The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research

Pittig, Andre; Treanor, Michael; LeBeau, Richard T.; Craske, Michelle G.

doi:10.1016/j.neubiorev.2018.03.015

Cited by 229 publications

(155 citation statements)

References 397 publications

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“…For some, habitual avoidance is said to persist during Avoidance Extinction 10 extinction because it has become a form of defensive action or habit, disconnected from the initially reinforcing, goal-oriented consequence of aversive event removal (Gillan et al, 2016;. However, it is not the aim of the present review to consider the relative merits of such accounts or the role of fear and avoidance in anxiety disorders per se (for reviews, see Krypotos et al 2015;LeDoux & Daw, 2018;Pittig et al, 2018). Instead, the aim of the present paper is to review the different procedures used in the extinction of avoidance and to remain agnostic on the conceptual status of the persistence of avoidance behavior in humans.…”

Section: Varieties Of Avoidance Extinctionmentioning

confidence: 98%

“…A re-examination of the learning processes involved in the extinction of avoidance is therefore required (Beckers & Craske, 2017;Cain, 2018;Dymond & Roche, 2009;Krypotos et al, 2015;Pittig et al, 2018;Riccio & Silvestri, 1973;Treanor & Barry, 2017). Given that nowadays it is accepted avoidance involves an instrumental component (Cain, 2018;, then understanding the extinction of avoidance requires a consideration of the contributions of operant conditioning research.…”

Section: Avoidance Extinctionmentioning

confidence: 99%

“…Recent reviews of avoidance have focused on issues arising from the historical adaptation of threat conditioning paradigms (Beckers & Craske, 2017;Dymond & Roche, 2009;, theoretical developments in avoidance learning only with little attention paid to the extinction of avoidance (Corr, 2013;Krypotos et al, 2015;LeDoux & Daw, 2018), the role of associative learning of avoidance in the treatment of anxiety and related disorders (Arnadouva et al, 2017;Pittig et al, 2018;Treanor & Barry, 2017), behavioral and neuroimaging findings from animal-human translational research (Kirlic et al, 2017), the impact of avoidant-like safety behavior in exposure therapy (Meulders et al, Avoidance Extinction 7 2016) and coping with pain (Vlaeyen et al, 2016), and on distinct learning mechanisms such as generalization (Dymond et al, 2015(Dymond et al, , 2018. No existing review has focused exclusively on avoidance extinction procedures.…”

Section: Avoidance Extinctionmentioning

confidence: 99%

“…Basic and clinical research aimed at improving the effectiveness of exposure therapy and preventing relapse has, however, tended to prioritize other learning mechanisms, such as fear extinction learning (Craske et al, 2018). As a result, comparable research on the learning processes responsible for the acquisition and maintenance of maladaptive avoidance is relatively underdeveloped, despite the central status of avoidance in psychopathology (Cain, 2018;Dymond & Roche, 2009;Hofmann & Hay, 2018;Krypotos et al, 2015;Pittig et al, 2018;Treanor & Barry, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Overcoming avoidance in anxiety disorders: The contributions of Pavlovian and operant avoidance extinction methods

Dymond

2019

Neuroscience & Biobehavioral Reviews

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Avoidance is generally adaptive, yet excessive threat-avoidance may soon become maladaptive and lead to functional impairment and psychopathology. Laboratory-based treatment research has provided important insights about the acquisition, maintenance, and extinction of maladaptive avoidance. Despite this, laboratory research on avoidance learning and extinction in humans is relatively underdeveloped. A better understanding of avoidance extinction methods has implications for basic research with humans and the development of treatment interventions aimed at replacing maladaptive behavior with an adaptive, functional repertoire. The present article reviews, for the first time, the use of the term extinction in human research on avoidance, contrasts existing Pavlovian and operant approaches to the extinction of avoidance, considers the validity of approaches to avoidance extinction, and suggests a consistent terminology and research gaps for future translational research on anxiety and related disorders.

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Section: Varieties Of Avoidance Extinctionmentioning

confidence: 98%

Section: Avoidance Extinctionmentioning

confidence: 99%

Section: Avoidance Extinctionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Overcoming avoidance in anxiety disorders: The contributions of Pavlovian and operant avoidance extinction methods

Dymond

2019

Neuroscience & Biobehavioral Reviews

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“…Thus, operant processes play an important, yet understudied, role in clinical treatment and relapse. The relative dearth of operant work in this area is noteworthy in light of the seminal contributions made by behavior analysis in research on avoidance (e.g., Dinsmoor, 1977;Higgins & Morris, 1984;Hineline, 1981;Sidman, 1953) and the longacknowledged role of operant processes in maintaining and overcoming avoidance (e.g., Cain, 2019;Dymond & Roche, 2009;Hayes & Hofmann, 2018;LeDoux & Pine, 2016;Pittig, Treanor, LeBeau, & Craske, 2018;. Closer cooperation between researchers from operant and Pavlovian domains is clearly needed if the translational relevance of this research agenda is to be fully realized.…”

Section: Translational Research In Anxiety Disordersmentioning

confidence: 99%

Relapse of anxiety‐related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Smith

Dymond

2019

J Exper Analysis Behavior

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Excessive fear and avoidance in relatively safe situations can lead to a narrowing of one's behavioral repertoire and less engagement with valued aspects of living. Ultimately, these processes can reach clinical levels, as seen in anxiety, trauma, and obsessive-compulsive disorders. Research on the basic behavioral processes underlying successful treatment with exposure therapy is growing, yet little is known about the mechanisms contributing to clinical relapse. Until recently, these mechanisms have largely been conceptualized in terms of Pavlovian return of fear, with relatively little research into operant processes. In the current paper, we briefly review translational research in anxiety disorders and the connections between fear and avoidance, focusing on recent work in the acquisition, extinction, and relapse of avoidance behavior and the generalization of this learning through arbitrary symbolic relations. We then introduce one possible treatment approach to mitigating clinical relapse, acceptance and commitment therapy (ACT), and provide a conceptual analysis for why ACT may be especially well-situated to address this issue. Finally, we end with potential directions for future research on treatment and relapse of anxiety disorders.

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Learning, Cognition, and Emotion

Fielding¹,

Ryan²,

Waters³

2020

The Encyclopedia of Child and Adolescent Development

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This entry reviews the key tenets of learning and cognitive models of emotion and provides a summary of the empirical evidence to support the roles of direct and indirect learning pathways and biases in attention, evaluation, and memory in the development of internalizing and externalizing emotional problems in children. The evidence suggests that enhanced acquisition and generalization of directly and indirectly conditioned fear as well as biases in attending to, evaluating, and retaining memories about stimuli associated with threat underpin children's anxiety symptoms. In contrast, children's depression may be characterized by reduced reactivity to conditioned threats, suggestive of withdrawal from salient environmental cues that should elicit reactivity, and biases in attention, evaluation, and overgeneralized memory for negative information. Conversely, failure to acquire inhibitory fear associations, reduced sensitivity to reward, and biases in attending to and evaluating stimuli associated with hostility, aggression, and injustice, and potentially an absence of memory biases for such stimuli, appear to underpin children's externalizing problems. These findings highlight common and distinct processes underlying the development and expression of children's emotions and underscore the importance of considering learning and cognitive processes in the conceptualization of internalizing and externalizing psychopathology in children.

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The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research

Cited by 229 publications

References 397 publications

Overcoming avoidance in anxiety disorders: The contributions of Pavlovian and operant avoidance extinction methods

Overcoming avoidance in anxiety disorders: The contributions of Pavlovian and operant avoidance extinction methods

Relapse of anxiety‐related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Learning, Cognition, and Emotion

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