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    Self-efficacy moderates the relationship between avoidance intentions and anxiety. Ng Anuja,Lovibond Peter F Emotion (Washington, D.C.) Future-directed intentions elicit emotional changes that may affect behavioral performance. We have previously shown that avoidance intentions can elicit a reduction in anxiety (Ng & Lovibond, 2017). In the present experiment, we manipulated within-participant self-efficacy for an avoidance behavior to determine whether self-efficacy moderates the relationship between avoidance intentions and anxiety. Anxiety was indexed through skin conductance response and self-report. Participants learned that certain stimuli signaled an aversive electric shock, which they could avoid by performing an easy task or a hard task. Participants had relatively high self-efficacy for the easy task and low self-efficacy for the hard task. Results indicated that on trials when participants intended to avoid the shock, they experienced significantly greater reductions in anxiety when they had to perform the easy task compared with the hard task. We conclude that self-efficacy for avoidance behavior moderates the relationship between avoidance intentions and anxiety. In situations in which avoiding a harmful outcome is an adaptive response, it may be important to increase self-efficacy for avoidance behaviors from the intention-formation stage itself. If that occurs, the reinforcing reductions in anxiety may reaffirm the intention and increase its temporal stability, thereby increasing the likelihood of behavioral performance. (PsycInfo Database Record (c) 2020 APA, all rights reserved). 10.1037/emo0000594
    Intolerance of uncertainty as a vulnerability factor for excessive and inflexible avoidance behavior. Flores Amanda,López Francisco J,Vervliet Bram,Cobos Pedro L Behaviour research and therapy Recent studies have shown that avoidance behavior may become excessive and inflexible (i.e., detached from its incentive value and resistant to extinction). On the other hand, prospective intolerance of uncertainty (P-IU) has been defined as a factor leading to excessive responding in uncertain situations. Thus, uncertain avoidance situations may be taken as a relevant scenario to examine the role of intolerance of uncertainty as a factor that facilitates excessive and inflexible avoidance behavior. In our experiment, we tested the hypothesis that P-IU is associated with excessive and inflexible avoidance in an outcome devaluation paradigm. Specifically, healthy participants learned in a free-operant discriminative task to avoid an aversive sound, and were tested in extinction to measure the sensitivity of avoidance responses to the devaluation of the sound aversiveness. The results showed that an increase in P-IU was positively associated to an increase in insensitivity to the devaluation. Moreover, P-IU was also related to an increase in the frequency of avoidance responses during the instrumental learning phase, and to resistance to extinction. Interestingly, these associations involving P-IU were still significant when trait anxiety was controlled for. The pattern of results suggests that P-IU may be a vulnerability factor for excessive and inflexible avoidance, which, in turn, has been found to be associated with several mental disorders. 10.1016/j.brat.2018.02.008
    Know Your Movements: Poorer Proprioceptive Accuracy is Associated With Overprotective Avoidance Behavior. The journal of pain Pain-related avoidance of movements that are actually safe (ie, overprotective behavior) plays a key role in chronic pain disability. Avoidance is reinforced through operant learning: after learning that a certain movement elicits pain, movements that prevent pain are more likely to be performed. Proprioceptive accuracy importantly contributes to motor learning and memory. Interestingly, reduced accuracy has been documented in various chronic pain conditions, prompting the question whether this relates to avoidance becoming excessive. Using robotic arm-reaching movements, we tested the hypothesis that poor proprioceptive accuracy is associated with excessive pain-related avoidance in pain-free participants. Participants first performed a task to assess proprioceptive accuracy, followed by an operant avoidance training during which a pain stimulus was presented when they performed one movement trajectory, but not when they performed another trajectory. During a test phase, movements were no longer restricted to 2 trajectories, but participants were instructed to avoid pain. Unbeknownst to the participants, the pain stimulus was never presented during this phase. Results supported our hypothesis. Furthermore, exploratory analyses indicated a reduction in proprioceptive accuracy after avoidance learning, which was associated with excessive avoidance and higher trait fear of pain. PERSPECTIVE: This study is the first to show that poorer proprioceptive accuracy is associated with excessive pain-related avoidance. This finding is especially relevant for chronic pain conditions, as reduced accuracy has been documented in these populations, and points toward the need for research on training accuracy to tackle excessive avoidance. 10.1016/j.jpain.2022.03.233
