title: Reinstatement of contextual anxiety in humans: Effects of state anxiety.
abstract: After successful extinction of conditioned fear, the presentation of an unsignaled unconditioned stimulus (US) leads to return of fear, thus, the previously extinguished conditioned stimulus (CS) triggers fear responses again. Human studies on such reinstatement processes are still inconclusive. Some revealed a general increase of fear reactions, both to the fear (CS+) and the safety stimulus (CS-), whereas other studies discovered a differential return of fear with enhanced fear responses to the CS+ only. Moreover, we know little about reinstatement of contextual anxiety, a state of general anxious apprehension and chronic worry. Therefore, the present study investigated reinstatement of contextual anxiety with an ecological valid virtual reality (VR) design. Additionally, we examined whether the current state anxiety might modulate the reinstatement of contextual anxiety. To this end, two groups underwent context conditioning on Day 1, i.e., one context (CXT+) became paired with unpredictable USs, but not the other context (CXT-), and an extinction training on Day 2. On Day 3 a reinstatement test was conducted, i.e., one group (reinstatement group, n=21) received one unsignaled US before testing, whereas the control group (n=21) did not. Only the reinstatement group showed a differential return of contextual anxiety as measured by fear-potentiated startle and anxiety ratings. Interestingly, the reinstatement of fear-potentiated startle was additionally influenced by state anxiety. Conclusively, an anxious state before an unsignaled aversive event might favor a return of contextual anxiety.
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstr. 9-11, 97070 Würzburg, Germany; Clinical Cognitive Neuroscience Center, Institute of Human Behavioural Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, 110-744 Seoul, Republic of Korea.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Glotzbach-Schoon
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstr. 9-11, 97070 Würzburg, Germany.
authors.forename: Marta
authors.initials: M
authors.lastname: Andreatta
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstr. 9-11, 97070 Würzburg, Germany; Department of Experimental Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Universitätsstrasse 31, 95053 Regensburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mühlberger
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstr. 9-11, 97070 Würzburg, Germany. Electronic address: pauli@psychologie.uni-wuerzburg.de.
authors.forename: Paul
authors.initials: P
authors.lastname: Pauli
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000503:physiopathology*; D003214:Conditioning, Classical / Q000502:physiology*; D004576:Electromyography; D005108:Extinction, Psychological; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013216:Reflex, Startle / Q000502:physiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Context conditioning; Fear-potentiated startle; Ratings; Reinstatement; State anxiety