Clinical interventions which produce cue and contextual extinction learning can reduce craving and relapse in substance abuse and inhibit conditioned fear responses in anxiety disorders.
Does extinction enhance efficacy of pharmacological and behavioral treatments for addiction?
Abstract. Clinical interventions which produce cue and contextual extinction learning can reduce craving and relapse in substance abuse and inhibit conditioned fear responses in anxiety disorders. In both types of disorders, classical conditioning links unconditioned drug or fear responses to associated contextual cues and result in enduring pathological responses to …
What is extinction therapy and how does it work?
Clinical use of extinction and reconsolidation based therapies. Several researchers have attempted to use extinction learning, known as cue exposure therapy clinically, to treat addiction to a variety of drugs of abuse (Conklin and Tiffany, 2002). Cue exposure therapy (CET) is based on the assumption that when environmental stimuli are repeatedly associated with a drug, the …
What is extinction of the original conditioned response?
Dec 15, 2013 · A treatment that neutralizes the power of drug cues could prove very valuable in efforts to manage addiction. Extinction has been used in such an effort. For example, the extinction-based treatment called cue-exposure therapy (Drummond et al., 1995) involves repeatedly presenting cues to addicts without the drug. This extinction should theoretically …
How can extinction techniques be used to change behavior?
Jan 01, 2011 · One goal in the psychotherapy and rehabilitation of patients with substance use disorders is to impede reconsolidation of drug cues and/or facilitate extinction learning. Some support for the clinical efficacy of an extinction-related treatment approach has been demonstrated in abstinent cocaine addicts who were repeatedly exposed to drug associated …
How is extinction used in treating a disorder?
Extinction therapy countermeasures seek to reduce conditioned responses using a set of techniques in which patients are repeatedly exposed to conditioned appetitive or aversive stimuli using imaginal imagery, in vivo exposure, or written scripts.
What is Retrieval extinction training?
“Retrieval-extinction” was first described for pavlovian fear memories, and involves reactivating the memory in a brief re-exposure session, followed by a separate prolonged re-exposure/extinction session after a short delay (typically 10–60 min, but theoretically within 3–4 h of the opening of the “reconsolidation ...Feb 20, 2020
What is cue extinction?
Cue extinction is the process of eliminating the cognitive cues that lead to substance use. By practicing coping skills that erode the brain's substance use patterns, recovering addicts can greatly weaken cravings and reduce their lifetime odds of having a relapse.Oct 21, 2019
What techniques are used to treat addiction?
Some of the most common forms of modern addiction treatment include behavioral therapies delivered as individual therapy, group therapy, and family therapy.Feb 21, 2022
How does extinction occur in operant conditioning?
In operant conditioning, extinction occurs when a response is no longer reinforced following a discriminative stimulus.Jun 27, 2021
What is an example of extinction in psychology?
Extinction in Operant Conditioning Operant extinction refers to the weakening and eventual stop of the voluntary, conditioned response. For example, a child associates the sound of a microwave with her favorite snack, and she rushes into the kitchen.Apr 13, 2022
What is Campral made of?
Each Campral® tablet contains acamprosate calcium 333 mg, equivalent to 300 mg of acamprosate.
What is cue exposure and response prevention?
Background. Cue Exposure Therapy (CET) is a behavioristic psychological approach to treating substance use disorders (SUD) whereby individuals are exposed to relevant drug cues to extinguish conditioned responses (Conklin and Tiffany, 2002, Drummond et al., 1990, Marlatt, 1990).
How does cue exposure work?
Cue exposure therapy (CET) aims to reduce this cue reactivity by exposing abstinent drug users to conditioned drug-related stimuli while preventing their habitual response, i.e. drug use.
What is the most effective in treating addiction?
According to American Addiction Centers, Cognitive Behavioral Therapy (CBT) is a valuable treatment tool because it can be used for many different types of addiction including, but not limited to, food addiction, alcohol addiction, and prescription drug addiction.Dec 12, 2020
What are three steps you can take to stay away from drugs?
Tips for Staying Drug-FreeLearn to Set SMART Goals. ... Build Habits to Stay Busy. ... Sweat it out. ... Cut out toxic relationships. ... Utilize support systems. ... Practice positive self talk. ... Adopt a pet. ... Walk away from stress.More items...
What is the most effective intervention for substance abuse?
CBT is often rated as the most effective approach to treatment with a drug and alcohol population.
Abstract
We previously showed that presenting two cocaine cues simultaneously during extinction deepens the extinction of cue-elicited cocaine seeking ( Kearns et al., 2012 ). The present study investigated whether compounding a non-drug appetitive cue with a cocaine cue would similarly deepen extinction.
