Increased Generalization, Stronger Acquisition, or Reduced Extinction? Investigation of the Mechanisms Underlying the Acquisition-in-Multiple-Contexts Effect.

Prior research has demonstrated that conducting acquisition in multiple contexts results in more responding to the point that it can even nullify the benefit of subsequent extinction in multiple contexts on reducing renewal of excitatory responding. The underlying mechanism to explain why this happens has not been systematically examined. Using self-reported expectancy of the outcome, the current study investigates three mechanisms that potentially explain why acquisition in multiple contexts results in more responding-greater generalization, stronger acquisition learning, or slower extinction learning. Participants (N = 180) received discriminative training with a conditioned stimulus (CS+) and outcome pairing and a CS- → noOutcome pairing in either one or three contexts. This was followed by either extinction treatment in a novel context or no extinction. Finally, testing occurred in the acquisition context, the extinction context, or a novel context. Stronger renewal of extinguished conditioned expectation was observed for participants who received CS+ → Outcome pairings in three contexts relative to one context. There was no effect of the number of contexts on the strength of the excitatory CS+ → Outcome association or degree of inhibitory learning that occurred during extinction. This suggests that generalization is the mechanism responsible for the adverse impact to extinction learning when acquisition is conducted in multiple contexts.

Application of Dialectical Behaviour Therapy in treating common psychiatric disorders: study protocol for a scoping review.

INTRODUCTION: Dialectical behaviour therapy (DBT) is a well-known intervention for treating borderline personality disorder, and has been increasingly adapted for other disorders. Standard DBT consists of four treatment modes, delivered over a year. Adaptations to DBT include changes to modes of delivery, treatment length, and skills modules taught to clients, or incorporating interventions from other evidence-based therapies. There is a need to synthesise existing evidence on DBT so that stakeholders-clinicians, researchers and policymakers-can understand how it has been provided for various psychiatric conditions, and whether it has been effective. METHODS AND ANALYSIS: This study proposes a scoping review conducted according to Arksey and O'Malley's (2005) procedures, to map and summarise the literature on DBT interventions for treating a range of psychiatric concerns. Electronic databases (ie, the Cochrane Central Register of Controlled Trials, PubMed, PsycINFO, SCOPUS, EBSCOhost and ProQuest Dissertations and Theses), conference proceedings and the US National Institutes of Health Ongoing Trial Register will be searched for intervention studies that involve a control or comparison group, and that report quantitative data on pre/post-measures for psychiatric symptom severity. The initial search was conducted on 18 September 2020, and data charting has not commenced. An update will be performed in September 2022, pending this protocol's publication. Data charting will collect individual studies' characteristics, methodology and reported findings. Outcomes will be reported by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews. ETHICS AND DISSEMINATION: No ethical approval is required for this study. The goal of dissemination is to keep DBT stakeholders abreast on latest updates in clinical applications of DBT. Findings from this research are intended to inform a more specific topic of study (eg, a meta-analysis), to further aid in the development of DBT interventions for psychiatric populations. REGISTRATION DETAILS: The study protocol was pre-registered with the Open Science Framework on 24 August 2021 (https://osf.io/vx6gw).

Gaining insights on the influence of attention, anxiety, and anticipation on pain perception.

PURPOSE: This article highlights the influence of attention and pain anticipation on pain attenuation. Pain-related trait anxiety was found to moderate the effect that attention strategies impose on pain perception. This article may contribute to clinical treatments quality, where pain attenuation effect is desired. PARTICIPANTS AND METHODS: One hundred seven participants, comprising of 72 (67%) females and 35 (33%) males between the age of 17 and 48 (M=22.6, SD =4.36), were used in the analysis. The current study measured the effect of pain anticipation and attention on three aspects of pain perception: threshold, tolerance, and perceived pain intensity. Pain anticipation was manipulated by varying the amount of information given to participants about a future pain stimulus. Attention was manipulated through a sensory focusing task and a distraction task. Participants were randomized into 1) InfoControl group with distraction task trial (n=30), 2) InfoControl group with attention to pain trial (n=26), 3) InfoExtra group with distraction task trial (n=26), or 4) InfoExtra group with attention to pain trial (n=25). The pain stimulus was delivered in a form of heat. The moderating effects of pain-related trait anxiety on these variables were also investigated using Pain Anxiety Symptom Scale Short Form. RESULTS: Two structural equation models revealed that anticipation is not a predictor of pain perception and neither did it interact with pain-related trait anxiety. However, attention strategies do significantly relate to pain perception. Furthermore, pain-related anxiety was a significant moderator of attention and pain attenuation. These findings imply that the effectiveness of attention strategies in attenuating pain is affected by individuals' pain-related trait anxiety. CONCLUSION: The results suggest the importance of appointing the appropriate attention strategy to different individuals with varying level of trait anxiety. Future explorations are necessary to develop a more specific understanding on the nature of information and distractions on pain perception.

