Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, the Netherlands; Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Marcusstraße 9-11, 97070 Würzburg, Germany.
School of Psychology, University of New South Wales Sydney, Kensington NSW 2052 Sydney, Australia.
Behav Res Ther. 2023 Jan;160:104233. doi: 10.1016/j.brat.2022.104233. Epub 2022 Nov 18.
Exposure-based treatment involves repeated presentation of feared stimuli or situations in the absence of perceived threat (i.e., extinction learning). However, the stimulus or situation of fear acquisition (CS+) is highly unlikely to be replicated and presented during treatment. Thereby, stimuli that resemble the CS+ (generalization stimuli; GSs) are typically presented. Preliminary evidence suggests that depending on how one generalizes fear (i.e., different generalization rules), presenting the same GS in extinction leads to differential effectiveness of extinction learning. The current study aimed to extend this finding to safety behaviors. After differential fear and avoidance conditioning, participants exhibited discrete generalization gradients that were consistent with their reported generalization rules (Similarity vs Linear). The Linear group showed stronger safety behaviors to a selected GS compared to the Similarity group, presumably due to higher threat expectancy. After extinction learning to this GS, the Linear group exhibited stronger reduction in safety behaviors generalization compared to the Similarity group. The results show that identifying distinct generalization rules allows one to predict expectancy violation to the extinction stimulus, in addition to corroborating the idea that strongly violating threat expectancy leads to better extinction learning and its generalization. With regard to clinical implications, identifying one's generalization rule (e.g., threat beliefs) help designing exposure sessions that evoke strong expectancy violation, enhancing the reduction in the generalization of maladaptive safety behaviors.
暴露疗法涉及在没有感知到威胁的情况下（即，消退学习）反复呈现恐惧刺激或情境。然而，恐惧习得的刺激或情境（条件刺激；CS+）极不可能在治疗中被复制和呈现。因此，通常会呈现类似于 CS+的刺激（泛化刺激；GS）。初步证据表明，取决于一个人如何泛化恐惧（即，不同的泛化规则），在消退中呈现相同的 GS 会导致消退学习的效果不同。本研究旨在将这一发现扩展到安全行为。在差异化的恐惧和回避条件作用后，参与者表现出与他们报告的泛化规则一致的离散泛化梯度（相似性与线性）。线性组在所选 GS 上表现出比相似性组更强的安全行为，这可能是由于更高的威胁预期。在对这个 GS 进行消退学习后，线性组表现出比相似性组更强的安全行为泛化减少。结果表明，识别不同的泛化规则可以预测对消退刺激的期望违反，此外还证实了这样一种观点，即强烈违反威胁预期会导致更好的消退学习及其泛化。关于临床意义，识别一个人的泛化规则（例如，威胁信念）有助于设计引发强烈期望违反的暴露治疗，从而增强对适应不良的安全行为的泛化减少。
