Multiverse analyses of fear acquisition and extinction retention in posttraumatic stress disorder.
Multiverse analyses of fear acquisition and extinction retention in posttraumatic stress disorder.
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创伤后应激障碍中恐惧获得和消退保留的多元分析。
DOI：
10.1111/psyp.14265
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Rosso,IsabelleM
中科院分区：
文献类型：
--
作者：
Lewis,MichaelW;Bradford,DanielE;Pace-Schott,EdwardF;Rauch,ScottL;Rosso,IsabelleM
持续恐惧是创伤后应激障碍(PTSD)的一个基本特征，缺乏恐惧消退保持是暴露治疗的一种发病机制和靶点。然而，关于创伤后应激障碍中恐惧消退不足的证据在实验室范例中被混杂在一起，这可能与研究中未被发现的方法学差异有关。我们回顾了文献，以确定不同研究中关于创伤后应激障碍中恐惧消退保留的参数。然后，我们在一个新的样本中进行了多元宇宙分析，以量化这些方法参数对统计结果的影响。在25例创伤后应激障碍患者(女性15例)和36例创伤暴露非创伤后应激障碍对照(TENC)(女性20例)中，我们记录了恐惧获得和消退学习(第1天)和消退回忆(第2天)时的皮肤电导反应(SCR)。第一个多元分析检验了文献综述确定的方法参数对PTSD和TENC中基于SCR的恐惧消退保持的比较的影响。第二个多元宇宙分析考察了这些方法参数对恐惧习得过程中SCR与危险线索(CS+)和安全线索(CS−)的比较的影响。文献综述和多元世界分析都得出了PTSD和TENC中恐惧消退保持不一致的结果，大多数分析发现没有统计学上的显著差异。相比之下，在文献综述和对新数据的多元分析中，在所有分析中一致发现，Scr显著提高到CS+而不是CS−。我们讨论了可能导致创伤后应激障碍中恐惧消退、保留缺陷的不一致发现的方法学参数，以及对未来临床研究的启示。
Persistent fear is a cardinal feature of posttraumatic stress disorder (PTSD), and deficient fear extinction retention is a proposed illness mechanism and target of exposure‐based therapy. However, evidence for deficient fear extinction in PTSD has been mixed using laboratory paradigms, which may relate to underidentified methodological variation across studies. We reviewed the literature to identify parameters that differ across studies of fear extinction retention in PTSD. We then performed Multiverse Analysis in a new sample, to quantify the impact of those methodological parameters on statistical findings. In 25 PTSD patients (15 female) and 36 trauma‐exposed non‐PTSD controls (TENC) (20 female), we recorded skin conductance response (SCR) during fear acquisition and extinction learning (day 1) and extinction recall (day 2). A first Multiverse Analysis examined the effects of methodological parameters identified by the literature review on comparisons of SCR‐based fear extinction retention in PTSD versus TENC. A second Multiverse Analysis examined the effects of those methodological parameters on comparisons of SCR to a danger cue (CS+) versus safety cue (CS−) during fear acquisition. Both the literature review and the Multiverse Analysis yielded inconsistent findings for fear extinction retention in PTSD versus TENC, and most analyses found no statistically significant group difference. By contrast, significantly elevated SCR to CS+ versus CS− was consistently found across all analyses in the literature review and the Multiverse Analysis of new data. We discuss methodological parameters that may most contribute to inconsistent findings of fear extinction retention deficit in PTSD and implications for future clinical research.