Gradual extinction reduces reinstatement

Youssef Shiban, Jasmin Wittmann, Mara Weißinger, Andreas Mühlberger, Youssef Shiban, Jasmin Wittmann, Mara Weißinger, Andreas Mühlberger

Abstract

The current study investigated whether gradually reducing the frequency of aversive stimuli during extinction can prevent the return of fear. Thirty-one participants of a three-stage procedure (acquisition, extinction and a reinstatement test on day 2) were randomly assigned to a standard extinction (SE) and gradual extinction (GE) procedure. The two groups differed only in the extinction procedure. While the SE group ran through a regular extinction process without any negative events, the frequency of the aversive stimuli during the extinction phase was gradually reduced for the GE group. The unconditioned stimulus (US) was an air blast (5 bar, 10 ms). A spider and a scorpion were used as conditioned stimuli (CS). The outcome variables were contingency ratings and physiological measures (skin conductance response, SCR and startle response). There were no differences found between the two groups for the acquisition and extinction phases concerning contingency ratings, SCR, or startle response. GE compared to SE significantly reduced the return of fear in the reinstatement test for the startle response but not for SCR or contingency ratings. This study was successful in translating the findings in rodent to humans. The results suggest that the GE process is suitable for increasing the efficacy of fear extinction.

Keywords: contingency ratings; gradual extinction; pavlovian fear conditioning; skin conductance response; startle response; virtual reality.

Figures

Figure 1
Figure 1
Virtual environment and virtual stimuli. (A) Virtual room where acquisition and extinction phases in a virtual reality (VR) took place. (B) Virtual room where reinstatement test in VR took place. (C) The presented virtual spider was used as an aversive conditioned stimulus (CS+). (D) The virtual scorpion was used as a non-aversive CS−.
Figure 2
Figure 2
Schematic procedure of the experiment. Each phase for the 2 days is given. Arrows represent the moments ratings were given. Each rating included a presentation of the CS+ and the CS−. Stimulus presentations for the ratings are not included in the numbers of CS+ and CS−.
Figure 3
Figure 3
Pattern of the presentation of the US during the extinction phase for the gradual group. Each box symbolizes the presentation of a CS+, which was paired with an US at the colored boxes.
Figure 4
Figure 4
Schematic procedure. The number of analyzed data for the measures in each phase of the experiment (acquisition phase, extinction phase, and reinstatement test) is given. Note: n, number of participants with analyzable data.
Figure 5
Figure 5
Contingency rating for CS+ and CS− for all phases for the Gradual and Standard groups. Note: CS+, stimulus with negative consequences; CS−, stimulus without negative consequences; Standard, the experimental group which participated in the Standard extinction (SE) process; Gradual, the experimental group which participated in the Gradual extinction (GE) process. Mean contingency ratings are given. Standard errors are presented as error bars.
Figure 6
Figure 6
Startle response for CS+ and CS− for all phases for the Gradual and Standard groups. Note: CS+, stimulus with negative consequences; CS−, stimulus without negative consequences; Standard, the experimental group which participated in the Standard Extinction process; Gradual, the experimental group which participated in the Gradual Extinction process. Mean startle responses are given. Standard errors are presented as error bars.
Figure 7
Figure 7
Comparison of SCR at all phases for the gradual and standard groups. Note: CS+, stimulus with negative consequences; CS-, stimulus without negative consequences; Standard, the experimental group which participated in the Standard Extinction process; Gradual, the experimental group which participated in the Gradual Extinction process. Mean startle responses are given. Standard errors are presented as error bars.

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