Exaggerated sensitivity to threat and reduced medial prefrontal engagement during threat generalization in reactive aggressive adolescents

Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N=30) and a low aggression (LA) group (N=31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and generalization stimuli (GSs). A scream at 85 decibels served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.

Causally Probing the Role of the Hippocampus in Fear Discrimination: A Precision Functional Mapping-Guided, Transcranial Magnetic Stimulation Study in Participants With Posttraumatic Stress Symptoms

Background

Fear overgeneralization is a promising pathogenic mechanism of clinical anxiety. A dominant model posits that hippocampal pattern separation failures drive overgeneralization. Hippocampal network-targeted transcranial magnetic stimulation (HNT-TMS) has been shown to strengthen hippocampal-dependent learning/memory processes. However, no study has examined whether HNT-TMS can alter fear learning/memory.

Methods

Continuous theta burst stimulation was delivered to individualized left posterior parietal stimulation sites derived via seed-based connectivity, precision functional mapping, and electric field modeling methods. A vertex control site was also stimulated in a within-participant, randomized controlled design. Continuous theta burst stimulation was delivered prior to 2 visual discrimination tasks (1 fear based, 1 neutral). Multilevel models were used to model and test data. Participants were undergraduates with posttraumatic stress symptoms (final n = 25).

Results

Main analyses did not indicate that HNT-TMS strengthened discrimination. However, multilevel interaction analyses revealed that HNT-TMS strengthened fear discrimination in participants with lower fear sensitization (indexed by responses to a control stimulus with no similarity to the conditioned fear cue) across multiple indices (anxiety ratings: β = 0.10, 95% CI, 0.04 to 0.17, p = .001; risk ratings: β = 0.07, 95% CI, 0.00 to 0.13, p = .037).

Conclusions

Overgeneralization is an associative process that reflects deficient discrimination of the fear cue from similar cues. In contrast, sensitization reflects nonassociative responding unrelated to fear cue similarity. Our results suggest that HNT-TMS may selectively sharpen fear discrimination when associative response patterns, which putatively implicate the hippocampus, are more strongly engaged.

Fear generalization predicts post-traumatic stress symptoms: A two-year follow-up study in Dutch fire fighters

INTRODUCTION

Excessive fear generalization has been associated with pathological anxiety, including posttraumatic stress disorder (PTSD). However, studies investigating the longitudinal relationship between generalization and the development of anxiety symptomatology are scarce. This study aims to test the predictive value of fear generalization for PTSD symptoms in a high-risk profession sample and to explore the relationship between generalization and neuroticism, which are both linked to PTSD.

METHOD

Longitudinal data from a multi-wave study in 529 Dutch fire-fighters were used. Fear generalization, PTSD symptoms and neuroticism were assessed at baseline. PTSD symptoms were reevaluated at six, 12, 18, and 24 months. Generalization was assessed in a differential conditioning paradigm by measuring expectancies of an aversive outcome when presented with stimuli similar to previously conditioned stimuli.

RESULTS

Higher expectancy ratings towards stimuli most similar to safety signals predicted PTSD symptoms at follow-up after controlling for baseline PTSD symptoms, whereas higher expectancy ratings towards stimuli most similar to danger signals was associated with neuroticism. Neuroticism weakened the predictive power of fear generalization when considered simultaneously.

DISCUSSION

These findings suggest that heightened fear generalization is associated with the development of anxiety and trauma-related symptoms. Targeting problematic fear generalization may be a promising intervention approach.

High-Anxious People Generalize Costly Pain-Related Avoidance Behavior More to Novel Safe Contexts Compared to Low-Anxious People

Pain-related avoidance is adaptive when there is a bodily threat, but when it generalizes to safe movements/situations, it may become disabling. Both subclinical anxiety-a vulnerability marker for chronic pain-and chronic pain are associated with excessive fear generalization to safe stimuli/situations. Previous research focused mainly on passive fear correlates (psychophysiological arousal and self-reports) leaving avoidance behavior poorly understood. Therefore, we tested whether high-anxious individuals generalize their pain-related avoidance behavior more to novel, safe contexts than low-anxious people. In a robotic-arm-reaching task, both groups (low vs high trait anxiety) performed 1 of 3 movements to reach a target. In the threat context (black background), a painful stimulus could be partly/completely prevented by performing more effortful trajectories (longer and more force needed); in the safe context (white background), no pain occurred. Generalization of avoidance was tested in 2 novel contexts (light/dark gray backgrounds). We assessed pain expectancy, pain-related fear, startle eyeblink responses for all trajectories, and avoidance behavior (ie, maximal deviation from shortest trajectory). Results indicated that differential fear and expectancy selectively generalized to the novel context resembling the original threat context in both groups. Interestingly and in contrast with the verbal reports, high-anxious participants avoided more in the novel context resembling the original safe context, but not in the 1 resembling the threat context. No generalization emerged in the startle data. Because excessive pain-related avoidance specifically may cause withdrawal from daily life activities, these findings suggest that high-anxious individuals may be vulnerable to developing chronic pain disability. PERSPECTIVE: This paper shows that high-anxious people do not overgeneralize pain-related fear and pain expectancy learned in a threat context more to novel, safe contexts than low-anxious individuals, but that they do avoid more in those contexts. These findings suggest that high-anxious individuals may be vulnerable to developing chronic pain disability.

Mental threat rehearsal increases fear generalization

BACKGROUND AND OBJECTIVES

Fear generalization to harmless stimuli characterizes anxiety-related disorders, but much remains unknown about its determinants. Based on studies showing that mental imagery of threat can increase conditioned fear responding, we tested whether it also facilitates fear generalization, and whether threat inflation moderates this effect.

METHODS

In a fear conditioning study, 120 participants first completed an acquisition phase, in which one of two pictures was followed by an aversive sound (human scream). Then, the sound was presented 11 times at an increasing (threat inflation) or constant volume (no threat inflation). Finally, a generalization stimulus was presented, and some participants were asked to imagine the last sound (threat rehearsal) and others were not (no threat rehearsal).

RESULTS

Bayesian informative hypotheses tests indicated that imagery-based threat rehearsal increased generalization of threat expectancy, and, combined with threat inflation, it also resulted in stronger generalized distress.

LIMITATIONS

due to the absence of a test phase, it is unclear whether our effects would transfer to other GSs and whether they would persist beyond the manipulation phase.

CONCLUSIONS

Mental imagery of threat may put individuals at risk for fear generalization. Future studies should examine whether modulating imagery may prevent clinical anxiety.

Pharmacological modulation of Kv3 voltage-gated potassium channels regulates fear discrimination and expression in a response-dependent manner

Various psychiatric diseases are characterized by aberrant cognition and emotional regulation. This includes inappropriately attributing affective salience to innocuous cues, which can be investigated using translationally relevant preclinical models of fear discrimination. Activity in the underpinning corticolimbic circuitry is governed by parvalbumin-expressing GABAergic interneurons, which also regulate fear discrimination. Kv3 voltage-gated potassium channels are highly expressed in these neurons and are important for controlling their activity, suggesting that pharmacological Kv3 modulation may regulate fear discrimination. We determined the effect of the positive Kv3 modulator AUT00206 given systemically to female rats undergoing limited or extended auditory fear discrimination training, which we have previously shown results in more discrimination or generalization, respectively, based on freezing at retrieval. We also characterized darting and other active fear-related responses. We found that limited training resulted in more discrimination based on freezing, which was unaffected by AUT00206. In contrast, extended training resulted in more generalization based on freezing and the emergence of discrimination based on darting during training and, to a lesser extent, at retrieval. Importantly, AUT00206 given before extended training had dissociable effects on fear discrimination and expression at retrieval depending on the response examined. While AUT00206 mitigated generalization without affecting expression based on freezing, it reduced expression without affecting discrimination based on darting, although darting levels were low overall. These results indicate that pharmacological Kv3 modulation regulates fear discrimination and expression in a response-dependent manner. They also raise the possibility that targeting Kv3 channels may ameliorate perturbed cognition and emotional regulation in psychiatric disease.

