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Trask S, Ferrara NC. Enhancing fear extinction. eLife 2024; 13:e97633. [PMID: 38619041 PMCID: PMC11018348 DOI: 10.7554/elife.97633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
Gradually reducing a source of fear during extinction treatments may weaken negative memories in the long term.
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Affiliation(s)
- Sydney Trask
- Department of Psychological Sciences, Purdue University West LafayetteWest LafayetteUnited States
- Purdue Institute for Integrative Neuroscience, Purdue University West LafayetteWest LafayetteUnited States
| | - Nicole C Ferrara
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and ScienceNorth ChicagoUnited States
- Discipline of Physiology and Biophysics, Chicago Medical School, Rosalind Franklin University of Medicine and ScienceNorth ChicagoUnited States
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Kampa M, Stark R, Klucken T. The impact of extinction timing on pre-extinction arousal and subsequent return of fear. Learn Mem 2024; 31:a053902. [PMID: 38627067 PMCID: PMC11098463 DOI: 10.1101/lm.053902.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/07/2024] [Indexed: 04/19/2024]
Abstract
Exposure-based therapy is effective in treating anxiety, but a return of fear in the form of relapse is common. Exposure is based on the extinction of Pavlovian fear conditioning. Both animal and human studies point to increased arousal during immediate compared to delayed extinction (>+24 h), which presumably impairs extinction learning and increases the subsequent return of fear. Impaired extinction learning under arousal might interfere with psychotherapeutic interventions. The aim of the present study was to investigate whether arousal before extinction differs between extinction groups and whether arousal before extinction predicts the return of fear in a later (retention) test. As a highlight, both the time between fear acquisition and extinction (immediate vs. delayed) and the time between extinction and test (early vs. late test) were systematically varied. We performed follow-up analyses on data from 103 young, healthy participants to test the above hypotheses. Subjective arousal ratings and physiological arousal measures of sympathetic and hypothalamic pituitary adrenal axis activation (tonic skin conductance and salivary cortisol) were collected. Increased pre-extinction arousal in the immediate extinction group was only confirmed for subjective arousal. In linear regression analyses, none of the arousal measures predicted a significant return of fear in the different experimental groups. Only when we aggregated across the two test groups, tonic skin conductance at the onset of extinction predicted the return of fear in skin conductance responses. The overall results provide little evidence that pre-extinction arousal affects subsequent extinction learning and memory. In terms of clinical relevance, there is no clear evidence that exposure could be improved by reducing subjective or physiological arousal.
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Affiliation(s)
- Miriam Kampa
- Department of Clinical Psychology and Psychotherapy, University of Siegen, 57072 Siegen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University, 35394 Giessen, Germany
| | - Rudolf Stark
- Bender Institute of Neuroimaging, Justus Liebig University, 35394 Giessen, Germany
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, 35032 Marburg, Germany and Justus Liebig University, 35394 Giessen, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, University of Siegen, 57072 Siegen, Germany
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Bonanno GR, Met Hoxha E, Robinson PK, Ferrara NC, Trask S. Fear Reduced Through Unconditional Stimulus Deflation Is Behaviorally Distinct From Extinction and Differentially Engages the Amygdala. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:756-765. [PMID: 37881558 PMCID: PMC10593882 DOI: 10.1016/j.bpsgos.2023.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
Background Context fear memory can be reliably reduced by subsequent pairings of that context with a weaker shock. This procedure shares similarities with extinction learning: both involve extended time in the conditioning chamber following training and reduce context-elicited fear. Unlike extinction, this weak-shock exposure has been hypothesized to engage reconsolidation-like processes that weaken the original memory. Methods We directly compared the weak-shock procedure with extinction using male and female Long Evans rats. Results Both repeated weak-shock exposure and extinction resulted in decreased context freezing relative to animals that received context fear conditioning but no subsequent context exposure. Conditioning with the weak shock was not enough to form a persistent context-shock association on its own, suggesting that the weak-shock procedure does not create a new memory. Weak-shock exposure in a new context can still reduce freezing elicited by the training context, suggesting that it reduces responding through a different process than extinction, which does not transcend context. Finally, reduced fear behavior produced through both extinction and weak-shock exposure was mirrored by reduced zif268 expression in the basolateral amygdala. However, only the weak-shock procedure resulted in changes in lysine-48 polyubiquitin tagging in the synapse of the basolateral amygdala, suggesting that this procedure produced long-lasting changes in synaptic function within the basolateral amygdala. Conclusions These results suggest that the weak-shock procedure does not rely on the creation of a new inhibitory memory, as in extinction, and instead may alter the original representation of the shock to reduce fear responding.
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Affiliation(s)
| | - Erisa Met Hoxha
- Purdue University Department of Psychological Sciences, West Lafayette, Indiana
| | - Payton K. Robinson
- Purdue University Department of Psychological Sciences, West Lafayette, Indiana
| | - Nicole C. Ferrara
- Purdue University Department of Psychological Sciences, West Lafayette, Indiana
- Rosalind Franklin University of Medicine and Science Discipline of Physiology and Biophysics, North Chicago, Illinois
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, North Chicago, Illinois
| | - Sydney Trask
- Purdue University Department of Psychological Sciences, West Lafayette, Indiana
- Purdue Institute for Integrative Neuroscience, West Lafayette, Indiana
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Siegel P. Genome-wide association study and the randomized controlled trial: A false equivalence. Behav Brain Sci 2023; 46:e200. [PMID: 37694937 DOI: 10.1017/s0140525x22002230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Madole & Harden's assertion that the effects derived from within-family genome-wide association studies (GWASs) and from randomized controlled trials (RCTs) are equivalent is misleading. GWASs are substantially more "non-unitary, non-uniform, and non-explanatory" than RCTs. While the within-family GWAS bring us closer to identifying genetic causes, whether it will change behavioral genetics into a causal science is an open question.
