Citation

Paskewitz S, Stoddard J, Jones M. Comput. Psychiatr. 2022; 6(1): 213-237.

Copyright

(Copyright © 2022, Ubiquity Press)

DOI

10.5334/cpsy.88

PMID

unavailable

Abstract

Exposure therapy -- exposure to a feared stimulus without harmful consequences -- can reduce fear responses in many mental disorders. However, such relief is often partial and temporary: fear can return after the therapy has ended. Conditioning research has identified three mechanisms for the return of fear, viz. change in physical context (renewal), the passage of time (spontaneous recovery), and an encounter with the fear-producing unconditioned stimulus (reinstatement). To understand why fear returns and thereby develop more effective therapies, we develop mathematical learning models based on that of Rescorla and Wagner. According to this model, context cues present during extinction become conditioned inhibitors (i.e. safety signals) which prevent total erasure of the threat association. Adding various mechanisms to the model allows it to explain different facets of the return of fear. Among these mechanisms is decay of inhibitory associations, which provides a novel explanation for spontaneous recovery. To make the benefits of exposure robust and permanent, one must minimize the degree to which the extinction context becomes inhibitory in order to maximize unlearning. We simulate several experimental paradigms that reduce the return of fear and explain them according to this principle.

Language: en

Keywords

conditioning; exposure therapy; extinction; learning model; return of fear; simulation