Abstract
BackgroundDysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response.MethodsWe investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response.ResultsDifferential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus.ConclusionsOur data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions. This implies that more research is required before therapeutic interventions may benefit from a combination with reconsolidation processes.
Highlights
Fear is an important symptom in many mental disorders such as phobia, generalized anxiety disorder or posttraumatic stress disorder [1]
Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions
Our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions
Summary
Fear is an important symptom in many mental disorders such as phobia, generalized anxiety disorder or posttraumatic stress disorder [1]. Extinction learning is a well-established therapeutic intervention, it is well known to every clinician that patients may re-experience fear after exposure therapy: the fear may spontaneously recover over time, or be evoked when exposed to a relevant cue in the same or within a new context [10,11,12,13]. This is explained by a temporary dominance of the fear over the safety memory. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and prevent the spontaneous recovery and reinstatement of the fear response
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