Approach and Conquer: Optimizing Fear Extinction by Adding Approach?

Exposure treatment involves systematic confrontation with fear-inducing stimuli, effectively reducing fear and anxiety. However, a significant number of clients still experience a return of fear (ROF) after treatment. This study investigates whether incorporating an approach component during fear extinction, a laboratory exposure analog, could mitigate this return of fear. Furthermore, we explored the underlying mechanisms by drawing on predictions from the inhibitory learning theory and the reflective-impulsive model of behavior. In a within-subjects design, we compared instructed active approach of a stimulus during extinction to more passive non-avoidance. Contrary to expectations, our findings revealed that performing approach behavior during extinction did not reduce ROF when compared to non-avoidance. Furthermore, valence and action tendencies, which were potential mechanisms based on the reflective-impulsive model of behavior, remained unaltered. Still, a noteworthy discovery emerged in the form of increased threat expectancies for the approached stimulus during extinction, suggesting a heightened level of expectancy violation, as predicted on the basis of the inhibitory learning theory. These findings offer valuable insights into the intricate relationship between approach behavior, ROF, and underlying mechanisms, highlighting the need for further research to assess the potential benefits of emphasizing approach in exposure treatment.