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Affiliation(s)
- Paul Siegel
- School of Natural and Social Sciences, Purchase College, State University of New York, Purchase, NY, USA https://www.purchase.edu/live/profiles/671-paul-siegel
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Ferrara NC, Kwapis JL, Trask S. Memory retrieval, reconsolidation, and extinction: Exploring the boundary conditions of post-conditioning cue exposure. Front Synaptic Neurosci 2023; 15:1146665. [PMID: 36937567 PMCID: PMC10017482 DOI: 10.3389/fnsyn.2023.1146665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
Following fear conditioning, behavior can be reduced by giving many CS-alone presentations in a process known as extinction or by presenting a few CS-alone presentations and interfering with subsequent memory reconsolidation. While the two share procedural similarities, both the behavioral outcomes and the neurobiological underpinnings are distinct. Here we review the neural and behavioral mechanisms that produce these separate behavioral reductions, as well as some factors that determine whether or not a retrieval-dependent reconsolidation process or an extinction process will be in effect.
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Affiliation(s)
- Nicole C. Ferrara
- Discipline of Physiology and Biophysics, Rosalind Franklin University, North Chicago, IL, United States
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University, North Chicago, IL, United States
| | - Janine L. Kwapis
- Department of Biology, The Pennsylvania State University, University Park, PA, United States
| | - Sydney Trask
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
- Purdue Institute for Integrative Neuroscience, West Lafayette, IN, United States
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Cautionary Observations Concerning the Introduction of Psychophysiological Biomarkers into Neuropsychiatric Practice. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The combination of statistical learning technologies with large databases of psychophysiological data has appropriately generated enthusiastic interest in future clinical applicability. It is argued here that this enthusiasm should be tempered with the understanding that significant obstacles must be overcome before the systematic introduction of psychophysiological measures into neuropsychiatric practice becomes possible. The objective of this study is to identify challenges to this effort. The nonspecificity of psychophysiological measures complicates their use in diagnosis. Low test-retest reliability complicates use in longitudinal assessment, and quantitative psychophysiological measures can normalize in response to placebo intervention. Ten cautionary observations are introduced and, in some instances, possible directions for remediation are suggested.
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Yaşar AB, Konuk E, Kavakçı Ö, Uygun E, Gündoğmuş İ, Taygar AS, Uludağ E. A Randomized-Controlled Trial of EMDR Flash Technique on Traumatic Symptoms, Depression, Anxiety, Stress, and Life of Quality With Individuals Who Have Experienced a Traffic Accident. Front Psychol 2022; 13:845481. [PMID: 35401305 PMCID: PMC8987710 DOI: 10.3389/fpsyg.2022.845481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
The Flash Technique of Eye Movement Desensitization and Reprocessing (EMDR) is widely recognized for its effectiveness in reducing the effects of emotional responses associated with traumatic memories. Using a randomized-controlled trial methodology, this study attempts to establish the efficacy of the EMDR Flash Technique. This study’s sample includes volunteers who were involved in traffic accidents and were given the randomized EMDR Flash Technique and Improving Mental Health Training for Primary Care Residents (mhGAP) Stress management module. The participants were given a socio-demographic data form, the Depression-Anxiety-Stress 21 scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the WHOQOL Quality of Life scale. Participants were evaluated using measurements taken before and after the application, as well as a one-month follow-up. The mean age of the participants was 36.20 (11.41) years and 82.1% (n = 32) were female. The DASS-21 Anxiety (η2 = 0.085), IES-R Intrusion (η2 = 0.101), Avoidance (η2 = 0.124), Total (η2 = 0.147), and WHOQOL-BREF Psychological (η2 = 0.106) score improvements of the EMDR Flash Technique group were shown to be statistically significant when compared to the mhGAP group. However, no statistically significant difference in the DASS-21 Depression, Stress, Impact of Event Scale-Revised Hyperarousal WHOQOL-BREF General Health, Physical, Social Relationships, and Environment component scores was reported between the two groups. The present study’s findings clearly demonstrate that the EMDR Flash technique, when applied to persons involved in traffic accidents, is successful in improving anxiety, intrusion, avoidance, total traumatic stress, and mental quality of life symptoms for at least 1 month. We believe that these findings will improve the reliability and applicability of the EMDR Flash Technique, which was tested for the first time in a clinical randomized-controlled trial (RCT).
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Affiliation(s)
- Alişan Burak Yaşar
- Department of Clinical Psychology, İstanbul Gelişim University, İstanbul, Turkey
| | - Emre Konuk
- Davranış Bilimleri Institute, İstanbul, Turkey
| | - Önder Kavakçı
- Department of Psychology, İstanbul Kültür University, İstanbul, Turkey
| | - Ersin Uygun
- Department of Psychology, İstanbul Bilgi University, İstanbul, Turkey
| | - İbrahim Gündoğmuş
- Department of Psychiatry, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Turkey
- *Correspondence: İbrahim Gündoğmuş,
| | | | - Esra Uludağ
- Department of Psychology, Sabahattin Zaim University, İstanbul, Turkey
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Trask S. Rethinking Extinction-Based Treatments for Specific Phobias. Biol Psychiatry 2022; 91:e15-e16. [PMID: 34961598 DOI: 10.1016/j.biopsych.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Sydney Trask
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana.
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