title: Novelty-facilitated extinction: providing a novel outcome in place of an expected threat diminishes recovery of defensive responses.
abstract: BACKGROUND
  Experimental extinction serves as a model for psychiatric treatments based on associative learning. However, the effects of extinction are often transient, as evidenced by postextinction return of defensive behaviors. From a therapeutic perspective, an inherent problem with extinction may be that mere omission of threat is not sufficient to reduce future threat uncertainty. The current study tested an augmented form of extinction that replaced, rather than merely omitted, expected threat outcomes with novel nonthreat outcomes, with the goal of reducing postextinction return of defensive behaviors.
  
  
  METHODS
  Thirty-two healthy male Sprague-Dawley rats and 47 human adults underwent threat conditioning to a conditioned stimulus paired with an electrical shock. Subjects then underwent a standard extinction protocol with shock omitted or an augmented extinction protocol wherein the shock was replaced by a surprising tone. Tests of postextinction recovery occurred 24 hours later in the absence of the tone.
  
  
  RESULTS
  Replacing the shock with a novel nonthreat outcome, as compared with shock omission, reduced postextinction recovery (freezing in rats and anticipatory skin conductance responses in humans) when tested 24 hours later. Self-reported intolerance of uncertainty was positively correlated with recovery following standard extinction in humans, providing new evidence that postextinction recovery is related to sensitivity to future threat uncertainty.
  
  
  CONCLUSIONS
  These findings provide cross-species evidence of a novel strategy to enhance extinction that may have broad implications for how to override associative learning that has become maladaptive and offer a simple technique that could be straightforwardly adapted and implemented in clinical situations.
authors: Psychology Department and Center for Neural Sciences, New York University, New York.
authors: Joseph E
authors: JE
authors: Dunsmoor
authors: Psychology Department and Center for Neural Sciences, New York University, New York.
authors: Vinn D
authors: VD
authors: Campese
authors: Psychology Department and Center for Neural Sciences, New York University, New York.
authors: Ahmet O
authors: AO
authors: Ceceli
authors: Psychology Department and Center for Neural Sciences, New York University, New York; Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York.
authors: Joseph E
authors: JE
authors: LeDoux
authors: Psychology Department and Center for Neural Sciences, New York University, New York; Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York. Electronic address: liz.phelps@nyu.edu.
authors: Elizabeth A
authors: EA
authors: Phelps
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001007:Anxiety / Q000523:psychology*; D001522:Behavior, Animal; D003214:Conditioning, Classical / Q000502:physiology*; D005108:Extinction, Psychological / Q000502:physiology*; D005239:Fear / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D055815:Young Adult
keywords: Anxiety; Arousal; Electrodermal; Fear; Pavlovian; Regulation
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