Predicting clinical outcomes via human fear conditioning: A narrative review.

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Date: July 2021
Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 333 words

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Abstract :

Keywords Fear conditioning; Anxiety disorders; Exposure therapy; Extinction; External validity Highlights * Prospective conditioning studies for anxiety and treatment outcome are reviewed. * Reduced extinction and broader generalization predict higher anxiety levels. * Evidence on predicting treatment outcome by extinction (recall) is mixed. * Acquisition does not predict treatment response, with mixed results for anxiety. * Future research will benefit from large samples, preregistration and transparency. Abstract A common assumption in human fear conditioning research is that findings are informative for the etiology and treatment of clinical anxiety. One way to empirically evaluate the external validity of fear conditioning is by prospective studies. We review available prospective research investigating whether individual performance in fear conditioning predicts individual differences in anxiety levels and exposure-based treatment outcome. We focus on fear extinction, generalization, acquisition, and avoidance. Results suggest that reduced extinction and broader generalization predict higher anxiety levels. Results with respect to the predictive value of acquisition for anxiety levels are mixed. With regard to predicting exposure-based treatment outcome, some studies do find an association with extinction whereas others do not. The majority of studies does not find an association with acquisition. Evidence on extinction recall is limited and not consistent. The interpretation of these results requires caution. The number of available studies is limited. It is possible that not all work, in particular studies with only null effects, has found its way to publication. Future research on this topic will benefit from large sample sizes, preregistered hypotheses, full transparency about the conducted analyses and the publication of high-quality studies with null effects. Author Affiliation: (a) Center for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium (b) Department of Experimental Clinical and Health Psychology, Ghent University, Belgium * Corresponding author. Centre for Learning Psychology and Experimental Psychopathology, University of Leuven, Tiensestraat 102, bus 3712, 3000, Leuven, Belgium. Article History: Received 3 June 2020; Revised 7 April 2021; Accepted 19 April 2021 Byline: Sara Scheveneels [Sara.scheveneels@kuleuven.be] (a,*), Yannick Boddez (b,a), Dirk Hermans (a)

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Gale Document Number: GALE|A664259795