adding costs to the avoidance behaviour.
回避无害线索是各种焦虑相关障碍的一个关键诊断标准。重要的是，对于焦虑相关障碍最有效的干预措施，即暴露疗法和反应预防，有时并不能防止焦虑症状的复发。我们测试了是否可以通过增加不愉快事件发生的预测（呈现电击）与实际事件（不呈现电击）之间的差异来增强消退效应，即暴露的实验替代物。48 名参与者首先观看了三张刺激物的图片。两张图片（CSA 和 CSB）之后会呈现电击（US），而一张（CS-）则不会。接下来，参与者通过按下计算机键来学习避免 US。随后进行了消退和反应预防程序。在第一部分中，参与者看到了所有 CS 的无强化呈现。在第二部分，组看到了 CSA 和 CS-的无强化呈现。组则遇到了 CSA 和 CSB 的复合无强化呈现，以及 CS-的单独呈现。在 US 无信号呈现后，测试了回避和恐惧的恢复情况。与标准消退相比，复合消退导致恐惧和回避的减少相当。我们讨论了未来的研究如何通过对回避行为增加成本来增强消退效应。
