Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural responses

Aversive conditioning has been proposed as an important factor involved in the etiology of posttraumatic stress disorder (PTSD). However, it is not yet fully understood exactly which learning mechanisms are characteristic for PTSD. PTSD patients (n=36), and healthy individuals with and without trauma exposure (TE group, n=21; nTE group, n=34), underwent a differential fear conditioning experiment consisting of habituation, acquisition, and extinction phases. An electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures as conditioned stimuli (CS+, paired; CS-, unpaired). Conditioned responses were quantified by skin conductance responses (SCRs), subjective ratings of CS valence and US-expectancy, and a behavioural test. In contrast to the nTE group, PTSD patients showed delayed extinction of SCRs to the CS+. Online ratings of valence and US-expectancy as well as the behavioural test confirmed this pattern. These findings point to a deficit in extinction learning and highlight the role of affective valence appraisals and cognitive biases in PTSD. In addition, there was some evidence that a subgroup of PTSD patients had difficulties in learning the CS-US contingency, thereby providing preliminary evidence of reduced discrimination learning.     

Constraint, Alcoholism, and Electrodermal Response in Aversive Classical Conditioning and Mismatch Novelty Paradigms

This study investigated whether low levels of the personality trait of constraint and early-onset alcoholism would be associated with deficits in aversive conditioning and smaller responses to novelty in a stimulus mismatch protocol. Personality traits (constraint and socialization) and skin conductance responses (SCRs) during conditioning and novelty paradigms were assessed in alcoholics (n=41) and non-alcoholics (n = 32). The conditioning protocol involved measuring SCRs after conditioned stimuli (CS+: tones) paired with shock, CS- tones unpaired with shock, and CS+ probes unpaired with shock. The mismatch protocol involved measuring SCRs to auditory stimuli consisting of a series of 5 pure tones of the same pitch followed a shorter white noise stimulus (the novel stimulus). Contrary to the hypothesis, alcoholics did not differ from non-alcoholics in SCRs to CS+ probes or on the mismatch measure (SCR novel tone-SCR to 5th tone). Higher levels of constraint and self-reports of fear during conditioning were associated with smaller responses to both the CS+ probes and the CS- tones as well as the mismatch measure within non-alcoholics, but not within alcoholics. In alcoholics, low constraint was associated with greater habituation to CS+ probes, and poor differential conditioning on measures of change across trials in SCR to CS+ probes and CS- stimuli. The results suggest that different processes influence levels of constraint in non-alcoholics and alcoholics. The data indicate that low constraint in non-alcoholics is associated with allocating fewer processing resources to potentially significant stimuli, rather than being associated with a specific deficit in aversive conditioning per se.     

Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder

Aversive conditioning to explicit and contextual cues was examined in Gulf War veterans with and without posttraumatic stress disorder (PTSD) by use of the startle reflex methodology. Veterans participated in a differential aversive conditioning experiment consisting of 2 sessions separated by 4 or 5 days. Each session comprised two startle habituation periods, a preconditioning phase, a conditioning phase, and a postconditioning extinction test. In contrast to the non-PTSD group, the PTSD group showed a lack of differential startle response in the presence of a conditioned stimulus with or without an unconditioned stimulus in Session 1 and an increase in the baseline startle response during Session 2. The PTSD group also exhibited normal differential conditioning following reconditioning in Session 2. These data suggest that individuals with PTSD tend to generalize fear across stimuli and are sensitized by stress.     

Classical conditioning of autonomic fear responses is independent of contingency awareness

