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Implicit but not explicit extinction to threat-conditioned stimulus prevents spontaneous recovery of threat-potentiated startle responses in humans.
Brain Behav. 2019 01; 9(1):e01157.BB

Abstract

INTRODUCTION

It has long been posited that threat learning operates and forms under an affective and a cognitive learning system that is supported by different brain circuits. A primary drawback in exposure-based therapies is the high rate of relapse that occurs when higher order areas fail to inhibit responses driven by the defensive circuit. It has been shown that implicit exposure of fearful stimuli leads to a long-lasting reduction in avoidance behavior in patients with phobia. Despite the potential benefits of this approach in the treatment of phobias and posttraumatic stress disorder, implicit extinction is still underinvestigated.

METHODS

Two groups of healthy participants were threat conditioned. The following day, extinction training was conducted using a stereoscope. One group of participants was explicitly exposed with the threat-conditioned image, while the other group was implicitly exposed using a continuous flash suppression (CFS) technique. On the third day, we tested the spontaneous recovery of defensive responses using explicit presentations of the images.

RESULTS

On the third day, we found that only the implicit extinction group showed reduced spontaneous recovery of defensive responses to the threat-conditioned stimulus, measured by threat-potentiated startle responses but not by the electrodermal activity.

CONCLUSION

Our results suggest that implicit extinction using CFS might facilitate the modulation of the affective component of fearful memories, attenuating its expression after 24 hr. The limitations of the CFS technique using threatful stimuli urge the development of new strategies to improve implicit presentations and circumvent such limitations. Our study encourages further investigations of implicit extinction as a potential therapeutic target to further advance exposure-based psychotherapies.

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Authors+Show Affiliations

Oyarzún JP
Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain. Cognition and Brain Plasticity Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.
Càmara E
Cognition and Brain Plasticity Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.
Kouider S
Brain and Consciousness Group, Département d'Études Cognitives, École Normale Supérieure, PSL Research University, Paris, France.
Fuentemilla L
Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain. Cognition and Brain Plasticity Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain. Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
de Diego-Balaguer R
Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain. Cognition and Brain Plasticity Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain. Institute of Neurosciences, University of Barcelona, Barcelona, Spain. Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain.

MeSH

AdultConditioning, ClassicalExtinction, PsychologicalFearFemaleGalvanic Skin ResponseHumansLearningMaleMemoryReflex, Startle

Pub Type(s)

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

Language

eng

PubMed ID

30516021

Citation

Oyarzún, Javiera P., et al. "Implicit but Not Explicit Extinction to Threat-conditioned Stimulus Prevents Spontaneous Recovery of Threat-potentiated Startle Responses in Humans." Brain and Behavior, vol. 9, no. 1, 2019, pp. e01157.
Oyarzún JP, Càmara E, Kouider S, et al. Implicit but not explicit extinction to threat-conditioned stimulus prevents spontaneous recovery of threat-potentiated startle responses in humans. Brain Behav. 2019;9(1):e01157.
Oyarzún, J. P., Càmara, E., Kouider, S., Fuentemilla, L., & de Diego-Balaguer, R. (2019). Implicit but not explicit extinction to threat-conditioned stimulus prevents spontaneous recovery of threat-potentiated startle responses in humans. Brain and Behavior, 9(1), e01157. https://doi.org/10.1002/brb3.1157
Oyarzún JP, et al. Implicit but Not Explicit Extinction to Threat-conditioned Stimulus Prevents Spontaneous Recovery of Threat-potentiated Startle Responses in Humans. Brain Behav. 2019;9(1):e01157. PubMed PMID: 30516021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implicit but not explicit extinction to threat-conditioned stimulus prevents spontaneous recovery of threat-potentiated startle responses in humans. AU - Oyarzún,Javiera P, AU - Càmara,Estela, AU - Kouider,Sid, AU - Fuentemilla,Lluis, AU - de Diego-Balaguer,Ruth, Y1 - 2018/12/04/ PY - 2018/05/22/received PY - 2018/10/05/revised PY - 2018/10/09/accepted PY - 2018/12/6/pubmed PY - 2019/7/31/medline PY - 2018/12/6/entrez KW - electrodermal activity KW - extinction learning KW - fear conditioning KW - implicit extinction KW - skin conductance response KW - threat conditioning KW - threat-potentiated startle responses SP - e01157 EP - e01157 JF - Brain and behavior JO - Brain Behav VL - 9 IS - 1 N2 - INTRODUCTION: It has long been posited that threat learning operates and forms under an affective and a cognitive learning system that is supported by different brain circuits. A primary drawback in exposure-based therapies is the high rate of relapse that occurs when higher order areas fail to inhibit responses driven by the defensive circuit. It has been shown that implicit exposure of fearful stimuli leads to a long-lasting reduction in avoidance behavior in patients with phobia. Despite the potential benefits of this approach in the treatment of phobias and posttraumatic stress disorder, implicit extinction is still underinvestigated. METHODS: Two groups of healthy participants were threat conditioned. The following day, extinction training was conducted using a stereoscope. One group of participants was explicitly exposed with the threat-conditioned image, while the other group was implicitly exposed using a continuous flash suppression (CFS) technique. On the third day, we tested the spontaneous recovery of defensive responses using explicit presentations of the images. RESULTS: On the third day, we found that only the implicit extinction group showed reduced spontaneous recovery of defensive responses to the threat-conditioned stimulus, measured by threat-potentiated startle responses but not by the electrodermal activity. CONCLUSION: Our results suggest that implicit extinction using CFS might facilitate the modulation of the affective component of fearful memories, attenuating its expression after 24 hr. The limitations of the CFS technique using threatful stimuli urge the development of new strategies to improve implicit presentations and circumvent such limitations. Our study encourages further investigations of implicit extinction as a potential therapeutic target to further advance exposure-based psychotherapies. SN - 2162-3279 UR - https://www.unboundmedicine.com/medline/citation/30516021/Implicit_but_not_explicit_extinction_to_threat_conditioned_stimulus_prevents_spontaneous_recovery_of_threat_potentiated_startle_responses_in_humans_ DB - PRIME DP - Unbound Medicine ER -