Abstract
A valuable experimental model for the pathogenesis of anxiety disorders is that they originate from a learned association between an intrinsically non-aversive event (Conditioned Stimulus, CS) and an anticipated disaster (Unconditioned Stimulus, UCS). Most anxiety disorders, however, do not evolve from a traumatic experience. Insights from neuroscience show that memory can be modified post-learning, which may elucidate how pathological fear can develop after relatively mild aversive events. Worrying - a process frequently observed in anxiety disorders - is a potential candidate to strengthen the formation of fear memory after learning. Here we tested in a discriminative fear conditioning procedure whether worry strengthens associative fear memory. Participants were randomly assigned to either a Worry (n = 23) or Control condition (n = 25). After fear acquisition, the participants in the Worry condition processed six worrisome questions regarding the personal aversive consequences of an electric stimulus (UCS), whereas the Control condition received difficult but neutral questions. Subsequently, extinction, reinstatement and re-extinction of fear were tested. Conditioned responding was measured by fear-potentiated startle (FPS), skin conductance (SCR) and UCS expectancy ratings. Our main results demonstrate that worrying resulted in increased fear responses (FPS) to both the feared stimulus (CS+) and the originally safe stimulus (CS−), whereas FPS remained unchanged in the Control condition. In addition, worrying impaired both extinction and re-extinction learning of UCS expectancy. The implication of our findings is that they show how worry may contribute to the development of anxiety disorders by affecting associative fear learning.
Highlights
Emotional memory is considered to lie at the root of anxiety disorders, and originates from a learned association between a previously neutral event (Conditioned Stimulus or CS, e.g., stranger) and an anticipated catastrophe (Unconditioned Stimulus or unconditioned stimulus (UCS), e.g., physical attack)
Pavlovian fear conditioning serves as a valuable experimental model for studying associative fear memory, it falls short in explaining that most anxiety disorders evolve after relatively mild aversive events rather than traumatic experiences
In the present discriminative fear conditioning study, in which one of two neutral pictures (CS1+ but not CS22) is paired with an aversive stimulus, we investigated the effects of experimentally induced worry on associative fear memory
Summary
Emotional memory is considered to lie at the root of anxiety disorders, and originates from a learned association between a previously neutral event (Conditioned Stimulus or CS, e.g., stranger) and an anticipated catastrophe (Unconditioned Stimulus or UCS, e.g., physical attack). Patients with anxiety disorders feel, think and act as if the feared CS predicts the later occurrence of a catastrophic outcome (UCS). Pavlovian fear conditioning serves as a valuable experimental model for studying associative fear memory, it falls short in explaining that most anxiety disorders evolve after relatively mild aversive events rather than traumatic experiences. Processes following fear acquisition may contribute to the development of pathological fear. Negative thinking such as worry is a potential candidate for strengthening associative fear memory after fear acquisition. To account for the negative consequences of worry, specific components have been identified: the repetitive nature, the typical negative valence (e.g., catastrophizing on a real or potential problem), and the abstract level of thinking (e.g., thinking about meanings and implications) [1,5,6]
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