Pre-trauma individual differences in extinction learning predict posttraumatic stress

In the aftermath of a traumatic event, many people suffer from psychological distress, but only a minority develops posttraumatic stress disorder (PTSD). Pre-trauma individual differences in fear conditioning, most notably reduced extinction learning, have been proposed as playing an important role in the etiology of PTSD. However, prospective data are lacking. In this study, we prospectively tested whether reduced extinction was a predictor for later posttraumatic stress. Dutch soldiers (N = 249) were administered a conditioning task before their four-month deployment to Afghanistan to asses individual differences in extinction learning. After returning home, posttraumatic stress was measured. Results showed that reduced extinction learning before deployment predicted subsequent PTSD symptom severity, over and beyond degree of pre-deployment stress symptoms, neuroticism, and exposure to stressors on deployment. The findings suggest that reduced extinction learning may play a role in the development of PTSD.

► A conditioning paradigm assessed individual differences in extinction learning.
► Fear extinction learning was measured with a cognitive outcome measure.
► Reduced extinction learning predicted PTSD severity beyond known risk factors.
► Reduced fear extinction learning may be a pre-trauma vulnerability factor for PTSD.