Thinking of attachment figures blocks differential fear conditioning

Social support and fear-inhibition: an examination of underlying neural mechanisms

Recent work has demonstrated that reminders of those we are closest to have a unique combination of effects on fear learning and represent a new category of fear inhibitors, termed prepared fear suppressors. Notably, social-support-figure images have been shown to resist becoming associated with fear, suppress conditional-fear-responding and lead to long-term fear reduction. Due to the novelty of this category, understanding the underlying neural mechanisms that support these unique abilities of social-support-reminders has yet to be investigated. Here, we examined the neural correlates that enable social-support-reminders to resist becoming associated with fear during a retardation-of-acquisition test. We found that social-support-figure-images (vs stranger-images) were less readily associated with fear, replicating prior work, and that this effect was associated with decreased amygdala activity and increased ventromedial prefrontal cortex (VMPFC) activity for social-support-figure-images (vs stranger-images), suggesting that social-support-engagement of the VMPFC and consequent inhibition of the amygdala may contribute to unique their inhibitory effects. Connectivity analyses supported this interpretation, showing greater connectivity between the VMPFC and left amygdala for social-support-figure-images (vs stranger-images).

In safe hands: Attachment figures' safety properties and the link with attachment style

According to the Learning Theory of Attachment, naturalistic learning experiences about others' responsiveness during distress are an underlying mechanism in the development of attachment. Previous studies have demonstrated attachment figures' unique safety-inducing effects in highly controlled conditioning procedures. Yet, neither have studies examined the presumed influence of safety learning on state attachment, nor have they examined how attachment figures' safety-inducing effects relate to attachment styles. To address these gaps, a differential fear conditioning paradigm was used in which pictures of participants' attachment figure and two control stimuli served as safety cues (CS-). US-expectancy and distress ratings were measured as indicators of fear responding. Results indicate that attachment figures evoked enhanced safety responding compared to control safety cues at the start of acquisition, which was maintained throughout acquisition and when presented together with a danger cue. Attachment figures' safety-inducing effects were reduced in individuals with higher attachment avoidance, although attachment style did not affect the rate of new safety learning. Finally, safe experiences with the attachment figure in the fear conditioning procedure resulted in diminished anxious state attachment. Adding to previous work, these findings underscore the importance of learning processes for attachment development and attachment figures' provision of safety.

A partner's smile is not per se a safety signal: Psychophysiological response patterns to instructed threat and safety

Recent studies on fear conditioning and pain perception suggest that pictures of loved ones (e.g., a romantic partner) may serve as a prepared safety cue that is less likely to signal aversive events. Challenging this view, we examined whether pictures of smiling or angry loved ones are better safety or threat cues. To this end, 47 healthy participants were verbally instructed that specific facial expressions (e.g., happy faces) cue threat of electric shocks and others cue safety (e.g., angry faces). When facial images served as threat cues, they elicited distinct psychophysiological defensive responses (e.g., increased threat ratings, startle reflex, and skin conductance responses) compared to viewing safety cues. Interestingly, instructed threat effects occurred regardless of the person who cued shock threat (partner vs. unknown) and their facial expression (happy vs. angry). Taken together, these results demonstrate the flexible nature of facial information (i.e., facial expression and facial identity) to be easily learned as signals for threat or safety, even when showing loved ones.

Attachment processes in posttraumatic stress disorder: A review of mechanisms to advance theories and treatments

Current conceptualisations of posttraumatic stress disorder (PTSD) are driven by biological, learning, and cognitive models that have shaped current treatments of the disorder. The strong influence of these models has resulted in a relative neglect of social mechanisms that can influence traumatic stress. There is abundant evidence from experimental, observational, and clinical studies that social factors can moderate many of the mechanisms articulated in prevailing models of PTSD. In this review it is proposed that attachment theory provides a useful framework to complement existing models of PTSD because it provides explanatory value for social factors can interact with biological, learning, and cognitive processes that shape traumatic stress response. The review provides an overview of attachment theory in the context of traumatic stress, outlines the evidence for how attachment factors can moderate stress responses and PTSD, and considers how harnessing attachment processes may augment recovery from and treatment of PTSD. This review emphasizes that rather than conceptualizing attachment theory as an independent theory of traumatic stress, there is much to gain by integrating attachment mechanisms into existing models of PTSD to accommodate the interactions between cognitive, biological, and attachment processes.