1. INTRODUCTION
Drug cues play a central role in addiction ( Volkow et al., 2012 ). In humans, drug cues can elicit craving for the drug ( Kennedy et al., 2013; Sinha, 2013 ), activate the brain’s reward circuits ( Fotros et al., 2013; Volkow et al., 2012 ), and trigger relapse ( Marhe et al., 2013; Prisciandaro et al., 2013 ).
2. METHODS AND MATERIALS
Naïve adult male Long-Evans rats served as subjects. Thirteen rats completed Experiment 1 and 12 rats completed Experiment 2. Rats were individually housed in plastic cages with wood chip bedding and metal wire tops. They were maintained at 85% of their free-feeding weights (approximately 350–450 g).
2.3 Procedure: Experiment 1
The present procedure was similar to that previously used by Kearns et al. (2012) except that one of the S D s – the light – was established as an S D for food-reinforced responding rather than cocaine-reinforced responding.
2.4. Procedure: Experiment 2
Because the opposite of deepened extinction was observed in Experiment 1, a second experiment was conducted to help in understanding this result. In Experiment 1, response rates to light – the food cue – were significantly higher than response rates to click or tone – the cocaine cues.
2.5 Data analysis
For all statistical tests, α = 0.05. Response rate was the primary measure of interest for all training phases, extinction phases, and for the test in both experiments. Repeated measures analyses of variance (ANOVAs) and/or paired samples t -tests, where appropriate, were used to compare response rates across stimulus conditions.
3.2. Experiment 2
Rats required 1-2 sessions to acquire the lever-press response with the light on continuously. They then had a mean of 18.0 (±0.7 SEM) total discrimination training sessions (including terminal baseline sessions and all previous discrimination sessions). Figure 1.
How does extinction therapy work?
Extinction therapy countermeasures seek to reduce conditioned responses using a set of techniques in which patients are repeatedly exposed to conditioned appetitive or aversive stimuli using imaginal imagery, in vivo exposure, or written scripts. Such interventions allow patients to rehearse more adaptive responses to conditioned stimuli. The ultimate goal of these interventions, extinction of the original conditioned response, is a new learning process that results in a decrease in frequency or intensity of conditioned responses to drug or fear cues. This review explores extinction approaches in conditioned drug reward and fear responses. The behavioral, neuroanatomical and neurochemical mechanisms of conditioned reward and fear responses and their extinction are derived from our understanding of the animal literature. Extensive neuroscience research shows that even though many mechanisms differ in conditioned fear and reward, converging prefrontal cortical glutamatergic pathways underlie extinction learning. Efficacy of pharmacological and behavioral treatment approaches in addiction and anxiety disorders may be optimized by enhancing extinction and weakening the bond between the original conditioned stimuli and conditioned responses. Adjunctive pharmacotherapy approaches using agents which alter glutamate or γ-aminobutyric acid signaling or epigenetic mechanisms in prefrontal cortical pathways can enhance extinction learning. A comparative study of extinction processes and its neural mechanisms can be translated into more effective behavioral and pharmacological treatment approaches in substance abuse and anxiety.
How do drugs interact with stimuli?
Drugs of abuse interact with stimuli in the drug-taking environment via classical and instrumental conditioning to alter motivational responses and self-administration behaviors ( Robbins et al., 2008 ). Pavlovian conditioning mechanisms link unconditioned drug responses to associated contextual cues, allowing the drug responses to be elicited by these non-drug stimuli. For example, drug cue exposure in heroin and cocaine abusing individuals results in real-time drug craving and consequent drug use ( Epstein et al., 2009 ). The temporal and spatial relatedness of these contextual stimuli to motivational responses produces powerful conditioned effects ( O'Brien et al., 1993 ). When these stimuli are encountered in an abstinent state, they can induce memories of prior drug experience, or drug craving, which can result in drug taking and relapse ( Weiss, 2005 ). Cue-induced craving is predictive of relapse in addiction. Any improvements in our understanding of mechanisms of craving or conditioned reward will lead to a better development of treatment approaches ( Sinha and Li, 2007 ).
Which part of the brain is responsible for fear conditioning?
Fear related sensory information is transmitted to the amygdala through its basal and lateral (BLA) nuclei. PTSD can be conceptualized as a cue- and context-associated fear conditioning process that results from amygdalar hyperresponsivity and an inability to extinguish these neural responses. The hippocampus is critical in associative learning, memory consolidation and in the retrieval of episodic memories. The sites of extinction learning may be distributed across several structures, especially the PFC and its corticolimbic projections to the amygdala ( Fig. 2 ). Glutamatergic excitatory projections from the PL extend to the sites of fear memory storage in the BLA and central nucleus of the amyg dala (CNA) and activate downstream fear circuitry. Projections from the BLA to the CNA are thought to activate fear responses through outputs to the hypothalamus and brainstem. The IL cortex appears to be the primary candidate key pathway to suppress fear responses via extinction learning. Single unit recordings have shown that IL neurons respond to conditioned stimuli only after extinction learning has developed ( Milad et al., 2006 ). Agents that activate IL pathways suppress conditioned fear ( Vidal-Gonzalez et al, 2006 ). The IL projects to GABAergic neurons between the BLA and CNA called the intercalated cell masses (ITC) positioned between these two amygdalar subregions. Activation of the ITC inhibits output from the CNA and reduces fear responses. It has been hypothesized that fear extinction entails an increase in excitatory drive to the ITC and produces reductions in output from the CNA ( Peters et al., 2009 ).