Proactive interference by cues presented without outcomes: Differences in context specificity of latent inhibition and conditioned inhibition.

This report is part of a larger project examining associative interference as a function of the nature of the interfering and target associations. Lick suppression experiments with rats assessed the effects of context shifts on proactive outcome interference by latent inhibition (LI) and Pavlovian conditioned inhibition (CI) treatments on subsequently trained Pavlovian conditioned excitation treatment. LI and CI were trained in Context A during Phase 1, and then excitation treatment was administered in Context B during Phase 2, followed by tests for conditioned excitation in Contexts A, B, or C. Experiment 1 preliminarily established our LI and CI treatments and resulted in equally retarded acquisition of behavioral control when the target cue was subsequently trained as a conditioned excitor and tested in Context A. However, only CI treatment caused the target to pass a summation test for inhibition. Centrally, Experiment 2 consisted of LI and CI treatments in Context A followed by excitatory training in Context B. Testing found low excitatory control by both LI and CI cues in Context A relative to strong excitatory control in Context B, but CI treatment transferred to Context C more strongly than LI treatment. Experiment 3 determined that LI treatment failed to transfer to Context C even when the number of LI trials was greatly increased. Thus, first-learned LI appears to be relatively context specific, whereas first-learned CI generalizes to a neutral context. These observations add to existing evidence that LI and CI treatments result in different types of learning that diverge sharply in transfer to a novel test context.

Involving relatives in ICU patient care: critical care nursing challenges.

AIMS AND OBJECTIVES: To identify the barriers critical care nurses experience to relative involvement in intensive care unit patient care. BACKGROUND: Previous studies have discussed the experiences of relatives visiting an intensive care unit, the needs of relatives in the intensive care environment, critical care nurse and relative interaction, intensive care unit visiting policies and the benefits of including relatives in patient care. The barriers that critical care nurses experience to relative involvement in patient care have received minimal exploration. DESIGN: Critical care nurses were recruited for a mixed methods study. An explanatory mixed method design was used, with two phases. Phase 1 was Quantitative and Phase 2 was Qualitative. METHODS: Data collection occurred over five months in 2012-2013. Phase 1 used an online questionnaire (n = 70), and semi-structured interviews (n = 6) were conducted in Phase 2. Phase 1 participants were 70 critical care nurses working in Australian intensive care units and six critical care nurses were recruited from a single Sydney intensive care unit for Phase 2. Through sequential data collection, Phase 1 results formed the development of Phase 2 interview questions. RESULTS: Participants reported various barriers to relative involvement in critically ill patient care. Factors related to the intensive care unit patient, the intensive care unit relative, the critical care nurse and the intensive care environment contributed to difficulties encompassing relative involvement. CONCLUSIONS: This study has identified that when considering relative involvement in patient care, critical care nurses take on a paternalistic role. The barriers experienced to relative involvement result in the individual critical care nurse deciding to include or exclude relatives from patient care. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the barriers to relative involvement in critically ill patient care may provide a basis for improving discussion on this topic and may assist intensive care units to implement strategies to reduce barriers.

Associative Accounts of Recovery-from-Extinction Effects.

Recovery-from-extinction effects (e.g., spontaneous recovery, renewal, reinstatement, and facilitated reacquisition) have become the focus of much research in recent years. However, despite a great deal of empirical data, there are few theoretical explanations for these effects. This paucity poses a severe limitation on our understanding of these behavioral effects, impedes advances in uncovering neural mechanisms of response recovery, and reduces our potential to prevent relapse after exposure therapy. Towards correcting this oversight, this review takes prominent models of associative learning that have been used in the past and continue to be used today to explain Pavlovian conditioning and extinction, and assesses how each model can be applied to account for recovery-from-extinction effects. The models include the Rescorla-Wagner (1972) model, Mackintosh's (1975) attentional model, Pearce and Hall's (1980) attentional model, Wagner's (1981) SOP model, Pearce's (1987) configural model, McLaren and Mackintosh's (2002) elemental model, and Stout and Miller's (2007) SOCR (comparator hypothesis) model. Each model is assessed for how well it explains or does not explain the various recovery-from-extinction phenomena. We offer some suggestions for how the models might be modified to account for these effects in those instances in which they initially fail.

Associative foundation of causal learning in rats.

