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3 - Learning Not to Fear: A Neural Systems Approach

Published online by Cambridge University Press:  27 July 2009

By
Gregory J. Quirk ,
Mohammed R. Milad ,
Edwin Santini  and
Kelimer Lebrón
Edited by
Laurence J. Kirmayer ,
Robert Lemelson  and
Mark Barad
Gregory J. Quirk
Affiliation:
Professor Department of Physiology, Ponce School of Medicine, Puerto Rico
Mohammed R. Milad
Affiliation:
Instructor Department of Psychiatry, Harvard Medical School; Assistant in Research Department of Psychiatry, Massachusetts General Hospital
Edwin Santini
Affiliation:
Postdoctoral Fellow Department of Pharmacology, Ponce School of Medicine, Puerto Rico
Kelimer Lebrón
Affiliation:
Postdoctoral Fellow Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA
Laurence J. Kirmayer
Affiliation:
McGill University, Montréal
Robert Lemelson
Affiliation:
University of California, Los Angeles
Mark Barad
Affiliation:
University of California, Los Angeles
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Summary

Most people who experience trauma do not develop posttraumatic stress disorder (PTSD). While 75% of adults have had a traumatic experience fulfilling current DSM–IV criteria as potential factors in the development of PTSD, only 12% actually developed PTSD (Breslau & Kessler, 2001). This suggests that the majority of persons are highly resilient in the face of trauma (Charney, 2004). What are the neural mechanisms that allow a person to recover from trauma without enduring effects? Recent work has focused on extinction of classically conditioned fear as a useful animal model of recovery after trauma. In cued fear conditioning, a tone is paired with a mild footshock. After several such pairings, rats learn that the tone predicts the shock and exhibit a range of species-specific fear responses, including freezing and potentiated startle responses (see Rau & Fanselow, this volume). In extinction, the conditioned tone is repeatedly presented without the shock, causing rats to learn that the tone is no longer dangerous. Understanding the neural mechanisms of extinction learning could lead to new treatments for PTSD, given that extinction underlies exposure-based therapies used to treat PTSD (Foa, 2000; Rothbaum & Schwartz, 2002).

EXTINCTION OF FEAR IS NEW LEARNING

While it may be tempting to think that extinction of conditioned fear simply erases the original tone–shock association, substantial behavioral evidence suggests that this is not the case.

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Chapter
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Understanding Trauma
Integrating Biological, Clinical, and Cultural Perspectives
 , pp. 60 - 77
Publisher: Cambridge University Press
Print publication year: 2007

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  • Learning Not to Fear: A Neural Systems Approach
    • By Gregory J. Quirk, Professor Department of Physiology, Ponce School of Medicine, Puerto Rico, Mohammed R. Milad, Instructor Department of Psychiatry, Harvard Medical School; Assistant in Research Department of Psychiatry, Massachusetts General Hospital, Edwin Santini, Postdoctoral Fellow Department of Pharmacology, Ponce School of Medicine, Puerto Rico, Kelimer Lebrón, Postdoctoral Fellow Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.007
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  • Learning Not to Fear: A Neural Systems Approach
    • By Gregory J. Quirk, Professor Department of Physiology, Ponce School of Medicine, Puerto Rico, Mohammed R. Milad, Instructor Department of Psychiatry, Harvard Medical School; Assistant in Research Department of Psychiatry, Massachusetts General Hospital, Edwin Santini, Postdoctoral Fellow Department of Pharmacology, Ponce School of Medicine, Puerto Rico, Kelimer Lebrón, Postdoctoral Fellow Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.007
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  • Learning Not to Fear: A Neural Systems Approach
    • By Gregory J. Quirk, Professor Department of Physiology, Ponce School of Medicine, Puerto Rico, Mohammed R. Milad, Instructor Department of Psychiatry, Harvard Medical School; Assistant in Research Department of Psychiatry, Massachusetts General Hospital, Edwin Santini, Postdoctoral Fellow Department of Pharmacology, Ponce School of Medicine, Puerto Rico, Kelimer Lebrón, Postdoctoral Fellow Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.007
Available formats
×