The overgeneralization of pain-related fear in individuals with higher pain sensitivity: A behavioral and event-related potential study

Fear generalization contributes to the development and maintenance of pain. Pain sensitivity has been proposed to predict the strength of fear responses to aversive stimuli. However, whether individual variation in pain sensitivity affects pain-related fear generalization and its underlying cognitive processing remains unclear. To address this gap, we recorded behavioral and event-related potential (ERP) data among 22 high pain sensitivity (HPS) and 22 low pain sensitivity (LPS) healthy adults when exposed to a fear generalization paradigm. The behavioral results indicate that the HPS group displayed higher unconditioned stimulus expectancy and greater fear, arousal, and anxiety ratings to conditioned stimulus and generalization stimulus than the LPS group (all p values < 0.05). The ERP results showed that the HPS group exhibited a larger late positive potential evoked by GS2, GS3 and CS- (all p < 0.005) but a smaller N1 evoked by all CS and GSs (all p values < 0.05) relative to the LPS group. These findings suggest that individuals with a high level of pain sensitivity allocate more attention resources to pain-related threatening stimuli, which contributes to an overgeneralization of pain-related fear.

Fear conditioning and fear generalization in children and adolescents with anxiety disorders

Overgeneralization of conditioned fear is associated with anxiety disorders (AD). Most results stem from studies done in adult patients, but studies with children are rare, although the median onset of anxiety disorders lies already in childhood. Thus, the goal of the present study was to examine fear learning and generalization in youth participants, aged 10-17 years, with AD (n = 39) compared to healthy controls (HC) (n = 40). A discriminative fear conditioning and generalization paradigm was used. Ratings of arousal, valence, and US expectancy (the probability of an aversive noise following each stimulus) were measured, hypothesizing that children with AD compared to HC would show heightened ratings of arousal and US expectancy, and decreased positive valence ratings, respectively, as well as overgeneralization of fear. The results indicated that children with AD rated all stimuli as more arousing and less pleasant, and demonstrated higher US expectancy ratings to all stimuli when compared to HC. Thus, rather than displaying qualitatively different generalization patterns (e.g., a linear vs. quadratic slope of the gradient), differences between groups were more quantitative (similar, but parallel shifted gradient). Therefore, overgeneralization of conditioned fear does not seem to be a general marker of anxiety disorders in children and adolescents.

Behavioral characterization of Capn15 conditional knockout mice

Calpain 15 (CAPN15) is an intracellular cysteine protease belonging to the non-classical small optic lobe (SOL) family of calpains, which has an important role in development. Loss of Capn15 in mice leads to developmental eye anomalies and volumetric changes in the brain. Human individuals with biallelic variants in CAPN15 have developmental delay, neurodevelopmental disorders, as well as congenital malformations. In Aplysia, a reductionist model to study learning and memory, SOL calpain is important for non-associative long-term facilitation, the cellular analog of sensitization behavior. However, how CAPN15 is involved in adult behavior or learning and memory in vertebrates is unknown. Here, using Capn15 conditional knockout mice, we show that loss of the CAPN15 protein in excitatory forebrain neurons reduces self-grooming and marble burying, decreases performance in the accelerated roto-rod and reduces pre-tone freezing after strong fear conditioning. Thus, CAPN15 plays a role in regulating behavior in the adult mouse.

Calibrating your own fears: Feasibility of a remote fear conditioning paradigm with semi-subjective stimulus calibration and differences in fear learning

Fear conditioning studies have occurred mostly in the laboratory, but recently researchers have started to adapt fear conditioning procedures for remote application. Standardization of aversive stimulus material not causing unnecessarily strong discomfort remains an issue especially relevant to research without experimental supervision. The present study introduces a novel semi-subjective method to calibrate aversive sounds in a remotely conducted fear conditioning paradigm. To demonstrate feasibility and proof of concept, 165 participants completed the paradigm, calibrating the loudness of an aversive sound without the guidance of an experimental instructor. This study also aimed to replicate existing findings of participant groups that differed in their early CS-UCS contingency awareness. Participants were classified as Accurate (UCS more likely after the CS+ than CS-), Poor (UCS more likely after the CS- than CS+, or UCS unlikely after either CS), and Threat Biased (UCS equally likely after the CS+ and CS-). Results indicated both the feasibility and efficacy of the paradigm, with participants showing typical patterns of fear learning. Threat Biased participants showed significantly higher uncertainty towards safety signals. There were no differences between the groups in terms of personality traits, thus questioning whether these attributes mediate differences in fear learning and the emergence of anxiety disorders. Using semi-subjective sound calibration appears to be functional, and future studies may consider implementing the new method when remotely administering fear conditioning paradigms.

Impact of observational and direct learning on fear conditioning generalization in humans

Humans gain knowledge about threats not only from their own experiences but also from observing others' behavior. A neutral stimulus is associated with a threat stimulus for several times and the neutral stimulus will evoke fear responses, which is known as fear conditioning. When encountering a new event that is similar to one previously associated with a threat, one may feel afraid and produce fear responses. This is called fear generalization. Previous studies have mostly focused on fear conditioning and generalization based on direct learning, but few have explored how observational fear learning affects fear conditioning and generalization. To the best of our knowledge, no previous study has focused on the neural correlations of fear conditioning and generalization based on observational learning. In the present study, 58 participants performed a differential conditioning paradigm in which they learned the associations between neutral cues (i.e., geometric figures) and threat stimuli (i.e., electric shock). The learning occurred on their own (i.e., direct learning) and by observing other participant's responses (i.e., observational learning); the study used a within-subjects design. After each learning condition, a fear generalization paradigm was conducted by each participant independently while their behavioral responses (i.e., expectation of a shock) and electroencephalography (EEG) recordings or responses were recorded. The shock expectancy ratings showed that observational learning, compared to direct learning, reduced the differentiation between the conditioned threatening stimuli and safety stimuli and the increased shock expectancy to the generalization stimuli. The EEG indicated that in fear learning, threatening conditioned stimuli in observational and direct learning increased early discrimination (P1) and late motivated attention (late positive potential [LPP]), compared with safety conditioned stimuli. In fear generalization, early discrimination, late motivated attention, and orienting attention (alpha-event-related desynchronization [alpha-ERD]) to generalization stimuli were reduced in the observational learning condition. These findings suggest that compared to direct learning, observational learning reduces differential fear learning and increases the generalization of fear, and this might be associated with reduced discrimination and attentional function related to generalization stimuli.

Stimulus diversity increases category-based fear generalization and the effect of intolerance of uncertainty

Fear generalization refers to conditioned fear responses extending to related stimuli and fear overgeneralization is a key feature of pathological anxiety. Along with perception similarity, conceptual relations affect fear generalization. We investigated whether stimulus diversity-an important principle of category-based induction-influences fear generalization. Induction studies have shown that generalization from a premise involving diverse instances is stronger than that from non-diverse instances. We adopted this framework for fear learning and established two groups. The diverse group developed fear in response to diverse instances from one category, while the non-diverse group acquired fear of non-diverse instances from the same category. An effect of stimulus diversity was observed in shock-expectancy ratings, with the diverse group displaying higher fear generalization than the non-diverse group. We also tested whether intolerance of uncertainty (IU) might affect the difference in fear generalization between the two conditions. Individuals with higher IU showed reduced difference in fear generalization between two conditions, mainly driven by heightened fear generalization to novel stimulus with ambiguous threat levels in the non-diverse condition. This study helps illustrate the mechanisms behind differential category-based fear generalization and provides a potential explanation for why higher IU individuals may develop anxiety disorders following trauma.

Fear learning and generalization during pandemic fear: How COVID-19-related anxiety affects classical fear conditioning with traumatic film clips

The COVID-19 pandemic greatly disrupted our daily lives. Worldwide, people were confronted with health, financial, and existential fears or trauma-like experiences. Recent studies have identified an increase in stress, anxiety, and fear symptoms in connection with the pandemic. Furthermore, fear learning processes are central mechanisms in the development and maintenance of anxiety disorders. Patients commonly show impairments not only in fear learning but also in its generalization. Thus, pandemic-related anxiety may constitute a risk factor for both enhanced fear acquisition and generalization. In a pre-registered online study with a final sample of 220 healthy university students, we investigated whether participants with higher COVID-19-related anxiety (COVID-Anxiety) show impaired fear learning and generalization. For this purpose, we used a differential fear conditioning paradigm with a traumatic film clip as the unconditioned stimulus (US) and collected US-expectancy as the main measure of interest. Participants with high COVID-Anxiety show a tendency toward poorer discrimination between the reinforced conditioned stimulus (CS+) and the unreinforced conditioned stimulus (CS-) during acquisition and significantly poorer discrimination patterns during generalization. Furthermore, participants with high COVID-Anxiety show greater general fear throughout the whole experiment. Our results show that the subjective effects of the COVID-19 pandemic on psychological well-being are associated with impairments in both fear learning and fear generalization. As expected, high COVID-Anxiety leads to poorer performance in stimulus discrimination and greater levels of fear, which might contribute to a higher risk of anxiety disorders. GERMAN CLINICAL TRIAL REGISTER: DRKS00022761.

