4.7 Review

Fear one, fear them all: A systematic review and meta-analysis of fear generalization in pathological anxiety

Journal

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 139, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2022.104707

Keywords

Fear generalization; Overgeneralization of fear; Pathological anxiety; Etiology of anxiety disorders; Systematic review; Meta-analysis

Funding

  1. University of Mannheim's Graduate School of Economic and Social Sciences - German Research Foundation (DFG)

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Fear generalization, which is the extension of fear from one conditioned stimulus to similar cues, is a defining feature of anxiety disorders. However, the link between generalization and pathological anxiety, as well as its moderators, has not been formally integrated. This systematic review and meta-analysis clarifies the relationship and provides recommendations for further research.
It is a defining feature of anxiety disorders that fear is elicited by a circumscribed class of stimuli rather than by only one specific exemplar of that class. Therefore, fear generalization, a mechanism by which associative fear extends from one conditioned stimulus to similar cues, has been central to theories on anxiety. Yet, experimental evidence for the link between generalization and pathological anxiety, as well as its moderators, has not been formally integrated. This systematic review and meta-analysis of empirical findings clarifies the relationship between fear generalization and pathological anxiety. In conclusion, enhanced fear generalization is associated with several anxiety disorders and stress-related disorders, which is supported statistically by a small, but robust effect size of g = 0.44 for risk ratings as an index of fear generalization. However, empirical results are inconsistent across disorders and they rarely allow for conclusions on their causality in the disorders' etiology. Therefore, based on theoretical considerations, we recommend directions for intensified research, especially on the causal relationship between overgeneralization and pathological fear.

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