The role of contingency awareness in classical conditioning experiments using human subjects is currently under debate. This study took a novel approach to manipulating contingency awareness in a differential Pavlovian conditioning paradigm. Complex sine wave gratings were used as visual conditional stimuli (CS). By manipulating the fundamental spatial frequency of the displays, we were able to construct pairs of stimuli that varied in discriminability. One group of subjects was given an "easy" discrimination, and another was exposed to a "difficult" CS+ and CS-. A 3rd group was exposed to a stimulus that was paired with the unconditional stimulus (UCS) 50% of the time and served as a control. Skin conductance response (SCR) and continuous UCS expectancy data were measured concurrently throughout the experiment. Differential UCS expectancy was found only in the easy discrimination group. Differential SCRs were found in the easy discrimination group as well as in the difficult discrimination group, but not in the 50% contingency control. The difficult discrimination group did not exhibit differential UCS expectancy but did show clear differential SCR. These observations support a dual process interpretation of classical conditioning whereby conditioning on an implicit level can occur without explicit knowledge about the contingencies. The role of contingency awareness in classical conditioning experiments using human subjects is currently under debate. This study took a novel approach to manipulating contingency awareness in a differential Pavlovian conditioning paradigm. Complex sine wave gratings were used as visual conditional stimuli (CS). By manipulating the fundamental spatial frequency of the displays, we were able to construct pairs of stimuli that varied in discriminability. One group of subjects was given an "easy" discrimination, and another was exposed to a "difficult" CS+ and CS-. A 3rd group was exposed to a stimulus that was paired with the unconditional stimulus (UCS) 50% of the time and served as a control. Skin conductance response (SCR) and continuous UCS expectancy data were measured concurrently throughout the experiment. Differential UCS expectancy was found only in the easy discrimination group. Differential SCRs were found in the easy discrimination group as well as in the difficult discrimination group, but not in the 50% contingency control. The difficult discrimination group did not exhibit differential UCS expectancy but did show clear differential SCR. These observations support a dual process interpretation of classical conditioning whereby conditioning on an implicit level can occur without explicit knowledge about the contingencies.     

Is aversive learning a marker of risk for anxiety disorders in children?

Aversive conditioning and extinction were evaluated in children with anxiety disorders (n=23), at-risk for anxiety disorders (n=15), and controls (n=11). Participants underwent 16 trials of discriminative conditioning of two geometric figures, with (CS+) or without (CS-) an aversive tone (US), followed by 8 extinction trials (4 CS+, 4 CS-), and 8 extinction re-test trials averaging 2 weeks later. Skin conductance responses and verbal ratings of valence and arousal to the CS+/CS- stimuli were measured. Anxiety disordered children showed larger anticipatory and unconditional skin conductance responses across conditioning, and larger orienting and anticipatory skin conductance responses across extinction and extinction re-test, all to the CS+ and CS-, relative to controls. At-risk children showed larger unconditional responses during conditioning, larger orienting responses during the first block of extinction, and larger anticipatory responses during extinction re-test, all to the CS+ and CS-, relative to controls. Also, anxiety disordered children rated the CS+ as more unpleasant than the other groups. Elevated skin conductance responses to signals of threat (CS+) and signals of safety (CS-; CS+ during extinction) are discussed as features of manifestation of and risk for anxiety in children, compared to the specificity of valence judgments to the manifestation of anxiety.     

Fear conditioning in panic disorder: Enhanced resistance to extinction

Enhanced conditionability has been proposed as a crucial factor in the etiology and maintenance of panic disorder (PD). To test this assumption, the authors of the current study examined the acquisition and extinction of conditioned responses to aversive stimuli in PD. Thirty-nine PD patients and 33 healthy control participants took part in a differential aversive conditioning experiment. A highly annoying but not painful electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures were used as either the paired conditioned stimulus (CS+) or the unpaired conditioned stimulus (CS-). Results indicate that PD patients do not show larger conditioned responses during acquisition than control participants. However, in contrast to control participants, PD patients exhibited larger skin conductance responses to CS+ stimuli during extinction and maintained a more negative evaluation of them, as indicated by valence ratings obtained several times throughout the experiment. This suggests that PD patients show enhanced conditionability with respect to extinction.     

Differential acquisition, extinction, and reinstatement of conditioned suppression in mice

In animals, the reappearance of conditioned fear responses after extinction has been primarily investigated using single-cue conditioning paradigms. However, a differential paradigm can overcome several of the disadvantages associated with a single-cue procedure. In the present study, the reinstatement phenomenon was assessed in mice using a differential conditioned suppression paradigm. In a first phase, one conditioned stimulus (CS + ) was consistently paired with an unconditioned stimulus (US; footshock) while another CS (CS-) was not, resulting in selective suppression of previously trained instrumental behaviour during the CS + . After the extinction phase, half of the animals (reinstatement group) were presented with unsignalled USs, while the other half were not (control group). A differential return of conditioned responding was observed in the reinstatement group, but not in the control group. The implications of these findings for future conditioning research are discussed.     

