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Journal of the Experimental Analysis of... Mar 2024Following successful treatment in which problem behavior is reduced, it may reemerge as a function of changes in contextual stimuli or the worsening of reinforcement... (Review)
Review
Following successful treatment in which problem behavior is reduced, it may reemerge as a function of changes in contextual stimuli or the worsening of reinforcement conditions for an alternative response. Although understudied, preliminary research suggests that simultaneous changes in contextual stimuli and reinforcement conditions may represent particularly exigent treatment challenges that create the condition for additive or superadditive relapse. The purpose of the present review was to systematically examine the relapse literature involving simultaneous changes in contextual stimuli and reinforcement conditions in relapse tests and experimental preparations arranged to evaluate their effect on response recovery. We identified 16 empirical articles spanning 27 experiments. Although all experiments included at least one condition that experienced a change in contextual stimuli and worsening of alternative reinforcement conditions, only two experiments included the comparison conditions needed to precisely evaluate additive and superadditive relapse. Our findings establish the preclinical generality of relapse effects associated with simultaneous changes to reinforcement conditions and contextual stimuli across a range of subjects, schedule arrangements, response topographies, reinforcers, and types of contextual changes. We make several recommendations for future research based on our findings from this nascent and clinically relevant subdomain of the relapse literature.
Topics: Humans; Conditioning, Operant; Extinction, Psychological; Reinforcement, Psychology; Recurrence; Problem Behavior; Reinforcement Schedule
PubMed: 38287780
DOI: 10.1002/jeab.902 -
Behaviour Research and Therapy Mar 2024Fear conditioning is a common experimental paradigm for modelling the development, and exposure-based treatment, of anxiety disorders. Measures of fear such as...
Fear conditioning is a common experimental paradigm for modelling the development, and exposure-based treatment, of anxiety disorders. Measures of fear such as threat-expectancy, physiological arousal, and fear ratings typically extinguish, however feared stimuli may still be evaluated negatively (i.e. retain negative valence). This systematic review provides the first investigation of the relationship between fear conditioning methodology and extinction of negative stimulus valence. Principal findings were that type of CS (conditioned stimulus) and the CS-US pairing (i.e. specific combination of CS and unconditioned stimulus) predicted extinction outcome. Extinction of absolute negative CS valence was always achieved with shape CSs; often achieved with low fear-relevant animals as CSs, and less frequently achieved with faces as CSs - particularly neutral faces paired with a shock US. Modified extinction procedures typically achieved the same outcome as standard extinction procedures, except for partially-reinforced extinction, which was less effective than standard extinction, and positive imagery training, which was more effective than standard extinction. Further studies are warranted to evaluate the influence of fear conditioning methodology on extinction of absolute negative CS valence.
Topics: Humans; Extinction, Psychological; Fear; Conditioning, Classical; Anxiety Disorders; Conditioning, Operant
PubMed: 38281443
DOI: 10.1016/j.brat.2024.104477 -
CNS Drugs Dec 2023The renewed interest in psychedelic research provides growing evidence of potentially unique effects on various aspects of reward processing systems. Using the Research...
BACKGROUND AND OBJECTIVES
The renewed interest in psychedelic research provides growing evidence of potentially unique effects on various aspects of reward processing systems. Using the Research Domain Criteria (RDoC) framework, as proposed by the National Institute of Mental Health, we aim to synthesize the existing literature concerning the impact of lysergic acid diethylamide (LSD) on the RDoC's Positive Valence Systems (PVS) domain, and to identify potential avenues for further research.
METHODS
Two LSD-related terms (lysergic acid diethylamide and LSD) and 13 PVS-related terms (reward, happiness, bliss, motivation, reinforcement learning, operant, conditioning, satisfaction, decision making, habit, valence, affect, mood) were used to search electronic databases such as PubMed, Scopus, PsychINFO, and Web of Science for relevant articles. A manual search of the reference list resulted in nine additional articles. After screening, articles and data were evaluated and included based on their relevance to the objective of investigating the effects of LSD on the PVS. Articles and data were excluded if they did not provide information about the PVS, were observational in nature, lacked comparators or reference groups, or were duplicates. A risk of bias assessment was performed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias (RoB) tool. Data from the included articles were collected and structured based on the RDoC bio-behavioral matrix, specifically focusing on the PVS domain and its three constituent constructs: reward responsiveness, reward learning, and reward valuation.
