Nothing is safe: Intolerance of uncertainty is associated with compromised fear extinction learning

Jayne Morriss,Anastasia Christakou,Carien M Van Reekum

doi:10.1016/j.biopsycho.2016.05.001

Jayne Morriss, Anastasia Christakou + Show 1 more

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https://doi.org/10.1016/j.biopsycho.2016.05.001

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Journal: Biological Psychology	Publication Date: May 10, 2016
Citations: 97	License type: cc-by

Affiliation: University of Reading

Abstract

Extinction-resistant fear is considered to be a central feature of pathological anxiety. Here we sought to determine if individual differences in Intolerance of Uncertainty (IU), a potential risk factor for anxiety disorders, underlies compromised fear extinction. We tested this hypothesis by recording electrodermal activity in 38 healthy participants during fear acquisition and extinction. We assessed the temporality of fear extinction, by examining early and late extinction learning. During early extinction, low IU was associated with larger skin conductance responses to learned threat vs. safety cues, whereas high IU was associated with skin conductance responding to both threat and safety cues, but no cue discrimination. During late extinction, low IU showed no difference in skin conductance between learned threat and safety cues, whilst high IU predicted continued fear expression to learned threat, indexed by larger skin conductance to threat vs. safety cues. These findings suggest a critical role of uncertainty-based mechanisms in the maintenance of learned fear.

Highlights

The ability to discriminate between threat and safety is crucial for survival
These findings suggest that Intolerance of Uncertainty (IU)-related mechanisms may play a critical role in disrupting fear extinction processes and maintain extinctionresistant fear in anxiety disorders such as specific phobia and Post-Traumatic Stress Disorder (PTSD)
Consistent with previous research examining IU and fear extinction (Morriss et al, 2015), low IU was associated with larger skin conductance response (SCR) magnitude to learned threat cues, relative to safety cues during early extinction, and no differences in SCR magnitude between learned threat and safety cues during late extinction

Summary

Introduction

The ability to discriminate between threat and safety is crucial for survival. Through fear conditioning, an organism can associate neutral cues (conditioned stimulus, e.g. a visual stimulus such as a shape) with aversive outcomes (unconditioned stimulus, e.g. shock, loud tone). A reduction in reactivity to the learned threat cue over time is thought to reflect changes in harm expectancy and contingency beliefs (for a review see, (Hofmann, 2008)). Such fear extinction processes, are thought to be disrupted by cognitive biases - including attentional and expectancy biases - in individuals with anxiety and trauma disorders (Aue & Okon-Singer, 2015), who display delayed fear extinction or even extinction-resistant fear (Graham & Milad, 2011; Milad & Quirk, 2012; Mineka & Oehlberg, 2008). Compared to healthy controls, patients show elevated autonomic nervous system activity to both learned threat and safety cues at the start of extinction, and to learned threat cues across fear extinction learning (Blechert, Michael, Vriends, Margraf, & Wilhelm, 2007; Michael, Blechert, Vriends, Margraf, & Wilhelm, 2007; Milad et al, 2008; Milad et al, 2009)

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