Fear Extinction: From Basic Neuroscience to Clinical Implications (Current Topics in Behavioral Neurosciences, 64)

✍ Scribed by Mohammed R. Milad (editor), Seth D. Norrholm (editor)

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 386
• Category: Library

✦ Synopsis

This book aims to provide the reader a neuroscientific understanding surrounding a very simple question: how do we learn not to fear? Exploring answers to this question is very important for two reasons. First, learning about the neural mechanisms of fear extinction is of relevance to everyone’s life - it is such a basic yet relevant question to our daily experiences. Therefore, understanding brain mechanisms of fear and its regulation is essential from a basic neuroscience point of view. Second, excessive fear and the inability to regulate its expression is one of the hallmarks of fear-, anxiety-, trauma-, and stressor-related psychopathologies. And as such, learning about how fear is acquired, stored, expressed, and regulated could help advance our understanding of the etiology of psychopathology, the maintenance of symptoms pertaining to failure to regulate fear, and could help us develop novel therapeutics to equip providers and patients with the tools to better quell their fears.The contributions contained in this book are provided by experts in the fields of basic and clinical neuroscience, experimental and clinical psychology, and neuropsychiatry. The contributions are organized to start the reader with basic definitions of how we define fear, how we study its neural circuits at the molecular and cellular levels, how to study human behavior and the brain using state-of-the art experimental and statistical tools, to how much fear contributes to psychopathology. This volume ends with current advances aimed to enhance the capacity to extinguish fear; a clinical result that would aid in the treatment of multiple psychiatric disorders, followed by a discussion on future directions of this highly important and relevant field.

