اضافه کردن تصویرسازی اسکریپت نویسی مجدد در طول انقراض منجر به بازسازی ABA کمتر
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|29615||2012||11 صفحه PDF||سفارش دهید||10445 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Behavior Therapy and Experimental Psychiatry, Volume 43, Issue 1, March 2012, Pages 614–624
Objective Although extinction is highly effective in reducing a conditioned fear response, return of the fear response (renewal) outside the extinction context often occurs. The present study investigated whether US devaluation, through imagery rescripting during extinction, resulted in less renewal than mere extinction. Method Seventy psychology students were subjected to a fear conditioning paradigm. During fear acquisition CS+ was always followed by the US, whereas CS− was never followed by the US. For all groups the acquisition phase took place in context A. During extinction both CS+ and CS− were offered, but no US was presented. For three groups extinction was conducted in a different context, context B (ABA groups). The fourth group received extinction in the acquisition context (AAA group) in order to demonstrate that renewal indeed took place. During extinction, participants received either an imagery rescripting (IR) instruction to devaluate the US (ABAir), a US-unrelated imagination instruction to assess the general influence of imagination (ABAcont), or no instruction at all (ABAno and AAAno). Subsequently, testing occurred for all groups in the acquisition context A. Results The results indicated that renewal of the US expectancy ratings was reduced if imagery rescripting (ABAir) was added to mere extinction (ABAno). Next to the reduction in renewal, imagery rescripting (ABAir) also resulted in the devaluation of the US valence, indicating that the mental representation of the US had changed. These findings are not only in line with contemporary conditioning theories, but also suggest that adding imagery rescripting to extinction might be beneficial in the treatment of anxiety problems. Highlights ► A change in context evokes renewal of an extinguished fear response. ► Imagery rescripting can limit this context-dependent renewal. ► Adding imagery rescripting resulted in less renewal than mere extinction.
Fear conditioning involves the pairing of a neutral stimulus with an aversive event (unconditioned stimulus, US). This neutral stimulus does initially not evoke an emotional response. However, after repeated pairing with the US the neutral stimulus comes to function as a valid predictor (conditioned stimulus, CS) for the occurrence of the US, resulting in an anticipatory fear response on its presentation (e.g., Watson & Rayner, 1920). Conditioning as a theoretical framework has gained enormous power not only to explain the aetiology of fear, but also in therapies that reduce fear. Exposure therapy is a widespread and highly effective method to attenuate a conditioned fear response by means of extinction. In an extinction procedure the CS is repeatedly presented without the US, diminishing the CR. Likewise, in a typical exposure session patients are also presented with the feared stimulus or situation until the conditioned fear response is extinguished (e.g., Marks et al., 1975, Öst, 1989, Öst, 1996 and Öst, 1997). Exposure therapy has proven to be an effective treatment in a variety of anxiety problems such as specific phobias (Öst, 1997), panic disorders (Barlow, Allen, & Basden, 2007), and post-traumatic stress disorder (Foa, Rothbaum, & Furr, 2003). Recent studies have indicated that associative learning can occur even if the CS or the US are not actually present (see for overviews Dadds et al., 1997, Dwyer, 2003 and Field, 2006). This implies that the acquisition of a conditioned response can take place if no direct CS–US presentation is experienced. That is, pairing an actual CS with a mentally imagined US can evoke a CR on subsequent CS presentations, and vice versa, a mentally imagined CS can come to evoke a CR after pairings with an actually present US (see for an overview Dadds et al., 1997). Even more, just thinking about a specific CS–US combination, for example imagining that a snake (CS) strangles you (US), might result in a conditioned fear response (but see for an alternative explanation Dadds et al., 1997). In a more recent conditioning model presented by Davey (1997) the strength of the CS–US association is not only influenced by the number of experienced pairings of the CS and US. Davey distinguishes two processes, expectancy evaluation and US