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Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention.
Behav Res Ther. 2018 05; 104:51-61.BR

Abstract

Exposure therapy is a key component of efficacious treatment for anxiety. Biases in the allocation of attention towards versus away from threat assessed prior to exposure-based treatments such as cognitive-behavioural therapy differentially predict treatment outcomes. However, it is unclear whether monitoring versus avoiding threat stimuli influences learning during exposure. Extinction paradigms are the experimental analogue of exposure therapy. Therefore, manipulating attention towards versus away from threat during extinction trials may shed light on the role of attention during exposure therapy. This study utilised a Pavlovian fear conditioning and extinction paradigm to examine whether directing attention towards versus away from the threat conditioned stimulus (CS+) related to differences in extinction, as indexed by skin conductance responses (SCR), CS evaluations and subjective measures of anxiety. Following a fear conditioning phase in which a dog image (CS+) was paired with an aversive tone unconditioned stimulus (US) and another dog image (CS-) was presented alone, 57 participants were randomly assigned to one of three conditions during extinction in which both CSs were presented alone: monitor the CS+ (N = 19), avoid the CS+ and attend to another stimulus (N = 18), no attention manipulation control (N = 20). Eye movements were monitored for visual adherence to assigned location using horizontal electro-oculogram. In the context of the acquisition of differential conditioning and visual adherence during extinction, both active groups exhibited larger SCRs to the CS + relative to the CS- during the first extinction block compared to the control group, and the avoid group exhibited significantly larger SCRs on CS+ and CS- trials throughout the extinction phase compared to the other groups. The avoid group also exhibited less decline in SCRs to the CS+ during the extinction retest phase relative to the control group. No significant group differences were observed in between-phase CS evaluations and subjective anxiety ratings. Avoidance of threat conditioned stimuli may impair extinction learning and increase physiological arousal generalisation to safe stimuli.

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Publisher Full Text (DOI)

Authors+Show Affiliations

O'Malley KR
School of Applied Psychology, Griffith University, Mt Gravatt Campus, Australia.
Waters AM
School of Applied Psychology, Griffith University, Mt Gravatt Campus, Australia. Electronic address: a.waters@griffith.edu.au.

MeSH

AdolescentAdultAnxiety DisordersArousalAttentionConditioning, ClassicalExtinction, PsychologicalFearFemaleGalvanic Skin ResponseGeneralization, PsychologicalHumansImplosive TherapyMaleMiddle AgedYoung Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29549751

Citation

O'Malley, Karina R., and Allison M. Waters. "Attention Avoidance of the Threat Conditioned Stimulus During Extinction Increases Physiological Arousal Generalisation and Retention." Behaviour Research and Therapy, vol. 104, 2018, pp. 51-61.
O'Malley KR, Waters AM. Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention. Behav Res Ther. 2018;104:51-61.
O'Malley, K. R., & Waters, A. M. (2018). Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention. Behaviour Research and Therapy, 104, 51-61. https://doi.org/10.1016/j.brat.2018.03.001
O'Malley KR, Waters AM. Attention Avoidance of the Threat Conditioned Stimulus During Extinction Increases Physiological Arousal Generalisation and Retention. Behav Res Ther. 2018;104:51-61. PubMed PMID: 29549751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention. AU - O'Malley,Karina R, AU - Waters,Allison M, Y1 - 2018/03/06/ PY - 2017/05/25/received PY - 2018/03/01/revised PY - 2018/03/05/accepted PY - 2018/3/20/pubmed PY - 2019/7/25/medline PY - 2018/3/18/entrez KW - Anxiety KW - Attention KW - Exposure therapy KW - Extinction SP - 51 EP - 61 JF - Behaviour research and therapy JO - Behav Res Ther VL - 104 N2 - Exposure therapy is a key component of efficacious treatment for anxiety. Biases in the allocation of attention towards versus away from threat assessed prior to exposure-based treatments such as cognitive-behavioural therapy differentially predict treatment outcomes. However, it is unclear whether monitoring versus avoiding threat stimuli influences learning during exposure. Extinction paradigms are the experimental analogue of exposure therapy. Therefore, manipulating attention towards versus away from threat during extinction trials may shed light on the role of attention during exposure therapy. This study utilised a Pavlovian fear conditioning and extinction paradigm to examine whether directing attention towards versus away from the threat conditioned stimulus (CS+) related to differences in extinction, as indexed by skin conductance responses (SCR), CS evaluations and subjective measures of anxiety. Following a fear conditioning phase in which a dog image (CS+) was paired with an aversive tone unconditioned stimulus (US) and another dog image (CS-) was presented alone, 57 participants were randomly assigned to one of three conditions during extinction in which both CSs were presented alone: monitor the CS+ (N = 19), avoid the CS+ and attend to another stimulus (N = 18), no attention manipulation control (N = 20). Eye movements were monitored for visual adherence to assigned location using horizontal electro-oculogram. In the context of the acquisition of differential conditioning and visual adherence during extinction, both active groups exhibited larger SCRs to the CS + relative to the CS- during the first extinction block compared to the control group, and the avoid group exhibited significantly larger SCRs on CS+ and CS- trials throughout the extinction phase compared to the other groups. The avoid group also exhibited less decline in SCRs to the CS+ during the extinction retest phase relative to the control group. No significant group differences were observed in between-phase CS evaluations and subjective anxiety ratings. Avoidance of threat conditioned stimuli may impair extinction learning and increase physiological arousal generalisation to safe stimuli. SN - 1873-622X UR - https://www.unboundmedicine.com/medline/citation/29549751/Attention_avoidance_of_the_threat_conditioned_stimulus_during_extinction_increases_physiological_arousal_generalisation_and_retention_ DB - PRIME DP - Unbound Medicine ER -