✦ Table of Contents

Preface
What Is This Book About?
Contents
Part I: To Fear or Not
Fear Extinction as a Psychologist Views It
1 What Is Extinction?
2 What Is an Association?
3 What Is Fear?
4 What Can We Learn from Fear Extinction?
5 Conclusion
References
Beyond Fear, Extinction, and Freezing: Strategies for Improving the Translational Value of Animal Conditioning Research
1 Rodent Assays and Translational Strategies
1.1 Propranolol in Post-Traumatic Stress Disorder (PTSD)
1.2 CRF1 Antagonists in Generalized Anxiety Disorder (GAD) and PTSD
2 A Challenge to Translational Research: The Two-System Framework for Fear
3 Beyond Fear
3.1 Fear vs. Anxiety
3.2 Is Fear the Problem?
4 Beyond Extinction
4.1 Fear Extinction
4.1.1 Extinction as a Translational Tool
4.1.2 Using Extinction to Study Pre-encounter Defense
4.2 Dynamic Responding to Changing Threat Imminence
4.2.1 Approaching Threats
4.2.2 Post-Threat Recovery
4.3 Non-associative Learning
5 Beyond Freezing
5.1 General Factors Affecting Response Concordance
5.2 Discordance in Avoidance Conditioning
5.3 Discordance vs. Misalignment in Translational Studies of Aversive Conditioning
5.4 Aligning the Measurement of Multiple Responses in Animals and Humans
5.5 Interdependent Defensive Responses
6 Conclusion
References
Understanding Human Fear Extinction: Insights from Psychophysiology
1 Introduction
2 Psychophysiological Tools
2.1 Electrodermal Indices: Skin Conductance (SC)
2.2 Electromyographic Indices: Acoustic Startle Response
3 Within-Session Extinction
4 Between-Session Extinction
5 Return of Fear After Extinction Learning
6 Experimental Design and Extinction Learning
7 Facilitation of Extinction Learning
8 Fear Extinction: Clinical Applications and Implications
9 Extinction Learning: State or Trait?
10 Conclusions
References
Neuroimaging of Fear Extinction
1 Introduction
2 Methodological Issues with Neuroimaging as a Tool for Studying Fear Extinction
3 Testing the Core Fear Extinction Circuit with Univariate Analytic Approaches
4 Context Sensitivity of Extinguished Fears: Methodological Considerations for Renewal and Reinstatement Tests
5 Fear Renewal
6 Fear Reinstatement
7 Expanding the Core Model
8 Advances Using Multivariate Approaches
9 Relating Fear Extinction Correlates to Individual Differences in Affect
10 Conclusions and Future Directions
References
Part II: Individual Differences in Fear Extinction
The Impacts of Sex Differences and Sex Hormones on Fear Extinction
1 Introduction
2 Sex Differences in FE
2.1 Menstrual/Estrous Cycle and FE
2.2 Estradiol and FE
2.3 Progesterone and FE
2.4 Testosterone and FE
2.5 Exogenous Hormones and FE
3 Areas of Future Research
4 Conclusions
References
The Impact of Sleep on Fear Extinction
1 Introduction
2 Sleep
3 Sleep and Memory Consolidation
4 Sleep Impacts the Consolidation of Memories for Fear Acquisition, Extinction Training, and Safety Signals
4.1 Sleep, Fear Acquisition, and Recall/Retention
4.2 Sleep, Extinction Training, and Recall/Retention
4.3 Sleep, Safety Signal Learning, and Recall/Retention
5 Altering Fear and Extinction Memories during Sleep
6 Sleep, Extinction Training, and Recall/Retention in Clinical Populations
7 The Role of Sleep and Circadian Rhythms in Treatment for Anxiety and Trauma- and Stressor-Related Disorders
8 Sleep´s Role in Processing Simulated and Real-Life Trauma
9 Uses for Sleep in Enhancing Therapeutic Extinction
10 Contemporary Challenges
11 Conclusions
References
Impact of Stress and Exercise on Fear Extinction
1 The Stress Response: Mechanisms and Brain Regions
2 Different Ways to Induce Stress in a Laboratory Setting
3 Impact of Stress on Fear Extinction
3.1 Impact of Stress-Related Synthetic Hormones in Men
3.2 Impact of Stress-Related Synthetic Hormones in Women
3.3 Impact of SAM Axis Modulation
3.4 Impact of Physical Stressors
3.5 Impact of Psychosocial and Combined Stressors
4 Impact of Stress Hormones on Exposure Therapy
4.1 In Populations with Anxiety Disorders
4.2 In Populations with Post-Traumatic Stress Disorder (PTSD)
5 The Influence of Physical Exercise
5.1 Impact of Exercise on Fear Extinction
6 Impact of Physical Exercise in Clinical Samples
References
How Different Factors in Combination Change Fear Extinction Learning: The Case of Sex and Stress Hormones
1 Introduction
2 Regulation and Importance of Stress and Sex Hormones
3 Stress Hormone Effects on Extinction Learning and Exposure Therapy
4 Sex Hormone Effects on Extinction Learning and Exposure Therapy
5 A Joint Impact of Stress and Sex Hormones on Extinction Learning
6 A Joint Impact of Stress and Sex Hormones on Exposure Therapy
