From Extinction Learning to Anxiety Treatment: Mind the Gap

Abstract

Laboratory models of extinction learning in animals and humans have the potential to illuminate methods for improving clinical treatment of fear-based clinical disorders. However, such translational research often neglects important differences between threat responses in animals and fear learning in humans, particularly as it relates to the treatment of clinical disorders. Specifically, the conscious experience of fear and anxiety, along with the capacity to deliberately engage top-down cognitive processes to modulate that experience, involves distinct brain circuitry and is measured and manipulated using different methods than typically used in laboratory research. This paper will identify how translational research that investigates methods of enhancing extinction learning can more effectively model such elements of human fear learning, and how doing so will enhance the relevance of this research to the treatment of fear-based psychological disorders.

Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder

“…Given the limitations of the present study (e.g. relatively weak conditioning as measured by SCR) and evidence that DCS can reduce reinstatement [19,20], it would be worth further investigating the procedural variants that might enable detection of DCS augmentation effects found in animal and human clinical research (see [40] for a discussion of needed improvements to human fear conditioning paradigms). For instance, using biologically “prepared” or other fear-relevant stimuli can lead to stronger conditioned responses that reflect a greater role of lower-order fear learning processes [41,42], and therefore may be more susceptible to the effects of DCS.…”

Renewal of fear and avoidance in humans to escalating threat: Implications for translational research on anxiety disorders

“…Avoidance may also paradoxically increase self-reported fear, while excessive avoidance is likely to facilitate relapse of anxiety symptoms and coping strategies after therapy (Craske, Hermans, & Vervliet, 2018;Craske et al, 2008;Hermans et al, 2006). Indeed, while it is known that avoidance may promote return of fear and interfere with recovery from anxiety disorders (Craske et al, 2018;Treanor & Barry, 2017), evidence suggests that expanding the therapeutic focus from fear alone to include avoidance may lead to a better understanding of why exposure treatments sometimes fail and lead to relapse (Carpenter, Pinaire, & Hofmann, 2019;Hofmann & Hay, 2018;Nakajima, 2014;Vervliet & Indekeu, 2015). As Craske et al (2018) highlighted, "albeit often underappreciated, return of fear is problematic only when accompanied by escape or avoidance behaviors.…”

Anxiety Level Recognition for Virtual Reality Therapy System Using Physiological Signals

“…We decided to investigate what window size is best for VRET stimuli. A sliding window with a 1-s interval was applied to all collected signals with these window sizes in seconds: 3,5,8,10,13,15,18,20,23,25,28,29, and 30.…”

“…Anxiety can severely impact patients' daily life, trigger social communication problems, and diminish life quality. Moreover, anxiety disorders are usually chronic conditions and require a prolonged treatment period [3].…”