Exposure to the context and removing the unpredictability of the US: two methods to reduce contextual anxiety compared.

Chronic anxiety may differ from cued fear and hence require other treatment strategies. In a human fear conditioning paradigm, chronic anxiety to the experimental context was experimentally induced by presenting unpredictable shocks. Two methods to reduce chronic anxiety were tested and compared. First, in parallel with the standard extinction procedure, participants were exposed to the anxiety-eliciting context in the absence of shocks (context-exposure group). Second, an alternative procedure was tested in which the previously unpredictable shocks were now signaled by a specific cue (signaled group). A control group continued to receive unsignaled shocks. Results indicated that chronic contextual anxiety, as measured by fear-potentiated startle and US-expectancy ratings, was equally reduced in the context-exposure group as in the signaled group compared with the control group. When applied to the treatment of, for example, panic disorder, these findings support the idea that exposure to the context in which the unpredictable panic attacks occurred and making unpredictable panic attacks predictable, are both valuable methods in order to reduce chronic anxiety.