revaluation, that can affect the CR. The first process stresses the influence of the predictive value or (expected) contingency between the CS and US on the CR. In this process not only direct conditioning experiences determine the associative strength between the CS and US, but also pre-existing beliefs and verbally and culturally transmitted information contribute to the establishment of a CS–US association (see for experiments Askew et al., 2008 and Muris et al., 2003). According to the second process, US revaluation, the mental representation of the US can change even if the US is not encountered. For example, socially or verbally transmitted information about the US can inflate or devaluate the US representation resulting in a stronger or diminished CR on subsequent CS presentations (see Davey, 1997 and Field, 2006 for reviews). Next to extinction or exposure procedures, imagery techniques that affect the mental representation of the CS and/or US can be implemented in the treatment of anxiety-related problems (Dadds et al., 1997). According to the model of Davey (1997) a devaluation of the US representation should result in a diminished CR on subsequent CS presentations. Arntz et al. have hypothesized that Imagery Rescripting (IR) might act through US revaluation (Arntz, in press, Arntz et al., 2007 and Arntz and Weertman, 1999). This technique has been successfully applied in a variety of anxiety-related disorders such as post-traumatic stress disorder (e.g., Arntz et al., 2007), social phobia (e.g, Wild, Hackmann, & Clark, 2007), and specific phobias (see for an overview Holmes et al., 2007 and Hunt and Fenton, 2007). During IR patients are asked to activate the memory of an aversive event and to mentally rescript it into another more neutral or positive image. For example, a traumatic memory of sexual abuse is rescripted by imagining that an adult intervenes and stops the abuser. If the assumed mechanism of IR is correct, the advantage of IR over extinction is that the former directly acts upon the US presentation and therefore, can more easily generalize to other stimuli and environments. This is not the case with an extinction or exposure procedure. After extinction the CS is thought to have an ambiguous meaning; it predicts both the occurrence and the absence of the US. Especially the second-learned CS–noUS association is highly vulnerable to context changes after extinction (see for an overview Bouton, 2002 and Bouton, 2004). One robust phenomenon that indicates this vulnerability is the renewal effect. In the most common renewal paradigm, ABA renewal, acquisition of the CS–US association takes place in context A and subsequently, the extinction is conducted in another context, context B. When the CS is then presented in the original acquisition context, context A, renewed responding is observed, indicating that the CS–US rather than the CS–noUS association is retrieved from memory (but see Nelson, del Carmen Sanjuan, Vadillo-Ruiz, Pérez, & León, 2010). Indeed this ABA renewal has been frequently observed in both animal (e.g., Thomas, Larsen, & Ayres, 2003) and human fear conditioning studies (e.g., Effting and Kindt, 2007 and Vansteenwegen et al., 2005). Less renewed responding is expected after an IR intervention. Even if the original CS–US association is retrieved, no strong CR is expected as the US representation itself has been changed. To our knowledge, no study has been conducted that examined the influence of IR during extinction on renewal. Therefore, the main aim of the present study is to investigate the influence of IR during extinction on renewal using an ABA paradigm. It was hypothesized that changing the US representation during an extinction procedure should reduce renewed responding at test and devaluate the US.
نتیجه گیری انگلیسی
3.1. Demographic variables and questionnaire data Table 2 displays the demographic information and the total scores on the BAI, STAI-DY, and QMI, per group. No significant differences were observed regarding age, questionnaire scores, Fs(3, 66) < 1.81, ps > .15, or gender distribution, χ2 = .57, p = .90. Table 2. Demographic information and mean scores (standard deviation) on the questionnaires. Group Age m/f BAI STAI-DY QMI State Trait ABAir 21.91 (2.35) 7/18 31.28 (7.62) 33.72(7.10) 36.52 (9.34) 90.88(30.05) ABAcont 21.78 (3.80) 5/11 29.13 (6.05) 30.63(4.54) 34.31 (7.25) 102.63 (28.09) ABAno 22.08 (2.17) 3/11 30.21 (5.01) 32.93 (10.03) 35.64 (9.59) 84.50(28.12) AAAno 22.39 (2.15) 5/10 27.93 (4.48) 29.47(6.24) 31.53 (7.28) 81.67(19.40)