Fear conditioning in panic disorder: Enhanced resistance to extinction.

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

[1]  F. Wilhelm,et al.  When two paradigms meet: Does evaluative learning extinguish in differential fear conditioning? , 2008 .

[2]  Frank H Wilhelm,et al.  Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural responses. , 2007, Behaviour research and therapy.

[3]  O. Lipp,et al.  Evidence for retarded extinction of aversive learning in anxious children. , 2006, Behaviour research and therapy.

[4]  R. Bryant,et al.  Extinction Learning Before Trauma and Subsequent Posttraumatic Stress , 2006, Psychosomatic medicine.

[5]  Martin Hautzinger,et al.  Beck Depressions-Inventar , 2006 .

[6]  S. Mineka,et al.  A contemporary learning theory perspective on the etiology of anxiety disorders: it's not what you thought it was. , 2006, The American psychologist.

[7]  C. Grillon,et al.  Classical fear conditioning in the anxiety disorders: a meta-analysis. , 2005, Behaviour research and therapy.

[8]  T. Michael,et al.  Enhanced priming for trauma-related material in posttraumatic stress disorder. , 2005, Emotion.

[9]  K. Kendler,et al.  A twin study of the genetics of fear conditioning. , 2003, Archives of general psychiatry.

[10]  M. Bouton.  Context, ambiguity, and unlearning: sources of relapse after behavioral extinction , 2002, Biological Psychiatry.

[11]  H. Flor,et al.  Psychophysiological and subjective indicators of aversive pavlovian conditioning in generalized social phobia , 2002, Biological Psychiatry.

[12]  G. Crombez,et al.  Expectancy-learning and evaluative learning in human classical conditioning: affective priming as an indirect and unobtrusive measure of conditioned stimulus valence. , 2002, Behaviour research and therapy.

[13]  D. Shanks,et al.  The role of awareness in Pavlovian conditioning: empirical evidence and theoretical implications. , 2002, Journal of experimental psychology. Animal behavior processes.

[14]  M. Fredrikson,et al.  Human fear conditioning is related to dopaminergic and serotonergic biological markers. , 2001, Behavioral neuroscience.

[15]  S. Behrens,et al.  Classic Conditioning and Dysfunctional Cognitions in Patients With Panic Disorder and Agoraphobia Treated With an Implantable Cardioverter/Defibrillator , 2001, Psychosomatic medicine.

[16]  S. Mineka,et al.  A modern learning theory perspective on the etiology of panic disorder. , 2001, Psychological review.

[17]  S. Orr,et al.  De novo conditioning in trauma-exposed individuals with and without posttraumatic stress disorder. , 2000, Journal of abnormal psychology.

[18]  D. Clark,et al.  A cognitive model of posttraumatic stress disorder. , 2000, Behaviour research and therapy.

[19]  Gershon Ben-Shakhar,et al.  Psychophysiologic assessment of aversive conditioning in posttraumatic stress disorder , 2000, Biological Psychiatry.

[20]  Michael Davis,et al.  Neural Systems Involved in Fear Inhibition: Extinction and Conditioned Inhibition , 2000 .

[21]  I. Weiner,et al.  Contemporary Issues in Modeling Psychopathology , 2000, Neurobiological Foundation of Aberrant Behaviors.

[22]  C. A. Morgan,et al.  Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder. , 1999, Journal of abnormal psychology.

[23]  G. Eifert,et al.  Response intensity in content-specific fear conditioning comparing 20% versus 13% CO2-enriched air as unconditioned stimuli. , 1998, Journal of abnormal psychology.

[24]  P. Lovibond,et al.  Expectancy bias in trait anxiety. , 1996, Journal of abnormal psychology.

[25]  S. Mineka,et al.  Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models. , 1996, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[26]  Joseph E LeDoux.  Emotion: clues from the brain. , 1995, Annual review of psychology.

[27]  C. Grillon,et al.  Baseline and fear-potentiated startle in panic disorder patients , 1994, Biological Psychiatry.

[28]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[29]  J. Margraf,et al.  «Angst vor der Angst»: Ein neues Konzept in der Diagnostik der Angststörungen , 1993 .

[30]  P. Lovibond.  Tonic and phasic electrodermal measures of human aversive conditioning with long duration stimuli. , 2007, Psychophysiology.

[31]  Capt. J.R. Cusack.  Fear and Courage, 2nd ed , 1992 .

[32]  A. Tobeña,et al.  Learning and unlearning fear: A clinical and evolutionary perspective , 1990, Neuroscience & Biobehavioral Reviews.

[33]  Michael W. Otto,et al.  Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic , 1989 .

[34]  S. Orr,et al.  Test of the conditioning model of neurosis: differential aversive conditioning of angry and neutral facial expressions in anxiety disorder patients. , 1986, Journal of abnormal psychology.

[35]  L. Laux,et al.  Das State-Trait-Angstinventar. Theoretische Grundlagen and Handanweisung. , 1981 .

[36]  S. Rachman,et al.  Fear And Courage , 1978 .

[37]  D. Chambless,et al.  A reanalysis of agoraphobia. , 1978 .

[38]  R. Rescorla,et al.  A theory of Pavlovian conditioning : Variations in the effectiveness of reinforcement and nonreinforcement , 1972 .