Developmental aspects of fear generalization - A MEG study on neurocognitive correlates in adolescents versus adults

BACKGROUND

Fear generalization is pivotal for the survival-promoting avoidance of potential danger, but, if too pronounced, it promotes pathological anxiety. Similar to adult patients with anxiety disorders, healthy children tend to show overgeneralized fear responses.

OBJECTIVE

This study aims to investigate neuro-developmental aspects of fear generalization in adolescence - a critical age for the development of anxiety disorders.

METHODS

We compared healthy adolescents (14-17 years) with healthy adults (19-34 years) regarding their fear responses towards tilted Gabor gratings (conditioned stimuli, CS; and slightly differently titled generalization stimuli, GS). In the conditioning phase, CS were paired (CS+) or remained unpaired (CS-) with an aversive stimulus (unconditioned stimuli, US). In the test phase, behavioral, peripheral and neural responses to CS and GS were captured by fear- and UCS expectancy ratings, a perceptual discrimination task, pupil dilation and source estimations of event-related magnetic fields.

RESULTS

Closely resembling adults, adolescents showed robust generalization gradients of fear ratings, pupil dilation, and estimated neural source activity. However, in the UCS expectancy ratings, adolescents revealed shallower generalization gradients indicating overgeneralization. Moreover, adolescents showed stronger visual cortical activity after as compared to before conditioning to all stimuli.

CONCLUSION

Various aspects of fear learning and generalization appear to be mature in healthy adolescents. Yet, cognitive aspects might show a slower course of development.

Fear one, fear them all: A systematic review and meta-analysis of fear generalization in pathological anxiety

It is a defining feature of anxiety disorders that fear is elicited by a circumscribed class of stimuli rather than by only one specific exemplar of that class. Therefore, fear generalization, a mechanism by which associative fear extends from one conditioned stimulus to similar cues, has been central to theories on anxiety. Yet, experimental evidence for the link between generalization and pathological anxiety, as well as its moderators, has not been formally integrated. This systematic review and meta-analysis of empirical findings clarifies the relationship between fear generalization and pathological anxiety. In conclusion, enhanced fear generalization is associated with several anxiety disorders and stress-related disorders, which is supported statistically by a small, but robust effect size of g = 0.44 for risk ratings as an index of fear generalization. However, empirical results are inconsistent across disorders and they rarely allow for conclusions on their causality in the disorders' etiology. Therefore, based on theoretical considerations, we recommend directions for intensified research, especially on the causal relationship between overgeneralization and pathological fear.

Ketamine attenuates the PTSD-like effect via regulation of glutamatergic signaling in the nucleus accumbens of mice

Post-traumatic stress disorder (PTSD) is a devastating mental illness with high morbidity and major social and economic burden. Currently, there is no promising therapy available for the treatment of PTSD. Some clinical studies showed that ketamine could effectively alleviate PTSD symptoms. However, it is still unclear which brain region ketamine targets and how it attenuates the PTSD-like effects. In this study, we examined the effect of ketamine on fear generalization (a core symptom of PTSD) by using a mice model of fear generalization induced by fear conditioning procedure. Before retrieval, ketamine was locally infused into the nucleus accumbens (a brain region closely associated with PTSD). Fear generalization mice were subjected to behavioral testing and biochemical assessments, following ketamine infusion. The results showed that the foot shock strength-dependently induced fear generalization in mice with increased c-fos activity, and a lower level of GluR1(S845), GluR1(S831) protein, and a higher level of P-GluN2B protein in the nucleus accumbens (NAc). Local infusion of ketamine into NAc decreased the fear generalization together with an increased level of GluR1(S845), GluR1(S831) protein, and decreased level of P-GluN2B protein. Altogether, these results conclude that ketamine might affect the glutamatergic signaling in the NAc to attenuate the fear generalization in mice.

Generalization of fear of movement-related pain and avoidance behavior as predictors of work resumption after back surgery: a study protocol for a prospective study (WABS)

Background

Previous studies indicated that about 20% of the individuals undergoing back surgery are unable to return to work 3 months to 1 year after surgery. The specific factors that predict individual trajectories in postoperative pain, recovery, and work resumption are largely unknown. The aim of this study is to identify modifiable predictors of work resumption after back surgery.

Methods

In this multisite, prospective, longitudinal study, 300 individuals with radicular pain undergoing a lumbar decompression will be followed until 1-year post-surgery. Prior to surgery, participants will perform a computer task to assess fear of movement-related pain, avoidance behavior, and their generalization to novel situations. Before and immediately after surgery, participants will additionally complete questionnaires to assess fear of movement-related pain, avoidance behavior, optimism, expectancies towards recovery and work resumption, and the duration and severity of the pain. Six weeks, 3 months, 6 months, and 12 months after surgery, they will again complete questionnaires to assess sustainable work resumption, pain severity, disability, and quality of life. The primary hypothesis is that (generalization of) fear of movement-related pain and avoidance behavior will negatively affect sustainable work resumption after back surgery. Second, we hypothesize that (generalization of) fear of movement-related pain and avoidance behavior, negative expectancies towards recovery and work resumption, longer pain duration, and more severe pain before the surgery will negatively affect work resumption, pain severity, disability, and quality of life after back surgery. In contrast, optimism and positive expectancies towards recovery and work resumption are expected to predict more favorable work resumption, better quality of life, and lower levels of pain severity and disability after back surgery.

Discussion

With the results of this research, we hope to contribute to the development of strategies for early identification of risk factors and appropriate guidance and interventions before and after back surgery.

Trial registration The study was preregistered on ClinicalTrials.gov: NCT04747860 on February 9, 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00736-5.

Fear conditioning and stimulus generalization in association with age in children and adolescents

The aim of the study was to investigate age-related differences in fear learning and generalization in healthy children and adolescents (n = 133), aged 8-17 years, using an aversive discriminative fear conditioning and generalization paradigm adapted from Lau et al. (2008). In the current task, participants underwent 24 trials of discriminative conditioning of two female faces with neutral facial expressions, with (CS+) or without (CS-) a 95-dB loud female scream, presented simultaneously with a fearful facial expression (US). The discriminative conditioning was followed by 72 generalization trials (12 CS+, 12 GS1, 12 GS2, 12 GS3, 12 GS4, and 12 CS-): four generalization stimuli depicting gradual morphs from CS+ to CS- in 20%-steps were created for the generalization phases. We hypothesized that generalization in children and adolescents is negatively correlated with age. The subjective ratings of valence, arousal, and US expectancy (the probability of an aversive noise following each stimulus), as well as skin conductance responses (SCRs) were measured. Repeated-measures ANOVAs on ratings and SCR amplitudes were calculated with the within-subject factors stimulus type (CS+, CS-, GS1-4) and phase (Pre-Acquisition, Acquisition 1, Acquisition 2, Generalization 1, Generalization 2). To analyze the modulatory role of age, we additionally calculated ANCOVAs considering age as covariate. Results indicated that (1) subjective and physiological responses were generally lower with increasing age irrespective to the stimulus quality, and (2) stimulus discrimination improved with increasing age paralleled by reduced overgeneralization in older individuals. Longitudinal follow-up studies are required to analyze fear generalization with regard to brain maturational aspects and clarify whether overgeneralization of conditioned fear promotes the development of anxiety disorders or vice versa.

