دینامیک زمانبندی امداد در شرایط تهییج و ترس انقراض: اعتبار تجربی و ارتباط بالینی

The learning principles that guide the acquisition and extinction of avoidance are not fully understood. We developed a novel paradigm to study the temporal dynamics of relief, a putative reinforcer of avoidance, and the recovery of fear and avoidance following extinction. During conditioning, the avoidance action canceled the aversive unconditional stimulus (US), without terminating the predictive conditional stimulus (CS). Relief pleasantness was rated after fixed CS offsets, when US omission occured. Avoidance was effective to one CS, but not to another, to track stimulus-specific avoidance learning. Fear was extinguished under response prevention in a separate context. Recovery tests took place 24 h later, in both contexts and with a monetary cost added to the avoidance action. We found that avoidance gradually became stimulus-specific during conditioning, but hardly recovered during delayed testing. Across all phases, initial omissions of the aversive US triggered relief that gradually declined over consecutive omissions, in line with a theoretical prediction error signal. Participants that scored low on distress tolerance, however, displayed sustained levels of relief over continuous omissions. We propose that such forms of sustained relief may produce over-reinforcement of foregoing avoidance actions and promote the development of pathological avoidance. The current paradigm represents an efficacious tool to study the temporal dynamics of relief across avoidance learning and fear extinction and to characterize relief dysregulations in relation to psychopathology.