Are humans unique in their ability to interpret exogenous events as causes? We addressed this question by observing the behavior of rats for indications of causal learning. Within an operant motor-sensory preconditioning paradigm, associative surgical techniques revealed that rats attempted to control an outcome (i.e., a potential effect) by manipulating a potential exogenous cause (i.e., an intervention). Rats were able to generate an innocuous auditory stimulus. This stimulus was then paired with an aversive stimulus. The animals subsequently avoided potential generation of the predictive cue, but not if the aversive stimulus was subsequently devalued or the predictive cue was extinguished (Exp. 1). In Experiment 2, we demonstrated that the aversive stimulus we used was in fact aversive, that it was subject to devaluation, that the cue-aversive stimulus pairings did make the cue a conditioned stimulus, and that the cue was subject to extinction. In Experiments 3 and 4, we established that the decrease in leverpressing observed in Experiment 1 was goal-directed instrumental behavior rather than purely a product of Pavlovian conditioning. To the extent that interventions suggest causal reasoning, it appears that causal reasoning can be based on associations between contiguous exogenous events. Thus, contiguity appears capable of establishing causal relationships between exogenous events. Our results challenge the widely held view that causal learning is uniquely human, and suggest that causal learning is explicable in an associative framework.

Extinction with multiple excitors.

Four conditioned suppression experiments with rats, using an ABC renewal design, investigated the effects of compounding the target conditioned excitor with additional, nontarget conditioned excitors during extinction. Experiment 1 showed stronger extinction, as evidenced by less renewal, when the target excitor was extinguished in compound with a second excitor, relative to when it was extinguished with associatively neutral stimuli. Critically, this deepened extinction effect was attenuated (i.e., more renewal occurred) when a third excitor was added during extinction training. This novel demonstration contradicts the predictions of associative learning models based on total error reduction, but it is explicable in terms of a counteraction effect within the framework of the extended comparator hypothesis. The attenuated deepened extinction effect was replicated in Experiments 2a and 3, which also showed that pretraining consisting of weakening the association between the two additional excitors (Experiments 2a and 2b) or weakening the association between one of the additional excitors and the unconditioned stimulus (Experiment 3) attenuated the counteraction effect, thereby resulting in a decrease in responding to the target excitor. These results suggest that more than simple total error reduction determines responding after extinction.

Contrasting predictions of extended comparator hypothesis and acquisition-focused models of learning concerning retrospective revaluation.

Three conditioned suppression experiments with rats investigated contrasting predictions made by the extended comparator hypothesis and acquisition-focused models of learning, specifically, modified SOP and the revised Rescorla-Wagner model, concerning retrospective revaluation. Two target cues (X and Y) were partially reinforced using a stimulus relative validity design (i.e., AX-Outcome; BX-No outcome; CY-Outcome; DY-No outcome), and subsequently one of the companion cues for each target was extinguished in compound (BC-No outcome). In Experiment 1, which used spaced trials for relative validity training, greater suppression was observed to target cue Y for which the excitatory companion cue had been extinguished in relation to target cue X for which the nonexcitatory companion cue had been extinguished. Experiment 2 replicated these results in a sensory preconditioning preparation. Experiment 3 massed the trials during relative validity training, and the opposite pattern of data was observed. The results are consistent with the predictions of the extended comparator hypothesis. Furthermore, this set of experiments is unique in being able to differentiate between these models without invoking higher-order comparator processes.

Protection from extinction provided by a conditioned inhibitor.

Three conditioned suppression experiments with rats as subjects investigated the influence of higher order associations in determining the response potential of a target stimulus. In these experiments, a Pavlovian conditioned inhibitor was compounded with the target cue during extinction treatment. In Experiment 1, strong suppression was observed to the target cue that was given extinction treatment in the presence of a conditioned inhibitor, relative to a target that was extinguished with an associatively neutral cue or was extinguished alone, suggestive of enhanced protection from extinction provided by a conditioned inhibitor. This effect was replicated in a sensory preconditioning preparation in Experiment 2; in Experiment 3, in a sensory preconditioning preparation, this protection effect was retroactively attenuated when the conditioned excitor used to train the conditioned inhibitor was extinguished following extinction of the target. This provides evidence that, at least in a sensory preconditioning preparation, stimuli that are only indirectly associated with the target cue can contribute to the response potential of that target.

Protection from latent inhibition provided by a conditioned inhibitor.

Two conditioned suppression experiments with rats investigated the influence on latent inhibition of compounding a Pavlovian conditioned inhibitor with the target cue during preexposure treatment. Results were compared with those of subjects that received conventional latent inhibition training, no preexposure, or preexposure to the target cue in compound with a neutral stimulus. In Experiment 1, greater attenuation of the latent inhibition effect was observed in subjects that received target preexposure in compound with a Pavlovian conditioned inhibitor relative to subjects that received preexposure with a neutral stimulus or to the target alone. In Experiment 2, this protection from latent inhibition was attenuated if the excitor that was used to train the conditioned inhibitor was extinguished between preexposure and target training. The results are consistent with an account offered by the extended comparator hypothesis.