Exploring the effect of loneliness on fear: Implications for the effect of COVID-19-induced social disconnection on anxiety

The consequences of the COVID-19 pandemic have resulted in many disruptions to daily life, including an abrupt increase in social disconnection. As measures were put in place to combat the spread of COVID-19, people across the globe began living in states of limited social contact, fostering feelings of social isolation and loneliness. Previous literature suggests that these increases in social disconnection can have profound effects on both physical and mental health, perhaps especially in the case of fear disorders. The combination of feeling disconnected from others and the high level of daily threat experienced due to COVID-19 created conditions under which dysfunctional and persistent fears were especially likely to develop. Building on current understanding of the harmful effects of social disconnection on well-being in general as well as specific implications for fear, here we present findings from three preliminary investigations that are the first to directly examine the effects of loneliness on how fears are learned and maintained. The Results of this work show that loneliness impairs the process by which fears are extinguished, which is central to both the regulation of fear and treatment of fear disorders, and provide insight into potential avenues to mitigate such effects.

Reclassifying the Unique Inhibitory Properties of Social Support Figures: A Roadmap for Exploring Prepared Fear Suppression

Recent work has revealed that social support cues are powerful inhibitors of the fear response. They are endowed with a unique combination of inhibitory properties, enabling them to both inhibit fear in the short term and reduce fear in the long term. While these findings had previously been thought to suggest that social support cues belong to a category of prepared safety stimuli, mounting evidence clearly shows that the mechanisms underlying safety signaling cannot account for the unique effects of social support cues. Here, we propose a reclassification of social support cues as members of a prepared fear suppressor category. We present an argument for the prepared fear suppressor classification, discuss potential mechanisms underlying the unique effects of prepared fear suppressors, and outline next steps to build an understanding of this category and its clinical implications. This review is meant to serve as a roadmap for exploring this novel category of prepared fear suppressors, whose never-before-seen range of inhibitory effects makes them an important and impactful discovery with implications for both fear learning theory and clinical application.

Attachment voices promote safety learning in humans: A critical role for P2

Humans have evolved to seek the proximity of attachment figures during times of threat in order to obtain a sense of safety. In this context, we examined whether or not the voice of an intimate partner (termed "attachment voice") could reduce fear-learning of conditioned stimuli (CS+) and enhance learning of safety signals (CS-). Although the ability to learn safety signals is vital for human survival, few studies have explored how attachment voices affect safety learning. To test our hypothesis, we recruited thirty-five young couples and performed a classic Pavlovian conditioning experiment, recording behavioral and electroencephalographic (EEG) data. The results showed that compared with a stranger's voice, the voices of the partners reduced expectancy of the unconditioned stimulus (a shock) during fear-conditioning, as well as the magnitude of P2 event-related potentials within the EEG responses, provided the voices were safety signals. Additionally, behavioral and EEG responses to the CS+ and CS- differed more when the participants heard their partner's voice than when they heard the stranger's voice. Thus, attachment voices, even as pure vowel sounds without any semantic information, enhanced acquisition of conditioned safety (CS-). These findings may provide implications for investigating other new techniques to improve clinical treatments for fear- and anxiety-related disorders and for psychological interventions against the mental health effects of the public health emergency.

The Role of Implicit Memory in the Development and Recovery from Trauma-Related Disorders

Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.

Activating the attachment system modulates neural responses to threat in refugees with PTSD

Social attachment systems are disrupted for refugees through trauma and forced displacement. This study tested how the attachment system mitigates neural responses to threat in refugees with posttraumatic stress disorder (PTSD). Refugees with PTSD (N = 28) and refugee trauma-exposed controls (N = 22) viewed threat-related stimuli primed by attachment cues during a functional magnetic resonance imaging scan. Group differences and the moderating effects of avoidant or anxious attachment style and grief related to separation from family on brain activity and connectivity patterns were examined. Separation grief was associated with increased amygdala but decreased ventromedial prefrontal cortical (VMPFC) activity to the attachment prime and decreased VMPFC and hippocampal activity to attachment primed threat in the PTSD (vs trauma-exposed control) group. Avoidant attachment style was connected with increased dorsal frontoparietal attention regional activity to attachment prime cues in the PTSD group. Anxious attachment style was associated with reduced left amygdala connectivity with left medial prefrontal regions to attachment primed threat in the PTSD group. Separation grief appears to reduce attachment buffering of threat reactivity in refugees with PTSD, while avoidant and anxious attachment style modulated attentional and prefrontal regulatory mechanisms in PTSD, respectively. Considering social attachments in refugees could be important to post-trauma recovery, based within changes in key emotion regulation brain systems.