7 Underlying Mechanisms
8 Where to Go from Here?
References
Part III: Psychopathology
Is Fear Extinction Impairment Central to Psychopathology?
1 Introduction
2 The Rationale for Fear Conditioning and Extinction in Anxiety
3 Current Evidence About Aberrant Extinction in Anxiety
4 Neural Evidence of Extinction in Anxiety
5 The Role of Extinction in Treatment of Anxiety Disorders
6 Does Extinction Encompass the Totality of Anxiety Mechanisms?
7 Role of Reconsolidation
8 Optimizing Extinction to Enhance Exposure Therapy
9 Extinction and Predictors of Treatment Response
10 Concluding Comments
References
Getting Better with Age? A Review of Psychophysiological Studies of Fear Extinction Learning Across Development
1 Introduction
1.1 Psychophysiological Measurement of Fear
2 The Neurobiological Bases of Fear Learning and Extinction
3 Evidence for Age Effects on Fear Extinction Learning
3.1 The Screaming Lady Paradigm
3.2 The Bells Paradigm
3.3 The Shapes Paradigm
3.4 Multiple Paradigms
4 Effects of Anxiety on Fear Extinction Learning Across Development
5 Effects of Childhood Adversity on Fear Conditioning and Extinction
6 Future Directions
7 Conclusions
References
Extinction Learning Across Development: Neurodevelopmental Changes and Implications for Pediatric Anxiety Disorders
1 Introduction
2 The Basics of Operationalizing Fear Learning and Extinction Across Development
3 Fear Learning and Extinction Across Development
4 Neurodevelopmental Changes Underlying Fear Learning and Extinction
4.1 Developmental Changes in Neural Circuitry Supporting Fear Learning and Extinction
5 Fear Learning and Extinction in Pediatric Anxiety Disorders
5.1 Alterations in Fear Learning and Extinction in Pediatric Anxiety
5.2 Anxiety-Related Alterations in Relevant Neural Circuitry in Youth
5.3 Age-Modulated Patterns of Diagnostic Differences in Relevant Neural Circuitry
5.4 Implications for Treatment for Pediatric Anxiety
5.5 Safety Cue Learning
5.6 Parental Involvement in Treatment
6 Conclusion
References
Fear Extinction Learning in Posttraumatic Stress Disorder
1 Experimental Paradigm of Fear Extinction in PTSD
2 Neurobiology of PTSD-Related Alterations in Fear Responses
2.1 Alterations During Fear Conditioning and Fear Extinction
2.2 Alterations During Extinction Recall and Fear Renewal
2.3 Altered Contextual Processing
2.4 Relation to Other Fear-Related Psychopathologies
3 Fear Extinction in Exposure-Based Therapy
4 Future Directions
References
Part IV: Therapeutics and Neuromodulations of Fear Extinction
Exposure Therapy and Its Mechanisms
1 Introduction to Exposure Therapy
2 Exposure Therapy in the Clinic
2.1 Emotional Processing Theory
3 Evidence Supporting the Four Indicators of Emotional Processing from Human Studies
4 Advances in Fear Conditioning and Extinction
5 Inhibitory Learning Theory (ILT) and Its Application to Exposure Therapy
6 Evidence Supporting Expectation Violation
7 Summary and Directions for Future Research
References
Enhancing Fear Extinction: Pharmacological Approaches
1 Introduction
2 Overview of Psychopharmacological Interventions
3 D-Cycloserine
4 Scopolamine
5 Losartan
6 Ketamine
7 MDMA
8 Cannabinoids
9 BDNF and Growth Factors
10 HPA Modulation
11 Neurosteroids (Allopregnanolone)
12 Conclusions
References
Reconsolidation and Fear Extinction: An Update
1 Introduction
2 Mechanisms
3 Boundary Conditions
3.1 Timing
3.2 Memory/Stimulus Type
3.3 Outcome Measures
3.4 Prediction Error
4 Individual Differences
4.1 Genetics
4.2 Age
4.3 Psychopathology
4.4 Orienting and Extinction Phenotypes
5 Treatment Studies
6 Conclusion
References
Extinction-Based Exposure Therapies Using Virtual Reality
1 Introduction
2 Virtual Reality Exposure Therapy
3 Advantages of VR for Extinction Training
3.1 VR-Facilitated Presence in Exposures
3.2 VR-Facilitated Precision in Exposures
3.3 VR-Facilitated Avoidance Prevention in Exposures
3.4 VR-Facilitated Feasibility in Exposures
3.5 Summary of VR Advantages for Extinction Learning
4 Virtual Reality Exposure Therapy Research
5 Virtual Reality Exposure for Specific Phobia
6 Virtual Reality Exposure for PTSD
7 Effective Approaches to VR Extinction
8 Future Research Directions
References
Contemporary Approaches Toward Neuromodulation of Fear Extinction and Its Underlying Neural Circuits
1 Introduction
2 Electroconvulsive Therapy (ECT)
3 Transcranial Magnetic Stimulation (TMS)
4 Magnetic Seizure Therapy (MST)
5 Transcranial Focused Ultrasound (tFUS)
6 Deep Brain Stimulation (DBS)
7 Vagus Nerve Stimulation (VNS)
8 Transcranial Electrical Stimulation (tES)
9 Conclusion
References