Avoidance learning as predictor of posttraumatic stress in firefighters

Behavioural Brain Research, vol. 402, pp. 113064

Abstract

BACKGROUND: Avoidance is a well-established maintenance factor in anxiety-related psychopathology. Individuals prone to anxiety show more maladaptive avoidance responses in conditioning paradigms aimed at avoidance learning, which indicates impairments in safety learning. To what extent avoidance learning is associated with posttraumatic stress disorder (PTSD) is still unclear, despite the logical relevance to the symptomatology. In this prospective study, we investigate avoidance learning responses in first responders, a population at high risk for traumatic exposure and thus PTSD development, and studied whether avoidance learning was associated with concurrent and future PTSD symptoms. METHOD: Firefighters (N = 502) performed an avoidance learning task at baseline assessment in which they first learned that two conditioned stimuli (CS+) were followed by an aversive stimulus (US) and one conditioned stimulus (CS-) was not. After that, they could learn to which CS avoidance of the US was effective, ineffective or unnecessary. Self-reported PTSD symptoms were assessed at baseline, and at 6, 12, 18 and 24 months. RESULTS: Participants exhibited comparable avoidance patterns to low anxiety individuals from previous studies. Avoidance learning responses were not associated with PTSD symptoms at baseline nor at follow-up. DISCUSSION: Our study found no evidence that avoidance learning was related to PTSD symptom severity in a high-risk, yet low symptomatic population, nor did it predict the development of PTSD symptoms at a later point in time. Future research should focus on studying avoidance learning in a clinical or high symptomatic sample to further clarify the role of avoidance learning in PTSD development.

Authors 4

1. Rick de Haart

   GGZ Drenthe

   Affiliation as printed

   GGZ Drenthe Mental Health Institute, Department Trauma Center, Altingerweg 1, 9411 PA, Beilen, the Netherlands. Electronic address: rick.de.haart@ggzdrenthe.nl

   GGZ Drenthe Mental Health Institute, Department Trauma Center, Altingerweg 1, 9411 PA, Beilen, the Netherlands

2. Joanne Mouthaan Aachen Institute of Psychology Department of Clinical Psychology

   Leiden University

   Affiliation as printed

   Leiden University, Institute of Psychology, Department of Clinical Psychology, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands. Electronic address: j.mouthaan@fsw.leidenuniv.nl

   Leiden University, Institute of Psychology, Department of Clinical Psychology, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands

3. Bram Vervliet

   KU Leuven

   Affiliation as printed

   KU Leuven, Laboratory for Biological Psychology, Tiensestraat 102, 3000, Leuven, Belgium. Electronic address: bram.vervliet@kuleuven.be

   KU Leuven, Laboratory for Biological Psychology, Tiensestraat 102, 3000, Leuven, Belgium

4. Miriam J.J. Lommen corresponding

   University of Groningen

   Affiliation as printed

   University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands. Electronic address: m.j.j.lommen@rug.nl

   University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands