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The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research.
Neurosci Biobehav Rev. 2018 05; 88:117-140.NB

Abstract

Anxiety disorders are the most common mental disorders and are often chronic and disabling. Although exposure-based treatments are effective, a substantial number of individuals fail to fully remit or experience a return of symptoms after treatment. Understanding the critical processes underlying the development and treatment of anxiety disorders will help identify individuals at risk and optimize treatments. Aversive associative learning offers explanatory pathways through which fear and anxiety emerge, spread, persist, and resurge. This narrative review examines the advances made in our understanding of associative fear and avoidance learning in anxiety disorders. Overall, the extant literature supports a key role of aversive associative learning in the development and treatment of anxiety disorders. However, research targeting specific mechanisms such as extinction generalization and avoidance, the fragility of extinction, and moderating influences of individual differences pertinent to anxiety disorders (e.g., age, sex, depression) is needed. We discuss the need for more ecological valid and complex paradigms to model ambiguity and conflict as well as for clinical translation studies to optimize treatment.

Authors+Show Affiliations

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany. Electronic address: andre.pittig@uni-wuerzburg.de.Department of Psychology, University of California, Los Angeles, CA, 90095-1563, United States.Department of Psychology, University of California, Los Angeles, CA, 90095-1563, United States.Department of Psychology, University of California, Los Angeles, CA, 90095-1563, United States.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

29550209

Citation

Pittig, Andre, et al. "The Role of Associative Fear and Avoidance Learning in Anxiety Disorders: Gaps and Directions for Future Research." Neuroscience and Biobehavioral Reviews, vol. 88, 2018, pp. 117-140.
Pittig A, Treanor M, LeBeau RT, et al. The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neurosci Biobehav Rev. 2018;88:117-140.
Pittig, A., Treanor, M., LeBeau, R. T., & Craske, M. G. (2018). The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neuroscience and Biobehavioral Reviews, 88, 117-140. https://doi.org/10.1016/j.neubiorev.2018.03.015
Pittig A, et al. The Role of Associative Fear and Avoidance Learning in Anxiety Disorders: Gaps and Directions for Future Research. Neurosci Biobehav Rev. 2018;88:117-140. PubMed PMID: 29550209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. AU - Pittig,Andre, AU - Treanor,Michael, AU - LeBeau,Richard T, AU - Craske,Michelle G, Y1 - 2018/03/14/ PY - 2017/10/06/received PY - 2018/02/16/revised PY - 2018/03/13/accepted PY - 2018/3/20/pubmed PY - 2019/2/28/medline PY - 2018/3/19/entrez KW - Anxiety disorders KW - Associative learning KW - Aversive learning KW - Avoidance KW - Exposure KW - Extinction KW - Fear conditioning SP - 117 EP - 140 JF - Neuroscience and biobehavioral reviews JO - Neurosci Biobehav Rev VL - 88 N2 - Anxiety disorders are the most common mental disorders and are often chronic and disabling. Although exposure-based treatments are effective, a substantial number of individuals fail to fully remit or experience a return of symptoms after treatment. Understanding the critical processes underlying the development and treatment of anxiety disorders will help identify individuals at risk and optimize treatments. Aversive associative learning offers explanatory pathways through which fear and anxiety emerge, spread, persist, and resurge. This narrative review examines the advances made in our understanding of associative fear and avoidance learning in anxiety disorders. Overall, the extant literature supports a key role of aversive associative learning in the development and treatment of anxiety disorders. However, research targeting specific mechanisms such as extinction generalization and avoidance, the fragility of extinction, and moderating influences of individual differences pertinent to anxiety disorders (e.g., age, sex, depression) is needed. We discuss the need for more ecological valid and complex paradigms to model ambiguity and conflict as well as for clinical translation studies to optimize treatment. SN - 1873-7528 UR - https://www.unboundmedicine.com/medline/citation/29550209/The_role_of_associative_fear_and_avoidance_learning_in_anxiety_disorders:_Gaps_and_directions_for_future_research_ DB - PRIME DP - Unbound Medicine ER -