Comparing three extinction methods to reduce fear expression and generalization

Fear extinction is easy to achieve but difficult to maintain, as evidenced by the relapse of fear after extinction. Counterconditioning and novelty-facilitated extinction have been shown to interfere with fear expression without erasing it. Because of the similarity between the two extinction paradigms, we extended the standard extinction, which merely omitted the expected threat outcomes after exposure to original threat cues. The modified paradigm provided a stimulus (neutral picture or positive picture) to replace the omitted threat outcomes during extinction. Sixty-four healthy volunteers were randomized into three groups for a three-day procedure: fear acquisition (day 1), fear extinction (day 2), and fear recall and generalization test (day 3). Our results showed the modified extinction paradigm failed to prevent fear expression in spontaneous recovery and reinstatement tests. However, novelty-facilitated extinction showed powerful effects in preventing fear generalization. Besides, there was a negative correlation between spontaneous recovery index and emotion regulation scores. We speculated that emotion and prediction error may be important factors influencing fear extinction and affect fear recall and generalization. Overall, this study suggests that novelty-facilitated extinction had a superior effect in preventing fear generalization, providing new perspectives for enhancing the effect of exposure therapy.

Conceptual fear generalization gradients and their relationship with anxious traits: Results from a Registered Report

A hallmark symptom of fear and anxiety disorder is generalization of fear to essentially innocuous stimuli and situations. Such generalization can occur through both perceptual and conceptually similarities. Recent studies indicate that perceptual generalization is inflated in anxiety patients and individuals prone to develop anxiety disorders, suggesting that perceptual generalization may be involved in the etiology of anxiety disorders. In the current Registered Report, we wanted to address whether conceptual generalization is potentially implicated in the development of anxiety disorders as well. Therefore, we used a novel paradigm in which the Dutch word mini [tiny] or enorm [enormous] was paired with an electric shock and assessed fear to the conceptually related words klein [small], medium [medium], and groot [large]. The sample (N = 120) consisted of healthy university students. As hypothesized, we observed clear conceptual fear generalization gradients using both self-report and psychophysiological measures. However, in contrast to our expectations, these conceptual generalization gradients were not correlated with different anxious traits (i.e., trait anxiety, intolerance of uncertainty, and behavioral inhibition). These results show that fear can generalize conceptually along a gradient, without requiring perceptual errors as postulated by traditional models of fear generalization. Instead, our results correspond well with inferential reasoning theories of fear generalization. Additionally, we discuss potential reasons for the absence of the expected correlations between conceptual fear generalization and anxious traits, such as restricted variability in both the generalization task and the sample. We conclude that the paradigm has promise for further research on conceptual fear generalization.

Transcranial Direct Current Stimulation of the Ventromedial Prefrontal Cortex Modulates Perceptual and Neural Patterns of Fear Generalization

BACKGROUND

Overgeneralization of fear is a pathogenic marker of anxiety and stress-related disorders and has been linked with perceptual discrimination deficits, reduced fear inhibition, and prefrontal hyporeactivity to safety-signaling stimuli. We aimed to examine whether behavioral and neural patterns of fear generalization are influenced by the fear-inhibiting ventromedial prefrontal cortex (vmPFC).

METHODS

Three groups of healthy participants received excitatory (n = 27), inhibitory (n = 26), or sham (n = 26) transcranial direct current stimulation of the vmPFC after a fear conditioning phase and before a fear generalization phase. We obtained, as dependent variables, fear ratings and unconditioned stimulus-expectancy ratings, perceptual aspects of fear generalization (perceptual discrimination), pupil dilations, and source estimations of event-related fields elicited by conditioned and generalization stimuli.

RESULTS

After inhibitory (compared with excitatory and sham) vmPFC stimulation, we observed reduced performance in perceptual discrimination and less negative inhibitory gradients in frontal structures at midlatency and late time intervals. Fear and unconditioned stimulus-expectancy ratings as well as pupil dilation remained unaffected by stimulation.

CONCLUSIONS

These findings reveal a causal contribution of vmPFC reactivity to generalization patterns and suggest that vmPFC hyporeactivity consequent on inhibitory vmPFC stimulation may serve as a model for pathological processes of fear generalization (reduced discrimination, impaired fear inhibition via frontal brain structures). This encourages further basic and clinical research on the potential of targeted brain stimulation to modulate fear generalization and overgeneralization.

Overgeneralization of fear, but not avoidance, following acute stress

Research has demonstrated the spreading of fear from threat-related stimuli to perceptually similar, but innocuous, stimuli. Less is known, however, about the generalization of avoidance behavior. Given that stress is known to affect learning and memory, we were interested in the effect of acute stress on (over)generalization of fear and avoidance responses. On the first day, one geometrical shape was paired with a mild electrical stimulus (CS+), whereas another shape was not (CS-). One day later, after participants had been exposed to the Maastricht Acute Stress Test or a control task, generalization of avoidance responses and fear (shock expectancy and skin conductance responses) was tested to a range of perceptual generalization stimuli. Generalization gradients were observed across different outcome measures. Stress enhanced generalization of shock expectancy to the stimulus most similar to the CS+. Our findings confirm that stress can affect the generalization of fear, but further studies are warranted.

The neurobiology of human fear generalization: meta-analysis and working neural model

Fear generalization to stimuli resembling a conditioned danger-cue (CS+) is a fundamental dynamic of classical fear-conditioning. Despite the ubiquity of fear generalization in human experience and its known pathogenic contribution to clinical anxiety, neural investigations of human generalization have only recently begun. The present work provides the first meta-analysis of this growing literature to delineate brain substrates of conditioned fear-generalization and formulate a working neural model. Included studies (K = 6, N = 176) reported whole-brain fMRI results and applied generalization-gradient methodology to identify brain activations that gradually strengthen (positive generalization) or weaken (negative generalization) as presented stimuli increase in CS+ resemblance. Positive generalization was instantiated in cingulo-opercular, frontoparietal, striatal-thalamic, and midbrain regions (locus coeruleus, periaqueductal grey, ventral tegmental area), while negative generalization was implemented in default-mode network nodes (ventromedial prefrontal cortex, hippocampus, middle temporal gyrus, angular gyrus) and amygdala. Findings are integrated within an updated neural account of generalization centering on the hippocampus, its modulation by locus coeruleus and basolateral amygdala, and the excitation of threat- or safety-related loci by the hippocampus.

Neural substrates of human fear generalization: A 7T-fMRI investigation

Fear generalization - the tendency to interpret ambiguous stimuli as threatening due to perceptual similarity to a learned threat - is an adaptive process. Overgeneralization, however, is maladaptive and has been implicated in a number of anxiety disorders. Neuroimaging research has indicated several regions sensitive to effects of generalization, including regions involved in fear excitation (e.g., amygdala, insula) and inhibition (e.g., ventromedial prefrontal cortex). Research has suggested several other small brain regions may play an important role in this process (e.g., hippocampal subfields, bed nucleus of the stria terminalis [BNST], habenula), but, to date, these regions have not been examined during fear generalization due to limited spatial resolution of standard human neuroimaging. To this end, we utilized the high spatial resolution of 7T fMRI to characterize the neural circuits involved in threat discrimination and generalization. Additionally, we examined potential modulating effects of trait anxiety and intolerance of uncertainty on neural activation during threat generalization. In a sample of 31 healthy undergraduate students, significant positive generalization effects (i.e., greater activation for stimuli with increasing perceptual similarity to a learned threat cue) were observed in the visual cortex, thalamus, habenula and BNST, while negative generalization effects were observed in the dentate gyrus, CA1, and CA3. Associations with individual differences were underpowered, though preliminary findings suggested greater generalization in the insula and primary somatosensory cortex may be correlated with self-reported anxiety. Overall, findings largely support previous neuroimaging work on fear generalization and provide additional insight into the contributions of several previously unexplored brain regions.

Pavlovian Learning Processes in Pediatric Anxiety Disorders: A Critical Review

Deficits in associative and Pavlovian learning are thought to lie at the center of anxiety-related disorders. However, the majority of studies have been carried out in adult populations. The aim of this review was to critically examine the behavioral and neuroimaging literature on Pavlovian learning in pediatric anxiety disorders. We conclude that although there is evidence for deficits in Pavlovian processes (e.g., heightened reactivity to safety cues in anxious samples), the extant literature suffers from key methodological and theoretical issues. We conclude with theoretical and methodological recommendations for future research in order to further elucidate the role of Pavlovian learning in the etiology, maintenance, and treatment of pediatric anxiety disorders.

Intranasal oxytocin decreases fear generalization in males, but does not modulate discrimination threshold

BACKGROUND

A previously acquired fear response often spreads to perceptually or conceptually close stimuli or contexts. This process, known as fear generalization, facilitates the avoidance of danger, and dysregulations in this process play an important role in anxiety disorders. Oxytocin (OT) has been shown to modulate fear learning, yet effects on fear generalization remain unknown.