    Avoidance behavior can function as a negative occasion setter. De Houwer Jan,Crombez Geert,Baeyens Frank Journal of experimental psychology. Animal behavior processes The authors put forward the hypothesis that avoidance learning can result from the fact that participants learn (a) that a stimulus is followed by an unconditioned stimulus (US) when the avoidance behavior is not emitted and (b) that the stimulus is not followed by the US when the avoidance behavior is emitted. As such, avoidance behavior is assumed to function as a negative occasion setter. The results of a contingency judgment experiment involving 65 students showed that avoidance behavior indeed has the unique functional properties of a negative occasion setter (resistance to counterconditioning and selective transfer of modulation). 10.1037/0097-7403.31.1.101
    Extrapolation of two-factor learning theory of infrahuman avoidance behavior to psychopathology. Levis D J Neuroscience and biobehavioral reviews This paper involves a theoretical attempt to extend O. H. Mowrer's two-factor theory of infrahuman avoidance behavior to the area of human psychopathology, Central to any such theoretical extrapolation is the need to explain why human fears and avoidance behavior manifest such strong resistance to extinction while the abundance of infrahuman findings suggests that the extinction of such behaviors is rapid. The position is advanced that this noted paradox can be resolved both theoretically and empirically by modifying and extending the Solomon and Wynne conservation of anxiety hypothesis to include complex, serial ordered cues. The model presented also provides the rationale for an extinction approach to psychotherapy, referred to as implosive therapy which is briefly described. Supporting data for the model as well as alternative explanations are provided and discussed. 10.1016/0149-7634(81)90030-0
    The role of avoidance behavior in the treatment of adolescents with irritable bowel syndrome: A mediation analysis. Bonnert Marianne,Olén Ola,Bjureberg Johan,Lalouni Maria,Hedman-Lagerlöf Erik,Serlachius Eva,Ljótsson Brjánn Behaviour research and therapy Irritable bowel syndrome (IBS) is common in adolescents with a pronounced negative impact on quality of life. A pattern of avoidance behavior is commonly seen in the IBS population, which is associated with more gastrointestinal (GI) symptoms. Exposure-based cognitive behavior therapy (CBT) targets the avoidance behavior to reduce symptoms, but it is unknown whether reduced avoidance is a mediator of symptom improvement in adolescent IBS. Stress has been suggested to play a key role in worsening GI symptoms and is also a potential mediator of the treatment effect in IBS. This study was based on data from a randomized controlled trial (N = 101) that evaluated exposure-based internet-delivered CBT (Internet-CBT) compared with a wait-list for adolescents with IBS. We investigated whether avoidance behavior and perceived stress mediated the improvement in global GI symptoms due to treatment. We found that a change in avoidance behavior, but not perceived stress, mediated the effect of exposure-based Internet-CBT on GI symptoms. The decrease in avoidance behavior explained a large portion (67%) of the total treatment effect. Moreover, a unidirectional relationship over time was observed between avoidance behavior and GI symptoms. Our conclusion is that exposure-based CBT in adolescent IBS reduces avoidance and, consequently, reduces GI symptoms. 10.1016/j.brat.2018.03.006
