The validity of laboratory-based treatment research: Bridging the gap between fear extinction and exposure treatment

Abstract

A major objective of experimental psychopathology research is to improve clinical practice via the experimental study of treatment mechanisms. The success of this endeavor depends on the external validity of the procedures used to model the treatment component in the laboratory. We propose a general framework and a set of specific criteria that will allow evaluating whether a certain laboratory procedure is a valid model for a certain clinical treatment. We illustrate this framework by evaluating the validity of extinction as a laboratory model for clinical exposure therapy. Although we acknowledge the merits of the extinction model, we argue that its validity might not be as firmly established as the research community assumes. We also use extinction as an example to demonstrate how considerations of the proposed criteria can stimulate further improvements to existing models of treatment. We conclude that the systematic assessment of external validity of treatment models is an important step towards bridging the gap between science and practice in the field of experimental psychopathology.

Fear inoculation among snake experts

“…Our results suggest that people could become immunized even against highly biologically prepared fearful stimuli, such as snakes, after a certain amount of previous benign exposure. This is in line with previous findings on snake fear in primates (Mineka & Cook, 1986), social phobia in humans (Golkar & Olsson, 2016) and the effectiveness of exposure therapy (Barry, Vervliet, & Hermans, 2015;Scheveneels, Boddez, Vervliet, & Hermans, 2016). In terms of fear acquisition, therefore, how much experience is needed to learn not to fear particular stimuli (extinction) and the potential consequences of lack of fear (hypophobia) might be more important questions to answer than how much learning experience is needed to acquire fear.…”

Targeting avoidance via compound extinction

“…pictures of spiders; Conditioned Stimulus or CS) that have been previously paired with an aversive stimulus (e.g. a shock; Unconditioned Stimulus or US), without the US happening any more (Scheveneels, Boddez, Vervliet, & Hermans, 2016). Although fear extinction can successfully reduce fear responses (e.g.…”

Critical evaluation of current data analysis strategies for psychophysiological measures of fear conditioning and extinction in humans

“…Not only does the absence of such a strategy limit certainty about findings, but it also detracts from an agreed definition of what fear extinction might actually look like physiologically, and a huge opportunity for furthering our understanding of fear extinction mechanisms based on feedback from our physiological data is being missed. In light of recent efforts in validating and standardising this area of research (Bach et al, 2018;Bach et al, 2013;Beckers et al, 2013;Lonsdorf et al, 2017;Lonsdorf & Merz, 2017;Scheveneels, Boddez, Vervliet, & Hermans, 2016;Staib et al, 2015), we feel that inconsistencies and lack of power in the research may be at least partly statistical-rather than design-or even samplebased. It is our duty to report our opinion that the field is consequently in an exploratory phase, and researchers need to be aware that many findings will be either false, exaggerated or in the wrong direction.…”