The impact of threat- and safety-enhancing information on the acquisition of fear of interoceptive threat.

Social learning, such as learning through verbal instruction, has been proposed to play a crucial role in the development pathological fear of bodily sensations. Despite the ubiquity of verbal information in daily life, the effects of verbal information on subsequent interoceptive fear learning remain empirically untested. Therefore, we aimed to examine how verbal information about the threatening vs. benign nature of bodily sensations influences subsequent interoceptive fear conditioning. 77 healthy participants were randomly assigned to receive either threat- or safety-enhancing information about bodily sensations before completing an interoceptive fear acquisition and extinction task. Two geometric symbols served as CSs and temporary dyspnea (inspiratory load) as the US. Verbal reports indicated successful differential learning in both groups, with no modulation of information type. However, participants of the threat information group showed no differential response in startle response magnitudes towards CS + relative to CS-, indexing that the activation of brain defensive networks, that did not differ between CS+ and CS-. This pattern might suggest a generalization of, or failure to inhibit defensive activation toward the safety stimulus. In contrast, the safety information group exhibited significantly smaller startle response magnitudes towards CS- vs. CS+, indicating preserved differentiation between threat and safety. No group differences emerged during the extinction phase. Despite the preliminary nature of our findings, the pattern of results demonstrates interaction of different fear learning pathways in shaping the risk for the development of pathological fear and anxiety.