Learning abnormalities have long been centrally implicated in posttraumatic psychopathology. Indeed of all anxiety disorders, PTSD may be most clearly attributable to discrete, aversive learning events. In PTSD, such learning is acquired during the traumatic encounter and is expressed as both conditioned fear to stimuli associated with the event and more general over-reactivity—or failure to adapt—to intense, novel, or fear-related stimuli. The relatively straightforward link between PTSD and these basic, evolutionarily old, learning processes of conditioning, sensitization, and habituation affords models of PTSD comprised of fundamental, experimentally tractable mechanisms of learning that have been well characterized across a variety of mammalian species including humans. Though such learning mechanisms have featured prominently in explanatory models of psychological maladjustment to trauma for at least 90 years, much of the empirical testing of these models has occurred only in the past two decades. The current review delineates the variety of theories forming this longstanding tradition of learning-based models of PTSD, details empirical evidence for such models, attempts an integrative account of results from this literature, and specifies limitations of, and future directions for, studies testing learning models of PTSD.

Fear-conditioning experiments in the anxiety disorders focus almost exclusively on passive-emotional, Pavlovian conditioning, rather than active-behavioral, instrumental conditioning. Paradigms eliciting both types of conditioning are needed to study maladaptive, instrumental behaviors resulting from Pavlovian abnormalities found in clinical anxiety. One such Pavlovian abnormality is generalization of fear from a conditioned danger-cue (CS+) to resembling stimuli. Though lab-based findings repeatedly link overgeneralized Pavlovian-fear to clinical anxiety, no study assesses the degree to which Pavlovian overgeneralization corresponds with maladaptive, overgeneralized instrumental-avoidance. The current effort fills this gap by validating a novel fear-potentiated startle paradigm including Pavlovian and instrumental components. The paradigm is embedded in a computer game during which shapes appear on the screen. One shape paired with electric-shock serves as CS+, and other resembling shapes, presented in the absence of shock, serve as generalization stimuli (GSs). During the game, participants choose whether to behaviorally avoid shock at the cost of poorer performance. Avoidance during CS+ is considered adaptive because shock is a real possibility. By contrast, avoidance during GSs is considered maladaptive because shock is not a realistic prospect and thus unnecessarily compromises performance. Results indicate significant Pavlovian-instrumental relations, with greater generalization of Pavlovian fear associated with overgeneralization of maladaptive instrumental-avoidance.