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Safety behaviours preserve threat beliefs: Protection from extinction of human fear conditioning by an avoidance response
Abstract
A laboratory autonomic conditioning procedure was used to establish fear conditioning in human participants by pairing neutral stimuli with electric shock. Participants were also trained to make a button-press response to avoid shock. A target fear stimulus was then extinguished by presenting it without shock. The experimental group was given the opportunity to make the avoidance response during extinction whereas the control group was not. When the fear stimulus was tested without the response available, the control group showed normal extinction of both shock expectancy ratings and skin conductance responses, but the experimental group showed "protection from extinction": they continued to give high expectancy ratings and strong skin conductance responses. We interpret this effect as analogous to the role of within-situation safety behaviours in preserving threat beliefs during exposure therapy for anxiety disorders. The results support a cognitive account of learning and anxiety. The procedure provides a potential laboratory model for further examination of the cognitive and neural mechanisms underlying anxiety and its reduction.
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“Other experiments in humans, as well as clinical studies, have found that avoidance or safety behavior during extinction or exposure therapy can hinder the reduction of threat responses or fear (Lovibond et al., 2009; Blakey and Abramowitz, 2016; Volders et al., 2012).”
From Active avoidance: Neural mechanisms and attenuation of pavlovian conditioned responding (2017) · cites this paper as Lovibond et al., 2009
In the citing paper
“A small experimental literature on avoidance in humans and a large clinical literature have yielded conflicting findings regarding whether avoidance attenuates threat responses or patients' fear.”
From Active avoidance: Neural mechanisms and attenuation of pavlovian conditioned responding (2017) · cites this paper as Lovibond et al., 2009
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“…because safety behaviors “cancel the expectancy of [aversive outcomes] generated by the target excitatory stimulus, such that there is no discrepancy between what is expected (nothing) and what actually occurs (nothing),” thereby precluding durable fear extinction (Lovibond et al., 2009, p. 716).”
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ResultPittig, A., Wong, A. H. K., Glück, V. M., & Boschet, J. M. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103550 · Cited by 148
An elevated plus-maze in mixed reality for studying human anxiety-related behavior
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“bending to pick something up with a straight back) has been theorized to impede fear extinction [33].”
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“Safety signals Removal and prohibition of safety behaviors and signals during extinction training Increases threat expectancy to augment their violation; shows that safety behaviors/signals are not necessary for safety to occur [48]”
Ketamine effects on memory reconsolidation favor a learning model of delusions
Corlett, P. R., Cambridge, V., Gardner, J. M., Piggot, J. S., Turner, D. C., Everitt, J. C., Arana, F. S., Morgan, H. L., Milton, A. L., Lee, J. L., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0065088 · Cited by 105
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“A, B, and C were 6 x 6 cm blue, yellow, or pink squares (color was randomized for each participant) shown in the middle of the screen for 3 s. Lovibond et al. (2009) used blue, yellow, and green squares.”
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“Event-related potentials Miskovic & Keil (2012) Bublatzky & Schupp (2012) Weymar et al. (2013) Avoidance behavior Lovibond et al. (2009) Dymond et al. (2012) Bennett et al. (2015) Visual attention bias Koster et al. (2005) Deltomme et al. (2017) Implicit measures of evaluation Hermans et al. (2002)…”
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“Others have considered the top-down influence of high-level cognitive processes (Lovibond et al., 2009; Lovibond & Shanks, 2002; Mitchell et al., 2009).”
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“Actual avoidance behavior can serve to maintain CS fear through protection from extinction (Lovibond et al., 2009), lending it a self-perpetuating nature.”
BackgroundToward an assessment of escape/avoidance coping in depression
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“We used a within-subjects s a f e t y b e h a v i o r r e t u r n s t h r e a t e x p e c t a n c y fear conditioning paradigm adapted from Lovibond et al. (2009) to investigate this hypothesis.”
InfluentialPredicting clinical outcomes via human fear conditioning: A narrative review.
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“The limited opportunities to encounter evidence contradicting the dysfunctional threat beliefs maintain the anxiety [18, 76, 79, 129].”
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Wong, A. H. K., Wirth, F. M., & Pittig, A. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104056 · Cited by 43
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“Past work has shown that subjective and physiological measures of fear not always covary (Mauss & Robinson, 2009).”
