Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Avoidance behavior constitutes a major transdiagnostic symptom that exacerbates anxiety. It hampers fear extinction and predicts poor therapy-outcome. Pavlovian counterconditioning with reward could alleviate avoidance better than traditional by reducing negative valence of the feared situation. However, previous studies are scarce did not consider pathological is often costly typically evolves from an approach-avoidance conflict. Therefore, we used conflict paradigm to model effects on (i.e., leads missing out rewards). Results our preregistered Bayesian Mixed Model analyses in fifty-one healthy participants (43 females) indicated was more effective valuation decreasing extinction. This study supports application simple technique, shows its efficacy transfers complex situations, suggests treatment may benefit increasing drive combination overcome avoidance. Application clinical sample necessary next step assess utility counterconditioning.