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Abstract：
Fear conditioning and extinction serve as a dominant model for the development and maintenance of pathological anxiety, particularly for phasic fear to specific stimuli or situations. The validity of this model would be supported by differences in the physiological or subjective fear response between patients with fear-related disorders and healthy controls, whereas the model\'s validity would be questioned by a lack of such differences. We derived pupillometry, skin conductance response and startle electromyography as well as unconditioned stimulus expectancy in a two-day fear acquisition, immediate extinction and recall task and compared an unmedicated group of patients (n = 73) with phobias or panic disorder and a group of patients with posttraumatic stress disorder (PTSD, n = 21) to a group of carefully screened healthy controls (n = 35). Bayesian statistics showed no convincing evidence for a difference in physiological and subjective responses between the groups during fear acquisition, extinction learning or recall. Only the PTSD subgroup had altered startle reactions during extinction learning. Our data do not provide evidence for general differences in associative fear or extinction learning in fear-related pathologies and thereby question the diagnostic validity of the associative fear learning model of these disorders.
摘要：
恐惧调节和灭绝是病理性焦虑发展和维持的主要模型，特别是对特定刺激或情况的阶段性恐惧。该模型的有效性将得到恐惧相关障碍患者和健康对照者之间生理或主观恐惧反应差异的支持。而该模型的有效性将因缺乏这种差异而受到质疑。我们推导了瞳孔测量，在两天的恐惧获取中，皮肤电导反应和惊吓肌电图以及无条件刺激预期，立即灭绝和回忆任务，并比较了一组患有恐惧症或惊恐障碍的患者（n=73）和一组患有创伤后应激障碍的患者（PTSD，n=21）至一组仔细筛选的健康对照（n=35）。贝叶斯统计没有令人信服的证据表明，在恐惧获取过程中，两组之间的生理和主观反应存在差异，灭绝学习或回忆。在灭绝学习过程中，只有PTSD亚组改变了惊吓反应。我们的数据没有提供证据证明恐惧相关病理中联想恐惧或灭绝学习的一般差异，从而质疑这些疾病的联想恐惧学习模型的诊断有效性。
