Self-report measures of fear learning and extinction and their association with internet-based cognitive behavioural therapy outcome

TY - JOUR

T1 - Self-report measures of fear learning and extinction and their association with internet-based cognitive behavioural therapy outcome

AU - McGregor, Tom

AU - Carr, Ewan

AU - Davies, Molly

AU - Kerr, Tim

AU - Krebs, Georgina

AU - Purves, Kirstin

AU - Skelton, Megan

AU - Breen, Gerome

AU - Hirsch, Colette

AU - Eley, Thalia

N1 - Publisher Copyright: © 2025 Elsevier Ltd

PY - 2025/4

Y1 - 2025/4

N2 - Despite the widespread use of cognitive-behavioural therapy (CBT), only about half of patients respond favourably. Understanding whether relevant psychological processes are associated with treatment response could help identify patients at risk of non-response prior to treatment and improve their outcomes by enabling clinicians to tailor interventions accordingly. Fear conditioning tasks are a valuable tool for studying the learning processes associated with anxiety disorders and their treatment. This study examined associations between outcomes from a remote fear conditioning task and responses to internet-based CBT. Anxious adults (n = 112) completed a fear conditioning task before receiving internet-based CBT. Participants rated their expectancy of an aversive noise (unconditioned stimulus; US) in response to a reinforced conditional stimulus (CS+) and a nonreinforced conditional stimulus (CS-) during acquisition, followed by extinction where neither stimulus was reinforced. Anxiety symptoms were assessed before each CBT session. Linear regression models indicated no significant association between mean US-expectancy ratings for 'safe' stimuli (acquisition CS- and extinction CS+) and change in anxiety across treatment. These findings contribute to the mixed literature on fear conditioning's role in treatment outcomes, highlighting the need for further research to elucidate the complex interplay between fear conditioning processes and response to CBT in anxiety disorders.

AB - Despite the widespread use of cognitive-behavioural therapy (CBT), only about half of patients respond favourably. Understanding whether relevant psychological processes are associated with treatment response could help identify patients at risk of non-response prior to treatment and improve their outcomes by enabling clinicians to tailor interventions accordingly. Fear conditioning tasks are a valuable tool for studying the learning processes associated with anxiety disorders and their treatment. This study examined associations between outcomes from a remote fear conditioning task and responses to internet-based CBT. Anxious adults (n = 112) completed a fear conditioning task before receiving internet-based CBT. Participants rated their expectancy of an aversive noise (unconditioned stimulus; US) in response to a reinforced conditional stimulus (CS+) and a nonreinforced conditional stimulus (CS-) during acquisition, followed by extinction where neither stimulus was reinforced. Anxiety symptoms were assessed before each CBT session. Linear regression models indicated no significant association between mean US-expectancy ratings for 'safe' stimuli (acquisition CS- and extinction CS+) and change in anxiety across treatment. These findings contribute to the mixed literature on fear conditioning's role in treatment outcomes, highlighting the need for further research to elucidate the complex interplay between fear conditioning processes and response to CBT in anxiety disorders.

UR - http://www.scopus.com/inward/record.url?scp=85218457659&partnerID=8YFLogxK

U2 - 10.1016/j.brat.2025.104705

DO - 10.1016/j.brat.2025.104705

M3 - Article

SN - 0005-7967

VL - 187

JO - Behaviour Research and Therapy

JF - Behaviour Research and Therapy

M1 - 104705

ER -