Reappraisal facilitates extinction in healthy and socially anxious individuals

•Basic conditioning research can delineate mechanisms of cognitive behavior therapy.•Cognitive reappraisal was applied during Pavlovian conditioning.•Reappraisal slowed acquisition and sped extinction of conditioned negative valence.•Reappraisal compensated for extinction deficit in participants with high social anxiety.

Background and objectivesCognitive behavioral therapy (CBT) combines cognitive restructuring with exposure to feared stimuli in the treatment of anxiety disorders. Due to the complexities of cognition–emotion interactions during ongoing CBT, the underlying mechanisms remain unclear, which hinders treatment optimization.MethodsWe created a laboratory analogue by combining reappraisal, a key ingredient of cognitive restructuring, with Pavlovian conditioning, a key ingredient in behavioral treatments. The novel differential Pavlovian acquisition and extinction task featured social stimuli as conditioned and unconditioned stimuli under unregulated and reappraisal instructions.ResultsFindings indicated that reappraising the conditioned stimuli attenuated acquisition (Study 1) and facilitated extinction (Study 2) of conditioned negative valence. In Study 3, highly socially anxious individuals showed deficient extinction learning relative to low socially anxious individuals but compensated for this by using reappraisal.LimitationsDiagnostic status of participants was not assessed in structured clinical interviews.ConclusionsReappraisal of feared stimuli could be useful in prevention and treatment of social anxiety.