Guided reactivation of personal phobic memories prior to exposure exercises prevents the renewal of fear responses in subjects with claustrophobic fears

Abstract

Background and objectives: Basic research suggest behavioral strategies for interferencing the reconsolidation of fear memories to be a promising approach in reducing clinical fears. However, first clinical studies revealed mixed results highlighting the need to identify boundary conditions. We experimentally tested the specific hypothesis that post-retrieval threat exposure prevents context renewal usually observed in protocols without fear memory reactivation.

Methods: In a preliminary investigation forty-three individuals with claustrophobic fears reactivated the individual phobic memory or not during a guided emotional imagery task and then performed standardized threat exposure to provide new information for updating the original memory. During retests seven and 28 days later, the context was different from that during treatment in half of the subjects.

Results: In those who were guided, the fear memory was successfully reactivated as indexed by increased skin conductance level (SCL) during the imagery of personal scenes relative to neutral scenes. During retests the subjects of the memory non-activation group showed a return of reported fear after context change that, however, was not observed after post-retrieval exposure. In line, autonomic arousal (SCL) decreased over time in the memory reactivation group only if the context changed during retest.

Limitations: Limited sample size and the inclusion of an analog sample reduce the generalizability of the results.

Conclusions: The reactivation of fear memory prior to treatment through guided imagery of past personal phobic situations prevented contextual renewal of phobic fears which was observed in those subjects without reactivation of memory.

Keywords: Anxiety disorders; Exposure therapy; Fear memory reconsolidation; Post-retrieval extinction.