The incubation theory of fear/anxiety: experimental investigation in a human laboratory model of Pavlovian conditioning

The aim of this work was to test Eysenck's incubation theory of fear/anxiety in human Pavlovian B conditioning of heart rate (HR) responses. The conditioned stimuli (CSs) were phobia-relevant slides (snakes and spiders) and the unconditioned stimuli (UCSs) were aversive noises. The subjects were presented with two levels of noise intensity during acquisition and three levels of nonreinforced CS presentation (CS-only) in a delay differential (CS+/CS-) conditioning paradigm (2 x 3 x 2). Consistent with the incubation theory, conditioned HR acceleratory responses were sustained (resistance to extinction) for high-noise intensity and short-presentations of CS-only subjects. During the extinction phase, HR acceleratory responses quickly extinguished in low-noise intensity groups after the first presentations of CS-only. These findings were interpreted as support for the incubation theory of phobic fear.     

Hemispheric asymmetry and human associative learning: Interactions with attention

In a previous study (Hugdahl & Brobeck, 1986) it was shown that Pavlovian conditioning to an auditory verbal conditioned stimulus (CS) initially presented only to the left cerebral hemisphere was stronger than when the same CS was presented to the right hemisphere. This was followed up in the present study by controlling for the possibility that the effect was caused by laterally biased attention. The study was performed using the “dichotic extinction paradigm,” which consists of three different phases. During the habituation phase, the CS+ and CS- were presented binaurally and separated in time. During the acquisition phase, the CS+ was followed by a white-noise unconditioned stimulus (UCS). During the dichotic extinction phase, the CS+ and CS- were presented dichotically, i.e., simultaneous presentations on each trial. Half of the subjects had the CS+ in the right ear, and half had the CS+ in the left ear. Each group was further divided into two subgroups, with one subgroup instructed to attend only to the right ear input, and the other subgroup to attend only to the left ear input. During acquisition, larger electrodermal responses were obtained to the CS+ than to the CS-. During dichotic extinction, the CS+ right ear group showed superior resistance to extinction compared to the CS+ left ear group, with no effect of the manipulation of attention. The effect was, however, attenuated when levels of acquisition was used as covariates in an analysis of covariance. There were overall larger responses from the left hand recording.     

Reaction time task as unconditional stimulus

The present study was conducted to demonstrate classic conditioning in electrodermal (ED) and heart rate (HR) responses by using a nonaversive reaction time (RT) task as unconditional stimulus (US). Three groups of 12 subjects each were studied to test the efficacy of this US procedure by varying the essential components of the RT task-US between groups. Eight seconds differential delay conditioning was applied in each group. Simple geometric features (square, cross) displayed on a TV screen were used as CS+ and CS−. RT task consisted of a nonaversive tone (72 dBA, 1000 or 1200 Hz) and a motor response (pressing a button with the left index finger). Subjects were asked to respond as soon as the tone stimulus was presented. The three groups received different stimulus sequences during the 16-trial acquisition phase only. In one group (Group C1), CS+ was followed by a tone to which subjects were to respond, whereas CS− was not followed by a tone. Similarly, in a second group (Group H), CS+ was followed by a tone, whereas CS− was not; however, subjects of Group H (habituation group) were not required to respond to the tone. In a third group, (Group C2) CS+ was followed by a tone to which subjects were to respond, while CS− was followed by a different tone requiring no response. According to analysis of Group C1 data, differential conditioning was obtained in each response measure. Group H displayed habituation in each response measure obtained. In Group C2, differential conditioning was obtained in the second latency window of ED responses only. In all trials, first-interval anticipatory ED responses and HR responses did occur during acquisition, but were not differentiated with respect to the CS conditions. Although the results of Group C2 need further exploration, differential conditioning of HR and in all latency windows of ED responses was demonstrated by the use of a nonaversive RT task as US.     