BackgroundAvoidant decision making in social anxiety: the interaction of angry faces and emotional responses
Pittig, A., Pawlikowski, M., Craske, M., & Alpers, G. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.01050 · Cited by 36
“Andre Pittig, Department of Psychology, School of Social Sciences, University of Mannheim, Germany, and Anxiety Disorders Research Center, University of California, Los Angeles, USA; Mirko Pawlikowski, General Psychology: Cognition, Department for Informatics and Applied Cognitive Science, University of Duisburg-Essen…”
BackgroundInfluentialLovibond, P., Chen, S. X., Mitchell, C. J., & Weidemann, G. (2013) · Biological Psychology · doi:10.1016/j.biopsycho.2011.09.007 · Cited by 36
Self-citationBurchi, E., Makris, N., Lee, M. R., Pallanti, S., & Hollander, E. (2019) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2019.00070 · Cited by 35
“…learning, where alcohol exposure leads in time to alteration in the neurocircuitry underlying stress response, reward and cognitive functioning, all of which ultimately leads to compulsive substance use (Wise, 1987; Di Chiara, 1999; Berke and Hyman, 2000; Everitt et al., 2001; Lubman et al., 2004).”
BackgroundAvoidance and Decision Making in Anxiety: An Introduction to the Special Issue
Beckers, T., & Craske, M. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.05.009 · Cited by 35
“The protection-from-extinction that avoidance can produce is itself a central topic of the expectancy theory of avoidance (Lovibond et al., 2008, 2009).”
Neuroimaging the temporal dynamics of human avoidance to sustained threat
Schlund, M. W., Hudgins, C. D., Magee, S., & Dymond, S. (2013) · Behavioural Brain Research · doi:10.1016/j.bbr.2013.09.042 · Cited by 33
Wong, A. H. K., & Pittig, A. (2020) · Psychological Research · doi:10.1007/s00426-021-01490-w · Cited by 33
Morriss, J., Chapman, C., Tomlinson, S., & van Reekum, C. M. (2018) · Biological Psychology · doi:10.1016/j.biopsycho.2018.08.017 · Cited by 32
“22 research showing that engaging in avoidance behaviour reduces extinction (Lovibond et al., 2009; Rattel et al., 2017; Vervliet & Indekeu, 2015; Xia et al., 2017).”
BackgroundResultA Social Safety Net: Developing a Model of Social-Support Figures as Prepared Safety Stimuli
Hornstein, E. A., & Eisenberger, N. I. (2018) · Current Directions in Psychological Science · doi:10.1177/0963721417729036 · Cited by 37
Luciano, C., Valdivia-Salas, S., Ruiz, F. J., Rodríguez-Valverde, M., Barnes-Holmes, D., Dougher, M., Cabello, F., Sánchez, V., Barnes-Holmes, Y., & Gutiérrez, O. (2013) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2013.05.001 · Cited by 32
Conditioned inhibition: Historical critiques and controversies in the light of recent advances.
Sosa, R., & Ramírez, M. (2019) · Journal of Experimental Psychology: Animal Learning and Cognition · doi:10.1037/xan0000193 · Cited by 32
Ohi, K., Fujikane, D., Takai, K., Kuramitsu, A., Muto, Y., Sugiyama, S., & Shioiri, T. (2025) · Molecular Psychiatry · doi:10.1038/s41380-025-03155-1 · Cited by 35
“Although avoidance is typically considered a consequence of anxiety and fear [25], the evidence suggests that it may also act as a cocontributor, maintaining or exacerbating anxiety through a cycle of negative reinforcement [26, 27].”
Passive avoidance is linked to impaired fear extinction in humans.Preprint
Cornwell, B., Overstreet, C., Krimsky, M., & Grillon, C. (2013) · Learning & memory (Cold Spring Harbor, N.Y.) · doi:10.1101/lm.028902.112 · Cited by 31
“to active avoidant behavior [Lovibond et al. 2009]), and thus lead to a preservation of fear despite the absence of threat.”
BackgroundResultInfluentialTransdiagnostic fears and avoidance behaviors in self-reported eating disorders
Melles, H., & Jansen, A. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00745-8 · Cited by 30
Richter, J., Pittig, A., Hollandt, M., & Lueken, U. (2017) · Zeitschrift für Psychologie · doi:10.1027/2151-2604/a000309 · Cited by 37
Cross-US reinstatement of human conditioned fear: return of old fears or emergence of new ones?
