Sleep promotes consolidation and generalization of extinction learning in simulated exposure therapy for spider fear

Abstract

Simulated exposure therapy for spider phobia served as a clinically naturalistic model to study effects of sleep on extinction. Spider-fearing, young adult women (N=66), instrumented for skin conductance response (SCR), heart rate acceleration (HRA) and corrugator electromyography (EMG), viewed 14 identical 1-min videos of a behaving spider before a 12-hr delay containing a normal night’s Sleep (N=20) or continuous daytime Wake (N=23), or a 2-hr delay of continuous wake in the Morning (N=11) or Evening (N=12). Following the delay, all groups viewed this same video 6 times followed by six 1-min videos of a novel spider. After each video, participants rated disgust, fearfulness and unpleasantness. In all 4 groups, all measures except corrugator EMG diminished across Session 1 (extinction learning) and, excepting SCR to a sudden noise, increased from the old to novel spider in Session 2. In Wake only, summed subjective ratings and SCR to the old spider significantly increased across the delay (extinction loss) and were greater for the novel vs. the old spider when it was equally novel at the beginning of Session 1 (sensitization). In Sleep only, SCR to a sudden noise decreased across the inter-session delay (extinction augmentation) and, along with HRA, was lower to the novel spider than initially to the old spider in Session 1 (extinction generalization). None of the above differentiated Morning and Evening groups suggesting that intervening sleep, rather than time-of-testing, produced differences between Sleep and Wake. Thus, sleep following exposure therapy may promote retention and generalization of extinction learning.

1120 Effects of Post-Exposure Naps on Change in Autonomic Arousal to A social Challenge Across Exposure Therapy for Social Anxiety

“…From the clinical view, it is important that fear extinction generalizes so that the individuals can be less reactive to the fearful stimuli encountered outside of therapy (Rowe & Craske, 1998;Vansteeenwegen et al, 2007). Although preliminary studies (Pace-Schott et al, 2012;Kleim et al, 2014) …”

“…Studies have found that sleep strengthens the consolidation of memories, regulation of emotional memories, stabilization of memories, and fear extinction (Rasch & Born, 2013;Pace-Schott, Verga, Bennett, & Spencer, 2012;Walker, 2008;Spoormaker et al 2012). Specifically, sleep participates in improving synaptic and systems consolidation, the storing of newly encoded information into memory, which are major processes of memory consolidation (Maquet, 2001).…”

Conquer your cravings

“…The finding that expectancy violation was a significant mediator for kcal intake is interesting and in line with previous research , suggesting that that the violation of expectancies indeed is an important target for cue exposure sessions, though it's causal role needs to be investigated in experimental designs that manipulate expectancy violation. And although good sleep has shown to be important for consolidation of new CS-noUS memories (e.g., Pace-Schott et al, 2012;Spoormaker et al, 2012), sleep quality did not influence or moderate treatment outcome.…”

“…However, no generalisation to non-exposed foods was found. Generalisation of the exposure effect remains very important for the usability of exposure in clinical practice; it is plausible that more sessions are required for generalisation to occur, and/or better consolidation of the new CS-noUS memory, for example by sleeping after the session (Pace-Schott, Verga, Bennett, & Spencer, 2012). Further, even when the new CS-noUS association has been wellconsolidated, the original CS-US association remains intact and forms a risk of return of responses in another context or later in time.…”

“…It will also be investigated whether habituation of cue reactivity vs. violation of CS-US expectancies serve as mediators or moderators of treatment outcome. Finally, because good sleep quality has been shown to be related to better treatment outcome in exposure treatment due to enhanced memory consolidation (Pace-Schott, Verga, Bennett, & Spencer, 2012;Zalta et al, 2013), it is investigated whether sleep quality moderates the effect of treatment on outcome variables.…”