Mindfulness and Fear Extinction: A Brief Review of Its Current Neuropsychological Literature and Possible Implications for Posttraumatic Stress Disorder

Abstract

Research in the neuroscience of mindfulness has grown rapidly in recent years. This includes empirical investigations into structural and functional changes in several brain regions-particularly, the hippocampus, the prefrontal cortex, and the amygdala-in association with the practice of mindfulness. Of interest to the current paper is that such brain regions are also implicated in empirical research focusing on fear extinction. While fear extinction has, therefore, been suggested as one of the possible mechanisms to underlie the positive effects of mindfulness, the conceptual links and research implications have lacked specific focus and detailed discussion in the literature. The purpose of this paper is, therefore, two-fold. First, this paper briefly reviews the extant literature on the neuropsychological mechanisms underlying mindfulness-particularly that, which has been found to be similarly implied in fear extinction-and hence, suggests future research directions based on its current state in the literature. Second, this paper explores the implications of this for fear-based psychopathologies, specifically for posttraumatic stress disorder (PTSD). Discussion from this paper suggests the idea of fear extinction as an underlying mechanism of mindfulness to be one that is still preliminary, yet promising; in turn, elucidating the need for further methodologically rigorous study to specifically determine fear extinction as a result of mindfulness, as well as to incorporate neuroimaging techniques in supporting the existing literature that have found preliminary support of mindfulness for PTSD.

Mindfulness and Behavior Change

“…Despite this increased challenge, the social context of the group helps people spend time away from unhealthy behavior-activating cues and in a social environment that values collective learning of mindfulness. 277 As community MBP practice continues, autonomic stability increases, 152 allowing for a “window of tolerance,” 278 , 279 within which exposure, response prevention, reconsolidation, associative learning, and extinction learning processes 150 , 280 may begin to unwind the habit learning 273 and fear conditioning 281 that were maintaining unhealthy habits.…”

A neurobehavioral account for decentering as the salve for the distressed mind

“…Mindfulness meditation has been proposed to reflect a form of exposure to feared and distressing spontaneous thoughts and internal experiences leading to decreased subjective and neural reactivity [57,[113][114][115]. MBI-related changes occur in the same limbic and orbitofrontal/prefrontal regions [52,[87][88][89]115] underlying fear conditioning, extinction, and extinction recall [50,100,116]. One study reports MBSR increased fear conditioning as well as extinction learning, and also increased structural connectivity (fractional anisotropy) with the uncinate fasciculus, a fiber tract involved in emotional regulation and associative learning [113].…”

“…[29,119] within neuroimaging paradigms, to better understand their specific functional neurocircuitry. An important future direction will be to delineate whether MBI-linked changes in connectivity patterns may provide the neural basis for decreased identification with and emotional reactivity to spontaneously generated negative episodic memories in PTSD and depression, and negative or catastrophic future prospections that are central features of disorders of distress [46,115].…”

A neurobehavioral account for decentering as the salve for the distressed mind

“…[29,119] within neuroimaging paradigms, to better understand their specific functional neurocircuitry. An important future direction will be to delineate whether MBI-linked changes in connectivity patterns may provide the neural basis for decreased identification with and emotional reactivity to spontaneously generated negative episodic memories in PTSD and depression, and negative or catastrophic future prospections that are central features of disorders of distress [46,115].…”