Extinction in multiple virtual reality contexts diminishes fear reinstatement in humans
Open accessAbstract
Although conditioned fear can be effectively extinguished by unreinforced exposure to a threat cue, fear responses tend to return when the cue is encountered some time after extinction (spontaneous recovery), in a novel environment (renewal), or following presentation of an aversive stimulus (reinstatement). As extinction represents a context-dependent form of new learning, one possible strategy to circumvent the return of fear is to conduct extinction across several environments. Here, we tested the effectiveness of multiple context extinction in a two-day fear conditioning experiment using 3-D virtual reality technology to create immersive, ecologically-valid context changes. Fear-potentiated startle served as the dependent measure. All three experimental groups initially acquired fear in a single context. A multiple extinction group then underwent extinction in three contexts, while a second group underwent extinction in the acquisition context and a third group underwent extinction in a single different context. All groups returned 24h later to test for return of fear in the extinction context (spontaneous recovery) and a novel context (renewal and reinstatement/test). Extinction in multiple contexts attenuated reinstatement of fear but did not reduce spontaneous recovery. Results from fear renewal were tendential. Our findings suggest that multi-context extinction can reduce fear relapse following an aversive event--an event that often induces return of fear in real-world settings--and provides empirical support for conducting exposure-based clinical treatments across a variety of environments.
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Exposure to multiple virtual contexts and multiple virtual phobic stimuli reduces the recurrence of fear to a greater extent than exposure to only one scenario and the same stimuli, making it possible to generalize the results.
“Results showed that exposure to multiple virtual contexts and multiple virtual phobic stimuli reduced the recurrence of fear to a greater extent than exposure to only one scenario and the same stimuli, making it possible to generalize the results.”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [87]
The Discussion reports that extinction across multiple virtual-reality contexts diminished fear reinstatement compared with extinction in a single context. But the Methods (§2.1–2.3) describe psychologically healthy volunteers and the same conditioned stimuli across groups, not exposure to multiple phobic stimuli. The paper suggests potential clinical applications; it does not demonstrate that the result generalizes to phobias. (LLM, conf=0.90)
Experimental — accuracy not yet measuredVR/AR facilitates exposure to different contexts, producing a positive effect in terms of fear renewal and generalization of results.
“Regarding this last strategy, as mentioned above, VR/AR facilitates the exposure to different contexts, producing a positive effect in terms of fear renewal and generalization of results [75,76,87].”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [87]
The Discussion says immersive VR made it possible to present multiple spatial contexts, and the Results report reduced fear reinstatement after extinction in multiple contexts. But the Results (section 3.3) found no significant group difference in fear renewal, and the Discussion calls that test inconclusive. The paper therefore does not establish the claimed positive effect on fear renewal or a general improvement across outcomes; it studies VR, not AR. (LLM, conf=0.90)
Experimental — accuracy not yet measured
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- Authors
- Dunsmoor, J. E., Ahs, F., Zielinski, D. J., & LaBar, K. S.
- Affiliations
- Duke University (US)
- Corresponding author
- LaBar, Kevin S.
- Venue
- Neurobiology of Learning and Memory
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 113
- Pages
- 157-164
- ISSN
- 1074-7427 (ISSN-L)
- PMC
- PMC4053498
- OpenAlex
- W1999197227
- Cited by
- 93
- References
- 32
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 3 · 2023: 14 · 2022: 12 · 2021: 4 · 2020: 6 · 2019: 9 · 2018: 7 · 2017: 8 · 2016: 5 · 2015: 10 · 2014: 5
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurobiology of Learning and Memory (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Sweden-America Foundation
- Vetenskapsrådet
- National Institutes of Health
- National Institute of Mental Health (F31MH090682)
- National Institute on Drug Abuse (R01DA027802)
- 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
- fear extinction, fear reinstatement, fear renewal, spontaneous recovery, fear-potentiated startle, fear conditioning, virtual reality, context-dependent learning, fear relapse, exposure therapy
- MeSH terms
- Adolescent, Adult, Conditioning, Classical, Extinction, Psychological, Fear, Female, Humans, Male, Random Allocation, User-Computer Interface, Young Adult
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