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The propounded thesis investigated fear learning including fear conditioning, its generalization as well as its extinction in 133 healthy children and adolescents aged 8 to 17 years. The main goal was to analyze these processes also in the course of childhood and adolescence due to far less research in this age span compared to adults. Of note, childhood is the typical period for the onset of anxiety disorders. To achieve this, an aversive discriminative fear conditioning, generalization and extinction paradigm, which based on the “screaming lady paradigm” from Lau et al. (2008) and was adapted by Schiele & Reinhard et al. (2016), was applied. All probands traversed the pre-acquisition (4 x CS-, 4 x CS+, no US), the acquisition (12 x CS-, 12 x CS+, reinforcement rate: 83%), the generalization (12 x CS-, 12 x GS4, 12 x GS3, 12 x GS2, 12 x GS1, 12 x CS+, reinforcement rate: 50%) and the extinction (18 x CS-, 18 x CS+, no US). The generalization stimuli, i.e. GS1-GS4, were built out of CS- and CS+ in different mixtures on a percentage basis in steps of 20% from CS- to CS+. Pictures of faces of two actresses with a neutral expression were used for the discriminative conditioning, whereby the CS+ was paired with a 95-dB loud female scream at the same time together with a fearful facial expression (US). CS- and GS1-GS4 were never followed by the US. Subjective ratings (arousal, valence and US expectancy) were collected and further the psychophysiological measure of the skin conductance response (SCR). The hypotheses were 1) that underage probands show a negative correlation between age and overgeneralization and 2) that anxiety is positively correlated with overgeneralization in the same sample. ANOVAs with repeated measures were conducted for all four dependent variables with phase (pre-acquisition phase, 1. + 2. acquisition phase, 1. + 2. generalization phase, 1. - 3. extinction phase) and stimulus type
(CS-, CS+, GS1-GS4) as within-subject factors. For the analyses of the modulatory effects of age and anxiety in additional separate ANCOVAs were conducted including a) age, b) the STAIC score for trait anxiety and c) the CASI score for anxiety sensitivity as covariates. Sex was always included as covariate of no interest. On the one hand, findings indicated that the general extent of the reactions (arousal, valence and US expectancy ratings and the SCR) decreased with growing age, i.e. the older the probands the lower their reactions towards the stimuli regardless of the type of dependent variable. On the other hand, ratings of US expectancy, i.e. the likelihood that a stimulus is followed by a US (here: female scream coupled with a fearful facial expression), showed better discrimination skills the older the probands were, resulting in a smaller overgeneralization within older probands. It must be emphasized very clearly that no causality can be derived. Thus, it was only an association revealed between
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age and generalization of conditioned fear, which is negative. Furthermore, no obvious impact of trait anxiety could be detected on the different processes of fear learning. Especially, no overgeneralization was expressed by the probands linked to higher trait anxiety. In contrast to trait anxiety, for anxiety sensitivity there was an association between its extent and the level of fear reactions. This could be described best with a kind of parallel shifts: the higher the anxiety sensitivity, the stronger the fear reactions. Likewise, for anxiety sensitivity no overgeneralization due to a stronger extent of anxiety sensitivity could be observed.
Longitudinal follow-up examinations and, furthermore, neurobiological investigations are needed for replication purposes and purposes of gaining more supporting or opposing insights, but also for the profound exploration of the impact of hormonal changes during puberty and of the maturation processes of different brain structures. Finally, the question whether enhanced generalization of conditioned fear facilitates the development of anxiety disorders or vice versa remains unsolved yet.
Abstract
Tobacco addiction is considered as a chronic relapsing disorder, characterized by compul-sive drug seeking and intake. Learning processes are stressed to account for the situational-specific expression of core features of the disorder, e.g., craving for drug, tolerance and ex-cessive consumption. According to incentive theories, smoke conditioned stimuli are hy-pothesized to be appetitive in nature, promoting craving, approach and consummatory be-havior. Commonly, smoking cues are treated as simple excitatory conditioned stimuli formed by a close and reliable overlap with the drug effect. However, the smoking ritual comprises a multitude of stimuli which may give rise to different forms of learning and con-ditioned responses partially opposing each other. Previous research suggests the predictive content and the temporal proximity of smoking stimuli to the drug effect as important de-terminants of cue reactivity. In contrast to stimuli related to the preparatory stage of smok-ing and the start of consumption (BEGIN stimuli), stimuli from the terminal stage of smok-ing (END stimuli) apparently lack high cue reactivity. Several lines of evidence suggest the poor cue properties of terminal stimuli to be related to their signaling of poor smoke availa-bility. Indeed, cue reactivity is commonly decreased when smoking appears to be unavaila-ble. Moreover, the learning literature suggests that stimuli predictive for the non-availability of reward may acquire the capacity to modulate or oppose the responses of ex-citatory conditioned stimuli. Therefore, the aim of the present thesis was to enhance our knowledge of stimulus control in human drug addiction and incentive motivation by running a series of conditioning studies with smoke intake and monetary reward as reinforcer. Sub-jective report and physiological measures of motivational valence and consummatory re-sponse tendencies were used as dependent variables.