Classical conditioning and information processing: Different mechanism for prepared and unprepared stimuli?

Although learning without awareness conflicts with recent theories of classical human Pavlovian conditioning, there is at least one type of conditioning in which CS-US contingency is processed without awareness—the so-called prepared conditioning. Therefore, presenting a secondary reaction time probe to measure the amount of information processing capacity required should produce interference with the secondary task in unprepared, but not in prepared conditioning, since in the latter information should be processed in parallel. In a previous study, the authors could not find differences between both types of conditioning, neither in reaction time nor in electrodermal indicators of information processing. The present study was conducted to replicate and extend these findings, using a differential autonomic conditioning paradigm. One half of 42 subjects received spider and snake slides as prepared stimuli, while the other half received flower slides as unprepared stimuli. Both kinds of stimuli were used as CS+ and as CS-. An electric shock served as unconditioned stimulus. During 24 acquisition and 24 extinction trials, electrodermal and heart rate responses, as well as reaction times to a probe stimulus, were recorded. The results revealed significant conditioning effects in terms of CS-/CS+ differences. However, no differences were found between prepared and unprepared stimuli, neither in autonomic measures nor in reaction time. Again, our results are in favor of serial information processing in both prepared and unprepared stimuli, suggesting that the so-called prepared conditioning may be treated as a subclass of classical autonomic conditioning instead of forming a specific class of learning.     

Is there a mutual relationship between opposite attentional biases underlying anxiety?

Current models that account for attentional processes in anxiety have proposed that high-trait anxious individuals are characterized by a hypervigilant-avoidant pattern of attentional biases to threat. We adopted a laboratory conditioning procedure to induce concomitant hypervigilance and avoidance to threat, emphasizing a putative relationship between lower-level reactive and upper-level controlled attentional mechanisms as the core account of attentional processes involved in the development and maintenance of anxiety. Eighty high- and low-trait anxious participants underwent Pavlovian conditioning to a human face. Eye tracking was used to monitor attentional changes to the conditioned stimulus (CS+) face and the neutral stimulus (CS-) face, presented at 200, 500, and 800 ms durations. The high-anxious participants developed the expected attentional bias toward the CS+ at 200 ms presentation time and attentional avoidance at 500 and 800 ms durations. Hypervigilance to aversive stimuli at 200 ms and later avoidance to the same stimuli at 500 and 800 ms were associated with higher levels of galvanic skin conductance to the CS+. The low-anxious individuals developed the opposite attentional pattern with an initial tendency to orient attention away from the aversive stimuli in the 200 ms condition and to orient attention toward aversive stimuli in the remaining time. The differential modulation between hypervigilance and avoidance elicited in the two groups by the conditioning procedure suggests that vulnerability to anxiety is characterized by a latent relationship between diverse attentional mechanisms. Within this relationship, hypervigilance and avoidance to threat operate at different stages of information processing suggesting fuzzy boundaries between early reactive and later-strategic processing of threat.     

Heart rate changes accompanying jaw movement Pavlovian conditioning in rabbits: Concomitant blood pressure adjustments and effects of peripheral autonomic blockade

Two experiments were conducted to ascertain the cardiovascular accompaniments of differential Pavlovian jaw movement (JM) conditioning. The first examined the blood pressure (BP) changes that accompany the tachycardiac conditioned responses (CRs) associated with JM conditioning. The BP response in all instances consisted of a depressor response that was greater to the reinforced CS+ than CS-, although the magnitude of the CR was quite small. The second experiment determined the effects of peripheral autonomic antagonists on the cardiac accelerations associated with JM conditioning. It was found that the peripheral vagal antagonist methyl scopolamine completely abolished responses to both CS+ and CS-, whereas atenolol, a beta adrenergic antagonist, augmented the response, compared to saline control injections. The JM responses were also affected by the autonomic blockades, with minimal responding occurring in the scopolamine group but slightly more JM CRs in the atenolol group, compared to saline control animals. These results suggest that the major cardiovascular response to an appetitive stimulus, which evokes JM conditioning, consists of cardiac accelerations with the BP depressor responses playing a minimal, if any, role. Moreover, these conditioned cardiac increases appear to be due solely to the release of vagal inhibition.     