Secure attachment priming protects against relapse of fear in Young adults

Previous studies have shown that activating the attachment system attenuates fear learning. This study aimed to explore whether attachment priming can also impact on fear extinction processes, which underpin the management of anxiety disorders. In this study, 81 participants underwent a standard fear conditioning and extinction protocol on day 1 and returned 24 h later for an extinction recall and reinstatement test. Half the participants were primed to imagine their closest attachment figure prior to undergoing extinction training, while the other half were instructed to imagine a positive situation. Fear-potentiated startle and subjective expectancies of shock were measured as the primary indicators of fear. Attachment priming led to less relapse during the reinstatement test at the physiological but not subjective levels. These findings have translational potential to imply that activating awareness of attachment figures might augment long-term safety memories acquired in existing treatments to reduce relapse of fear.

Secure attachment primes reduce fear consolidation

BACKGROUND

Recent studies have found that attachment security primes can inhibit fear acquisition. This current study aimed to examine whether a brief imaginal prime of one's attachment figure could impact on fear consolidation.

METHODS

A total of 75 participants underwent fear conditioning on Day 1 and fear recall was tested on Day 2. Immediately following conditioning, half the participants were instructed to imagine an attachment figure while the other half imagined a nonattachment positive situation. Fear-potentiated startle and subjective expectancy of shock ratings were used as the measures of fear learning across trials.

RESULTS

The attachment group showed significantly lower levels of fear recall on Day 2 at both physiological and subjective levels. Furthermore, this effect was moderated by attachment anxiety, such that it was greatest for individuals who were securely attached.

CONCLUSIONS

These findings suggest that attachment relationships are protective during the consolidation of fear memories, and may have implications for how social attachments may impact how anxiety disorders can develop.

Imagery-induced negative affect, social touch and frontal EEG power band activity

Social touch seems to modulate emotions, but its brain correlates are poorly understood. Here, we investigated if frontal power band activity in the electroencephalogram (EEG) during aversive mental imagery is modulated by social touch from one's romantic partner and a stranger. We observed the highest theta and beta power when imaging alone, next so when being touched by a stranger, with lowest theta and beta activity during holding hands with the loved one. Delta power was higher when being alone than with a stranger or a partner, with no difference between the two. Gamma power was highest during the stranger condition and lower both when being alone and with the partner, while alpha power did not change as a function of social touch. Theta power displayed a positive correlation with electrodermal activity supporting its relation to emotional arousal. Attachment style modulated the effect of touch on the EEG as only secure but not insecure partner bonding was associated with theta power reductions. Because theta power was sensitive to the experimental perturbations, mapped onto peripheral physiological arousal and reflected partner attachment style we suggest that frontal theta power might serve as an EEG derived bio-marker for social touch in emotionally significant dyads.

Infant Trauma Alters Social Buffering of Threat Learning: Emerging Role of Prefrontal Cortex in Preadolescence

Within the infant-caregiver attachment system, the primary caregiver holds potent reward value to the infant, exhibited by infants' strong preference for approach responses and proximity-seeking towards the mother. A less well-understood feature of the attachment figure is the caregiver's ability to reduce fear via social buffering, commonly associated with the notion of a "safe haven" in the developmental literature. Evidence suggests this infant system overlaps with the neural network supporting social buffering (attenuation) of fear in the adults of many species, a network known to involve the prefrontal cortex (PFC). Here, using odor-shock conditioning in young developing rats, we assessed when the infant system transitions to the adult-like PFC-dependent social buffering of threat system. Rat pups were odor-shock conditioned (0.55 mA-0.6 mA) at either postnatal day (PN18; dependent on mother) or 28 (newly independent, weaned at PN23). Within each age group, the mother was present or absent during conditioning, with PFC assessment following acquisition using 14C 2-DG autoradiography and cue testing the following day. Since the human literature suggests poor attachment attenuates the mother's ability to socially buffer the infants, half of the pups at each age were reared with an abusive mother from PN8-12. The results showed that for typical control rearing, the mother attenuated fear in both PN18 and PN28 pups, although the PFC [infralimbic (IL) and ventral prelimbic (vPL) cortices] was only engaged at PN28. Abuse rearing completely disrupted social buffering of pups by the mother at PN18. The results from PN28 pups showed that while the mother modulated learning in both control and abuse-reared pups, the behavioral and PFC effects were attenuated after maltreatment. Our data suggest that pups transition to the adult-like PFC social support circuit after independence from the mother (PN28), and this circuit remains functional after early-life trauma, although its effectiveness appears reduced. This is in sharp contrast to the effects of early life trauma during infancy, where social buffering of the infant is more robustly impacted. We suggest that the infant social buffering circuit is disengaged by early-life trauma, while the adolescent PFC-dependent social buffering circuit may use a safety signal with unreliable safety value.