Sokol, N., & Lovibond, P. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.02.005 · Cited by 30
Self-citationCounterconditioned fear responses exhibit greater renewal than extinguished fear responsesPreprint
Holmes, N. M., Leung, H. T., & Westbrook, R. F. (2016) · Learning & memory (Cold Spring Harbor, N.Y.) · doi:10.1101/lm.040659.115 · Cited by 29
“It has previously been suggested that treatment efficacy (i.e., resistance to relapse) is undermined by the presence of safety signals across the course of cue exposure, as experience of fear is necessary for learned fear inhibition (see Lovibond et al. 2000, 2009).”
BackgroundEditorial: Avoidance: From Basic Science to Psychopathology
Servatius, R. J. (2016) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2016.00015 · Cited by 37
“Avoidance expression reflects propositional knowledge but also the context in which knowledge is to be expressed (Seligman and Johnston, 1973; Lovibond et al., 2008, 2009; Dymond and Roche, 2009).”
BackgroundInfluentialExtinction of instrumental avoidance
Urcelay, G. P., & Prével, A. (2019) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2019.01.018 · Cited by 28
Optimizing Long-term Outcomes of Exposure for Chronic Primary Pain from the Lens of Learning Theory
Gatzounis, R., den Hollander, M., & Meulders, A. (2021) · Journal of Pain · doi:10.1016/j.jpain.2021.04.012 · Cited by 29
Remote cognitive behavioral therapy for panic disorder: A meta-analysis
Efron, G., & Wootton, B. M. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102385 · Cited by 38
Lommen, M., Duta, M., Vanbrabant, K., de Jong, R., Juechems, K., & Ehlers, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0184485 · Cited by 27
“Moreover, avoidance seems to play a crucial role in the maintenance and possibly even exacerbation of pathological anxiety by preventing disconfirmation of irrational or exaggerated danger beliefs[13].”
Backgroundde Baets, L., Meulders, A., Damme, S. V., Caneiro, J., & Matheve, T. (2023) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2023.11420 · Cited by 26
Inconsistent analytic strategies reduce robustness in fear extinction via skin conductance response
Ney, L. J., Laing, P. A. F., Steward, T., Zuj, D. V., Dymond, S., & Felmingham, K. L. (2020) · Psychophysiology · doi:10.1111/psyp.13650 · Cited by 32
Enhanced avoidance behavior in social anxiety: Evidence from a probabilistic learning task
Stevens, S., Peters, A., Abraham, A., & Hermann, C. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.07.007 · Cited by 42
“Such avoidance prevents exposure to social situations and therefore interferes with extinction, hence maintaining pathological anxiety (Lovibond et al., 2009).”
BackgroundResultInfluentialCostly avoidance triggered by categorical fear generalization
Wong, A. H. K., & Pittig, A. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103606 · Cited by 28
The Reduction of Fear of Movement-related Pain: Does Motivational Context Matter?
Volders, S., Meulders, A., Peuter, S. D., & Vlaeyen, J. (2015) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000187 · Cited by 25
Metadata
- Authors
- Lovibond, P. F., Mitchell, C. J., Minard, E., Brady, A., & Menzies, R. G.
- Affiliations
- UNSW Sydney (AU)
- The University of Sydney (AU)
- Corresponding author
- Lovibond, Peter F.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 47
- Issue
- 8
- Pages
- 716-720
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2086885179
- Cited by
- 275
- References
- 21
- Citations by year
- 2026: 19 · 2025: 12 · 2024: 26 · 2023: 19 · 2022: 26 · 2021: 32 · 2020: 21 · 2019: 18 · 2018: 15 · 2017: 18 · 2016: 13 · 2015: 10 · 2014: 17 · 2013: 9 · 2012: 8
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- safety behavior, threat beliefs, fear conditioning, extinction, avoidance response, skin conductance response, exposure therapy, anxiety disorders, autonomic conditioning
- MeSH terms
- Avoidance Learning, Conditioning, Classical, Culture, Electric Stimulation, Extinction, Psychological, Fear, Female, Galvanic Skin Response, Humans, Male, Safety
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