Journal
BIOLOGICAL PSYCHIATRY
Volume 78, Issue 3, Pages 203-209Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2014.12.008
Keywords
Anxiety; Arousal; Electrodermal; Fear; Pavlovian; Regulation
Categories
Funding
- National Institutes of Health [RO1 MH097085]
- National Institutes of Health Grant [M0H38774]
- National Institute of Mental Health Training Award in Systems and Integrative Neuroscience [T32 MH019524]
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BACKGROUND: Experimental extinction serves as a model for psychiatric treatments based on associative learning. However, the effects of extinction are often transient, as evidenced by postextinction return of defensive behaviors. From a therapeutic perspective, an inherent problem with extinction may be that mere omission of threat is not sufficient to reduce future threat uncertainty. The current study tested an augmented form of extinction that replaced, rather than merely omitted, expected threat outcomes with novel nonthreat outcomes, with the goal of reducing postextinction return of defensive behaviors. METHODS: Thirty-two healthy male Sprague-Dawley rats and 47 human adults underwent threat conditioning to a conditioned stimulus paired with an electrical shock. Subjects then underwent a standard extinction protocol with shock omitted or an augmented extinction protocol wherein the shock was replaced by a surprising tone. Tests of postextinction recovery occurred 24 hours later in the absence of the tone. RESULTS: Replacing the shock with a novel nonthreat outcome, as compared with shock omission, reduced postextinction recovery (freezing in rats and anticipatory skin conductance responses in humans) when tested 24 hours later. Self-reported intolerance of uncertainty was positively correlated with recovery following standard extinction in humans, providing new evidence that postextinction recovery is related to sensitivity to future threat uncertainty. CONCLUSIONS: These findings provide cross-species evidence of a novel strategy to enhance extinction that may have broad implications for how to override associative learning that has become maladaptive and offer a simple technique that could be straightforwardly adapted and implemented in clinical situations.
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