Tackling Fearful Avoidance using Counterconditioning: A Causal Test for the Role of Appetitive Motivation in Fearful Avoidance Behaviour

Anxiety disorders are prevalent in the population and costly for society, while current treatment is not effective in all individuals. A central symptom of anxiety is avoidance behaviour, with excessive avoidance being predictive of poor clinical outcomes. Appetitive motivation could play a role in decreasing avoidance behaviour by increasing the positive valuation of the feared object. The current study used an approach-avoidance conflict paradigm to measure costly avoidance behaviour in a healthy group of 22 participants. During counterconditioning training one stimulus was followed by eating a tasty snack (CS+), while another was never followed by an outcome (CS-). Results indicated that the CC-training was effective in reducing negative valuation and decreasing avoidance behaviour for the CS+. This study showed the importance of appetitive motivation for avoidance behaviour, suggesting that treatment may benefit from focussing on increasing appetitive motivation to overcome avoidance.