Manish Kumar Asthana

Post-retrieval extinction has been proposed to modify fear memories by introducing safety information during the reconsolidation window. Imagery rescripting (ImRS) is a visual imagery-based intervention that alters the valence of emotional memories through UCS revaluation. The integration of ImRS and extinction targets both UCS revaluation and expectancy revaluation, providing a dual mechanism for fear reduction. This study explores the combined effects of imagery rescripting (ImRS) and extinction during the reconsolidation window to attenuate the return of generalised fear. Sixty-one healthy individuals underwent fear acquisition and generalisation (Day 1), followed by intervention (Day 2: Reactivation- ImRS and Extinction group or ImRS and Extinction group). On Day 3, return of generalised fear through reinstatement was tested using unsignalled UCS presentations. Skin conductance responses (SCR), expectancy ratings, and valence ratings were the outcome measures. The reactivation-ImRS + extinction group showed reduced reinstatement effects compared to the ImRS + extinction group, evidenced by attenuated SCR and increased CS+ valence ratings. The current study suggests that imagery rescripting and extinction conducted post-retrieval is more effective in reducing the return of conditioned fear. Therefore, integrating ImRS with post-retrieval extinction may offer a novel therapeutic pathway for reducing fear relapse.

Extinction learning although initially successful in blocking fear responses, can result in relapse in some individuals over time. This deficit demands a strategy that could reinforce the extinction of fear. The current study aimed to investigate the top-down regulatory processes like cognitive reappraisal and the nature of reappraisal on augmentation of fear extinction and retention. We used a screaming lady fear conditioning paradigm with 63 participants (M = 43, F = 20; Mean (SD) age = 20.6 (1.40) years) and subjective fear, valence, expectancy ratings and skin conductance response (SCR) as outcome measures. The participants were randomly assigned into three groups: creative reappraisal, ordinary reappraisal and standard extinction groups and completed acquisition (day 1), extinction (day 2) and extinction-retest (day 3) phases. Our results indicate that cognitive reappraisal aimed at reducing the aversiveness of the UCS does not disrupt prediction error during extinction. Our results did not indicate any enhanced effect of cognitive reappraisal on subjective and physiological measures of conditioned fear responses during extinction. Our findings highlight the gap between the implementation of cognitive reappraisal and successful affective outcomes. Effective cognitive reappraisal requires careful consideration of factors like cognitive effort, situation intensity, reappraisal affordance, implementation cost and appraisals associated with fear. Interventions aimed at enhancing extinction through cognitive reappraisal should consider these factors for the effective implementation of cognitive reappraisal.