Transitions from avoidance: Reinforcing competing behaviours reduces generalised avoidance in new contexts

Abstract

Generalised avoidance behaviours are a common diagnostic feature of anxiety-related disorders and a barrier to affecting changes in anxiety during therapy. However, strategies to mitigate generalised avoidance are under-investigated. Even less attention is given to reducing the category-based generalisation of avoidance. We therefore investigated the potential of an operant-based approach. Specifically, it was examined whether reinforcing competing (non-avoidance) behaviours to threat-predictive cues would interfere with the expression of generalised avoidance. Using a matching-to-sample task, artificial stimulus categories were established using physically dissimilar nonsense shapes. A member of one category (conditioned stimulus; CS1) was then associated with an aversive outcome in an Acquisition context, unless an avoidance response was made. Next, competing behaviours were reinforced in response to the CS1 in new contexts. Finally, we tested for the generalisation of avoidance to another member of the stimulus category (generalisation stimulus; GS1) in both a Novel context and the Acquisition context. The selective generalisation of avoidance to GS1 was observed, but only in the Acquisition context. In the Novel context, the generalisation of avoidance to GSs was significantly reduced. A comparison group (Experiment 2), which did not learn any competing behaviours, avoided GS1 in both contexts. These findings suggest that reinforcing competing behavioural responses to threat-predictive cues can lead to reductions in generalised avoidance. This study is among the first study to demonstrate sustained reductions in generalised avoidance resulting from operant-based protocols, and the clinical and research implications are discussed.

Keywords: Avoidance; anxiety; category-based generalisation; generalisation.

Figure 1.

Schematic overview of the experimental stimuli and stages. (a) Stimuli: Physically dissimilar shapes were randomly assigned as conditioned stimuli (CSs) and generalisation stimuli (GSs). (b) Category learning: Two stimulus categories were established using a matching-to-sample (MTS) task. In a block of MTS training trials, relating CS1 and GS1 with X1 was reinforced using corrective feedback. Relating CS2 and GS2 with X2 was also reinforced. A block of testing trials then probed participants related CS1 with GS1 and CS2 with GS2, in the absence of any corrective feedback. (c) Experimental stages: In the Acquisition context, avoidance of CS1 and approach of CS2 were reinforced. Competing behaviours were then reinforced in response to the CSs. One group completed extended training—these participants learned two sets of competing behaviours across two contexts. A second group completed limited training—these participants learned just one set of competing behaviours in one context. We then tested for generalised avoidance. Here, GS1 and GS2 were presented in a Novel context and the Acquisition context.

Figure 2.

Avoidance learning. CS1 triggered more avoidance than CS2 during avoidance learning. CS2 triggered more approach than CS1. ○ = Individual data points; X = mean; ◊ = median. Edges of the box are the 25th and 75th percentiles. Whiskers extend to extreme value not considered to be an outlier: 2.7th and 99.3th percentile (based on MATLAB’s boxplot function). ***p < .0001.

Figure 3.

Outcome measures: Generalised avoidance. Generalised avoidance was estimated as responding to GS1 relative to GS2. A positive score indicates more avoidance of GS1. A negative score indicates more avoidance of GS2. Relative avoidance of GS1 was greater in the Acquisition context than in the Novel context. This was evident in both training groups. Competing behaviours. There was no effect of stimulus on competing behaviour. Overall, competing behaviours were more frequent in the Novel context than in the Acquisition context. Generalised approach. Generalised approach was estimated as responding to GS2 relative to GS1. A positive score indicates more approach of GS2. A negative score indicates more approach of GS1. Relative approach of GS2 was greater in the Acquisition context than in the Novel context. This was evident in both groups. ○ = Individual data points; X = mean; ◊ = median. Edges of the box are the 25th and 75th percentiles. Whiskers extend to extreme value not considered to be an outlier.

Figure 4.

Avoidance learning. CS1 triggered more avoidance than CS2 during avoidance learning. CS2 triggered more approach than CS1. ○ = Individual data points; X = mean; ◊ = median. Edges of the box are the 25th and 75th percentiles. Whiskers extend to extreme value not considered to be an outlier. The absence of a box indicates that the 25th and 75th percentiles overlapped with the median value. **p < .0001.

Figure 5.

Outcome Measures: Generalised avoidance. Generalised avoidance was estimated as responding to GS1 relative to GS2. A positive score indicates more avoidance of GS1. A negative score indicates more avoidance of GS2. In the Extended and Limited Training groups, relative avoidance of GS1 was greater in the Acquisition context than in the Novel context. In the No-Training group, relative avoidance of GS1 did not differ between the Novel context and the Acquisition context. Competing behaviours. There was no effect of stimulus on competing behaviour. Overall, competing behaviours were more frequent in the Novel context than in the Acquisition context. Generalised approach. Generalised approach was estimated as responding to GS2 relative to GS1. A positive score indicates more approach of GS2. A negative score indicates more approach of GS1. In the Extended and Limited Training groups, relative approach of GS2 was greater in the Acquisition context than in the Novel context. In the No-Training group, relative avoidance of GS2 did not differ between the Novel context and the Acquisition context. ○ = Individual data points; X = mean; ◊ = median. Edges of the box are the 25th and 75th percentiles. Whiskers extend to extreme value not considered to be an outlier. The absence of a box indicates that the 25th and 75th percentiles overlapped with the median value.