The first experiment of this thesis used a differential conditioning paradigm to reveal evi-dence for the conditioning of preparatory and consummatory responses to a CS+ for smok-ing. Neutral pictograms served as CSs and single puffs on a cigarette as US. In line with the predictions of incentive theories, the excitatory CS+ for smoking acquired the ability to evoke an appetitive conditioned response, as indicated by enhanced activity of the M. zy-gomaticus major. Moreover, anticipation of puffing on the cigarette increased the activity of the M. orbicularis oris (lip muscle), indicating the activation of consummatory response tendencies. Finally, the CS+ evoked stronger skin conductance responses, indicative of in-creased autonomic arousal and orienting in preparation for action. In contrast, the rating data were apparently unaffected by the experimental contingency. In sum, the physiological data provide support for the notion that excitatory smoke conditioning gives rise to appeti-tive and consummatory conditioned responses, which may at least partially contribute to the maintenance of tobacco addiction.
The second experiment of this thesis adapted the conditioning protocol of the first study to probe the functional significance of terminal stimuli in the control of addictive behavior. This study manipulated the predictive relationship of BEGIN and END stimuli to smoke rein-forcement to provide further support for the differential reactivity to both stimuli and the retarded (i.e., delayed) conditioning of END stimuli. Overall, the results of the first study of this thesis were conceptually replicated as the association of a BEGIN stimulus with smoke intake resulted in the acquisition of appetitive and consummatory physiological responses. Importantly, the results revealed evidence for a retarded excitatory conditioning of END stimuli. Thus, pairing of an END stimulus with smoke intake failed to produce a conditioned discrimination in terms of motivational valence and autonomic arousal, as indicated by the activity of the M. corrugator supercilii and the skin conductance data. These results provide further support for the notion that END stimuli may be weak cues for smoking. Moreover, in light of the results of the first study of this thesis, the retarded excitatory conditioning of terminal stimuli may be suggestive of an inhibitory response component, which may be re-lated to their signaling of poor smoke availability. In sum, these results add to a growing body of data, which suggest that the expression of cue reactivity may be modulated by the temporal proximity and the availability of the drug effect.
The aim of the third study of this thesis was to provide “proof of concept” for an inhibi-tory conditioning notion of terminal stimuli. In this analog study BEGIN and END stimuli were emulated as discriminative SD and S for monetary reward. During an acquisition phase conditioned inhibition was established to the S predictive of the non-availability of re-ward. Subsequently a retardation test was used to substantiate conditioned inhibition. In this test, excitatory conditioning of the previous S was compared to the excitatory condi-tioning of a novel control stimulus. Importantly, the results revealed evidence for reward conditioned inhibition as indicated by the retarded acquisition of subjective (pleasure and reward expectancy) and physiological (skin conductance and activity of the M. orbicularis oculi) responses. In sum, these results provide support for the notion that stimuli predictive for the non-availability of reward may acquire the capacity to oppose the responses of ex-citatory conditioned stimuli. Thus, future research may benefit from the consideration of inhibitory conditioning processes in drug addiction, which may be of theoretical, methodo-logical and clinical importance.
In sum, the present thesis revealed evidence for 1) an appetitive nature of excitatory condi-tioned smoking cues, 2) the dependency of this learning process on the temporal position of the conditioned stimuli in the intake ritual and 3) the acquisition of conditioned inhibition by a stimulus predictive for the non-availability of reward, as evident in retarded excitatory conditioning. Overall, these studies made a novel contribution to the field of human drug addiction and incentive motivation and provided valuable suggestions for further research.