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Reduced return of threat expectancy after counterconditioning verus extinction.
Behav Res Ther. 2018 09; 108:78-84.BR

Abstract

Exposure-based therapies are effective for anxiety disorders, but relapse remains a problem. One explanation might be that exposure therapy reduces threat expectancy but not related feelings of unpleasantness (negative valence of the conditioned stimulus; CS+), which may promote return of threat expectancy and associated fear. Laboratory research has indeed shown that fear extinction leaves negative valence of the conditioned stimulus (CS+) intact. Here, we tested whether adding positive consequences to the CS+ during extinction, a procedure known as counterconditioning, would change the valence of the CS+ and thereby prevent return of threat expectancy. Participants underwent Acquisition (day 1), Intervention (counterconditioning or extinction; day 2), and Spontaneous recovery and Reinstatement (day 3). As expected, threat expectancy ratings during the Spontaneous recovery and Reinstatement tests were lower after counterconditioning than after extinction, but counterconditioning did not reduce CS + negative valence more than extinction. Alternative mechanisms and clinical implications are discussed.

Authors+Show Affiliations

Department of Clinical Psychology, Utrecht University, The Netherlands.Center for the Psychology of Learning and Experimental Psychopathology, Leuven University, Belgium.Department of Clinical Psychology, Utrecht University, The Netherlands.Department of Clinical Psychology, Utrecht University, The Netherlands.Department of Clinical Psychology, Utrecht University, The Netherlands; Department of Clinical Psychology, Leiden University, The Netherlands. Electronic address: m.a.hagenaars@uu.nl.

Pub Type(s)

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

Language

eng

PubMed ID

30064009

Citation

Kang, Sahaj, et al. "Reduced Return of Threat Expectancy After Counterconditioning Verus Extinction." Behaviour Research and Therapy, vol. 108, 2018, pp. 78-84.
Kang S, Vervliet B, Engelhard IM, et al. Reduced return of threat expectancy after counterconditioning verus extinction. Behav Res Ther. 2018;108:78-84.
Kang, S., Vervliet, B., Engelhard, I. M., van Dis, E. A. M., & Hagenaars, M. A. (2018). Reduced return of threat expectancy after counterconditioning verus extinction. Behaviour Research and Therapy, 108, 78-84. https://doi.org/10.1016/j.brat.2018.06.009
Kang S, et al. Reduced Return of Threat Expectancy After Counterconditioning Verus Extinction. Behav Res Ther. 2018;108:78-84. PubMed PMID: 30064009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced return of threat expectancy after counterconditioning verus extinction. AU - Kang,Sahaj, AU - Vervliet,Bram, AU - Engelhard,Iris M, AU - van Dis,Eva A M, AU - Hagenaars,Muriel A, Y1 - 2018/06/26/ PY - 2018/01/17/received PY - 2018/05/10/revised PY - 2018/06/25/accepted PY - 2018/8/1/pubmed PY - 2019/9/10/medline PY - 2018/8/1/entrez KW - Anxiety disorders KW - Counterconditioning KW - Evaluative learning KW - Exposure therapy KW - Extinction KW - Return of fear SP - 78 EP - 84 JF - Behaviour research and therapy JO - Behav Res Ther VL - 108 N2 - Exposure-based therapies are effective for anxiety disorders, but relapse remains a problem. One explanation might be that exposure therapy reduces threat expectancy but not related feelings of unpleasantness (negative valence of the conditioned stimulus; CS+), which may promote return of threat expectancy and associated fear. Laboratory research has indeed shown that fear extinction leaves negative valence of the conditioned stimulus (CS+) intact. Here, we tested whether adding positive consequences to the CS+ during extinction, a procedure known as counterconditioning, would change the valence of the CS+ and thereby prevent return of threat expectancy. Participants underwent Acquisition (day 1), Intervention (counterconditioning or extinction; day 2), and Spontaneous recovery and Reinstatement (day 3). As expected, threat expectancy ratings during the Spontaneous recovery and Reinstatement tests were lower after counterconditioning than after extinction, but counterconditioning did not reduce CS + negative valence more than extinction. Alternative mechanisms and clinical implications are discussed. SN - 1873-622X UR - https://www.unboundmedicine.com/medline/citation/30064009/Reduced_return_of_threat_expectancy_after_counterconditioning_verus_extinction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0005-7967(18)30096-2 DB - PRIME DP - Unbound Medicine ER -