METHODS

We employed a randomized, placebo-controlled, double-blind, between-subject design during which healthy male participants received either intranasal OT or placebo (PLC) following fear acquisition and before fear generalization with concomitant acquisition of skin conductance responses (SCRs). Twenty-four to 72 h before the fear learning and immediately after the fear generalization task, participants additionally complete a discrimination threshold task.

RESULTS

Relative to PLC, OT significantly reduced perceived risk and SCRs towards the CS+ and GS1 (the generalization stimulus that is most similar to CS+) during fear generalization, whereas the discrimination threshold was not affected.

CONCLUSIONS

Together, the results suggest that OT can attenuate fear generalization in the absence of effects on discrimination threshold. This study provides the first evidence for effects of OT on fear generalization in humans and suggests that OT may have therapeutic potential in anxiety disorders characterized by dysregulated fear generalization.

Acute stress leaves fear generalization in healthy individuals intact

Because threatening situations often occur in a similar manner, the generalization of fear to similar situations is adaptive and can avoid harm to the organism. However, the overgeneralization of fear to harmless stimuli is maladaptive and assumed to contribute to anxiety disorders. Thus, elucidating factors that may modulate fear (over)generalization is important. Based on the known effects of acute stress on learning, which are at least partly due to noradrenergic arousal, we investigated whether stress may promote fear overgeneralization and whether we could counteract this effect by reducing noradrenergic arousal. In a placebo-controlled, double-blind, between-subjects design, 120 healthy participants underwent a fear-conditioning procedure on Day 1. Approximately 24 hours later, participants received orally either a placebo or the beta-adrenergic receptor antagonist propranolol and were exposed to a stress or control manipulation before they completed a test of fear generalization. Skin conductance responses as well as explicit rating data showed a successful acquisition of conditioned fear on Day 1 and a pronounced fear generalization 24 hours later. Although physiological data confirmed the successful stress manipulation and reduction of noradrenergic arousal, the extent of fear generalization remained unaffected by stress and propranolol. The absence of a stress effect on fear generalization was confirmed by a second study and a Bayesian analysis across both data sets. Our findings suggest that acute stress leaves fear generalization processes intact, at least in a sample of healthy, young individuals.

Noradrenergic stimulation increases fear memory expression

Fear responses are typically not limited to the actual threatening stimulus but generalize to other stimuli resembling the threatening stimulus. Although this fear generalization is generally adaptive, fear overgeneralization is maladaptive and assumed to contribute to anxiety disorders. Despite the clinical relevance of fear (over)generalization, how the extent of fear generalization is modulated remains not well understood. Based on the known effects of stress on learning and memory, we tested here the impact of major stress mediators, glucocorticoids and noradrenergic arousal, on fear generalization. In a laboratory-based, placebo-controlled, double-blind, between-subject design, 125 healthy participants first underwent a fear conditioning procedure. About 24 h later, participants received orally either a placebo, hydrocortisone, the α2-adrenoceptor antagonist yohimbine, leading to increased noradrenergic stimulation, or both drugs before a test of fear generalization. Skin conductance responses as well as explicit rating data revealed that yohimbine intake led to enhanced fear memory expression, i.e. an enhanced responding to the CS+ but not to stimuli resembling the CS+. Moreover, neither enhanced safety learning nor a mere enhancement of perceptual discrimination ability could explain this result. In contrast to yohimbine, hydrocortisone had no significant effect on fear memory. These findings suggest that noradrenergic arousal strengthens fear memory expression and have important implications for mental disorders in which the overgeneralization of conditioned fear is prominent.

Neural Abnormalities in Fear Generalization in Schizophrenia and Associations With Negative Symptoms

BACKGROUND

Associative learning and memory processes, including the generalization of previously learned associations, may be altered in schizophrenia. Deficits in schizophrenia in stimulus generalization, one of the simplest forms of memory, could interfere with the ability to efficiently categorize related, similar information, potentially leading to impairments in daily functioning.

METHODS

To measure generalization in schizophrenia, 37 individuals with a nonaffective psychotic disorder and 32 demographically matched healthy control subjects underwent a Pavlovian fear conditioning and generalization procedure, which accounted for variation in perceptual ability across participants, while undergoing functional magnetic resonance imaging. Skin conductance and neural responses to conditioned (CS+), neutral (CS-), and generalization stimuli were measured. Explicit memory ratings reflecting successful generalization were also collected after the scanning, as well as measures of symptom severity.

RESULTS

Compared with healthy control subjects, individuals with nonaffective psychotic disorders showed significant deficits in fear generalization across multiple measurements, with impairments in memory ratings and reductions in activation and deactivation of the salience and default networks, respectively, during fear generalization. Moreover, in the psychotic disorder group, greater behavioral and neural abnormalities in generalization were associated with higher levels of negative symptoms.

CONCLUSIONS

Fear generalization is impaired in psychotic illness. Given that successful generalization relies on a dynamic balance between excitatory and inhibitory neurotransmission, these results reveal a potentially quantifiable mechanism linked to negative symptoms that can be investigated further in future human and experimental animal studies.

Trait anxiety is associated with reduced typicality asymmetry in fear generalization

In fear conditioning, training with typical category exemplars has been shown to promote fear generalization to novel exemplars of the same category, whereas training with atypical category exemplars supports limited if any generalization to other category members, amounting to a typicality asymmetry in fear generalization. The present study sought to examine how trait anxiety bears on typicality asymmetry in fear generalization. Participants in one condition were presented with typical exemplars during fear acquisition and atypical exemplars of the same category in the subsequent generalization test (typical condition), whereas in the other group, atypical and typical exemplars were presented during fear acquisition and generalization test, respectively (atypical condition). We observed a typicality asymmetry in fear generalization in self-reported expectancy ratings in low trait anxious individuals only. High trait anxious individuals showed a similar degree of fear generalization in both conditions. The current results help illuminate why some individuals are at risk for exhibiting broad fear generalization after exposure to an aversive event.

Generalization of extinction with a generalization stimulus is determined by learnt threat beliefs

Expectancy violation refers to the mismatch between an expected and the actual outcome. Maximizing expectancy violation is crucial for exposure-based treatment. Since the original stimulus of fear acquisition (CS+) is rarely available, stimuli that resemble the CS+ (generalization stimuli; GSs) are presented during treatment. A given GS may evoke either strong or weak generalized fear depending on an individual's threat beliefs. Presenting this GS in extinction would then evoke different levels of expectancy violation, which determines the strength of the subsequent generalization of extinction to other stimuli, including the CS+. After differential fear conditioning, participants exhibited discrete generalization gradients depending on their inferred relational rules (Linear vs Similarity). Crucially, the Linear group showed strong generalized fear to the GS used in extinction. This strong expectancy violation led to enhanced extinction learning and subsequently to strong generalization of extinction as characterized by a flat generalization gradient, and reduced conditioned fear to the CS+. In contrast, the Similarity group showed weak generalized fear to the same GS in extinction, and limited generalization of extinction. These results corroborate the importance of expectancy violation in exposure-based treatment, and suggest that exposure sessions designed to evoke strong threat beliefs may lead to better treatment outcome.

Generalization of conditioned fear along a dimension of increasing positive valence

The amount of fear evoked by potential threats is oftentimes proportional to the overlap in shared features with known threats. An adaptive learning system should therefore extract relevant features from threat stimuli to successfully detect other novel threats in the environment. But what if the most relevant feature of a threat stimulus is emotionally positive? Here, we used Pavlovian fear conditioning to ask whether people extract positive emotional features of a fear conditioned stimulus (CS) to selectively generalize to other stimuli that contain positive features. In a between subjects design, we first paired a picture of a face expressing either a slight amount of happiness or fear with an electrical shock to the wrist. We then tested fear generalization to modified face stimuli of the same identity expressing more or less happiness or fear. Both groups exhibited biased physiological arousal (a peak shift) to a face stimulus with the most exaggerated emotional expression, regardless of valence. Fear generalization diminished to unreinforced happy faces over the course of testing, whereas arousal was maintained to unreinforced fearful faces throughout testing. Finally, subjects fear conditioned to a slightly happy face were accurate at retrospectively identifying the correct CS, whereas subjects fear conditioned to a fearful face retrospectively misidentified a more fearful face as the threat CS. These findings suggest that positive emotional features extracted from a known threat can guide biased fear generalization, but that generalization is maintained by a dimension of increasing fear which also produces retrospective biases in threat intensity estimation.

