Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Anxiety disorders are prevalent in the population and costly for society, while current treatment is not effective in all individuals. A central symptom of anxiety is avoidance behaviour, with excessive avoidance being predictive of poor clinical outcomes. Appetitive motivation could play a role in decreasing avoidance behaviour by increasing the positive valuation of the feared object. The current study used an approach-avoidance conflict paradigm to measure costly avoidance behaviour in a healthy group of 22 participants. During counterconditioning training one stimulus was followed by eating a tasty snack (CS+), while another was never followed by an outcome (CS-). Results indicated that the CC-training was effective in reducing negative valuation and decreasing avoidance behaviour for the CS+. This study showed the importance of appetitive motivation for avoidance behaviour, suggesting that treatment may benefit from focussing on increasing appetitive motivation to overcome avoidance.