Search

Generalised avoidance behaviours are a common diagnostic feature of anxiety-related disorders and a barrier to affecting changes in anxiety during therapy. However, strategies to mitigate generalised avoidance are under-investigated. Even less attention is given to reducing the category-based generalisation of avoidance. We therefore investigated the potential of an operant-based approach. Specifically, it was examined whether reinforcing competing (non-avoidance) behaviours to threat-predictive cues would interfere with the expression of generalised avoidance. Using a matching-to-sample task, artificial stimulus categories were established using physically dissimilar nonsense shapes. A member of one category (conditioned stimulus; CS1) was then associated with an aversive outcome in an Acquisition context, unless an avoidance response was made. Next, competing behaviours were reinforced in response to the CS1 in new contexts. Finally, we tested for the generalisation of avoidance to another member of the stimulus category (generalisation stimulus; GS1) in both a Novel context and the Acquisition context. The selective generalisation of avoidance to GS1 was observed, but only in the Acquisition context. In the Novel context, the generalisation of avoidance to GSs was significantly reduced. A comparison group (Experiment 2), which did not learn any competing behaviours, avoided GS1 in both contexts. These findings suggest that reinforcing competing behavioural responses to threat-predictive cues can lead to reductions in generalised avoidance. This study is among the first study to demonstrate sustained reductions in generalised avoidance resulting from operant-based protocols, and the clinical and research implications are discussed.

The experience of unpredictable pain fluctuations can trigger anticipatory pain-related fear. When discrete predictors for pain are lacking, fear typically accrues to the broader environmental context: a phenomenon referred to as contextual pain-related fear. We examined whether conceptual similarity between discrete contexts facilitates pain-related fear generalization; this mechanism is known as category-level fear generalization. Using a voluntary joystick movement paradigm, pain-free participants performed movements in 2 contexts (within-subjects design); context was manipulated by varying background color screens. In the predictable context, one movement predicted pain and another did not. In the unpredictable context, 2 other movements never predicted pain but pain was unpredictably delivered during the context. Participants subsequently learned to categorize novel background colors (ie, generalization contexts) as being similar to either the unpredictable or predictable pain context. Then we tested fear generalization to these novel contexts. We measured self-reported pain-related fear, expectancy, and eyeblink startle. Results indicated higher pain-related fear reports, but no elevated startle responses, for generalization contexts that were trained to be similar to the original unpredictable context rather than the predictable pain context. This highlights a potential pathway through which neutral contexts can elicit pain-related fear and motivate avoidance behavior associated with chronic pain disability., Perspective: Self-reported pain-related fear and expectancy of painful outcome in response to a context associated with unpredictable pain generalizes to perceptually distinct contexts that are trained to be conceptually similar to the unpredictable pain context. Category-level generalization may be a pathway contributing to spreading of fear and avoidance in chronic pain., (Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: During exposure therapy, patients are encouraged to approach the feared stimulus, so they can experience that this stimulus is not followed by the anticipated aversive outcome. However, patients might treat the absence of the aversive outcome as an 'exception to the rule'. This could hamper the generalization of fear reduction when the patient is confronted with similar stimuli not used in therapy. We examined the effect of providing information about the typicality of the extinction stimulus on the generalization of extinction to a new but similar stimulus., Methods: In a differential fear conditioning procedure, an animal-like figure was paired with a brief electric shock to the wrist. In a subsequent extinction phase, a different but perceptually similar animal-like figure was presented without the shock. Before testing the generalization of extinction with a third animal-like figure, participants were either instructed that the extinction stimulus was a typical or an atypical member of the animal family., Results: The typicality instruction effectively impacted the generalization of extinction; the third animal-like figure elicited lower shock expectancies in the typical relative to the atypical group., Limitations: Skin conductance data mirrored these results, but did not reach significance., Conclusion: These findings suggest that verbal information about stimulus typicality can be a promising adjunctive to standard exposure treatments., (Copyright © 2017 Elsevier Ltd. All rights reserved.)