Avoidance and its bi-directional relationship with conditioned fear: Mechanisms, moderators, and clinical implications. (March 2020)

• Record Type: Journal Article
• Authors: Pittig, Andre; Wong, Alex H.K.; Glück, Valentina M.; Boschet, Juliane M.
• Is Part Of: Behaviour research and therapy. Volume 126(2020)
• Publication Date: 2020-03
• Subjects: Avoidance -- Defensive behavior -- Fear conditioning -- Anxiety -- Habits -- Instrumental behavior -- Safety behavior -- Aversive conditioning; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2020.103550
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Fear motivates different types of defensive behaviors. These behaviors are, however, not mere byproducts of fear. In this review, we highlight a bi-directional relationship between conditioned fear and instrumental defensive behavior in humans. We discuss mechanisms involved in the link from fear to goal-directed avoidance (e.g., relief, generalization), that may become habitual. These defensive behaviors may in turn reduce, preserve, or amplify fear responding (e.g., protection-from-extinction, behavior-as-information). Multiple factors moderate the bi-directional relationship. Evidence for amplifying and dampening effects of inter-individual differences (e.g., trait anxiety, distress tolerance), intra-individual states (e.g., stress), and external factors (e.g., incentives for competing behavior) on goal-directed and/or habitual defensive behavior is reviewed. However, the exact mechanisms by which these factors moderate the bi-directional relationship are still largely unknown (e.g., modulating avoidance directly vs. indirectly via conditioned fear). Finally, we discuss major implications: First, understanding factors moderating the bi-directional relationship provides insights into risk and resilience factors for anxious psychopathology. Second, specific experimental models and clinical interventions can be mapped onto distinct defensive behaviors (e.g., goal-directed vs. habitual avoidance). More precise matching will help to develop nuanced models and interventions to reduce pathological behaviors and individualize treatments. Highlights: Conditioned fear and different types of defensive behaviors bi-directionally interact. Various moderating factors amplify or dampen this bi-directional relationship. Moderators give insight in risk and resilience factors for anxious psychopathology. Matching models and interventions to distinct defensive behaviors can improve treatment.