title: Acquisition of CS-US contingencies during Pavlovian fear conditioning and extinction in social anxiety disorder and posttraumatic stress disorder.
abstract: Fear-based disorders, like social anxiety disorder (SAD) and posttraumatic stress disorder (PTSD), are characterized by an exaggerated fear response and avoidance to trigger cues, suggesting a transdiagnostic mechanism of psychopathology. Current theories suggest that abnormalities in conditioned fear is a primary contributor to the pathophysiology of these disorders. The primary goal of this study was to compare acquisition of conditioned stimulus (CS) and aversive unconditioned stimulus (US) contingencies during fear learning and extinction in individuals with SAD and PTSD.
  
  
  
  In a standard Pavlovian fear conditioning-extinction paradigm we measured subjective US expectancy ratings to different CSs in patients with SAD (n=16) compared to patients with PTSD (n=13) and healthy controls (n=15) RESULTS: Both patient groups (SAD, PTSD) acquired differential conditioning between a CS that predicted US (CS+) and a CS that never predicted the US (CS-), however, both groups reported an increased expectancy that the US would occur following the CS-. Additionally, the PTSD group overestimated that the US would occur in general. Neither patient group showed evidence of successful extinction of the CS+-US contingency nor differentiated their expectation of US occurrence between the CS+ and CS- during extinction learning.
  
  
  
  Group sample sizes were small and we did not include a trauma-exposed group without PTSD CONCLUSIONS: Both SAD and PTSD generalize expectations of an aversive outcome across CSs, even when a CS never signals an aversive outcome and PTSD may tend to over-expect threat. Fear learning and extinction abnormalities may be a core feature underlying shared symptoms across fear-based disorders.
authors.affiliation: Department of Pharmacy Practice, Wayne State University, Detroit, MI, United States; Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, United States; Pharmaceutical Sciences, Wayne State University, Detroit, MI, United States; Translational Neuroscience Program, Wayne State University, Detroit, MI, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States. Electronic address: rabinak@wayne.edu.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Rabinak
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; SUNY Downstate College of Medicine, Brooklyn, NY, United States.
authors.forename: Shoko
authors.initials: S
authors.lastname: Mori
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Maryssa
authors.initials: M
authors.lastname: Lyons
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Milad
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Anatomy and Cell Biology and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, United States.
authors.forename: K Luan
authors.initials: KL
authors.lastname: Phan
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003214:Conditioning, Classical; D003463:Cues; D005108:Extinction, Psychological; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D000072861:Phobia, Social / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000523:psychology*; D055815:Young Adult
keywords: Aversive; Classical conditioning; PTSD; Social phobia; Threat expectancy