Social exclusion influences conditioned fear acquisition and generalization: A mediating effect from the medial prefrontal cortex

Fear acquisition and generalization play key roles in promoting the survival of mammals and contribute to anxiety disorders. While previous research has provided much evidence for the repercussions of social exclusion on mental health, how social exclusion affects fear acquisition and generalization has received scant attention. In our study, participants were divided into two groups according to two Cyberball paradigm conditions (exclusion/inclusion). Both groups underwent a Pavlovian conditioning paradigm, functional near-infrared spectroscopy (fNIRS), and skin conductance response (SCR) assessments. We aimed to determine the effects of social exclusion on fear acquisition and generalization and whether modulation of the medial prefrontal cortex (mPFC) mediates this relationship. Our results showed that socially excluded participants featured significantly higher and lower shock risk scores to safety stimuli (conditioned stimulus, CS-) and threatening stimuli (CS+), respectively, than did socially included subjects during fear acquisition. The exclusion group had increased skin conductance responses (SCRs) to CS and exhibited heightened shock risk and increased SCRs to generalized stimuli compared with the inclusion group. The fNIRS results demonstrated that the CS ​+ ​evoked larger oxy-Hb changes in the mPFC in the inclusion group than in the exclusion group during fear acquisition. Furthermore, the oxy-Hb of left mPFC of CS ​+ ​mediated the effect on the association between social exclusion and perceived risk of CS+ in the fear acquisition. Our results indicate that social exclusion impairs fear acquisition and generalization via the mediation of the mPFC and that social exclusion increases susceptibility to anxiety disorders through bias processing of fear discrimination in fear acquisition and generalization. By studying the role of social relationship in fear acquisition and generalization, our research provides new insights into the pathological mechanisms of anxiety disorder.

Costly avoidance triggered by categorical fear generalization

Fear generalization refers to the spread of acquired fear to novel stimuli that resemble the original fear-related stimulus. Preliminary evidence suggests that excessive fear generalization is a pathogenic feature of anxiety disorders, however, it remains unclear how fear generalization affects pathological avoidance. The current study thus aimed to examine the link between categorical fear generalization and costly avoidance. By combining a fear acquisition training phase and an avoidance test, the current findings showed that acquired fear spreads to novel stimuli that belonged to the same category of the original fear-related stimuli, but not to those that belonged to the fear-irrelevant categories. Importantly, participants avoided these fear-related novel stimuli despite costs. The current findings indicate that categorical fear generalization triggers costly avoidance. In terms of clinical implication, a decrease in costly avoidance aligned with a decrease in US expectancies. This emphasizes that behavioral approach may initiate extinction learning.

Noradrenergic and dopaminergic involvement in novelty modulation of aversive memory generalization of adult rats

The generalization of aversive memory can be defined as the phenomenon in which a situation similar to (but distinctive from) a previous aversive event triggers an avoidance response. This phenomenon has been suggested to play a role in several psychological disorders. In this study, we investigate the effects of novelty on the generalization of fear memories, and the involvement of noradrenergic and dopaminergic systems in this process. For this study we used male Wistar rats (3 months old, 300-400 g). The participation of each neurotransmitter system was evaluated separately (two set of experiments). In each experimental set, the animals were divided in groups (8 animals each): (i) control, (ii) novelty, and, (iii) antagonist + novelty group (timolol, a β-adrenergic antagonist, or SCH23390, a D1/D5 dopaminergic antagonist, in the first and in the second set of experiments, respectively). Additionaly, to investigate whether novelty exposure increases the levels of noradrenaline and/or dopamine in the hippocampus fifteen animals were divided in three groups (5 animals each).: (i) naïve, (ii) control; and, (iii) novelty. To examine aversive memory, and generalization of aversive memory, we trained adult male Wistar rats in an inhibitory avoidance (IA) memory task and after in a modified inhibitory avoidance (MIA). Before the MIA training some of the animals were exposed to environmental novelty (open field). Immediately before this novelty exposure, some animals received intrahippocampal infusion of timolol (β-adrenergic antagonist), SCH23390 (D1/D5 antagonist) or vehicle to evaluate the involvement of noradrenergic and dopaminergic systems. Finally, to evaluate aversive memory and generalization of aversive memory respectively, half of the animals in each group were tested on IA and half on MIA. We confirmed that the exposure to novelty blocks the generalization of aversive memory, but moreover, demonstrated that this process involves activation of β-adrenergic and dopaminergic D1/D5 pathways. We additionally observed that exposure to novelty raises hippocampal levels of noradrenaline and dopamine. This suggests that these neurotransmitters not only influence long-term memory (LTM) as such, but also aversive memory generalization.

The relation between anxious personality traits and fear generalization in healthy subjects: A systematic review and meta-analysis

BACKGROUND

Anxious personality characteristics form a risk factor for anxiety disorders. A proposed mechanistic pathway is that anxious personality could lead to greater vulnerability by increasing fear generalization. Here, we investigate if there is evidence for this relationship before the onset of pathological anxiety, with a meta-analysis in healthy subjects.

METHODS

Our search (anxious personality & fear generalization) was performed in PubMed, PsychInfo, and Embase and via snowballing.

RESULTS

In total, 4892 studies were screened and 19 studies (1348 participants) were included in the current review (meta-analysis: 18 studies, 1310 participants). The meta-analysis showed a significant, small, positive relationship between anxious personality and fear generalization (r = .19, 95%CI [.126, .260], p <.001). No moderators of the relationship were identified.

CONCLUSIONS

The identified robust relation suggests that people who score high on anxious personality have a somewhat stronger tendency to generalize fear to safe or novel situations. This might explain their vulnerability to anxiety disorders mechanistically, yet future (prospective) studies are warranted to confirm the hypothesized directionality of this effect.

Ketamine Alleviates Fear Generalization Through GluN2B-BDNF Signaling in Mice

Fear memories are critical for survival. Nevertheless, over-generalization of these memories, depicted by a failure to distinguish threats from safe stimuli, is typical in stress-related disorders. Previous studies have supported a protective role of ketamine against stress-induced depressive behavior. However, the effect of ketamine on fear generalization remains unclear. In this study, we investigated the effects of ketamine on fear generalization in a fear-generalized mouse model. The mice were given a single sub-anesthetic dose of ketamine (30 mg/kg, i.p.) 1 h before, 1 week before, immediately after, or 22 h after fear conditioning. The behavioral measure of fear (indicated by freezing level) and synaptic protein expression in the basolateral amygdala (BLA) and inferior-limbic pre-frontal cortex (IL-PFC) of mice were examined. We found that only ketamine administered 22 h after fear conditioning significantly decreased the fear generalization, and the effect was dose-dependent and lasted for at least 2 weeks. The fear-generalized mice showed a lower level of brain-derived neurotrophic factor (BDNF) and a higher level of GluN2B protein in the BLA and IL-PFC, and this was reversed by a single administration of ketamine. Moreover, the GluN2B antagonist ifenprodil decreased the fear generalization when infused into the IL-PFC, but had no effect when infused into the BLA. Infusion of ANA-12 (an antagonist of the BDNF receptor TrkB) into the BLA or IL-PFC blocked the effect of ketamine on fear generalization. These findings support the conclusion that a single dose of ketamine administered 22 h after fear conditioning alleviates the fear memory generalization in mice and the GluN2B-related BDNF signaling pathway plays an important role in the alleviation of fear generalization.

