The clinical applications and practical relevance of human conditioning paradigms for posttraumatic stress disorder

• Published in: Progress in neuro-psychopharmacology & biological psychiatry Vol. 88; pp. 339 - 351
• Main Authors: Zuj, Daniel V., Norrholm, Seth Davin
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 10.01.2019
• Subjects: Avoidance; Conditioning; Exposure therapy; Extinction; Generalization; Posttraumatic stress disorder; Posttraumatic stress disorder; Conditioning; Generalization; Extinction; Avoidance; Exposure therapy
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2018.08.014

The classical conditioning paradigm of fear learning has spawned a number of experimental variations for the explanation of posttraumatic stress disorder (PTSD) etiology. These paradigms include extinction learning and recall, fear inhibition, fear generalization, and conditioned avoidance. As such, each of these paradigms have significant applications for understanding the development, maintenance, treatment, and relapse of the fear-related features of PTSD. In the present review, we describe each of these conditioning-based paradigms with reference to the clinical applications, and supported by case examples from patients with severe PTSD symptoms. We also review the neurobiological models of conditioning and extinction in animals, psychiatrically healthy humans, and PTSD patients, and discuss the current balance of evidence suggesting a number of biological, behavioral, and cognitive mechanisms/moderators of the conditioning and extinction process in experimental and clinical contexts. •Classical conditioning paradigm of fear learning are discussed in terms of their relevance to the etiology and treatment of Posttraumatic Stress Disorder (PTSD)•Clinically relevant paradigms include extinction learning and recall, fear inhibition, fear generalization, and conditioned avoidance•Each of these conditioning-based paradigms is discussed with reference to clinical applications and case examples from patients with severe PTSD symptoms