RESULTS
We reviewed 28 clinical studies with 477 participants. Lysergic acid diethylamide, assessed at self-report (23 studies), molecular (5 studies), circuit (4 studies), and paradigm (3 studies) levels, exhibited dose-dependent mood improvement (20 short-term and 3 long-term studies). The subjective and neural effects of LSD were linked to the 5-HT receptor (molecular). Animal studies (14 studies) suggested LSD could mildly reinforce conditioned place preference without aversion and reduce responsiveness to other rewards. Findings on reward learning were inconsistent but hinted at potential associative learning enhancements. Reward valuation measures indicated potential reductions in effort expenditure for other reinforcers.
CONCLUSION
Our findings are consistent with our previous work, which indicated classical psychedelics, primarily serotonin 2A receptor agonists, enhanced reward responsiveness in healthy individuals and patient populations. Lysergic acid diethylamide exhibits a unique profile in the reward learning and valuation constructs. Using the RDoC-based framework, we identified areas for future research, enhancing our understanding of the impact of LSD on reward processing. However, applying RDoC to psychedelic research faces limitations due to diverse study designs that were not initially RDoC-oriented. Limitations include subjective outcome measure selection aligned with RDoC constructs and potential bias in synthesizing varied studies. Additionally, some human studies were open-label, introducing potential bias compared to randomized, blinded studies.
Topics: Animals; Humans; Hallucinogens; Lysergic Acid Diethylamide; Serotonin Receptor Agonists; Affect; Self Report
PubMed: 37999867
DOI: 10.1007/s40263-023-01044-1 -
The European Journal of Neuroscience Mar 2024Dopamine, a catecholamine neurotransmitter, has historically been associated with the encoding of reward, whereas its role in aversion has received less attention. Here,...
Dopamine, a catecholamine neurotransmitter, has historically been associated with the encoding of reward, whereas its role in aversion has received less attention. Here, we systematically gathered the vast evidence of the role of dopamine in the simplest forms of aversive learning: classical fear conditioning and extinction. In the past, crude methods were used to augment or inhibit dopamine to study its relationship with fear conditioning and extinction. More advanced techniques such as conditional genetic, chemogenic and optogenetic approaches now provide causal evidence for dopamine's role in these learning processes. Dopamine neurons encode conditioned stimuli during fear conditioning and extinction and convey the signal via activation of D receptor sites particularly in the amygdala, prefrontal cortex and striatum. The coordinated activation of dopamine receptors allows for the continuous formation, consolidation, retrieval and updating of fear and extinction memory in a dynamic and reciprocal manner. Based on the reviewed literature, we conclude that dopamine is crucial for the encoding of classical fear conditioning and extinction and contributes in a way that is comparable to its role in encoding reward.
Topics: Dopamine; Extinction, Psychological; Conditioning, Classical; Fear; Prefrontal Cortex; Avoidance Learning
PubMed: 37848184
DOI: 10.1111/ejn.16157 -
Quantifying Fear Avoidance Behaviors in People With Concussion: A COSMIN-Informed Systematic Review.The Journal of Orthopaedic and Sports... Sep 2023The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess...
The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess fear avoidance behavior in individuals with concussion and (2) assess the measurement properties of these PROMs. A systematic review of outcome measurement instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We performed a systematic search of 7 databases. Studies were included if they assessed fear avoidance behavior (eg, kinesiophobia or cogniphobia) in participants with concussion, occurring in all settings (eg, sport, falls, assaults). Methodological quality of the PROMs was assessed using the COSMIN checklist, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We identified 40 studies assessing fear avoidance. Four studies (n = 875 participants, representing 3 PROMs) were eligible for COSMIN assessment. Content validity for all PROMs was insufficient due to extreme risk of bias. The Fear Avoidance Short Form Scale demonstrated the greatest validity: moderate-certainty evidence for sufficient structural validity and internal consistency, and low-certainty evidence for measurement invariance. Current PROMs for measuring fear avoidance behaviors in people with concussion have insufficient content validity and should be used with caution in research and clinical practice. .
