Stressor controllability modulates fear extinction in humans
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Traumatic events are proposed to play a role in the development of anxiety disorders, however not all individuals exposed to extreme stress experience a pathological increase in fear. Recent studies in animal models suggest that the degree to which one is able to control an aversive experience is a critical factor determining its behavioral consequences. In this study, we examined whether stressor controllability modulates subsequent conditioned fear expression in humans. Participants were randomly assigned to an escapable stressor condition, a yoked inescapable stressor condition, or a control condition involving no stress exposure. One week later, all participants underwent fear conditioning, fear extinction, and a test of extinction retrieval the following day. Participants exposed to inescapable stress showed impaired fear extinction learning and increased fear expression the following day. In contrast, escapable stress improved fear extinction and prevented the spontaneous recovery of fear. Consistent with the bidirectional controllability effects previously reported in animal models, these results suggest that one's degree of control over aversive experiences may be an important factor influencing the development of psychological resilience or vulnerability in humans.
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To persistently diminish threat conditioned responses in humans, avoidance actions need to be learned through trial and error and there needs to be a subjective sense of control over the unconditioned stimulus during learning.
“However, in order to persistently diminish threat conditioned responses in humans, avoidance actions need to be learned through trial and error and there needs to be a subjective sense of control over the unconditioned stimulus during learning [115].”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [115]
The Results (§3.3) report that participants who had controlled shocks showed reduced conditioned fear responses during extinction, with the reduction retained the next day. Results (§3.4) also link greater perceived control to lower fear expression. But the paper does not establish that trial-and-error avoidance learning and a subjective sense of control are both necessary: objective avoidance performance was not significantly related to fear responses at retrieval, and perceived control was a predictor rather than a demonstrated requirement. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA 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.
“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 Hartley et al., 2014
The Discussion (page unavailable) reports that escapable stress diminished conditioned fear expression in the human experiment. It does not describe a large clinical literature yielding conflicting findings about whether avoidance reduces patients’ fear; instead, it says active-coping techniques have received relatively little clinical attention. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn humans, avoidance learning and history with escapable shock can persistently reduce conditioned threat actions as measured with SCR, even when no avoidance action is available.
“In humans, there is evidence that both avoidance learning and history with escapable shock can persistently reduce conditioned threat actions as measured with SCR, even when no avoidance action is available [114, 115].”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [115]
Some studies in humans have found that learning to prevent shocks eliminated spontaneous recovery.
“Consistent with the results of experiments in rodents discussed above, some studies in humans (Hartley et al., 2014; C. A. Hartley, C. A. Coelho, E. A. Boeke, F. Ramirez, and E. A. Phelps, unpublished observations) have found that learning to prevent shocks eliminated spontaneous recovery.”
From Active avoidance: Neural mechanisms and attenuation of pavlovian conditioned responding (2017) · cites this paper as Hartley et al., 2014
Translation of rodent research on instrumental control over threat to humans has been limited.
“Translation of this research to humans has been limited (Collins et al., 2014; Hartley et al., 2014).”
From Active avoidance: Neural mechanisms and attenuation of pavlovian conditioned responding (2017) · cites this paper as Hartley et al., 2014
A previous study observed similar behavioral effects without any differential instruction between groups.
“However, a previous study observed similar behavioral effects without any differential instruction between groups (Hartley et al., 2014).”
From Active avoidance: Neural mechanisms and attenuation of pavlovian conditioned responding (2017) · cites this paper as Hartley et al., 2014
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- Authors
- Hartley, C. A., Gorun, A., Reddan, M. C., Ramirez, F., & Phelps, E. A.
- Affiliations
- Weill Cornell Medicine (US)
- New York University (US)
- Icahn School of Medicine at Mount Sinai (US)
- Nathan Kline Institute for Psychiatric Research (US)
- Corresponding author
- Phelps, Elizabeth A.
- Venue
- Neurobiology of Learning and Memory
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 113
- Pages
- 149-156
- ISSN
- 1074-7427 (ISSN-L)
- PMC
- PMC4053478
- OpenAlex
- W2004180496
- Cited by
- 110
- References
- 39
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 12 · 2023: 10 · 2022: 9 · 2021: 15 · 2020: 9 · 2019: 9 · 2018: 7 · 2017: 5 · 2016: 6 · 2015: 3 · 2014: 4
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurobiology of Learning and Memory (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Science Foundation
- National Institute of Mental Health (R01MH080756, R01MH097085, MH 080756, MH062104, R01MH062104)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- stressor controllability, fear extinction, inescapable stress, fear conditioning, anxiety disorders, psychological resilience, trauma exposure, extinction retrieval
- MeSH terms
- Adolescent, Adult, Avoidance Learning, Conditioning, Classical, Extinction, Psychological, Fear, Female, Humans, Male, Middle Aged, Random Allocation, Stress, Psychological, Young Adult
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