Resting Heart Rate Variability Predicts Safety Learning and Fear Extinction in an Interoceptive Fear Conditioning Paradigm

This study aimed to investigate whether interindividual differences in autonomic inhibitory control predict safety learning and fear extinction in an interoceptive fear conditioning paradigm. Data from a previously reported study (N = 40) were extended (N = 17) and re-analyzed to test whether healthy participants’ resting heart rate variability (HRV) - a proxy of cardiac vagal tone - predicts learning performance. The conditioned stimulus (CS) was a slight sensation of breathlessness induced by a flow resistor, the unconditioned stimulus (US) was an aversive short-lasting suffocation experience induced by a complete occlusion of the breathing circuitry. During acquisition, the paired group received 6 paired CS-US presentations; the control group received 6 explicitly unpaired CS-US presentations. In the extinction phase, both groups were exposed to 6 CS-only presentations. Measures included startle blink EMG, skin conductance responses (SCR) and US-expectancy ratings. Resting HRV significantly predicted the startle blink EMG learning curves both during acquisition and extinction. In the unpaired group, higher levels of HRV at rest predicted safety learning to the CS during acquisition. In the paired group, higher levels of HRV were associated with better extinction. Our findings suggest that the strength or integrity of prefrontal inhibitory mechanisms involved in safety- and extinction learning can be indexed by HRV at rest

Multiple fear-related stimuli enhance physiological arousal during extinction and reduce physiological arousal to novel stimuli and the threat conditioned stimulus

Highlights•Involved Pavlovian conditioning, extinction, extinction generalization test, and extinction retest.•Compared extinction with CS+ and CS− and generalization stimuli and ‘extinction-as-usual’.•Multiple stimuli increased physiological arousal to both CSs during, and negative CS evaluations, after extinction.•Multiple stimuli reduced physiological arousal to novel stimuli and CS+ after extinction but did not alter negative CS evaluations.•No group differences were observed in subjective anxiety ratings

Learned Fear of Gastrointestinal Sensations in Healthy Adults

Background & Aims Gastrointestinal symptom-specific fear and anxiety are important determinants of gastrointestinal symptom perception. We studied learning of fear toward innocuous gastrointestinal sensations as a putative mechanism in the development of gastrointestinal symptom-specific fear and anxiety. Methods Fifty-two healthy subjects (26 women) received 2 types of esophageal balloon distention at a perceptible but nonpainful intensity (conditioned stimulus [CS], the innocuous sensation) and at a painful intensity (unconditioned stimulus [US]). Subjects were assigned randomly to 1 of 2 groups. During the learning phase, the innocuous CS preceded the painful US in the experimental group (n = 26). In the control group (n = 26), on the contrary, the US never followed the CS directly. During a subsequent extinction phase, both groups received only CS distention—the painful US was no longer administered. Indexes of fear learning toward the innocuous CS distention included the skin conductance response, fear-potentiated startle (measured by the eye-blink electromyogram), and self-reported expectancy of the US. Results During the learning phase, only the experimental group learned to fear the innocuous gastrointestinal CS, based on the increase in US expectancy (compared with the control group, P = .04), increased skin conductance response (compared with the control group, P = .03), and potentiated startle reflex (compared with the control group, P = .001) in response to the CS. The differences between the experimental and control groups in US expectancy and skin conductance, but not fear-potentiated startle, disappeared during the extinction phase. Conclusions Fear toward innocuous gastrointestinal sensations can be established through associative learning in healthy human beings. This may be an important mechanism in the development of fear of gastrointestinal symptoms, implicated in the pathophysiology of functional gastrointestinal disorders

Executive functions deficits impair extinction of generalization of fear of movement‐related pain

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Background Generalization of fear of movement‐related pain across novel but similar movements can lead to fear responses to movements that are actually not associated with pain. The peak‐shift effect describes a phenomenon whereby particular novel movements elicit even greater fear responses than the original pain‐provoking movement (CS+), because they represent a more extreme version of the CS+. There is great variance in the propensity to generalize as well as the speed of extinction learning when these novel movements are not followed by pain. It can be argued that this variance may be associated with executive function capacity, as individuals may be unable to intentionally inhibit fear responses. This study examined whether executive function capacity contributes to generalization and extinction of generalization as well as peak‐shift of conditioned fear of movement‐related pain and expectancy. Methods Healthy participants performed a proprioceptive fear conditioning task. Executive function tests assessing updating, switching, and inhibition were used to predict changes in (extinction of) fear of movement‐related pain and pain expectancy generalization. Results Low inhibitory capacity was associated with slower extinction of generalized fear of movement‐related pain and pain expectancy. Evidence was found in favor of an area‐shift, rather than a peak‐shift effect, which implies that the peak conditioned fear response extended to, but did not shift to a novel stimulus. Conclusions Participants with low inhibitory capacity may have difficulties withholding fear responses, leading to a slower decrease of generalized fear over time. The findings may be relevant to inform treatments. Significance Low inhibitory capacity is not associated with slower generalization, but extinction of fear generalization. Fear elicited by a novel safe movement, situated outside the CS+/− continuum on the CS+ side, can be as strong as to the original stimulus predicting the pain‐onset

Afferent cardiac signals modulate attentional engagement to low spatial frequency fearful faces

Despite the growing consensus that the continuous dynamic cortical representations of internal bodily states shape the subjective experience of emotions, physiological arousal is typically considered only a consequence and rarely a determinant of the emotional experience. Recent experimental approaches study how afferent autonomic signals from the heart modulate the processing of sensory information by focussing on the phasic properties of arterial baroreceptor firing that is active during cardiac systole and quiescent during cardiac diastole. For example, baroreceptor activation has been shown to enhance the processing of threat-signalling stimuli. Here, we investigate the role of cardiac afferent signals in the rapid engagement and disengagement of attention to fear stimuli. In an adapted version of the emotional attentional cueing paradigm, we timed the presentation of cues, either fearful or neutral faces, to coincide with the different phases of the cardiac cycle. Moreover, we presented cues with different spatial frequency ranges to investigate how these interoceptive signals influence the processing of visual information. Results revealed a selective enhancement of attentional engagement to low spatial frequency fearful faces presented during cardiac systole relative to diastole. No cardiac cycle effects were observed to high spatial frequency nor broad spatial frequency cues. These findings expand our mechanistic understanding of how body–brain interactions may impact the visual processing of fearful stimuli and contribute to the increased attentional capture of threat signals