Topics: Humans; Avoidance Learning; Psychometrics; Brain Concussion; Checklist; Sports; Patient Reported Outcome Measures; Quality of Life; Reproducibility of Results
PubMed: 37561611
DOI: 10.2519/jospt.2023.11685 -
Behavioural Brain Research Aug 2023In clinical research, aberrant avoidance behavior and inhibitory control deficit have a high comorbidity in different psychopathological disorders. Therefore, avoidance... (Review)
Review
In clinical research, aberrant avoidance behavior and inhibitory control deficit have a high comorbidity in different psychopathological disorders. Therefore, avoidance and impulsive and/or compulsive behaviors might be classified as transdiagnostic traits, where the assessment through animal models could address evidence of their contribution as neurobehavioral mechanisms in psychopathology. The objective of the present review has been to assess the avoidance trait and the implication of inhibitory control behaviors, through studies using passive and active avoidance tests in rodents, and a preclinical model using selective breeding of high- or low-avoidance Roman rats (RHA, RLA). A systematic search strategy was carried out in the PubMed and Web of Science databases, where a total of 40 studies were accepted in the qualitative synthesis. The results of the different studies reviewed pointed to a relation between a reduced avoidance profile in passive avoidance (PA) with impulsive decision making and novelty-seeking behaviors; an increased avoidance profile in PA with compulsive drinking; a high active avoidance profile, including RHA rats, with different types of impulsivity and novelty- seeking behaviors; and regarding compulsivity depending on its measure, a low active avoidance profile, including RLA rats, has been associated with increased anxiety in the EPM and increased grooming, while a high active avoidance profile, including RHA rats, has been associated with increased rearing, compulsive drinking including alcohol, and cognitive inflexibility. The results have been discussed in terms of environmental factors and the underlying mechanisms between these possible transdiagnostic traits in psychopathology.
Topics: Rats; Animals; Avoidance Learning; Exploratory Behavior; Models, Animal; Phenotype; Ethanol; Behavior, Animal
PubMed: 37207979
DOI: 10.1016/j.bbr.2023.114500 -
The Clinical Journal of Pain Aug 2023Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore...
OBJECTIVES
Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore important to determine the relationship between these consequences and pain management strategies such as activity pacing. This review aimed to examine the association between activity pacing and the level of negative emotions in chronic pain. A second objective was to explore sex differences in this association.
METHODS
A systematic review of the literature was conducted following the PRISMA guidelines. Three independent reviewers used a combination of keywords within four databases to include studies examining the link between pacing and negative emotions in chronic pain.
RESULTS
Pacing was associated with less negative emotions when measured using multidimensional tools, distinguishing it from avoidance, and highlighting the major components of pacing, such as maintaining a constant activity or conserving energy. Data did not allow examination of sex differences.
DISCUSSION
Pacing is multidimensional and consists of various strategies of pain management which are not equally associated with negative emotions. It is important to use measures reflecting this conception to strengthen knowledges about the role of pacing in the development of negative emotions.
Topics: Humans; Male; Female; Chronic Pain; Motor Activity; Pain Management; Avoidance Learning; Emotions
PubMed: 37154604
DOI: 10.1097/AJP.0000000000001128 -
JMIR MHealth and UHealth Mar 2022Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is... (Review)
Review
BACKGROUND
Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is potentially effective for delivering PFMT to pregnant women. Persuasive technology in the development of such mobile apps may facilitate behavior change by improving adherence to the exercises. The Capability, Opportunity, and Motivation-Behavior (COM-B) model is potentially useful in selecting the appropriate interventions to be incorporated into the apps.
OBJECTIVE
This review of mHealth apps for PFMT aims to describe the principles of persuasion used for each app and to propose mHealth app design features based on the COM-B model.
METHODS
A systematic literature search was conducted to answer three main research questions: what are the available mHealth apps for PFMT in the published literature, what persuasive strategies were used in their studies how were they mapped to the COM-B model, and how effective were the selected persuasive strategies for PFMT adherence? We searched PubMed, CINAHL, Web of Science, Scopus, and local Malaysian databases such as MyCite and MyMedR for articles reporting mHealth apps used for the delivery of PFMT. We included original articles reporting experimental and cross-sectional studies, including pilot or feasibility trials. Systematic and narrative reviews were excluded. Narrative and thematic syntheses were conducted on the eligible articles based on the research questions. The Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Non-randomized Studies were used to assess study bias.
RESULTS
Of the 169 records from the initial search, 10 (5.9%) articles meeting the selection criteria were included in this review. There were 8 mHealth apps designed for the delivery of PFMT. The Tät, which used 3 categories of persuasive system design, improved PFMT adherence and was cost-effective. Only 1 app, the iBall app, used all categories of persuasive system design, by including social support such as "competition" in its design. The Diário Saúde app was the only app developed using operant conditioning. All apps incorporated Tailoring and Expertise as part of their PSD strategies. Only 3 apps, the Diário Saúde, Tät, and Pen Yi Kang demonstrated improved PFMT adherence.
