Training discrimination diminishes maladaptive avoidance of innocuous stimuli in a fear conditioning paradigm

Abstract

Anxiety disorders are the most common mental disorder worldwide. Although anxiety disorders differ in the nature of feared objects or situations, they share a common mechanism by which fear generalizes to related but innocuous objects, eliciting avoidance of objects and situations that pose no objective risk. This overgeneralization appears to be a crucial mechanism in the persistence of anxiety psychopathology. In this study we test whether an intervention that promotes discrimination learning reduces generalization of fear, in particular, harm expectancy and avoidance compared to an irrelevant (control) training. Healthy participants (N = 80) were randomly allocated to a training condition. Using a fear conditioning paradigm, participants first learned visual danger and safety signals (set 1). Baseline level of stimulus generalization was tested with ambiguous stimuli on a spectrum between the danger and safety signals. There were no differences between the training groups. Participants then received the stimulus discrimination training or a control training. After training, participants learned a new set of danger and safety signals (set 2), and the level of harm expectancy generalization and behavioural avoidance of ambiguous stimuli was tested. Although the training groups did not differ in fear generalization on a cognitive level (harm expectancy), the results showed a different pattern of avoidance of ambiguous stimuli, with the discrimination training group showing less avoidance of stimuli that resembled the safety signals. These results support the potential of interventions that promote discrimination learning in the treatment of anxiety disorders.

Generalization of fear in post‐traumatic stress disorder

“…Based on the finding that stronger fear generalization is linked to a misperception of stimuli with high perceptual similarity in healthy participants and patients with generalized anxiety disorder (Laufer et al, ; Struyf et al, ), one approach is directed toward the improvement of perceptual discrimination processes. Lommen et al () showed that a discrimination training reduced avoidance behavior to generalization stimuli in healthy participants, although the explicit expectation of threat was not reduced. Whether such an approach is beneficial in PTSD has to be investigated in future studies.…”

Reducing avoidance in adults with high spider fear using perceptual discrimination training

“…The central role of fear overgeneralization in anxiety disorders makes it an ideal candidate to be targeted in interventions (Lissek, ). As deficits in perceptual discrimination are central factors in fear overgeneralization, recent attempts have been made to improve individuals’ perceptual discrimination abilities through the use of novel training tasks with a primary goal of moderating fear overgeneralization (Ginat‐Frolich, Klein, Katz, & Shechner, , Ginat‐Frolich, Gendler, Marzan, Tsuk, & Shechner, ; Lommen et al, ). However, no previous studies have examined the effect of perceptual discrimination training on fear overgeneralization and avoidance among highly anxious individuals.…”

“…As perception is a core component of stimulus classification, perceptual discrimination has been suggested as a possible moderator for fear overgeneralization (Struyf, Zaman, Hermans, & Vervliet, ; Struyf, Zaman, Vervliet, & Van Diest, ). Two previous studies, both conducted with healthy adults, assessed two different novel perceptual discrimination training tasks aimed to improve perceptual discrimination and decrease fear overgeneralization (Ginat‐Frolich et al, , Lommen et al, ). Lommen et al () found that, as compared with a control condition, participants in the training group showed less avoidance of GSs perceptually similar to the safety cue, though no between‐group differences emerged in self‐reported fear generalization.…”

“…Two previous studies, both conducted with healthy adults, assessed two different novel perceptual discrimination training tasks aimed to improve perceptual discrimination and decrease fear overgeneralization (Ginat‐Frolich et al, , Lommen et al, ). Lommen et al () found that, as compared with a control condition, participants in the training group showed less avoidance of GSs perceptually similar to the safety cue, though no between‐group differences emerged in self‐reported fear generalization. Ginat‐Frolich et al () demonstrated that following perceptual discrimination training, participants showed improved discrimination of geometric shapes that transferred onto affective stimuli, with participants in the training group exhibiting less self‐reported fear overgeneralization than did the control group.…”

Modulation of fear generalization by the zona incerta

“…Reducing fear generalization while maintaining adaptive fear responses will reduce the daily burden experienced by individuals living with these disorders. Recently, introducing procedures that involve stimulus discrimination into cognitive behavioral therapy has been shown to reduce fear generalization, re-experiencing and intrusive thoughts in PTSD patients (5)(6)(7).…”