The key role of extinction learning in anxiety disorders

Pittig, Andre; Berg, Linda van den; Vervliet, Bram

doi:10.1097/yco.0000000000000220

Cited by 92 publications

(47 citation statements)

References 104 publications

(46 reference statements)

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“…by helping to identify patients who will benefit or not from exposure-based therapies, and thereby adapt therapeutic strategies. Moreover, these results support current translational efforts to "boost" fear extinction learning as a way to improve CBT therapeutic outcomes (Fitzgerald, Seemann, & Maren, 2014;Pittig, van den Berg, & Vervliet, 2015;Rodrigues et al, 2014).…”

Section: Discussionsupporting

confidence: 72%

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study

Forcadell

Torrents-Rodas

Vervliet

et al. 2017

International Journal of Psychophysiology

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Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed.

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Section: Discussionsupporting

confidence: 72%

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study

Forcadell

Torrents-Rodas

Vervliet

et al. 2017

International Journal of Psychophysiology

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“…Exposure therapy, targeted at diminishing anxiety levels by repeated confrontations with the feared stimulus (i.e., a social situation), is often applied in SAD as a part of cognitive-behavioral therapy, with placebo-controlled trials typically showing only moderate effects (Carpenter et al, 2018;Klumpp & Fitzgerald, 2018). The effect of exposure therapy is thought to rely (at least partly) on habituation responses, but it is important to note that fear extinction, defined as the decrease in fear during repeated exposure to a previously conditioned stimulus, which is now presented in the absence of an unconditioned stimulus, also plays an essential role during exposure therapy (Craske, 2015;Myers & Davis, 2006;Pittig, van den Berg, & Vervliet, 2016). In this study, we did not include active conditioning and fear extinction of the neutral faces; however, a recent research paper on adults with speaking anxiety indicated that less amygdala activation during extinction learning predicted greater reduction in SA symptoms 2 weeks after a session of exposure (Ball, Knapp, Paulus, & Stein, 2017), while another study in patients with SAD indicated that a decrease in regional cerebral blood flow in the amygdala was associated with anxiety reduction following repeated stress exposure (Åhs, Gingnell, Furmark, & Fredrikson, 2017).…”

Section: Discussionmentioning

confidence: 99%

Impaired neural habituation to neutral faces in families genetically enriched for social anxiety disorder

et al. 2019

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BackgroundSocial anxiety disorder (SAD) is an incapacitating disorder running in families. Previous work associated social fearfulness with a failure to habituate, but the habituation response to neutral faces has, as of yet, not been investigated in patients with SAD and their family members concurrently. Here, we examined whether impaired habituation to neutral faces is a putative neurobiological endophenotype of SAD by using data from the multiplex and multigenerational Leiden Family Lab study on SAD.MethodsParticipants (n = 110; age, 9.2 – 61.5 years) performed a habituation paradigm involving neutral faces, as these are strong social stimuli with an ambiguous meaning. We used functional magnetic resonance imaging data to investigate whether brain activation related to habituation was associated with the level of social anxiety within the families. Furthermore, the heritability of the neural habituation response was estimated.ResultsOur data revealed a relationship between impaired habituation to neutral faces and social anxiety in the right hippocampus and right amygdala. In addition, our data indicated that this habituation response displayed moderate ‐ to‐moderately high heritability in the right hippocampus.ConclusionThe present results provide support for altered habituation as a candidate SAD endophenotype; impaired neural habitation cosegregrated with the disorder within families and was heritable. These findings shed light on the genetic susceptibility to SAD.

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“…Accordingly, a violation of such an expectation is an emotional violation which will heavily affect the given subject’s attitude what to learn already during infantile development (Stahl and Feigenson, 2015). Similarly, extinction learning has been shown to be able to profoundly influence behavioral patterns as in anxiety disorders (Pittig et al, 2016). …”

Section: The Believing Process – a New Perspective On Violations Of Ementioning

confidence: 99%

Violations of Expectations As Matter for the Believing Process

Angel

Seitz

2017

Front. Psychol.

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For the purpose of this communication it is postulated that violation of expectation means a disturbing event or conflict interfering with a previously established mental state that affords a firm belief or confident feeling. According to this hypothesis a violation of an expectation contradicts predictions and intentions that have been attained on stored experiences, valuations, and actual mood. We will argue that the notion of belief as static or stable which is usually described by expressions such as “my belief” or “our general belief” has to be extended to accommodate the process of belief formation. The credition model emphasizes the procedural aspect of belief by which the “process of believing” becomes similar to other psychological processes. We will describe that the “violation of expectation” can be decoded from the credition perspective and has brain functional correlates.

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The key role of extinction learning in anxiety disorders

Cited by 92 publications

References 104 publications

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study

Impaired neural habituation to neutral faces in families genetically enriched for social anxiety disorder

Violations of Expectations As Matter for the Believing Process

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