Modeling Hierarchical Versus Random Exposure Schedules in Pavlovian Fear Extinction: No Evidence for Differential Fear Outcomes.Behav Ther. 2019 09; 50(5):967-977.BT
In exposure therapy, the client can either be confronted with the fear-eliciting situations in a hierarchical way or in a random way. In the current study we developed a procedure to investigate the effects of hierarchical versus random exposure on long-term fear responding in the laboratory. Using a fear conditioning procedure, one stimulus (CS+) was paired with an electric shock (US), whereas another stimulus was not paired with the shock (CS-). The next day, participants underwent extinction training including presentations of the CS-, CS+ and a series of morphed stimuli between the CS- and CS+. In the hierarchical extinction condition (HE; N = 32), participants were first presented with the CS-, subsequently with the morph most similar to the CS-, then with the morph most similar to that one, and so forth, until reaching the CS+. In the random extinction condition (RE; N = 32), the same stimuli were presented but in a random order. Fear responding to the CS+, CS- and a new generalization stimulus (GS) was measured on the third day. Higher expectancy violation, t(62) = -2.67, p = .01, physiological arousal, t(62) = -2.08, p = .04, and variability in US-expectancy ratings, t(62) = -2.25, p = .03, were observed in the RE condition compared to the HE condition, suggesting the validity of this novel procedure. However, no differences between the RE and HE condition were found in fear responding as tested one day later, F(1, 62) < 1. In conclusion, we did not find evidence for differential long-term fear responding in modeling hierarchical versus random exposure in Pavlovian fear extinction.