    Changes in Pain-Related Fear and Pain When Avoidance Behavior is no Longer Effective. van Vliet Christine M,Meulders Ann,Vancleef Linda M G,Meyers Elke,Vlaeyen Johan W S The journal of pain Avoidance is considered key in the development of chronic pain. However, little is known about how avoidance behavior subsequently affects pain-related fear and pain. We investigated this using a robotic arm reaching avoidance task. In a between-subjects design both Experimental Group (n = 30) and Yoked Control Group (n = 30) participants perform either of 3 movement trajectories (T1-T3) to reach a target location. During acquisition, only participants of the Experimental Group could partially or fully avoid a painful electrocutaneous stimulus by choosing the intermediate trajectory (T2; 50% reinforcement) or the longest trajectory (T3; 0% reinforcement) versus the shortest trajectory (T1: 100% reinforcement). After acquisition, contingencies changed (all trajectories 50% reinforced), and the acquired avoidance behavior no longer effectively prevented pain from occurring. The Yoked Control Group received the same reinforcement schedule as the Experimental Group irrespective of their behavior. When avoidance behavior became ineffective for the Experimental Group, pain-related fear increased for the previously safe(r) trajectories (T2 and T3) and remained the same for T1, whereas pain threshold and tolerance declined. For the Yoked Group, pain-related fear increased for all trajectories. The Experimental Group persisted in emitting avoidance behavior following the contingency change, albeit at a lower frequency than during acquisition. PERSPECTIVE: Results indicate participants become more afraid of and sensitive to pain, when previously acquired avoidance is no longer effective. Also, participants continue to show avoidance behavior despite it being not adaptive anymore. These findings suggest that ineffective avoidance may play role in the maintenance and development of chronic pain. 10.1016/j.jpain.2019.09.002
    Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm. Glogan Eveliina,Gatzounis Rena,Vandael Kristof,Franssen Mathijs,Vlaeyen Johan W S,Meulders Ann Journal of visualized experiments : JoVE Avoidance behavior is a key contributor to the transition from acute pain to chronic pain disability. Yet, there has been a lack of ecologically valid paradigms to experimentally investigate pain-related avoidance. To fill this gap, we developed a paradigm (the robotic arm-reaching paradigm) to investigate the mechanisms underlying the development of pain-related avoidance behavior. Existing avoidance paradigms (mostly in the context of anxiety research) have often operationalized avoidance as an experimenter-instructed, low-cost response, superimposed on stimuli associated with threat during a Pavlovian fear conditioning procedure. In contrast, the current method offers increased ecological validity in terms of instrumental learning (acquisition) of avoidance, and by adding a cost to the avoidance response. In the paradigm, participants perform arm-reaching movements from a starting point to a target using a robotic arm, and freely choose between three different movement trajectories to do so. The movement trajectories differ in probability of being paired with a painful electrocutaneous stimulus, and in required effort in terms of deviation and resistance. Specifically, the painful stimulus can be (partly) avoided at the cost of performing movements requiring increased effort. Avoidance behavior is operationalized as the maximal deviation from the shortest trajectory on each trial. In addition to explaining how the new paradigm can help understand the acquisition of avoidance, we describe adaptations of the robotic arm-reaching paradigm for (1) examining the spread of avoidance to other stimuli (generalization), (2) modeling clinical treatment in the lab (extinction of avoidance using response prevention), as well as (3) modeling relapse, and return of avoidance following extinction (spontaneous recovery). Given the increased ecological validity, and numerous possibilities for extensions and/or adaptations, the robotic arm-reaching paradigm offers a promising tool to facilitate the investigation of avoidance behavior and to further our understanding of its underlying processes. 10.3791/61717
    Treatment of avoidance behavior as an adjunct to exposure therapy: Insights from modern learning theory. Treanor Michael,Barry Tom J Behaviour research and therapy Pathological avoidance of benign stimuli is a hallmark of anxiety and related disorders, and exposure-based treatments have often encouraged the removal of avoidance, or safety behaviors, due to their negative effects on extinction learning. Unfortunately, empirical evidence suggests that avoidance behaviors can persist following treatment, and the mere availability of avoidance behavior can be sufficient to renew fear following successful extinction learning. The present paper critically examines the function of avoidance behavior through the lens of modern learning theory, and speculates on novel behavioral and pharmacological strategies for targeting avoidance as an adjunct to current evidence-based treatments. 10.1016/j.brat.2017.04.009