Persistence of extensively trained avoidance is not elevated in anxiety disorders in an outcome devaluation paradigm

Abstract

Background: A habitual avoidance component may enforce the persistence of maladaptive avoidance behavior in anxiety disorders. Whether habitual avoidance is acquired more strongly in anxiety disorders is unclear. Methods: Individuals with current social anxiety disorder, panic disorder and/or agoraphobia (n = 62) and healthy individuals (n = 62) completed a devaluation paradigm with extensive avoidance training, followed by the devaluation of the aversive outcome. In the subsequent test phase, habitual response tendencies were inferred from compatibility effects. Neutral control trials were added to assess general approach learning in the absence of previous extensive avoidance training. Results: The compatibility effects indicating habitual control did not differ between patients with anxiety disorders and healthy controls. Patients showed lower overall approach accuracy, but this effect was unrelated to the compatibility effects. Conclusions: In this study, anxiety disorders were characterized by reduced approach but not stronger habitual avoidance. These results do not indicate a simple and direct association between anxiety disorders and the acquisition of pervasive habitual avoidance in this devaluation paradigm.