A meta-analysis of conditioned fear generalization in anxiety-related disorders
A meta-analysis of conditioned fear generalization in anxiety-related disorders
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DOI：
10.1038/s41386-022-01332-2
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发表时间：
2022-04-30
影响因子：
7.6
通讯作者：
Dunsmoor, Joseph E.
中科院分区：
文献类型：
--
作者：
Cooper, Samuel E.;van Dis, Eva A. M.;Dunsmoor, Joseph E.
条件性恐惧的泛化在某些情况下是适应的，但当恐惧过度泛化为无伤大雅的刺激时，与真正的威胁线索偶然相似时，就不适应了。最近，对恐惧泛化作为焦虑相关障碍的跨诊断解释机制的经验兴趣有所增加。由于现在有几项关于多种类型的焦虑相关障碍的恐惧泛化的研究，作者对报告焦虑相关障碍与对照组的恐惧泛化的行为测量(主观评级和心理生理学指数)的研究进行了荟萃分析。我们对电子数据库进行了系统的搜索(从2020年1月至10月进行)，以寻找涉及焦虑相关障碍组或亚临床模拟组的恐惧泛化研究。总共对300条记录进行了全文筛选，获得了两个未发表的数据集，产生了16项报告行为恐惧概括措施的研究。随机效应元分析模型和元回归被应用于确定的数据。与对照参与者(N=428)相比，焦虑相关障碍参与者(N=439)的恐惧概括性显著增强。我们没有确定任何重要的临床、样本或方法学调节因素。高度的恐惧泛化从数量上支持将焦虑相关障碍组与对照组区分开来。有证据表明，这种效应是跨诊断的，对实验或样本参数相对稳健，泛化范式是研究焦虑相关障碍学习和情绪的神经行为研究的良好框架。我们在先前的恐惧条件作用元分析、过去对焦虑相关障碍中恐惧泛化的神经成像研究以及该领域未来的方向和挑战的背景下讨论了这些发现。
Generalization of conditioned fear is adaptive in some situations but maladaptive when fear excessively generalizes to innocuous stimuli with incidental resemblance to a genuine threat cue. Recently, empirical interest in fear generalization as a transdiagnostic explanatory mechanism underlying anxiety-related disorders has accelerated. As there are now several studies of fear generalization across multiple types of anxiety-related disorders, the authors conducted a meta-analysis of studies reporting behavioral measures (subjective ratings and psychophysiological indices) of fear generalization in anxiety-related disorder vs. comparison groups. We conducted systematic searches of electronic databases (conducted from January-October 2020) for fear generalization studies involving anxiety-related disorder groups or subclinical analog groups. A total of 300 records were full-text screened and two unpublished datasets were obtained, yielding 16 studies reporting behavioral fear generalization measures. Random-effects meta-analytic models and meta-regressions were applied to the identified data. Fear generalization was significantly heightened in anxiety-related disorder participants (N = 439) relative to comparison participants (N = 428). We did not identify any significant clinical, sample, or methodological moderators. Heightened fear generalization is quantitatively supported as distinguishing anxiety-related disorder groups from comparison groups. Evidence suggests this effect is transdiagnostic, relatively robust to experimental or sample parameters, and that generalization paradigms are a well-supported framework for neurobehavioral investigations of learning and emotion in anxiety-related disorders. We discuss these findings in the context of prior fear conditioning meta-analyses, past neuroimaging investigations of fear generalization in anxiety-related disorders, and future directions and challenges for the field.