The return of fear: Review and prospect

Abstract

The “return of fear” is the reappearance of fear that has undergone partial or complete extinction; the phenomenon is illustrated by clinical and other examples. The information on return of fear in humans, drawn from a review of experimental findings and clinical reports, is summarized. It is a robust and common phenomenon. The presence of an elevated heart rate response at the start of a fear reduction program is a strong predictor of the return of fear. Highly demanding treatment or training programs promote the return of fear. There is no relation between the return of fear and the amount of time taken to reduce the fear initially. The return of fear can be blocked by the repeated practice of fear-reducing tasks, or by ensuring a low level of arousal prior to and during fear-reduction exercises. The return of fear can be influenced by events that take place before, during and after the fear-reduction sessions. Attention is drawn to the posttraining enhancement of fear, and to the likelihood of fear inflation occurring after aversive events, even if they are not directly relevant to the fear itself. The similarities and differences between the return of fear, spontaneous recovery, and dishabituation are set out, and various explanations of the phenomenon are considered. The clinical implications of the return of fear are discussed, and research priorities are put forward.