nucleation

THEORY-921: As Craske et al.'s 2014 review reports it, citing six studies and reporting no data of its own, how far fear falls during an extinction or exposure session, or across sessions, does not predict how much fear is expressed at follow-up, in animals, human laboratory samples and fearful, mostly analog, human samples

2 min read

Properties7
StatusActive
Version2
Tagspsychopathology-and-treatment, learning-and-conditioning
SourceLIT-1500 — Maximizing exposure therapy: An inhibitory learning approach
Bears onQUESTION-333 — Does how far fear falls within or across exposure or extinction sessions predict fear at follow-up once initial fear is controlled, in the studies Craske et al. 2014 cite or a later meta-analysis, and in well-powered clinical samples?
Cited as “corroborated by” byCLAIM-446 — Some persistent anxiety may be governance-maintained rather than belief-maintained: anticipated threat grants defensive processes authority over action, attention and evidence acquisition; under the avoidance that authority selects, the hypotheses that the situation is dangerous and that it is safe predict the same observation, so repeated safety need not correct the threat estimate; relief reinforces the defense without being evidence of danger; and the regime can outlast a corrected belief, its pathology, where present, being defensive authority insensitive to corrective evidence at avoidable cost
Cited as “extends” byTHEORY-1193 — How far fear falls during an extinction or exposure session, or across sessions, does not predict how much fear is expressed at follow-up, in animals, human laboratory samples and fearful human samples

Graph View

Source

Craske, Treanor, Conway, Zbozinek & Vervliet, LIT-1500, read in full in NOTE-1137 from the NIH author manuscript (PMC4114726): the sections “Inhibitory Learning vs Habituation and Behavioral Testing Approaches to Exposure” and “(1) Expectancy Violation”.

What was actually shown

The paper reports two findings from the literature. First, “the amount by which fear has reduced at completion of extinction is not predictive of the amount of fear expressed at the follow-up extinction retest in either animals or human laboratory samples”. Second, “the amount by which fear reduces by the end of an exposure trial or series of exposure trials is not predictive of the fear level expressed at follow-up assessment in fearful human samples”. It adds that sustained arousal during extinction goes with less fear at retest, and that in several of the authors’ studies “failure to habituate throughout exposure therapy was not associated with poorer outcomes”.

What could have come out otherwise: within-session habituation could have predicted outcome, as habituation models (Foa & Kozak 1986) hold it must.

What this does not say

  • That fear reduction is harmful. It is said not to predict, not to hinder.
  • That the finding holds in diagnosed clinical samples generally. The cited exposure studies are of fearful, mostly analog, samples (acrophobia, contamination fear, public speaking).
  • What does predict outcome. The paper points to expectancy violation and to variability of fear. Both are argued and cited, not established here.

Connections

  • CLAIM-446. The authors’ gloss, “divergence in response systems”, is a cited instance of the claim’s dissociation between anxious affect and what has been learned (CLAIM-283, CLAIM-349). It is not a measure of defensive authority.

Backlinks