Heart Rate Changes Accompanying Jaw Movement Pavlovian Conditioning in Rabbits: Concomitant Blood Pressure Adjustments and Effects of Peripheral Autonomic Blockade

Two experiments were conducted to ascertain the cardiovascular accompaniments of differential Pavlovian jaw movement (JM) conditioning. The first examined the blood pressure (BP) changes that accompany the tachycardiac conditioned responses (CRs) associated with JM conditioning. The BP response in all instances consisted of a depressor response that was greater to the reinforced CS+ than CS-, although the magnitude of the CR was quite small. The second experiment determined the effects of peripheral autonomic antagonists on the cardiac accelerations associated with JM conditioning. It was found that the peripheral vagal antagonist methyl scopolamine completely abolished responses to both CS+ and CS-, whereas atenolol, a beta adrenergic antagonist, augmented the response, compared to saline control injections. The JM responses were also affected by the autonomic blockades, with minimal responding occurring in the scopolamine group but slightly more JM CRs in the atenolol group, compared to saline control animals. These results suggest that the major cardiovascular response to an appetitive stimulus, which evokes JM conditioning, consists of cardiac accelerations with the BP depressor responses playing a minimal, if any, role. Moreover, these conditioned cardiac increases appear to be due solely to the release of vagal inhibition.     

Reinstatement of fear in humans: autonomic and experiential responses in a differential conditioning paradigm

The present study investigated reinstatement of fear in humans using an aversive differential conditioning paradigm. Two neutral human face pictures were presented during habituation, acquisition, extinction, and postreinstatement phases. One picture served as a conditioned stimulus (CS) reinforced by an unconditioned stimulus (US) in the form of electrical stimulation (CS+) and the second picture as a control stimulus that was never reinforced (CS-). The prediction that in a reinstatement manipulation a previously extinguished fear response in humans can be reinstated in a reinstatement group by the mere presentation of three unpredicted electrical stimulations (USs) was tested. Participants in the control group were not exposed to unpredicted USs and no reinstatement effect was expected. Outcome measures included subjective US expectancy ratings and skin conductance responses. Results showed non-selective return of the fear response due to fear recovery associated with both CSs (CS+/CS-) in the reinstatement group. Unexpected fear recovery was observed for both CSs (CS+/CS-) in control participants. Results are discussed with respect to context conditioning, fear generalisation, and anxiety-related cognitive mechanisms underlying fear recovery after extinction.     

Observational fear conditioning in the acquisition and extinction of attentional bias for threat: an experimental evaluation

Anxious persons show automatic and strategic attentional biases for threatening information. Yet, the mechanisms and processes that underlie such biases remain unclear. The central aim of the present study was to elucidate the relation between observational threat learning and the acquisition and extinction of biased threat processing by integrating emotional Stroop color naming tasks within an observational differential fear conditioning procedure. Forty-three healthy female participants underwent several consecutive observational fear conditioning phases. During acquisition, participants watched a confederate displaying mock panic attacks (UCS) paired with a verbal stimulus (CS+), but not with a second nonreinforced verbal stimulus (CS-). As expected, participants showed greater magnitude electrodermal and verbal-evaluative (e.g., distress, fear) conditioned responses to the CS+ over the CS- word. Participants also demonstrated slower color-naming latencies to CS+ compared to the CS- word following acquisition and showed attenuation of this preferential processing bias for threat following extinction. Findings are discussed broadly in the context of the interplay between fear learning and processing biases for threat as observed in persons suffering from anxiety disorders.     

