Effects of Differential Rates of Alternative Reinforcement on Resurgence of Human Avoidance Behavior: A Translational Model of Relapse in the Anxiety Disorders

CBT is considered the gold standard in anxiety disorder treatments (e.g., Olatunji, Cisler, & Deacon, 2010). However, response rates remain relatively low (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012), and relapse is not uncommon, especially during long-term follow-up (Durham, Chambers, Macdonald, Power, & Major, 2003). Basic researchers traditionally conceptualize the mechanism of exposure as Pavlovian extinction, but this may overlook the important role of operant processes. Resurgence has been used as a model for investigating the elimination and relapse of operant behavior and may provide a promising analogue of treatment. Animal research has shown that, while higher rates of alternative reinforcement result in more comprehensive extinction of target behavior, they also result in greater resurgence once reinforcement has been removed (e.g., Sweeney & Shahan, 2013). This finding is somewhat counterintuitive and could have important implications for clinicians; however, it has yet to be investigated in humans or with respect to negatively reinforced avoidance behavior. This study takes a translational approach to investigating the effects of high and low rates of positive reinforcement of alternative behavior on extinction and resurgence of positively and negatively reinforced target behavior in humans using an analogue computer task