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Abstract

Background: Considerable research has revealed impaired fear extinction to be a significant predictor of PTSD.Fear extinction is also considered the primary mechanism of exposure therapy, and a critical factor in PTSDrecovery. The cognitive theory of PTSD proposes that symptoms persist due to excessive negative appraisalsabout the trauma and its sequelae. Research has not yet examined the relationship between fear extinction andnegative appraisals in PTSD.Methods: A cross-sectional sample of participants with PTSD (n =21), and trauma-exposed controls (n =33)underwent a standardized differential fear conditioning and extinction paradigm, with skin conductanceresponse (SCR) amplitude serving as the index of conditioned responses. The Posttraumatic Cognitions Inventory(PTCI) was used to index catastrophic negative appraisals.Results: Participants with PTSD demonstrated a slower decrease in overall SCR responses during extinction andgreater negative appraisals compared to the group. A moderation analysis revealed that both negative traumarelevantappraisals and fear extinction learning were independently associated with PTSD symptoms, but therewas no moderation interaction.Limitations: The current study was limited by a modest sample size, leading to the inclusion of participants withsubclinical PTSD symptoms. Further, the current study only assessed fear extinction learning; including a secondday extinction recall task may show alternative effects.Conclusions: These findings indicate that negative appraisals and fear extinction did not interact, but hadindependent relationships with PTSD symptoms. Here we show for the first time in an experimental frameworkthat negative appraisals and fear extinction play separate roles in PTSD symptoms.

Item Type:	Article
Authors/Creators:	Zuj, DV and Palmer, MA and Gray, Kate and Hsu, CMK and Nicholson, EL and Malhi, GS and Bryant, RA and Felmingham, KL
Keywords:	PTSD; Fear Extinction; Threat Expectancy; Negative Appraisals
Journal or Publication Title:	Journal of affective disorders
Publisher:	Elsevier Science Bv
ISSN:	0165-0327
DOI / ID Number:	https://doi.org/10.1016/j.jad.2017.04.016
Copyright Information:	Copyright 2017 Elsevier B.V.
Related URLs:	Google Scholar: Zuj, DV UTAS Profile: Zuj, DV Google Scholar: Palmer, MA UTAS Profile: Palmer, MA
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