Pavlovian conditioning of shock-elicited aggression: a discrimination procedure

Two auditory stimuli, separated by a fixed intertrial interval, were alternately presented to two rats in a closed environment. The positive conditioned stimulus (CS+) terminated with the offset of a 2-mA, 0.75-sec shock. The negative conditioned stimulus (CS-) terminated without shock. The incidence of the "stereotyped fighting posture" was recorded during the CS+, the CS-, the intertrial interval, and shock. The results showed an increase in the percentage of conditioned responses during the CS+, and a decrease during both the CS- and the intertrial interval, when the duration of the conditioned stimuli and the intertrial interval was 16 sec. Appropriate changes in the incidence of aggression during the two stimuli were obtained following the reversal of the stimulus functions. During the acquisition and reversal phases there was a between-session decrement and a within-session improvement in the incidence of aggression during the CS+, defined as warm-up. The presentation of free shocks before the conditioning sessions was effective in reducing the warm-up only when the interval between shocks was 64 sec. These data were interpreted as demonstrating classical conditioning of shock-elicited aggression, with little chance of non-associative factors contributing to the measurement of the conditioned response.     

Hippocampal lesions and pavlovian cardiovascular conditioning

New Zealand albino rabbits received either sham, cortical control, or hippocampal lesions and were subjected to differential Pavlovian conditioning in which tones of different frequencies served as conditional stimuli (CSs), and a brief paraorbital electric shock train served as the unconditional stimulus. Heart rate (HR), blood pressure (BP), and electromyographic (EMG) conditional responses (CRs) were recorded. Animals with cortical and hippocampal damage or animals with cortical damage alone revealed attenuated bradycardiac CRs, but HR CRs of the former two groups did not significantly differ. BP changes were minimal; reliable differences were not obtained between CS+ and CS?. However, these changes consisted of small but reliable depressor responses, which were not affected by either cortical or hippocampal lesions. Few EMG CRs were obtained. These data, combined with those of previous experiments, suggest that forebrain structures may modulate higher level processing of stimulus information, perhaps in terms of assessing the biological significance of such stimulation.     

Allocation of cognitive processing capacity during human autonomic classical conditioning

In each of two experiments, allocation of cognitive processing capacity was measured in college-student subjects during autonomic discrimination classical conditioning. A 7.0-sec delay paradigm was used to establish classically conditioned responses to a reinforced visual conditioned stimulus (CS+). Electrodermal responses were the primary measures of autonomic classical conditioning. Allocation of processing capacity was measured by monitoring performance on a secondary reaction-time (RT) task. The auditory secondary-task RT signal was presented before, and 300, 500, 3500, 6500, and 7500 msec following CS onset. The RT signal was also presented following properly and improperly cued shock unconditioned stimuli (UCSs). Significant discrimination classical conditioning was obtained in both experiments. Comparison with control subjects who did not receive the RT signals indicated that the presence of the RT signals did not interfere with the development of classical conditioning. Four principal findings were obtained with the secondary-task RT measure. First, RTs to signals presented during CS+ were consistently slower than RTs to signals presented during CS-. This finding indicates that greater capacity allocation occurred during CS+ than CS- and is consistent with recent cognitive interpretations of classical conditioning. Second, the largest capacity allocation (i.e., slowing of RTs) occurred 300 msec following CS+ onset. This finding is consistent with the notion that subjects are actively processing the signal properties of the CS+ at 300 msec following CS+ onset. Third, presentation of the UCS when improperly cued (following CS-) significantly increased capacity allocation, whereas presentation of the same UCS when properly cued (following CS+) did not affect capacity allocation. These findings indicate that subjects were actively prepared for the UCS following CS+ but not following CS- and that a surprising UCS elicits greater capacity allocation than does an expected UCS. Fourth, large electrodermal responders to the CSs exhibited patterns of capacity allocation during the CSs, particularly during the CS+, different from those of small electrodermal responders. In particular, they exhibited significantly longer RTs at 300 msec after CS+ onset than did the small responders, followed by a shortening of RT at 500 msec relative to the small responders. This finding suggests that large electrodermal responders devote greater processing capacity to significant environmental stimuli than do small responders and that their processing may begin and be completed more rapidly. All in all, the data indicate the complexity of the cognitive processes that occur during human classical conditioning and the usefulness of the secondary-task technique in integrating conditioning theories and psychophysiology with cognitive psychology.