CONCLUSIONS
Persuasive technology used in mobile apps may target desired behavior change more effectively. The persuasive system design can be mapped to the COM-B model to explain its effectiveness on behaviour change outcomes.
Topics: Cross-Sectional Studies; Female; Humans; Mobile Applications; Pelvic Floor; Persuasive Communication; Pregnancy; Technology; Telemedicine
PubMed: 35315777
DOI: 10.2196/28751 -
Acta Orthopaedica Et Traumatologica... May 2021The aim of this study was to systematically review whether the altered central pain modulation has a significant influence on post-surgical outcomes in patients...
OBJECTIVE
The aim of this study was to systematically review whether the altered central pain modulation has a significant influence on post-surgical outcomes in patients undergoing shoulder surgery due to musculoskeletal disorders.
METHODS
A systematic search of MEDLINE, PEDro, and EMBASE was conducted without time restriction, including observational prognostic studies. Quality in Prognostic Studies Tool was adopted for critical appraisal, and a qualitative synthesis was undertaken. Two authors independently performed study selection, data extraction, and risk of bias assessment; any disagreement was resolved by a third author. A review protocol is published in the PROSPERO registry (CRD42019122303). The data regarding the potential predictors and outcome measures were obtained from the studies.
RESULTS
11 prospective cohort studies were appraised. Overall, 952 patients were included with a sample size that ranged from 20 to 314. Studies included both arthroscopy and open surgery and presented low to moderate ROB. The prognostic factors investigated were depression, psychological distress, anxiety, catastrophizing, fear avoidance beliefs, self-efficacy and quantitative sensory testing. Only avoidance behaviors and self-efficacy were significantly related to post-surgical pain and function at 12 months after surgery.
CONCLUSION
Fear avoidance beliefs and inadequate coping strategies seem to be the most correlated factors with the worst pain and function scores. Surgeons and physical therapists should look for patients with signs of altered central pain modulation before surgery as they might be at risk of unfavorable outcome.
LEVEL OF EVIDENCE
Level II, Therapeutic Study.
Topics: Adaptation, Psychological; Avoidance Learning; Fear; Humans; Musculoskeletal Diseases; Pain Perception; Pain, Postoperative; Shoulder Pain; Surgical Procedures, Operative
PubMed: 34100363
DOI: 10.5152/j.aott.2021.20125 -
Journal of the American Academy of... Nov 2021Although instrumental learning deficits are, among other deficits, assumed to contribute to attention-deficit/hyperactivity disorder (ADHD), no comprehensive systematic...
OBJECTIVE
Although instrumental learning deficits are, among other deficits, assumed to contribute to attention-deficit/hyperactivity disorder (ADHD), no comprehensive systematic review of instrumental learning deficits in ADHD exists. This review examines differences between ADHD and typically developing (TD) children in basic instrumental learning and the effects of reinforcement form, magnitude, schedule, and complexity, as well as effects of medication, on instrumental learning in children with ADHD.
METHOD
A systematic search of PubMed, PsyINFO, CINAHL, EMBASE+EMBASE CLASSIC, ERIC, and Web of Science was conducted for articles up to March 16, 2020. Experimental studies comparing instrumental learning between groups (ADHD versus TD) or a manipulation of reinforcement/medication within an ADHD sample were included. Quality of studies was assessed with an adapted version of the Hombrados and Waddington criteria to assess risk of bias in (quasi-) experimental studies.
RESULTS
A total of 19 studies from among 3,384 non-duplicate screened articles were included. No difference in basic instrumental learning was found between children with ADHD and TD children, nor effects of form or magnitude of reinforcement. Results regarding reinforcement schedule and reversal learning were mixed, but children with ADHD seemed to show deficits in conditional discrimination learning compared to TD children. Methylphenidate improved instrumental learning in children with ADHD. Quality assessment showed poor quality of studies with respect to sample sizes and outcome and missing data reporting.
CONCLUSION
The review identified very few and highly heterogenous studies, with inconsistent findings. No clear deficit was found in instrumental learning under laboratory conditions. Children with ADHD do show deficits in complex forms of learning, that is, conditional discrimination learning. Clearly more research is needed, using more similar task designs and manipulations.
Topics: Attention Deficit Disorder with Hyperactivity; Child; Conditioning, Operant; Humans; Learning; Methylphenidate
PubMed: 33862167
DOI: 10.1016/j.jaac.2021.03.009