The effect of differential spatiotopic information on the acquisition and generalization of fear of movement-related pain

Fear of movement-related pain significantly contributes to musculoskeletal chronic pain disability. Previous research has shown that fear of movement-related pain can be classically conditioned. That is, in a differential fear conditioning paradigm, after (repeatedly) pairing a neutral joystick movement (conditioned stimulus; CS+) with a painful stimulus (unconditioned stimulus; pain-US), that movement in itself starts to elicit self-reported fear and elevated psychophysiological arousal compared to a control joystick movement (CS−) that was never paired with pain. Further, it has been demonstrated that novel movements that are more similar to the original CS+ elicit more fear than novel movements that are more similar to the CS−, an adaptive process referred to as stimulus generalization. By default, movement/action takes place in reference to the three-dimensional space: a movement thus not only involves proprioceptive information, but it also contains spatiotopic information. Therefore, the aim of this study was to investigate to what extent spatiotopic information (i.e., endpoint location of movement) contributes to the acquisition and generalization of such fear of movement-related pain besides proprioception (i.e., movement direction). In a between-subjects design, the location group performed joystick movements from the middle position to left and right; the movement group moved the joystick from left and right to the middle. One movement (CS+) was paired with pain, another not (CS−). Feature overlap between CSs typically reduces differential learning. The endpoint of both CSs in the movement group is an overlapping feature whereas in the location group the endpoint of both CSs is distinct; therefore we hypothesized that there would be less differential fear learning in the movement group compared to the location group. We also tested generalization to movements with similar proprioceptive features but different endpoint location. Following the principle of stimulus generalization, we expected that novel movements in the same direction as the CS+ but with a different endpoint would elicit more fear than novel movement in the same direction of the CS− but with a different endpoint. Main outcome variables were self-reported fear and pain-US expectancy and eyeblink startle responses (electromyographic). Corroborating the feature overlap hypothesis, the location group showed greater differential fear acquisition. Fear generalization emerged for both groups in the verbal ratings, suggesting that fear indeed accrued to proprioceptive CS features; these effects, however, were not replicated in the startle measures.

Reducing fear overgeneralization in children using a novel perceptual discrimination task

Fear generalization, while adaptive, can be detrimental when occurring in excess. To this end a perceptual discrimination training task was created with a goal of decreasing fear overgeneralization. The current study tested the effectiveness of the training task among typically-developing children. Participants (n = 73) were randomly assigned into a training, placebo or no task group. Following a differential fear-conditioning task, participants in the first two groups underwent the discrimination training or placebo task. An assessment task was then administered. Finally, all participants completed a fear generalization test, consisting of 11 morphs ranging in perceptual similarity from the threat cue to the safety cue. Physiological and self-report measures were collected. Fear-conditioning was achieved in both physiological and self-report measures. Further, in the assessment task, the training group showed better perceptual discrimination than did the placebo group. Last, the training group exhibited less overgeneralization of affective stimuli as indicated by a physiological measure than did the two control conditions. Findings suggest that the perceptual discrimination training task effectively moderated fear overgeneralization in children. This adds to previous evidence of the task's effectiveness among adults.

Functional neuroimaging of associative learning and generalization in specific phobia

BACKGROUND

Theoretical models have implicated classical fear conditioning, fear generalization, and extinction learning in the development of anxiety disorders. To date, it is largely unknown to what extent these mechanisms and the underlying neurobiology may be altered in specific phobia, a disorder characterized by focal fears. The current study systematically examined fear conditioning, fear generalization, extinction learning, and extinction recall in a sample of individuals with a specific phobia.

METHODS

Participants with a specific phobia (SP) of spiders (n = 46) and healthy controls (HC) (n = 48) underwent a 3-day fMRI cue-conditioning protocol, including a fear acquisition and a fear generalization phase (day 1), an extinction learning phase (day 2), and an extinction recall phase (day 3). Stimuli were phobia-irrelevant, as geometrical shapes served as conditioned threat (CS+) and safety stimuli (CS-), and an electrical shock as the unconditioned stimulus (US). Self-reported fear, US expectancy, and blood-oxygen-level dependent responses were measured.

RESULTS

Behavioral results only revealed enhanced CS+/CS-differentiation in fear scores during acquisition retention in SP. Some neural differences were observed during other task phases. During early fear acquisition, SP showed enhanced differential activation in the angular gyrus and lateral occipital cortex, and during extinction recall, more precuneus deactivation was found in SP compared to HC. There were no clear indications of altered neural fear generalization or extinction learning mechanisms in the SP group.

CONCLUSIONS

Results indicate that spider phobia may be characterized by enhanced differential fear retention and altered brain activation patterns during fear acquisition and extinction recall. The findings provide insight into the nature of fear learning alterations in specific phobia, and how these may differ from those found in disorders characterized by broad anxious distress.

Novelty exposure hinders aversive memory generalization and depends on hippocampal protein synthesis

Fear generalization is defined as the transferring of fear experienced during a traumatic event to safe conditions resembling or not the traumatic event. It has been related to several psychological disorders. Here we set out to determine whether novelty exposure can be effective to avoid fear generalization. We evaluated the effect of a novelty exposure on fear memory generalization using an aversive memory task, the inhibitory avoidance (IA). Male Wistar rats were trained in IA (day 1) and 24 h after (day 2) they were exposed to a new context similar to the original (modified IA - MIA), with some rats being exposed to a novelty just before the exposure to the MIA, while others were not (controls). On day 3, retention tests for IA and MIA contexts were performed. The control rats generalized the memory, expressing aversive behavioral in both contexts whereas rats exposed to novelty only expressed aversion on IA. Furthermore, both anisomycin, an inhibitor of ribosomal protein synthesis, and rapamycin, an inhibitor of mTOR-mediated protein synthesis, injected in the CA1 region of dorsal hippocampus blocked the novelty effect, promoting memory generalization. We conclude that novelty exposure hinders aversive memory generalization depending on hippocampal protein synthesis.

Direct and indirect effects of perception on generalization gradients

For more than a century, researchers have attempted to understand why organisms behave similarly across situations. Despite the robust character of generalization, considerable variation in conditioned responding both between and within humans remains a challenge for contemporary generalization models. The current study aims to investigate the extent to which variation in behavior in a context of generalization can be attributed to differences in perception. We combined a fear conditioning and generalization procedure with a perceptual decision task in humans. We found that the failure to perceive a novel stimulus as different from the trained fear-evoking stimulus led to increased conditioned responding. Furthermore, perceptual errors yielded perceived stimulus-outcome contingencies that differed substantially from the objective contingencies. Final, the impact of a perceptual error was dependent upon these perceived contingencies. These findings suggest that generalization across a perceptual dimension is to a large extent driven by perceptual errors that directly affect behavior but also indirectly as they yield different learning experiences between individuals.

Differential fear conditioning generates prefrontal neural ensembles of safety signals

Fear discrimination is critical for survival, while fear generalization is effective for avoiding dangerous situations. Overgeneralized fear is a typical symptom of anxiety disorders, including generalized anxiety disorder and posttraumatic stress disorder (PTSD). Previous research demonstrated that fear discrimination learning is mediated by prefrontal mechanisms. While the prelimbic (PL) and infralimbic (IL) subdivisions of the medial prefrontal cortex (mPFC) are recognized for their excitatory and inhibitory effects on the fear circuit, respectively, the mechanisms driving fear discrimination are unidentified. To obtain insight into the mechanisms underlying context-specific fear discrimination, we investigated prefrontal neuronal ensembles representing distinct experiences associated with learning to disambiguate between dangerous and similar, but not identical, harmless stimuli. Here, we show distinct quantitative activation differences in response to conditioned and generalized fear experiences, as well as modulation of the neuronal ensembles associated with successful acquisition of context-safety contingencies. These findings suggest that prefrontal neuronal ensembles patterns code functional context-danger and context-safety relationships. The PL subdivision of the mPFC monitors context-danger associations to conditioned fear, whereas differential conditioning sparks additional ensembles associated with the inhibition of generalized fear in both the PL and IL subdivisions of the mPFC. Our data suggest that fear discrimination learning is associated with the modulation of prefrontal subpopulations in a subregion- and experience-specific fashion, and the learning of appropriate responses to conditioned and initially generalized fear experiences is driven by gradual updating and rebalancing of the prefrontal memory representations.