What are the components of the neural circuitry for cue and context induced reward and relapse?
The major components of the neural circuitry for cue and context induced reward and relapse include the prefrontal cortex, which includes prelimbic (PL) and infralimbic (IL) subregions, the basolateral amygdala (BLA), hippocampus, nucleus accumbens (NAc), ventral pallidum, and ventral tegmental area (VTA) as highlighted in Fig. 1. Drugs of abuse produce direct motivational effects by activating dopaminergic neurons originating in the VTA which project to the amygdala, NAc, anterior cingulate cortex and PFC ( Hammer, 2002 ). Exposures to conditioned drug cue and context exposures also activate the mesolimbic dopaminergic system. In support of dopamine's role, cocaine dependent humans viewing drug cues demonstrate craving with correlated increases striatal dopamine levels ( Volkow et al., 2006 ). In conditioned drug reward, classically conditioned cue and contextual responses are established via activation of neurons in the medial PFC ( Taylor et al., 2009 ). Glutamatergic neurons from the prelimbic cortex (PL) of the PFC and from the basolateral amygdala (BLA) project to the NAc core region and to the VTA ( Kauer and Malenka, 2007) and are hypothesized to activate drug-seeking behavior ( McFarland et al., 2003, Di Ciano and Everitt, 2004 ). Inactivation of these PL cortical neurons reduces relapse in rat models ( LaLumiere and Kalivas, 2008 ). In contrast, glutamatergic projections from the infralimbic cortex (IL) to the NAc shell subregion are hypothesized to extinguish drug-seeking behavior ( Peters et al., 2008, LaLumiere et al., 2010 ).
What is extinction therapy?
However, scientists believe that lengthy exposure to environmental triggers for cravings could be precisely what smokers need to help them quit. The technique, known as extinction therapy, targets the harmful Pavlovian associations that drive addiction with the aim of rapidly “unlearning” them.
Why is extinction training important?
Ravi Das, a psychologist at University College London, who is trialling extinction training to reduce alcohol intake in heavy drinkers, said: “It’s a really important study because it’s the first to show an actual effect in real smokers.
Why do smokers have environmental triggers?
In smokers, environmental triggers have typically been reinforced thousands of times so that the sight of a lighter, for instance, becomes inextricably linked to the rush of nicotine that the brain has learned will shortly follow .
Who is Professor Robert West?
Professor Robert West, an expert in smoking cessation at University College London, said: “You’re dealing with really heavily over-learned cues. Short-circuiting the extinction process is a tough thing to do and pragmatically it might be very difficult.”.
What does "extinction" mean?
Extinction is formally defined as “the omission of previously delivered unconditioned stimuli or reinforcers, ” but it can also describe the “absence of a contingency between response and reinforcer.” Essentially, this means that learned behaviors will gradually disappear if they are not reinforced.
What are the three forms of extinction?
In order for extinction to occur, target behaviors need to be identified, and new ones need to be established, and procedures typically take on one of three different forms based on: Negative Reinforcement. Positive Reinforcement. Automatic Reinforcement.
What is the purpose of behavior modification?
Behavior Modification For Reducing Problematic Behaviors. Extinction, in psychology, has a different meaning than the traditional sense of the word. However, to an extent, they are also similar in some ways.
Can extinction behavior be done without professional assistance?
Using extinction behavior to help bring about change despite the sideeffects can be done without professional assistance in many cases, but others find the help of a therapist useful and might decide to meet with one who specializes in applied behavior analysis.
What is spontaneous recovery?
Spontaneous recovery is a term coined by Pavlov that means that if time is able to elapse after extinction, it can also return. Renewal refers to the return of extinguished responding when the conditioned stimulus is removed from the extinction context and tested in another one.
What is automatic reinforcement?
Automatic reinforcement, also known as sensory extinction, is slightly more straightforward but can be used in certain scenarios. For instance, if someone is fascinated by the feel and sound of clicking a pen, the act of doing so is stimulating and a form of automatic reinforcement.
What is ABA therapy?
ABA is a common therapy for individuals who have a disability, such as autism or Down syndrome, that may have challenging behaviors . ABA is not a typical form of psychotherapy, and it is not a one-size-fits-all approach, but with some trial and error and data collection, behavioral change can occur. Source: rawpixel.com.