Early life stress in rats sex-dependently affects remote endocrine rather than behavioral consequences of adult exposure to contextual fear conditioning

Exposure to electric foot-shocks can induce in rodents contextual fear conditioning, generalization of fear to other contexts and sensitization of the hypothalamic-pituitary-adrenal (HPA) axis to further stressors. All these aspects are relevant for the study of post-traumatic stress disorder. In the present work we evaluated in rats the sex differences and the role of early life stress (ELS) in fear memories, generalization and sensitization. During the first postnatal days subjects were exposed to restriction of nesting material along with exposure to a "substitute" mother. In the adulthood they were exposed to (i) a contextual fear conditioning to evaluate long-term memory and extinction and (ii) to a novel environment to study cognitive fear generalization and HPA axis heterotypic sensitization. ELS did not alter acquisition, expression or extinction of context fear conditioned behavior (freezing) in either sex, but reduced activity in novel environments only in males. Fear conditioning associated hypoactivity in novel environments (cognitive generalization) was greater in males than females but was not specifically affected by ELS. Although overall females showed greater basal and stress-induced levels of ACTH and corticosterone, an interaction between ELS, shock exposure and sex was found regarding HPA hormones. In males, ELS did not affect ACTH response in any situation, whereas in females, ELS reduced both shock-induced sensitization of ACTH and its conditioned response to the shock context. Also, shock-induced sensitization of corticosterone was only observed in males and ELS specifically reduced corticosterone response to stressors in males but not females. In conclusion, ELS seems to have only a minor impact on shock-induced behavioral conditioning, while affecting the unconditioned and conditioned responses of HPA hormones in a sex-dependent manner.

Persistent, generalized hypersensitivity of olfactory bulb interneurons after olfactory fear generalization

Generalization of fear from previously threatening stimuli to novel but related stimuli can be beneficial, but if fear overgeneralizes to inappropriate situations it can produce maladaptive behaviors and contribute to pathological anxiety. Appropriate fear learning can selectively facilitate early sensory processing of threat-predictive stimuli, but it is unknown if fear generalization has similarly generalized neurosensory consequences. We performed in vivo optical neurophysiology to visualize odor-evoked neural activity in populations of periglomerular interneurons in the olfactory bulb 1 day before, 1 day after, and 1 month after each mouse underwent an olfactory fear conditioning paradigm designed to promote generalized fear of odors. Behavioral and neurophysiological changes were assessed in response to a panel of odors that varied in similarity to the threat-predictive odor at each time point. After conditioning, all odors evoked similar levels of freezing behavior, regardless of similarity to the threat-predictive odor. Freezing significantly correlated with large changes in odor-evoked periglomerular cell activity, including a robust, generalized facilitation of the response to all odors, broadened odor tuning, and increased neural responses to lower odor concentrations. These generalized effects occurred within 24 h of a single conditioning session, persisted for at least 1 month, and were detectable even in the first moments of the brain's response to odors. The finding that generalized fear includes altered early sensory processing of not only the threat-predictive stimulus but also novel though categorically-similar stimuli may have important implications for the etiology and treatment of anxiety disorders with sensory sequelae.

Fear conditioning and stimulus generalization in patients with social anxiety disorder

Although overgeneralization seems to be a hallmark of several anxiety disorders, this until now has not been investigated in social anxiety disorder (SAD). Therefore, we examined fear generalization in 26 SAD patients and 29 healthy controls (HC) using two faces as conditioned stimuli (CS+, CS-), and a loud scream and a fearful face as unconditioned stimulus (US). Generalization was tested by presenting both CS and four morphs of the two faces (generalization stimuli [GSs]), while ratings, heart rate (HR) and skin conductance responses (SCR) were recorded. Results revealed that SAD patients rated all stimuli as less pleasant and more arousing compared to HC. Moreover, ratings and SCR indicated that both groups generalized their acquired fear from the CS+ to GSs. Remarkably, only SAD patients showed generalization in HR responses (fear bradycardia). Overall, SAD seems not to be characterized by strong overgeneralization but discrepancies in fear responses to both conditioned and generalized threat stimuli.

A developmental analysis of threat/safety learning and extinction recall during middle childhood

The current study examined developmental changes in fear learning and generalization in 54 healthy 5-10-year old children using a novel fear conditioning paradigm. In this task, the conditioned stimuli (CS+/CS-) were two blue and yellow colored cartoon bells, and the unconditioned stimulus was an unpleasant loud alarm sound presented with a red cartoon bell. Physiological and subjective data were acquired. Three weeks after conditioning, 48 of these participants viewed the CS-, CS+, and morphed images resembling the CS+. Participants made threat-safety discriminations while appraising threat and remembering the CS+. Although no age-related differences in fear learning emerged, patterns of generalization were qualified by child age. Older children demonstrated better discrimination between the CS+ and CS morphs than younger age groups and also reported more fear to stimuli resembling the CS+ than younger children. Clinical implications and future directions are discussed.

Hippocampal cytosolic estrogen receptors regulate fear generalization in females

Generalization of fear responses is a symptom of many anxiety disorders and we have previously demonstrated that female rats generalize fear to a neutral context at a faster rate compared to males. This effect is due in part, to activation of ER and modulation of memory retrieval mechanisms resulting in fear generalization. Given that the effects of estradiol on fear generalization required approximately 24h, our data suggested possible genomic actions on fear generalization. To determine whether these actions were due to cytosolic versus membrane bound receptors, female rats were given infusions of ICI 182,780, a cytosolic estrogen receptor antagonist, into the lateral ventricle or dorsal hippocampus simultaneously with estradiol treatment or with an ER agonist (DPN). Infusions of ICI into the lateral ventricle or the dorsal hippocampus blocked fear generalization induced by peripheral or central treatment with estradiol or DPN, suggesting that estradiol acts through cytosolic ERβ receptors. In further support of these findings, intracerebroventricular or intra-hippocampal infusions of bovine serum conjugated estradiol (E2-BSA), activating membrane-bound estrogen receptors only, did not induce fear generalization. Moreover, rats receiving intra-hippocampal infusions of the ERK/MAPK inhibitor, U0126, continued to display estradiol-induced generalization, again suggesting that membrane-bound estrogen receptors do not contribute to fear generalization. Overall, these data suggest that estradiol-induced enhancements in fear generalization are mediated through activation of cytosolic/nuclear ER within the dorsal hippocampus. This region seems to be an important locus for the effects of estradiol on fear generalization although additional neuroanatomical regions have yet to be identified.

Perceptual discrimination in fear generalization: Mechanistic and clinical implications

For almost a century, Pavlovian conditioning is the imperative experimental paradigm to investigate the development and generalization of fear. However, despite the rich research tradition, the conceptualization of fear generalization has remained somewhat ambiguous. In this selective review, we focus explicitly on some challenges with the current operationalization of fear generalization and their impact on the ability to make inferences on its clinical potential and underlying processes. The main conclusion is that, despite the strong evidence that learning influences perception, current research has largely neglected the role of perceptual discriminability and its plasticity in fear generalization. We propose an alternative operationalization of generalization, where the essence is that Pavlovian conditioning itself influences the breadth of fear generalization via learning-related changes in perceptual discriminability. Hence a conceptualization of fear generalization is incomplete without an in-depth analysis of processes of perceptual discriminability. Furthermore, this highlights perceptual learning and discriminability as important future targets for pre-clinical and clinical research.

Phenotypic responses to social defeat are associated with differences in cued and contextual fear discrimination

Conflict among individuals is one of the most common forms of stressors experienced across a variety of species, including humans. Social defeat models in mice produce two phenotypic behavioral responses characterized by prolonged social avoidance (susceptibility) or continued social interaction (resistance). The resistant phenotype has been proposed as a model of resilience to chronic stress-induced depression in humans. Previously, we have found that mice that are resistant to social defeat stress display significant impairments in extinction learning and retention, suggesting that continued social interaction following the experience of social defeat may be associated with maladaptive fear responses. Here, we examined how individual differences in response to social defeat may be related to differences in cued and context fear discrimination. Following defeat, resistant mice showed increased fear to a neutral cued stimulus (CS-) compared to control and susceptible mice, but were still able to significantly discriminate between the CS+ and CS-. Likewise, both phenotypes were generally able to discriminate between the training context and neutral context at all retention intervals tested (1, 5, 14 days). However, susceptible mice displayed significantly better discrimination compared to resistant and non-defeated control mice when assessing the discrimination ratio. Thus, at a time when most animals begin exhibiting generalization to contextual cues, susceptible mice retain the ability to discriminate between fearful and neutral contexts. These data suggest that the differences observed in context and cued discrimination between susceptible and resistant mice may be related to differences in their coping strategies in response to social defeat. In particular, resistance or resilience to social defeat as traditionally characterized may be associated with altered inhibitory learning. Understanding why individual differences arise in response to stress, including social confrontation is important in understanding the development and treatment of stress related pathologies such as PTSD.